Avicenna Journal of Health Research · Oct 14, 2026
Analysis of Nutritional Status and Quality of Life of Older Adults with Chronic Diseases in Nursing Homes to Optimize the National Nutrition Improvement Program: Literature Review
By Mustain M, Yuniarti T, Fadhilah N et al.
BACKGROUND: Older adults with chronic diseases living in nursing homes face a risk of malnutrition due to interactions among diseases, functional decline, cognitive impairment, eating difficulties, and institutional environmental factors. This condition can reduce physical function, independence, and quality of life. OBJECTIVE: This review analyzes the relationship of nutritional status with quality of life and health outcomes among older adults with chronic diseases in nursing homes and formulates implications for optimizing the national nutrition improvement program. METHODS: A systematic narrative literature review was reported using the PRISMA 2020 framework. Searches were conducted in PubMed/MEDLINE, ScienceDirect, ProQuest, and Google Scholar for articles from 2019 to July 20, 2026. Inclusion criteria covered quantitative studies of residents of nursing homes or long-term care facilities, assessment of nutritional status using standardized instruments or intake data, and reporting of quality of life or functional, clinical, and mortality outcomes. Methodological quality was assessed using Joanna Briggs Institute checklists. RESULTS: Ten studies with a total of 11.524 participants were synthesized. In single-facility and multisite studies, the prevalence of malnutrition ranged from 1.0% to 27.6%, and the risk of malnutrition ranged from 24.8% to 48.7%. An international audit found that 18.4% of residents were malnourished and 48.7% were at risk, whereas routine clinical assessments by staff detected lower proportions. Better nutritional status scores were consistently associated with better quality of life, activities of daily living function, physical performance, and frailty levels. Eating difficulties, cognitive impairment, low protein intake, variation in menu quality, and length of stay in nursing homes were important determinants. Malnutrition was also associated with six-month mortality and respiratory tract infections. CONCLUSIONS: Nutritional status is a modifiable determinant associated with quality of life and prognosis among nursing home residents. National programs need to integrate standardized screening, comprehensive assessment, individualized nutritional care plans, support for eating and dysphagia, menu audits, physical activity, and indicators for monitoring quality of life and clinical outcomes. KEYWORDS: nutritional status; quality of life; older adults