Researchers studied 60 older adults in a hospital to understand why some develop painful bed sores (pressure ulcers) while others don’t. They found that patients who weren’t eating well, had low protein levels in their blood, and didn’t get enough vitamin D were much more likely to develop bed sores. The study suggests that checking a patient’s nutrition early and making sure they eat well and get proper vitamins might help prevent these painful wounds from forming in the first place.

The Quick Take

  • What they studied: Whether older hospital patients who aren’t eating well are more likely to develop painful pressure sores on their skin
  • Who participated: 60 older adults (age 65 and up) in a hospital in 2015. Half had pressure sores, and half didn’t have any sores. Researchers compared the two groups to see what was different about them.
  • Key finding: Older patients with pressure sores were significantly more likely to be malnourished, have low protein levels, lack vitamin D, and have weaker muscles. Patients with a nutrition score below 17 were at especially high risk.
  • What it means for you: If you’re an older adult in the hospital or caring for one, paying attention to nutrition—eating enough protein, getting vitamins, and maintaining a healthy weight—may help prevent painful bed sores. However, this study is relatively small, so more research is needed to confirm these findings.

The Research Details

This was a cross-sectional study, which means researchers looked at a group of people at one point in time and compared those with pressure sores to those without them. They weren’t following people over months or years; instead, they took a snapshot of 60 older hospital patients and examined their medical records and blood tests.

The researchers divided the patients into two equal groups: 30 with pressure sores and 30 without. They then looked back at their nutrition status using a standard assessment tool called the Mini Nutritional Assessment (MNA), which asks questions about eating habits and weight. They also checked blood tests to measure protein levels (albumin) and vitamin D, and they assessed how well patients could do daily activities like getting dressed or bathing.

This approach allowed researchers to identify patterns and connections between poor nutrition and pressure sores, though it doesn’t prove that poor nutrition directly causes the sores.

This type of study design is useful for identifying risk factors quickly and efficiently. By comparing patients who already have pressure sores with those who don’t, researchers can spot what’s different about them. This information helps doctors know who to watch closely and what to prevent. However, because it’s a snapshot in time, it can’t prove cause-and-effect the way a long-term study could.

The study has some strengths: it used standardized, well-established assessment tools that are commonly used in hospitals, and the findings were statistically significant (p < 0.01, meaning there’s less than a 1% chance these results happened by accident). However, the study is relatively small with only 60 patients, and it was conducted in 2015 at a single hospital in one country, so the results may not apply to all older adults everywhere. The study also didn’t track patients over time, so we can’t be certain about cause-and-effect relationships.

What the Results Show

The study found striking differences between older patients with pressure sores and those without them. Patients with pressure sores were much more likely to be malnourished—meaning they weren’t getting enough calories and nutrients. Their body mass index (BMI, a measure of weight relative to height) was lower, and their nutrition assessment scores were significantly reduced.

Blood tests revealed two important nutritional markers were much lower in patients with pressure sores. First, albumin (a protein in the blood that shows overall nutrition status) was low in the pressure ulcer group. Second, vitamin D levels were deficient in most patients with sores. These differences were statistically significant, meaning they’re unlikely to have happened by chance.

Patients with pressure sores also had much lower scores on tests measuring their ability to do daily activities. The Barthel test (which measures basic activities like bathing and dressing) and the Lawton test (which measures more complex activities like managing money and medications) were both notably lower in the pressure ulcer group. This suggests that malnourished patients may also be weaker and less able to move around, which could contribute to pressure sore development.

When researchers used statistical analysis to identify which factors were most important, they found that a nutrition score below 17 was an independent risk factor for developing pressure sores. This means that even after accounting for other factors, poor nutrition stood out as a key predictor.

Beyond the main findings, the study revealed that reduced functional capacity (the ability to move around and do daily tasks) was also associated with pressure sores. This makes sense because patients who can’t move well are more likely to stay in one position, which increases pressure on the skin. The combination of poor nutrition plus reduced mobility appears to create a particularly high-risk situation for developing sores.

These findings align with what healthcare providers have long suspected: nutrition plays an important role in skin health and wound prevention. Previous research has shown that protein and vitamin D are essential for maintaining healthy skin and healing wounds. This study adds to that evidence by specifically showing the connection in older hospitalized patients. However, because this is a relatively small study from one hospital, it should be seen as supporting evidence rather than definitive proof of the relationship.

This study has several important limitations to consider. First, it’s small—only 60 patients—so the results might not apply to all older adults. Second, it was conducted at a single hospital in 2015, so practices and patient populations may have changed. Third, because it’s a cross-sectional study (a snapshot in time), researchers can’t prove that poor nutrition causes pressure sores; they can only show that the two are connected. It’s possible that patients with pressure sores eat poorly because they’re sick, rather than poor nutrition causing the sores. Finally, the study didn’t account for other important factors like how long patients had been in the hospital, what medications they were taking, or other medical conditions they might have.

The Bottom Line

Based on this research, healthcare providers should screen older hospital patients for malnutrition early in their hospital stay and take steps to improve nutrition. This might include ensuring patients eat adequate protein, checking vitamin D levels, and providing supplements if needed. For family members caring for older adults, paying attention to nutrition—making sure they eat enough, get adequate protein, and maintain healthy vitamin D levels—is a reasonable preventive measure. However, because this is a relatively small study, these recommendations should be considered as one piece of evidence among many, not as definitive medical advice. Always consult with a healthcare provider for personalized recommendations.

This research is most relevant to older adults (65 and up) who are hospitalized or at risk of hospitalization, their family members, and healthcare providers working in hospitals. It’s particularly important for people who are already at risk for malnutrition due to difficulty eating, limited appetite, or medical conditions. However, the findings may be less relevant to younger, healthier people or those living independently at home, though good nutrition is beneficial for everyone.

If nutrition is improved, it may take several weeks to see benefits in terms of pressure sore prevention. Protein and vitamin D levels in the blood take time to improve, and skin health improvements typically follow. For patients already hospitalized, preventing new sores is the goal, while healing existing sores may take weeks to months depending on severity.

Want to Apply This Research?

  • Track daily protein intake (in grams) and vitamin D supplementation. Set a goal of 1.0-1.2 grams of protein per kilogram of body weight daily, and monitor whether vitamin D levels are being supplemented or checked regularly.
  • Users caring for older adults should use the app to log meals and snacks, ensuring adequate protein at each meal (eggs, yogurt, chicken, fish, beans). Set reminders for vitamin D supplementation and track whether the person is eating enough calories throughout the day.
  • Create a monthly nutrition checklist that includes: protein intake goals met, vitamin D supplementation taken, weight stability maintained, and appetite changes noted. Share this data with healthcare providers during hospital visits or check-ups to identify trends early.

This research summary is for educational purposes only and should not be used as a substitute for professional medical advice. The study is relatively small and was conducted in a specific hospital setting, so results may not apply to all populations. If you or a loved one is hospitalized or at risk for pressure sores, please consult with a healthcare provider for personalized assessment and treatment recommendations. Do not start, stop, or change any medications or supplements without first speaking with a doctor.