IrSPEN2025

In 2011, when we last estimated the prevalence and cost of disease-related malnutrition in Ireland, adults over 65 made up just 11.4% of the population. Since then, Ireland has experienced the fastest rate of population aging in Europe, with the number of older adults increasing by over 55% and projected to reach one million within the next decade. Given the well-established link between aging, chronic disease, and nutritional deterioration, this demographic shift has significantly increased the scale and economic burden of malnutrition on our healthcare system.

This presentation will provide new insights into the current prevalence and cost of malnutrition, drawing on data from the 2023 IrSPEN/INDI National Malnutrition Survey—potentially the largest study of its kind relative to the population, with data captured for approximately one-third of all adult inpatients. Findings will highlight the considerable financial burden of malnutrition on Ireland’s health system, reinforcing its role as a major but frequently overlooked driver of healthcare costs—much of which could be mitigated through a focus on earlier and more effective interventions aimed at preserving or regaining function.

Notably, data from the 2023 survey suggests that while mandatory malnutrition screening and earlier intervention in acute care may be delivering measurable benefits, the overall prevalence of malnutrition risk at hospital admission continues to rise in line with the upward trend in age of the patient population, with a higher incidence of cancer.  Whilst the latest costing of malnutrition demonstrates that the vast majority of costs associated with malnutrition are incurred in acute care settings, it will be shown that the largest potential for saving money is through effective strategies for prevention of malnutrition in those living independently or semi  independently in their own home.   Putative cost savings will be presented for reducing the burden of malnutrition  of those entering the hospital system, based on the estimated excess costs of a malnourished older patient per year vs a normally nourished older person.

From a health economics perspective, we must ask whether a shift in how we view and respond to malnutrition is needed. Should malnutrition be recognised as a modifiable and costly co-morbidity of disease, particularly severe in older adults, rather than an inevitable consequence of illness? Given the enormous costs associated with malnutrition, both in terms of healthcare utilisation and the long-term burden on social care, what will it cost if we fail to address the factors driving malnutrition in the community—where early intervention could prevent hospitalisations, reduce complications, and improve recovery outcomes?

By integrating health economics into nutrition policy and practice, this presentation will explore how targeted interventions could maximise savings across both health and social care while improving patient outcomes. The question remains: will we adapt, or will we continue to absorb the escalating costs of a problem that is, in many cases, preventable?