Abstract
Objectives: Severe protein energy malnutrition results in muscle wasting and loss of subcutaneous tissue and has serious implications for health, recovery from illness or surgery, and hospital costs; however this condition is often underestimated and considered as one of the aspects of aging. We measure the incidence of malnutrition and its consequences on general health, physical and mental performance in a cohort of elderly patients. Study Design: This is a cross-sectional study conducted in a geriatric inpatient unit. Three hundred patients admitted to the clinic who fulfilled the inclusion criteria were enrolled. Main Outcome Measures: Nutritional status was evaluated by Mini Nutritional Assessment (MNA) questionnaire, macro and micronutrients intake, anthropometric measures and biochemical parameters. Physical and mental performances were recorded by questionnaires. Muscular strength was measured by a hand dynamometer and clinical outcomes were recorded. Results: Patients with poor nutritional status have lower physical and mental performance as respect to well nourished patients. Undernourished patients have longer hospitalization and worst outcomes. We observe a high prevalence of severe hypovitaminosis D and the intake of various micronutrients was severely unbalanced. The incidence of malnutrition was 25% (75 patients); 39% (119 patients) were at risk of malnutrition. MNA was inversely related with the length of hospital stay (R = -0.25, p = 0.012) and with Geriatric Depression Scale (GDS) (R = -0.56, p = 0.000), whereas directly related with cognitive performance measured through Mini Mental State Examination (MMSE) (R = 0.5, p = 0.000) and hand grip strength (R = 0.35, p = 0.000). Conclusions: Malnutrition significantly reduced quality of life, physical and mental performance and worsened patients’ prognosis.
Highlights
Malnutrition is a disorder of nutritional status due to reduced nutrient intake or impaired metabolism; it comprises a broad spectrum of clinical conditions from mild to very severe [1]
The incidence of malnutrition according to Mini Nutritional Assessment (MNA) was 25% (75 patients), 39% (119 patients) were at risk of malnutrition, whereas 36% (106 patients) did not have nutritional problems
Malnourished patients were older, more likely women, had a lower Body mass index (BMI), and lower body fat percentage, worst nutritional index, as shown in Table 1; these data confirm the good ability of MNA to detect malnutrition as previously demonstrated [18]
Summary
Malnutrition is a disorder of nutritional status due to reduced nutrient intake or impaired metabolism; it comprises a broad spectrum of clinical conditions from mild to very severe [1]. Malnutrition has been frequently described among the elderly in hospital patients [1]-[3]; this condition is often underestimated and considered as one of the aspects of aging. Vitamin D deficiency is attributable to lifestyle: outdoor activities and sun exposition that are generally reduced in the elderly population, vitamin D cutaneous synthesis is reduced by aging [12]. These peculiar dietary deficiencies are implied in the reduction of muscular strength [13] [14], increased risk of fractures [1] [15] [16] and chronic anaemia that often present together in the frail elderly
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