Nutrition Risk and Malnutrition in Older People in Viet Nam: From Screening to Safe, Person-Centered Nutrition Care Across Settings
AGE-FRIENDLY CARE QUALITYINTEGRATED CARE & CARE TRANSITIONS
Nutrition Risk and Malnutrition in Older People in Viet Nam: From Screening to Safe, Person-Centered Nutrition Care Across Settings
NUTRITION CARE, INTEGRATED CARE & LONG-TERM CARE QUALITY
Last reviewed: October 2026
Malnutrition in an older person does not always look like severe thinness. It may begin quietly: a few kilograms lost after an illness, smaller meals because food no longer tastes the same, difficulty chewing, fatigue that makes shopping or cooking harder, a hospital admission followed by poor appetite, or a family gradually accepting that an older parent now eats only half of what they once did. By the time low weight becomes obvious, the problem may have been developing for months.
Nutrition is therefore not simply a question of whether an older person is offered enough food. Good nutrition care requires a system that can recognize risk early, understand why intake or nutritional status is deteriorating, intervene safely, respect individual preferences and medical conditions, and follow what happens when the person moves between hospital, home, community services and long-term care.
For Viet Nam, this is becoming increasingly important as the population ages and care becomes more complex. Recent policy, regulatory and professional guidance has created stronger foundations for nutrition screening and care in hospitals, homes and communities. The next challenge is to connect those pieces so that nutritional deterioration does not disappear at the boundaries between services.
Nutrition risk and malnutrition are related, but they are not the same thing
A nutrition screening tool is designed to identify someone who may be at risk and needs closer assessment. It is not automatically a definitive diagnosis of malnutrition. Reduced food intake, recent unintentional weight loss, low body mass index, acute illness, functional decline and other warning signs may trigger further assessment before malnutrition has been formally established.
The Global Leadership Initiative on Malnutrition, or GLIM, uses this two-step logic. Its 2025 five-year update retained the core framework introduced in 2019: after nutrition-risk screening, malnutrition is assessed using three phenotypic criteria—unintentional weight loss, low BMI and low muscle mass—and two etiologic criteria—reduced food intake or assimilation and inflammation or disease burden. Diagnosis requires at least one phenotypic and one etiologic criterion.
This distinction is particularly important in older people because nutritional deterioration is rarely explained by one number. A person can have a normal or high BMI while experiencing clinically important weight loss and declining muscle mass. Someone living with overweight or obesity can also become malnourished. Conversely, a screening result indicating nutrition risk should lead to assessment and action rather than automatically becoming a permanent diagnostic label.
For this article, malnutrition refers primarily to undernutrition in older people, including disease-related malnutrition and malnutrition associated with reduced food intake or assimilation. This is narrower than the broader public-health use of “malnutrition,” which can also include overweight, obesity and micronutrient deficiencies or excesses.
The available Vietnamese evidence points to a real problem, but not one national prevalence figure
Recent Vietnamese studies increasingly show that nutrition risk and malnutrition are common among older people receiving healthcare, although estimates vary substantially according to setting, population and method of assessment.
At the Geriatrics Outpatient Clinic of University Medical Center Ho Chi Minh City, a study of 322 people aged 60 years and older seen between October 2024 and March 2025 found that MNA-SF placed 11.5% in its malnutrition category and another 38.1% in the at-risk category. Depression and gastritis were independently associated with poorer nutritional status.
A study of 304 older outpatients at E Hospital in Hanoi during 2024 produced lower estimates. Using the full Mini Nutritional Assessment, 3.9% were classified as malnourished and 19.1% as at risk of malnutrition. Age 80 years or older, multimorbidity and more frequent hospitalization were associated with poorer nutritional status.
Selected inpatient populations show a substantially higher burden. A 2026 study of 264 older inpatients at Military Hospital 354 in Hanoi reported that MNA-SF placed 34.8% in the malnutrition category and 37.9% in the at-risk category. Nutritional status was also associated with functional ability and health-related quality of life.
A separate prospective study involving 200 hospitalized older adults at Hanoi Medical University Hospital illustrates why screening and diagnosis should remain conceptually separate. MNA-SF identified 65% in the malnutrition or nutrition-risk range, while 54% met GLIM malnutrition criteria in the study's diagnostic assessment. The same study found that MNA-SF, NRS-2002, MUST and MST all performed well as first-step screening tools against the GLIM framework, with MNA-SF showing the highest sensitivity in that population.
These figures should not be combined into a single prevalence estimate for Viet Nam. They come from selected hospitals and clinics, involve different populations and use different instruments and definitions. What they do show consistently is that nutrition risk is clinically important and may be substantial, particularly among older people who are ill, frail, multimorbid or hospitalized.
Viet Nam now has stronger foundations for older-person nutrition care
Nutrition for older people is already part of Viet Nam's national policy architecture. The National Nutrition Strategy for 2021–2030, with a vision to 2045, approved through Decision No. 02/QĐ-TTg in January 2022, explicitly calls for stronger nutrition interventions for older people. It also includes development of nutrition counseling and rehabilitation services, nutrition interventions for prevention and management of noncommunicable diseases, improvement of intervention quality and continued strengthening of nutrition activities in hospitals.
The National Strategy on Older Persons to 2035, with a vision to 2045, approved in 2025, and the updated Older People Health Care Program to 2030 provide a broader framework for strengthening healthcare, rehabilitation, community care and longer-term support as the population ages.
A particularly practical development came in July 2026 with Decision No. 1976/QĐ-BYT, which issued professional guidance on caring for older people at home and in the community. Nutrition is not treated simply as dietary advice. The guidance calls for consideration of nutritional status, weight change, intake, health conditions, physical activity, function, digestion, chewing and swallowing ability when planning care. It emphasizes individualized nutrition needs, appropriate food preparation, monitoring and involvement of older people and their caregivers.
Decision 1976 also incorporates WHO's ICOPE approach. In the second edition of ICOPE, basic assessment addresses six domains of intrinsic capacity: cognition, mobility, vitality, vision, hearing and psychological capacity. Nutrition-related screening is particularly connected to vitality, while subsequent assessment and care planning considers the broader interaction between nutrition, disease, function and social-support needs.
These developments provide an important foundation. But a nutrition pathway is only effective if identifying risk changes what happens next.
Screening should be the beginning of care, not the completion of a form
A screening score has little value if nobody responds to it. If an older person has lost 4 kg in three months, the first question should not simply be “What supplement should we prescribe?” It should be why has this person lost weight?
Perhaps poorly fitting dentures have made meat difficult to eat. Perhaps swallowing has changed after a stroke. Depression may have reduced appetite. A diuretic may explain part of the change through fluid loss rather than tissue loss. Poorly controlled diabetes can cause weight loss. Dementia may mean meals are forgotten. The person may no longer be able to shop or cook. Cancer, infection or another inflammatory illness may increase nutritional requirements at the same time that appetite falls.
Different causes require different responses. Good nutrition assessment therefore connects weight and intake with disease, medicines, oral health, swallowing, cognition, mood, physical function, social circumstances and caregiver capacity. This is why nutrition care in older people fits naturally within comprehensive geriatric and integrated-care approaches rather than functioning as an isolated dietary service.
Weight and BMI matter, but they are not enough
BMI is useful because it is inexpensive, familiar and easy to measure, but it has important limitations in older people. Age-related loss of muscle can occur while body weight remains apparently stable. An older adult may lose muscle while retaining or gaining fat. Fluid retention can mask tissue loss in heart, kidney or liver disease. Someone who begins with obesity may experience substantial clinically important weight loss before reaching a BMI that appears low.
The updated GLIM framework therefore continues to include low muscle mass alongside weight loss and low BMI as a phenotypic criterion for malnutrition.
Muscle also connects nutrition with function. An older person who progressively eats less may not simply become lighter; they may become weaker, walk more slowly, struggle to rise from a chair, lose independence and become more vulnerable to falls. Malnutrition and sarcopenia frequently overlap, although they are not the same condition.
The practical lesson is that a stable or high BMI should not automatically reassure clinicians that nutrition is adequate.
Laboratory values require similar caution. Serum albumin can fall in acute or chronic inflammation, renal or gastrointestinal losses and other clinical conditions. International clinical nutrition guidance does not support using albumin or prealbumin alone as diagnostic markers of malnutrition. Laboratory results can contribute to understanding the clinical picture, but they cannot replace nutrition assessment.
The reasons older people stop eating are often multidimensional
Reduced appetite can occur with aging, but it should not become a convenient explanation for every decline in food intake. Changes in taste and smell, dental disease, poorly fitting dentures, dry mouth, constipation, nausea, chronic pain and medication effects can interfere with eating. Stroke, Parkinson disease, dementia and other neurological conditions may affect swallowing or the ability to organize a meal. Depression, bereavement, loneliness and cognitive decline can reduce interest in food.
Function matters as much as appetite. An older person may be hungry but unable to walk to the market, carry groceries, stand long enough to cook or open packaging. A spouse who prepared meals for decades may die or become ill. Financial constraints can change food choices. A family caregiver may understand the person's medical conditions but have little training in how to maintain adequate intake when chewing or swallowing becomes difficult.
Nutrition care therefore cannot stop at telling someone what they “should eat.” The plan has to be feasible within the person's actual life.
Person-centered nutrition care is not the same as prescribing the “healthiest” theoretical diet
Older people commonly live with several conditions at once. One person may have diabetes, hypertension, chronic kidney disease, heart disease and low body weight. Another may have obesity while losing muscle. A third may have advanced frailty and very limited appetite.
If each condition generates another list of foods to avoid, the combined diet can become so restrictive that the person barely eats.
Viet Nam's 2026 home- and community-care guidance appropriately calls for nutrition to be adapted to nutritional status, disease, physical activity, chewing and swallowing ability, economic circumstances, local conditions and individual eating habits. It also favors the use of locally available foods.
International geriatric nutrition guidance makes a similar point. ESPEN recommends individualized, comprehensive and multidisciplinary nutrition care and cautions against unnecessary dietary restrictions where they may compromise adequate intake. As broad clinical orientation rather than universal prescriptions, ESPEN uses approximately 30 kcal/kg body weight per day as a guiding value for energy intake and at least 1 g protein/kg/day, with both adjusted according to nutritional status, physical activity, disease, tolerance and other clinical factors. Kidney disease and other conditions may require individualized protein or fluid targets, so these figures should not be applied mechanically.
The purpose is not to reduce older-person nutrition to calculations. It is to recognize that preserving adequate intake, muscle and function can sometimes be more urgent than pursuing an idealized restrictive diet.
For someone eating poorly, familiar Vietnamese foods can often be adapted rather than replaced. Meals can be smaller and more frequent; familiar dishes can be made more energy- or protein-dense; and appropriate sources such as eggs, fish, meat, tofu or dairy can be incorporated according to preference, tolerance and medical condition. Oral nutrition supplements can be useful when ordinary food cannot adequately meet requirements, but they should complement a care plan rather than substitute for understanding why the person is not eating.
Swallowing safety is nutrition care
Nutrition quality is not simply about calories and protein. The person also has to be able to eat and drink safely.
Dysphagia can occur after stroke and with neurological disease, dementia, advanced frailty and other conditions. Warning signs may include coughing or choking during meals, a wet or altered voice after swallowing, prolonged eating, food remaining in the mouth, recurrent respiratory illness or unexplained weight loss.
One useful feature of Viet Nam's 2026 guidance is that it does not assume that turning food into porridge or making it softer automatically solves the problem. The guidance recognizes that chewing, dentures, feeding speed, posture and swallowing coordination matter and recommends adapting consistency to individual chewing and swallowing ability.
This is particularly relevant in Vietnamese practice because “ăn cháo” can easily become the default response when an older person begins to have difficulty eating. Yet making food softer or more liquid is not automatically the safest choice for every swallowing problem. An unnecessarily restrictive texture can also reduce enjoyment, food variety and intake.
Where dysphagia is suspected, the safer approach is appropriate assessment and referral where available, individualized decisions about food and fluid consistency, suitable positioning, adequate time for meals and caregiver training. Nutrition and swallowing safety have to be considered together.
Oral health belongs inside the nutrition pathway
Missing teeth, painful gums, poorly fitting dentures, dry mouth and oral infection can substantially reduce the range of foods an older person can or wants to eat. They can also make meals exhausting, uncomfortable or embarrassing.
A nutrition plan that recommends particular foods without asking whether the person can chew them is not genuinely individualized care. Routine nutrition assessment should therefore consider oral health and chewing ability and connect people with dental or oral-health support where appropriate. Food texture can then be adapted while preserving nutritional density, choice and enjoyment rather than simply eliminating foods until the diet becomes progressively narrower.
Hydration can deteriorate alongside nutrition
Older adults can be vulnerable to low-intake dehydration because of reduced thirst sensation, mobility limitations, continence concerns, cognitive impairment or dependence on another person to obtain drinks. Acute illness may increase fluid losses while simultaneously reducing intake.
ESPEN's geriatric guidance therefore recommends actively supporting appropriate fluid consumption. But “drink more water” is not a universal prescription. People with heart failure, advanced kidney disease or other conditions may need individualized fluid management, while some people with dysphagia require specific approaches to fluid consistency.
Good hydration care asks the same questions as good nutrition care: What does this person need? What can they safely consume? What is preventing adequate intake? And who is monitoring whether the plan is working?
Hospitals in Viet Nam already have explicit nutrition responsibilities
Viet Nam's regulatory framework for hospital nutrition is more developed than is sometimes appreciated.
For current consolidated reading, the requirements are reflected in Consolidated Document No. 16/VBHN-BYT dated 9 December 2025. It consolidates Circular No. 18/2020/TT-BYT following the partial repeal of provisions through Circular No. 08/2024/TT-BYT. As a consolidated document, it does not itself create a separate new set of obligations; it presents the currently applicable text of the hospital nutrition regulation in an integrated form.
Under that framework, outpatients are screened for nutrition-risk factors such as weight loss, reduced intake, BMI and other relevant risks. For inpatients, nutrition-risk screening, clinical examination, diagnosis and indication for nutrition treatment must be completed within 36 hours of admission and documented in the medical record.
When nutritional risk is identified, the patient must undergo nutrition-status assessment, diagnosis, prescription of an appropriate therapeutic diet and ongoing monitoring and reassessment during treatment. Patients initially considered not at nutritional risk must be screened again after every seven days of hospitalization. People with severe malnutrition and patients classified as requiring level-I nursing care require consultation between the treating physician and a nutrition physician or dietitian when the nutrition regimen is developed.
The regulation also requires patients to be supported, monitored and supervised in implementing their nutrition regimen throughout treatment. Nutrition is therefore not merely the responsibility of a hospital kitchen or nutrition department; physicians, nurses, nutrition professionals, clinical departments and hospital leadership all have defined responsibilities.
These are not optional quality aspirations. They form part of Viet Nam's regulatory framework for hospital nutrition.
The implementation challenge is different. A hospital can technically complete a screening form without ensuring that the person actually receives appropriate food, assistance to eat, assessment of swallowing concerns, nutrition consultation or follow-up after discharge. Screening compliance is therefore only the first quality measure. The more meaningful question is whether screening leads to effective care.
Hospitalization is both an opportunity and a risk
An acute admission can reveal nutritional deterioration that has been developing unnoticed at home. It can also make nutrition worse.
Older patients may eat less because they are acutely ill, fasting for procedures, unfamiliar with hospital food, unable to open packaging, fatigued or dependent on feeding assistance that is not available at the right time. Delirium, pain and changes in medication may further reduce intake.
A person who enters hospital with marginal nutrition can therefore leave several days later with less weight, less muscle and less capacity to function independently.
Nutrition care on the ward needs to include what actually happens at mealtimes. Was food placed within reach? Could the patient sit safely and comfortably? Did the person need assistance? How much was actually eaten? Was swallowing safe? Was a prescribed supplement consumed or merely ordered? Was the diet so restrictive or unfamiliar that the patient rejected it?
Nutrition treatment happens at the bedside, not only in the medical record.
Home and community care are becoming increasingly important parts of the nutrition system
Decision No. 1976/QĐ-BYT creates an important bridge between hospital-centered clinical nutrition and care closer to where older people live.
The guidance calls for consideration of BMI, weight change, dietary intake, malnutrition risk, chewing, swallowing, digestion, disease, physical activity and functional ability; identification of individual nutrition needs; appropriate meal preparation; monitoring; and education of older people and caregivers.
This matters because nutritional deterioration frequently happens outside hospitals. A widow may gradually stop cooking. An older man with early dementia may repeatedly forget lunch. Someone recovering from stroke may return home with modified-food instructions the family does not understand. A person discharged after pneumonia may technically be medically stable while still eating very little.
Community care can identify these problems earlier—but only if there is a clear pathway from detection to action. Finding nutrition risk without providing follow-up risks creating a screening program that produces data rather than better care.
Residential and social-care settings also need nutrition governance
As Viet Nam's long-term care sector develops, more older people are likely to receive support in residential or social-assistance settings.
Circular No. 33/2017/TT-BLĐTBXH remains partly in force. Circular No. 02/2020/TT-BLĐTBXH repealed Article 6, while the nutrition standards in Article 8 remain relevant to social assistance establishments within the Circular's legal scope.
Article 8 requires at least three meals each day, adequate energy and major food groups, and special nutrition arrangements for people with specific needs, including older people, people who are ill or malnourished, and those requiring diets because of disease, religion or belief.
These standards are important, but providing three meals does not by itself demonstrate good nutrition care.
A residential service also needs to know who is losing weight, who leaves most of their food uneaten, who requires assistance during meals, whose dentures no longer fit, who has developed swallowing difficulty, who may be becoming dehydrated and whether a previously prescribed restrictive diet is still appropriate.
Responsibility should be clear as well: who performs screening, who reviews concerning findings, who can authorize changes in food or fluid texture within their professional scope, who refers a person for medical or swallowing assessment, and who informs the family or healthcare team when nutritional status deteriorates.
That is the difference between food provision and nutrition governance.
Transitions are where nutrition information is easily lost
An older person may move from home to hospital, from hospital to rehabilitation, back home, and later into day care or residential care. Nutrition needs can change at every stage.
Yet discharge communication understandably tends to focus on diagnoses, procedures and medicines. Information about recent weight loss, nutrition risk, level of feeding assistance, swallowing, supplements or current food and fluid consistency may be less visible.
A safer nutrition handover should include the information the receiving caregiver or service actually needs: recent weight trajectory; identified nutrition risk or diagnosed malnutrition; current intake; oral-health, chewing or swallowing concerns; prescribed food or fluid texture; level of mealtime assistance; oral supplements or other nutrition therapy; relevant dietary restrictions; and the follow-up plan.
Without this information, the next service may unknowingly restart the assessment process only after deterioration becomes obvious.
An older person should not have to become malnourished again in each setting before someone notices.
Nutrition intervention itself has to be safe
For many older people at nutritional risk, the initial response can be relatively straightforward: address reversible causes, improve the mealtime environment, provide appropriate assistance, make food more appealing and nutrient-dense, offer smaller and more frequent meals, adapt texture where needed, and consider oral nutrition supplements when ordinary food remains inadequate.
More complex cases require clinical assessment. Enteral and parenteral nutrition are medical therapies, not simply alternative ways of providing food. Their indications, expected benefits, burdens, complications and compatibility with the person's overall goals need to be considered individually. ESPEN recommends supporting oral nutrition wherever feasible, with enteral nutrition considered when oral intake is insufficient or impossible and parenteral nutrition when enteral nutrition cannot adequately meet requirements and the overall clinical situation supports its use.
Another safety issue arises in people who have experienced prolonged substantial undernutrition. Reintroducing nutrition can, in susceptible patients, be associated with refeeding syndrome, involving potentially serious metabolic and electrolyte disturbances.
Management should therefore include appropriate assessment of refeeding risk, multidisciplinary clinical oversight, micronutrient support such as thiamine when indicated, and monitoring and correction of relevant electrolytes. Importantly, contemporary guidance has also moved away from treating prolonged restrictive feeding under a simple “start low, go slow” rule as appropriate for every person at risk. The pace and amount of nutrition should reflect the person's clinical condition, electrolyte status, route of feeding, monitoring capacity and the protocol being used, while avoiding unnecessary prolonged underfeeding.
Safe nutrition care means recognizing both the harm of inadequate nutrition and the potential harm of poorly planned intervention.
Disease-specific diets need to be balanced against the risk of undernutrition
Older adults frequently receive advice to restrict salt, sugar, fat, potassium, phosphorus or other nutrients because of chronic disease. Many such recommendations are clinically appropriate, and Viet Nam's 2026 guidance includes individualized dietary advice for conditions such as hypertension, diabetes, lipid disorders and osteoporosis.
Problems arise when restrictions accumulate.
An older person with diabetes may already be eating so little that an overly restrictive diet further reduces total energy intake. Someone with hypertension and poor appetite may find a highly restrictive low-salt diet so unpalatable that intake falls. A person with advanced frailty may have different nutritional priorities from a younger adult receiving long-term preventive dietary counseling.
The question is therefore not whether disease-specific dietary guidance is inherently “right” or “wrong.” It is whether the overall nutrition plan remains appropriate for this particular person at this particular stage of health.
Good geriatric nutrition care balances disease management with adequate intake, function, comfort, preferences and the person's goals.
Nutrition quality should be measured through outcomes, not only whether screening occurred
A service can achieve a high screening-completion rate and still provide poor nutrition care.
A stronger quality system asks what happened after risk was identified. Was an appropriate assessment completed? Was an individualized plan documented? Did the person actually receive and consume the recommended food or supplements? Was feeding assistance available? Were chewing or swallowing concerns addressed? Was weight stabilized? Did intake improve? Was function maintained where possible? Was the plan communicated when care transferred to another setting?
Useful measures could include screening completion, time from positive screening to assessment, clinically significant unintentional weight loss, meal intake, recurrent dehydration, swallowing-related incidents, care-plan review, appropriate referral, patient and caregiver experience and continuity of nutrition care following transitions.
Not every organization needs dozens of indicators. A small set that leads to action is more useful than extensive documentation that nobody reviews.
Viet Nam now has an opportunity to connect hospital nutrition with healthy aging and long-term care
Viet Nam does not lack every component of a nutrition system. The National Nutrition Strategy recognizes the need for stronger older-person nutrition interventions. Hospital regulations require screening and nutrition management. National professional guidance now extends nutrition assessment and care further into homes and communities. Social-assistance standards contain basic nutrition protections. WHO's ICOPE framework provides a way to consider nutrition within a broader assessment of intrinsic capacity and person-centered care.
What remains less developed is the connection between these components.
A useful next step would be a clearer across-setting nutrition pathway for older people: what should trigger screening; which tools are appropriate in different settings; when a positive screen requires deeper assessment; how oral-health and swallowing problems are managed; how individualized plans are documented; which professionals take responsibility; what information follows the person across transitions; and how outcomes are measured.
The pathway also needs to be proportionate. A relatively independent older person attending a community club does not require the same intensity of assessment as a frail inpatient with substantial recent weight loss or a residential-care resident with advanced dementia and dysphagia.
Quality governance should match risk.
From screening to nutrition care
Nutrition risk can sometimes be detected with only a few questions. Providing good nutrition care is harder.
It requires noticing that an older person has lost weight but also asking why. It means recognizing when a low BMI is concerning while also identifying malnutrition in someone whose BMI is not low. It means providing adequate food while ensuring that the person can chew it, swallow it, reach it and wants to eat it. It means managing diabetes, hypertension or other conditions without allowing multiple restrictions to make adequate intake impossible.
For families, good nutrition care may mean knowing which changes should prompt concern, how to adapt familiar foods without unnecessarily reducing nutritional value, when swallowing difficulty needs assessment and where to seek help. For hospitals, it means turning mandatory screening into timely assessment, treatment and monitoring. For home, community and long-term care services, it means treating nutrition as an ongoing quality responsibility rather than waiting until severe weight loss becomes obvious.
As Viet Nam develops a more integrated system of care for older people, the question should therefore not simply be: “Did we screen this person for malnutrition?”
A more important question is: “When nutrition risk was identified, did the system understand the cause, respond safely, respect what matters to the person and remain accountable until the problem was appropriately addressed?”
That is the difference between screening for malnutrition and providing high-quality nutrition care across the continuum.
References
World Health Organization. Integrated care for older people (ICOPE): guidance for person-centred assessment and pathways in primary care. 2nd ed. Geneva: World Health Organization; 2025.
Volkert D, Beck AM, Cederholm T, et al. ESPEN practical guideline: Clinical nutrition and hydration in geriatrics. Clinical Nutrition. 2022;41(4):958–989.
Cederholm T, Jensen GL, Correia MITD, et al. The GLIM consensus approach to diagnosis of malnutrition: a 5-year update. Clinical Nutrition. 2025;49:11–20.
Evans DC, Corkins MR, Malone A, et al. The Use of Visceral Proteins as Nutrition Markers: An ASPEN Position Paper. Nutrition in Clinical Practice. 2021;36(1):22–28.
Prime Minister of Viet Nam. Decision No. 02/QĐ-TTg approving the National Nutrition Strategy for 2021–2030, with a vision to 2045. 5 January 2022.
Prime Minister of Viet Nam. Decision No. 383/QĐ-TTg approving the National Strategy on Older Persons to 2035, with a vision to 2045. 21 February 2025.
Ministry of Health of Viet Nam. Consolidated Document No. 16/VBHN-BYT: Regulations on nutrition activities in hospitals. 9 December 2025.
Prime Minister of Viet Nam. Decision No. 1116/QĐ-TTg amending Decision No. 1579/QĐ-TTg approving the Older People Health Care Program to 2030. 22 June 2026.
Ministry of Health of Viet Nam. Decision No. 1976/QĐ-BYT issuing professional guidance on care for older people at home and in the community. 1 July 2026.
Ministry of Health of Viet Nam. Circular No. 34/2026/TT-BYT guiding selected implementation activities of the National Target Program on Health, Population and Development 2026–2035, Phase I: 2026–2030. 8 September 2026.
Ministry of Labour, Invalids and Social Affairs of Viet Nam. Circular No. 33/2017/TT-BLĐTBXH on organizational structure, staffing norms, processes and standards for social assistance establishments. 29 December 2017. Partly in force.
Ministry of Labour, Invalids and Social Affairs of Viet Nam. Circular No. 02/2020/TT-BLĐTBXH guiding the management of people receiving social-work services from social assistance establishments. 14 February 2020.
Luong TCN, Vo LQN, Nguyen NHMT, Than HNT. Prevalence of malnutrition and its associated factors among elderly outpatients at a geriatrics clinic. Vietnam Medical Journal. 2025;554(1).
Pham TH, Nguyen DH, Nguyen TD, Pham VP. Nutritional status of older people and associated factors at the Geriatric Outpatient Clinic of E Hospital in 2024. Vietnam Journal of Community Medicine. 2026;66(Special Issue 15).
Le Thi Thanh X, Duong Thi P, Le Thi H, et al. Validity of NRS-2002, MUST, MST, and MNA-SF as first-step screening tools for malnutrition based on GLIM criteria in older adults. Clinical Nutrition Open Science. 2025;63:99–112.
Lan TTP, Phu PV, Huong LT, Xuan Hung L, Dung NQ. Nutritional intake, biochemical profiles, and functional outcomes in elderly inpatients: a hospital-based cross-sectional study in Vietnam. PLOS Global Public Health. 2026;6(7):e0006803.
da Silva JSV, Seres DS, Sabino K, et al. ASPEN Consensus Recommendations for Refeeding Syndrome. Nutrition in Clinical Practice. 2020;35(2):178–195.
Matthews-Rensch K, Blackwood K, Lawlis D, et al. The Australasian Society of Parenteral and Enteral Nutrition: Consensus statements on refeeding syndrome. Nutrition & Dietetics. 2025;82(2):128–142.