Nutritional Status in Hospitalized Patients Over 65 Years of Age With Mental Disorders

This prospective observational study will be conducted at the Geriatric Psychiatry Unit of the University Psychiatric Clinic Ljubljana and will focus on hospitalized patients aged 65 years and older with mental disorders. Older adults with psychiatric conditions, particularly those with dementia and depression, represent a highly vulnerable population with an increased risk of malnutrition, dysphagia, and related clinical conditions. Despite their clinical importance, these conditions remain under-recognized and insufficiently addressed, particularly in hospital settings, where nutritional status may further deteriorate during admission.

The study aims to provide a comprehensive and systematic evaluation of nutritional status and nutrition-related conditions in this population, while also examining their relationship with clinical, functional, cognitive, psychological, and sociodemographic factors. In addition, the study will explore associations between nutritional conditions and laboratory biomarkers, including markers of inflammation, metabolism, and oxidative stress, to improve understanding of underlying pathophysiological mechanisms.

Data will be collected as part of routine clinical care using a multidisciplinary approach, including medical, nutritional, functional, psychological, and pharmacological assessments. Nutritional status and dysphagia will be evaluated using validated clinical tools and standard diagnostic criteria. Functional status will be assessed through established mobility and performance measures, while cognitive function and mood will be evaluated using standardized psychological instruments. Laboratory parameters will be obtained from routine diagnostics, with additional analyses performed on stored serum samples without increasing patient burden.

Patients will be assessed at hospital admission and followed during hospitalization, with repeated measurements performed in accordance with standard clinical practice. No additional invasive procedures will be performed solely for research purposes, and all participants will receive standard care according to current clinical guidelines. The study will therefore not interfere with treatment or impose additional risk to participants.

The findings of this study are expected to provide the first comprehensive national data on the prevalence of malnutrition and related conditions in hospitalized older adults with mental disorders in Slovenia. Based on these findings, a multidisciplinary clinical pathway for nutritional care will be developed and its feasibility and effectiveness evaluated. The results will contribute to improved early detection, prevention, and management of malnutrition and dysphagia, as well as to the development of national evidence-based clinical guidelines and healthcare strategies for this vulnerable population.

• Mini Nutritional Assessment (MNA) [Time frame: Baseline, Day 7, Day 14, and Day 21 (or hospital discharge if earlier).]
• Appendicular skeletal muscle mass index (ASMI) [Time frame: Baseline, Day 7, Day 14, and Day 21 (or hospital discharge if earlier).]
• Gugging Swallowing Screen (GUSS) score [Time frame: Baseline and Day 21 (or hospital discharge if earlier).]
• Phase angle [Time frame: Baseline, Day 7, Day 14, and Day 21 (or hospital discharge if earlier).]
• Barthel Index score [Time frame: Baseline and Day 21 (or hospital discharge if earlier).]
• Handgrip strength [Time frame: Baseline and Day 21 (or hospital discharge if earlier).]
• Cognitive function [Time frame: Baseline and Day 21 (or hospital discharge if earlier).]
• Geriatric Depression Scale (GDS) score [Time frame: Baseline and Day 21 (or hospital discharge if earlier).]
• Hospital length of stay [Time frame: From admission to discharge, an average of 3 weeks.]
• Number of participants experiencing at least one in-hospital adverse event [Time frame: During hospitalization, up to Day 21.]
• De Morton Mobility Index score [Time frame: Baseline and Day 21 (or hospital discharge if earlier).]
• 4-meter gait speed [Time frame: Baseline and Day 21 (or hospital discharge if earlier).]