Abstract
Objectives To determine the optimal cut-off points of handgrip strength (HGS) to identify the undernutrition risk among individuals older than 65 years of age in Bosnia and Herzegovina. Design Cross-sectional study. Setting Towns of Sarajevo, Foca, Rogatica, and Pale in Bosnia and Herzegovina. Participants 300 community-dwelling older adults and 146 nursing home residents. Comprehensive Geriatric multidimensional assessment (CGA) was carried out to evaluate general health, functional, and cognitive capabilities. Nutritional status and undernutrition risk were assessed by Mini Nutritional Assessment (MNA) and Seniors in the Community: risk evaluation for eating and nutrition, version II (SCREEN II). HGS was measured with a Smedley dynamometer. Results According to the classification of nutritional status by MNA, 42% of community-dwelling men and 39% of community-dwelling women were at undernutrition risk. The undernutrition risk was significantly higher among nursing home residing men (89%) and women (78%) (p < 0.001). When nutritional status was assessed by SCREEN II, 100% on nursing home residents, 86% of community-dwelling men and 80% of women were identified as having a high risk for undernutrition. Per MNA, HGS cut-off thresholds were 23.50 kgF (65–74 years) and 19.50 kgF (≥75 years) for men; 15.50 kgF (65–74 years) and 13.50 kgF (≥75 years) for women. Per SCREEN II, cut-points were 28.50 kgF (65–74 years) and 24.50 kgF (≥75 years) for men; 24.50 kgF (65–74 years), 19.50 kgF (≥75 years for women). Conclusion HGS can be a useful instrument to identify undernutrition risk among the elderly patients. This study provides threshold for men and women older than 65 years of age in Bosnia and Herzegovina.
Highlights
Undernutrition among the elderly population is a prevalent public health problem that may lead to the progression of underlying chronic diseases and the development of acute conditions [1]
According to the classification of nutritional status by Mini Nutritional Assessment (MNA), 42% of community-dwelling men and 39% of community-dwelling women were at undernutrition risk. e undernutrition risk was significantly higher among nursing home residing men (89%) and women (78%) (p < 0.001)
When nutritional status was assessed by SCREEN II, 100% on nursing home residents, 86% of community-dwelling men and 80% of women were identified as having a high risk for undernutrition
Summary
Undernutrition among the elderly population is a prevalent public health problem that may lead to the progression of underlying chronic diseases and the development of acute conditions (dehydration, infection, and delirium) [1]. Erefore, routine assessment of undernutrition risk is highly recommended in medical practice; once a year, for community-dwelling older people and at intervals, or 1–3 months for elderly inpatients [3,4,5]. E administration of a short nutrition screening instrument during the medical encounter was identified as the facilitator of nutritional status screening uptake [7] Anthropometric parameters, such as body mass index (BMI) and circumferences, have been used widely as standard indicators of nutritional status, they often mask sarcopenia or other weight changes needed to evaluate undernutrition risk [8]. According to the meta-analysis of normative data, HGS values of 16 kgF for women and 27 kgF for men could be accepted as cut-off point for undernutrition risk across Europe, Canada, United States, Australia, and Japan [14]. HGS cut-off points for the undernutrition risk have not been described so far for the Bosnian population
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