Can oral nutritional supplements reduce mortality for older inpatients at risk of malnutrition?

Malnutrition is common in hospitalized older adults, affecting up to 64% of patients, and is linked to higher mortality and complications. Oral nutritional supplements (ONS) are specially formulated drinks or powders that provide extra calories, protein, and nutrients. A 2024 Cochrane review and other research suggest that ONS can reduce the risk of death and other serious events in this population.

What the research says

A 2024 Cochrane review analyzed data from randomized controlled trials involving older inpatients (65 years or older) at risk of or with malnutrition. The review found that oral nutritional supplements likely reduce mortality compared to standard care or placebo, with moderate-certainty evidence ⁶. The same review also reported that ONS may reduce the number of people who experience serious adverse events, such as infections or complications ⁶. Another meta-analysis focusing on older adults with hip fractures found that ONS significantly reduced total complications, including infections and pressure ulcers, and showed a trend toward lower mortality ⁹. A 2021 Cochrane review on dietary advice with or without ONS for disease-related malnutrition in adults found low-certainty evidence that ONS may reduce mortality, but results were not conclusive across all settings ¹¹. Overall, the strongest evidence for mortality reduction comes from the 2024 review specifically in hospitalized older patients.

What to ask your doctor

• Based on my nutritional risk, would oral nutritional supplements be recommended for me?
• What type of oral nutritional supplement would be most appropriate for my condition?
• How long should I take the supplements to see potential benefits?
• Are there any side effects or interactions with my current medications?
• Can you refer me to a dietitian for a personalized nutrition plan?