To the Editor:

We are writing in response to the article titled ‘Overall Mortality for Community-Dwelling Adults Over 50 Years at Risk of Malnutrition’ [1]. This study highlights the significant association between malnutrition risk and overall mortality, underscoring the importance of broader nutritional screening at the community level. We commend the authors for their valuable contribution and would like to offer a few suggestions for consideration.

First, the study's sample is primarily drawn from the UK, lacking direct comparisons with other countries or regions. As a result, the findings may not be generalizable to older adults in different cultural contexts or healthcare systems, pointing to a clear geographical limitation.

Second, while the study performed subgroup analyses on cancer patients and gender, future research could benefit from further stratification by age groups, socioeconomic status, dietary habits and psychological health [2-4]. Such analyses would provide more precise insights and help tailor more targeted and personalized intervention strategies.

Third, the study relies not only on weight change but also on other self-reported data, which may be subject to recall bias or social desirability bias, potentially skewing the results. Future research could enhance accuracy by incorporating objective measures such as blood pressure, blood glucose levels, cholesterol levels and body fat percentage, thereby reducing potential errors.

This study effectively raises awareness of the prevalence and significant impact of malnutrition on the health of middle-aged and older adults. As healthcare professionals, we advocate for the early identification of malnutrition risk through enhanced nutritional screening and assessment. By collaborating across disciplines with dietitians, physicians, psychologists and social workers, we can develop and implement comprehensive nutritional management plans [5].

In conclusion, we greatly appreciate the insights this study provides into the relationship between malnutrition risk and mortality. Building on this research, we can formulate more targeted nutritional management strategies that improve individual health, extend life expectancy and reduce the burden on healthcare systems.

 致编辑：

我们写这篇文章是为了回应题为“50 岁以上有营养不良风险的社区居住成年人的总体死亡率”的文章 [1]。这项研究强调了营养不良风险与总体死亡率之间的显著关联，强调了在社区层面进行更广泛的营养筛查的重要性。我们赞扬作者的宝贵贡献，并想提供一些建议供考虑。

首先，该研究的样本主要来自英国，缺乏与其他国家或地区的直接比较。因此，这些发现可能无法推广到不同文化背景或医疗保健系统中的老年人，这表明存在明显的地理限制。

其次，虽然该研究对癌症患者和性别进行了亚组分析，但未来的研究可能受益于按年龄组、社会经济地位、饮食习惯和心理健康的进一步分层 [2-4]。此类分析将提供更精确的见解，并有助于定制更具针对性和个性化的干预策略。

第三，该研究不仅依赖于体重变化，还依赖于其他自我报告的数据，这些数据可能会受到回忆偏差或社会期望偏差的影响，从而可能扭曲结果。未来的研究可以通过结合客观测量方法（如血压、血糖水平、胆固醇水平和体脂百分比）来提高准确性，从而减少潜在的错误。

这项研究有效地提高了人们对营养不良的患病率和对中老年人健康的重大影响的认识。作为医疗保健专业人员，我们倡导通过加强营养筛查和评估来及早识别营养不良风险。通过与营养师、医生、心理学家和社会工作者进行跨学科合作，我们可以制定和实施全面的营养管理计划 [5]。

总之，我们非常感谢这项研究对营养不良风险与死亡率之间关系提供的见解。在这项研究的基础上，我们可以制定更有针对性的营养管理策略，以改善个人健康、延长预期寿命并减轻医疗保健系统的负担。