We regularly review the below statistics and try to keep them as up-to-date as possible. Last update: July 2024.
Definition
The National Institute for Health and Care Excellence (NICE) defines a person as being malnourished if they have:
- a body mass index (BMI) of less than 18.5 kg/m2
- unintentional weight loss greater than 10% within the past 3–6 months
- a BMI of less than 20 kg/m2 and unintentional weight loss greater than 5% within the past 3–6 months
“Nutrition Support for Adults,” Section 1.3, NICE guidelines, accessed June 2024, https://www.nice.org.uk/guidance/cg32
Malnutrition in Later Life
- In the UK, estimates suggest 1.3 million people over 65 suffer from malnutrition, and the vast majority (93%) live in the community
“Introduction to Malnutrition,” BAPEN, accessed June 2024, http://www.bapen.org.uk/about-malnutrition/introduction-to-malnutrition?showall=&start=4
Hospitals
- One-third (32%) of people in the UK aged 65 years or over are at risk of malnutrition on admission to hospital
65% of patients said they always got help to eat their meals, compared with 69% previously. https://www.cqc.org.uk/publications/surveys/adult-inpatient-survey “2022 Adult Inpatient Survey”, CQC, accessed June 2024
"Nutrition screening surveys in hospitals in the UK, 2007-2011,” BAPEN, accessed June 2024, http://www.bapen.org.uk/pdfs/nsw/bapen-nsw-uk.pdf, p.41
- In the UK, 50% of people admitted to hospital from care homes were at risk of malnutrition
"Nutrition screening surveys in hospitals in the UK, 2007-2011” BAPEN, accessed June 2024, http://www.bapen.org.uk/pdfs/nsw/bapen-nsw-uk.pdf, p.35
"Malnutrition and Nutritional Care Survey in Adults Report” BAPEN August 2023, accessed June 2024 pages 3 and 9 https://www.bapen.org.uk/pdfs/reports/mag/national-survey-of-malnutrition-and-nutritional-care-2022.pdf
- In hospitals, 44% of patients were at risk of malnutrition.
Care homes
- Of residents in the UK admitted to care homes and screened, 55% were reported to be at risk of malnutrition in care homes (BAPEN, 2023) which is in contrast to the 35% being at risk of malnutrition (BAPEN, 2015).
- https://www.bapen.org.uk/pdfs/reports/mag/national-survey-of-malnutrition-and-nutritional-care-2022.pdf page 9
"Malnutrition and Nutritional Care Survey in Adults Report” BAPEN August 2023, accessed June 2024 pages 3 and 9 https://www.bapen.org.uk/pdfs/reports/mag/national-survey-of-malnutriti…
"Nutrition Screening Surveys in care homes in the UK, 2007-11” BAPEN, accessed June 2024, http://www.bapen.org.uk/pdfs/nsw/care-homes/care-homes-uk.pdf , p.7
- While in 90% of care homes in the UK, nutrition screening was standard, there were inconsistencies in using and calibrating the equipment as well as translating the findings into care plans for individuals
"Nutrition screening survey in the UK and Republic of Ireland in 2011” BAPEN, accessed June 2024, http://www.bapen.org.uk/pdfs/nsw/nsw-2011-report.pdf
Meals on wheels
- The Association for Public Excellence (APSE) have reported that only 29% of UK local authorities, and less than 18% of English authorities, still offer a Meals on Wheels type service. This is down from a UK average of 48% and an English average of 43% in 2016. https://www.apse.org.uk/index.cfm/apse/news/articles/2024/meals-on-wheels-report/# accessed June 2024
- In the UK, the Provision of Meals on Wheels services by councils decreased to 50% in 2019, in comparison to 2014, 66% of councils provided a Meals on Wheels service. The campaign in 2022 stated that the survey of the NACC in 2019 reported that over “50% of local authority had shut down these essential services” and since then the funding has not recovered.
Meals on Wheels Survey 2018”, NACC and meals on wheels, accessed January 2023, https://www.thenacc.co.uk/news/home/meels-on-wheels-2019-press-release
Professional Awareness
- Professionals whose role involves frontline care were significantly more likely to identify preventing and treating malnutrition as a high priority than those whose role does not involve front-line care (33% and 20% respectively)
- Senior staff and those with financial responsibility were more likely to consider this issue a low priority
- Overall 47% of health and care professionals felt confident in their knowledge and skills to identify and treat older people at risk of malnutrition. This increased to 60% for those respondents whose role involves front-line care
- 51% of health and care professionals stated that tackling malnutrition was a high or medium priority
- 54% of professionals didn’t know if services were in place to tackle malnutrition, 55% didn’t know about support services and 61% were unaware of a pathway to tackle malnutrition
"Experiences of Patient Malnutrition” Dods research for the Malnutrition Task Force, 2016.
Consequences of malnutrition
Increased use of health services
In the UK, Malnourished people:
- saw their GP twice as often,
- had 3 times the number of hospital admissions and
- stayed in a hospital more than 3 days longer than those who were well-nourished
- have more ill health (co-morbidities)
Stratton RJ, Smith TS and Gabe SG. 2018. Managing malnutrition to improve lives and save money - https://www.bapen.org.uk/pdfs/reports/mag/managing-malnutrition.pdf
Elia M, 2015. The cost of malnutrition in England and potential cost savings from nutritional interventions: A report on the cost of disease-related malnutrition in England and a budget impact analysis of implementing the NICE clinical guidelines/quality standard on nutritional support in adults https://www.bapen.org.uk/pdfs/economic-report-short.pdf
Guest, J. F., Panca, M., Baeyens, J.P., de Man, F., Ljungqvist, O., Pichard, C., Wait, S & Wilson, L., ‘Health economic impact of managing patients following a community-based diagnosis of malnutrition in the UK’, Clinical Nutrition, Volume 30, Issue 4, Pages 422-429, August 2011
Costs to system:
- The cost of malnutrition to the health and care system was around £19.6 billion, in England, in 2011-12
- Treating someone who is malnourished is two to three times more expensive than for someone who is not malnourished
- Estimated health and social care expenditure per capita of the population is £2,417. For those malnourished or at risk, the expenditure rises to £7,408 per person in the population
Stratton RJ, Smith TS and Gabe SG. 2018. Managing malnutrition to improve lives and save money. https://www.bapen.org.uk/pdfs/reports/mag/managing-malnutrition.pdf
“The cost of malnutrition in England and potential cost savings from nutritional interventions,” Elia M. on behalf of the Malnutrition Action Group of BAPEN and the National Institute for Health Research Southampton Biomedical Research Centre, accessed June 2024, http://www.bapen.org.uk/pdfs/economic-report-short.pdf, p.5
Impact on carers:
- Carers UK found that 60% of carers worry about the nutrition of the person they care for. One is six carers is looking after someone at real risk of malnutrition but do not have nutritional support of any kind
The importance of good nutrition. Carers UK. https://www.carersuk.org/help-and-advice/your-health-and-wellbeing/the-importance-of-good-nutrition/
Spotlight on Caring and Nutrition 2023, Carers UK https://www.carersuk.org/media/4m4nt1dk/carers-uk-nutricia-report-2023.pdf
Factors contributing to malnutrition
Activities of Daily Living
Activities of Daily Living (ADL) are activities that relate to personal care and mobility around the home and are basic to daily living (e.g. eating, bathing, dressing, toileting, etc.).
Instrumental Activities of Daily Living (IADL) are activities which, while not fundamental to functioning, are important aspects of living independently (e.g. money management, cooking, shopping, etc).
- 19% of men and 28% of women aged 65 and over had some unmet need with at least one Activity of Daily Living. Unmet need for help among older adults in the most deprived areas was at least double that of those in the least deprived areas.”
“Health Survey for England 2021”, National Statistics, 2021, accessed June 2024, https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/2021#
- 77% of adults reported good or very good general health. 6% reported bad or very bad health.”
- 40% of adults had at least one longstanding illness or condition.”
- 22% of adults felt lonely at least some of the time, including 6% who reported that they often or always felt lonely.”
“Health Survey for England 2021” part 2, National Statistics, 2021, accessed June 2024 https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/2021-part-2
- 19% of men and 28% of women aged 65 and over had some unmet need with at least one Activity of Daily Living
- The unmet need for help among older adults in the most deprived areas was at least double that of those in the least deprived areas
- 11% of those aged 65 and over say they find it difficult to access a corner shop
- 12% of those aged 65 and over find it difficult to get to their local supermarket
“Health Survey for England 2018”, National Statistics, 2018, accessed June 2024, https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/2018
“Agenda for Later Life Survey,” TNS for Age UK, 2013, accessed June 2024 https://www.ageuk.org.uk/globalassets/age-uk/documents/annual-reports-and-reviews/annual_review_2012_2013.pdf
To find out more about ways to shop for food in your area click here https://www.ageuk.org.uk/services/in-your-area/shopping/
Ageing population
In 50 years there are projected to be an additional 8.6 million people aged 65 years and over in the UK– a population roughly equivalent to the size of London.
The 85+ age group is the fastest growing and is set to double to 3.2 million by mid-2041 and triple by 2066 (5.1 million; 7% of the UK population).
“Living Longer”, Office for National Statistics, 2019, accessed June 2024, from https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/ageing/articles/livinglongerhowourpopulationischangingandwhyitmatters/2019-03-15
Loneliness
17% of older people report they are in contact with family, friends and neighbours less than once a week; 11% report this contact is as infrequent as less than once a month
“Age UK Loneliness Evidence Review Evidence Review: Loneliness in Later Life”. Age UK, 2015, accessed June 2024, https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/health--wellbeing/rb_june15_lonelines_in_later_life_evidence_review.pdf
24% of people aged 50+ living in England feel lonely some of the time, while 7% (equating to around 1.4 million people) feel lonely often
“All the lonely people: Loneliness in Later Life”, Age UK, 2018, accessed June 2024, https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/loneliness/loneliness-report.pdf
https://www.ageuk.org.uk/our-impact/policy-research/loneliness-research-and-resources/
Long-term condition
An estimated 4 million older adults in the UK (36% of people aged 65-74, and 47% of those aged 75+) have a limiting long-standing illness; equating to 40% of all people aged 65+
“Later Life in the United Kingdom – Too old to care?” Horsfield, J. 2017,
Dementia
It is suggested that in the UK about a million people are living with a form of dementia which is “projected to rise to 1.4 million people by 2040" (2024 Report, commissioned by Alzheimer’s Society).
900,000 people are estimated to have dementia in the UK; this is predicted to rise to 1.6 million by 2040.
“Facts for the media”, Alzheimer’s Society, 2019, accessed June 2024, https://www.alzheimers.org.uk/about-us/news-and-media/facts-media
Mental Health
It is estimated that 40% of older people in GP clinics have a mental health problem, this rises to 50% of older people in general hospitals and 60% of those in care homes
Depression is the most common mental health problem among older adults; affecting 22% of men and 28% of women aged 65+
“Suffering in silence: age inequality in older people’s mental health care”, Royal College of Psychiatrists, 2018, accessed June 2024, https://www.rcpsych.ac.uk/improving-care/campaigning-for-better-mental-health-policy/college-reports/2018-college-reports/cr221
Poverty
A common definition of poverty is living in a household with an income below 60% of the median household income, taking into account for the number of people living in the household
- More than 2 million (one in five) older people in the UK live in poverty on this definition. Households below average income: for financial years ending 1995 to 2020, Department for Work and Pensions, 25 March 2021; see gov.uk/government/statistics/households-below-averageincome-for-financial-years-ending-1995-to-2020 These figures had risen since 2013-14 when 1.6 million (14 per cent) lived in poverty. https://www.ageuk.org.uk/globalassets/age-uk/documents/policy-positions/money-matters/poverty_in_later_life_briefing_june_2021.pdf
State of Ageing 2023 found that those individuals aged 60-64 have the highest rate of relative poverty (25%). https://ageing-better.org.uk/news/50-years-progress-against-pensioner-poverty-under-threat-state-ageing#:~:text=State%20of%20Ageing%202023%20highlights,amount%20needed%20to%20live%20on. Accessed June 2024.
- The report from the Centre of Ageing Better‘s State of Ageing Reports in 2023 stated that in the summer “almost half of people aged 50-69 in serious financial difficulties ate less than they felt they should have because they didn’t have enough money for food" https://ageing-better.org.uk/sites/default/files/2023-12/The-State-of-Ageing-interactive-summary-2023-4.pdf accessed June 2024