Heart failure (HF) has a high prevalence worldwide, that increases with age [1], and a natural history characterized, beside hospitalizations [3] and death, also by a progressive functional decline [2] and disability [3,4], that severely influence quality of life [5] and clinical outcomes [6,7]. Malnutrition is a common feature of this disease, especially in advanced stages: its prevalence ranges from 16% to 62.4% in stable HF [8] and increases up to 80% in advanced HF [9]. This large range of prevalence estimates may be related to different nutritional screening tools used and to the different mean age of the study participants: older adults affected by HF are at higher risk of malnutrition compared to younger people because to the HF-related mechanisms, such as low nutritional intake due to intestinal edema and anorexia [10], liver disfunction [11], and cytokine-induced hyper-catabolism [12], add up age-related factors, such as comorbidities, polytherapy, and social factors.
