Malnutrition In Elderly Research Articles

IJCM_6A: Prevalence of Malnutrition and its associated factors among elderly population in rural field practice area of Madras Medical College- A Cross-Sectional Study

Background: In India the elderly population (>60years) is on a raising trend has more than tripled in last 50 years and the projections for 2031 is 178.59 million of total population. As the health of the elderly will be an important issue defining the health of the whole population, hence elderly malnutrition is on focus. Objectives: To estimate the prevalence of malnutrition and factors associated with malnutrition among elderly population in rural field practice area of Madras Medical College. Methodology: This cross-sectional study was conducted from October to November-2023 among 480 elderly participants selected by simple random sampling in Medavakkam area. This study was done by using an interviewer administered semi-structured questionnaire that includes socio-demographic details and Mini Nutritional Assessment Questionnaire. Body Mass Index used to identify Obesity based on Asia Pacific BMI guidelines. Data was entered in MS-Excel and analysed using SPSS v16. Results: Among 480 participants,79.8% were in the age group of 60-70years,18.1% and 2.1% were in the age group of 71-80years and >80years respectively. Among them 53.1%were male. The prevalence of malnutrition and at risk of malnutrition were 7.7%(95%CI:5.5-10.5) and 39%(95%CI:34.6- 43.5) respectively which was assessed using MNA-questionnaire. Prevalence of obesity was 45.8%(95%CI:41.3-50.4) based on Asia-Pacific BMI guidelines. A significant association was found between malnutrition and older age groups, female gender, no formal education, kutcha house, widowed, unemployed and dependent financial status. Conclusion: According to this study, prevalence of malnutrition and at risk of malnutrition were lesser than previous studies done in rural South India, but the prevalence of Obesity found to be high (45.8%). Both undernutrition and over-nutrition are important health issues to be considered in elderly population. These problems can be solved through community level nutrition status screening of elderly and health education to the elderly and their families regarding balanced dietary practices and lifestyle modification, thereby enhancing their nutritional status and their quality of life.

Recognizing and Predicting the Risk of Malnutrition in the Elderly Using Artificial Intelligence: A Systematic Review

The global population is aging at an alarming rate, endangering conventional care models that have always relied on in-person supervision. Elderly malnutrition has been found to be a serious health problem associated with health deterioration, which has several, immediate effects on everyday activities and standard of living. Deficiency in nutrients is a frequent and serious concern in older adults and might have an impact on the emergence of geriatric diseases. The two most obvious indicators of malnutrition in the elderly include unintentional weight loss and a lower value of the body mass index (BMI). However, non-symptomatic or unnoticed insufficiencies, such as lower than expected level of different crucial micronutrients, which are quite challenging to diagnose and are typically disregarded among older residents of their communities. Artificial intelligence (AI) permeates every aspect of human existence. The current systematic review looks at how AI-based technology is currently being used and how it affects elderly malnutrition. Using the following keywords, computerized literature searches of many reliable data bases were used to compile relevant published articles: malnutrition, artificial intelligence (AI), machine learning (ML), elderly nutrition, risk factors of malnutrition among the elderly, chronic diseases, elderly. Prospective studies with original data were chosen, and their significant findings were integrated into the analysis of the state of malnutrition at the moment. In conclusion, it is challenging to deploy AI-based food and nutrient intake monitoring data because no single program is suitable for all international cuisines and eating customs. Geographic variations in the dietary habits of the population make it challenging to compile the necessary data sets for deep learning. Furthermore, even within a same region, hospital menus differ from patient to patient. It is suggested that meals served in hospitals under the same management be standardized to facilitate the procedure.

The Relationship Between Salivary Flow Rate and Malnutrition in Elderly

Purpose: This study aimed to evaluate the relationship between salivary flow rate (SFR) and nutritional status of elderly.Materials and methods: The study included 63 elderly people (20 males, 43 females, age: 70.83±6.42 years) who applied to the dentist's office. The data were collected by face-to-face interview method and sociodemographic characteristics, information on employment status and lifestyle habits of the participants were recorded in the questionnaire. To determine nutritional status, 3-day food consumption records were taken, Mini Nutritional Assessment Test (MNA) was applied and anthropometric parameters were measured. The carious teeth (DMFT) index and oral health impact scale (OHIP-14) were used to assess oral health, and unstimulated SFR was measured.
 Results: According to MNA, 23.8% of the elderly were malnourished or at risk of malnutrition. The mean SFR of the elderly was 0.40±0.31 ml/min and 15.9% of them had low SFR. The mean SFR of the elderly with normal body weight was higher than that of the obese (p

Prevalence of Malnutrition among Hospitalized Elderly Patients in Hospitals Affiliated to Tehran University of Medical Sciences, Tehran, Iran

Background: Following the improvement in health status and life expectancy in developing countries, the elderly population is increasing. Elderly malnutrition is common across healthcare services and is associated with high costs and adverse outcomes. This study assesses the prevalence of malnutrition among elderly patients in the selected hospitals affiliated to Tehran University of Medical Sciences. Methods: This cross-sectional study was conducted on elderly patients aged 65 years or older in 6 selected hospitals between June and September 2015. Using convenience sampling method, a total of 451 patients were included. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) tool. Results: The mean age of the patients was 71.49 ± 6.60 year and 55.5% were female. The prevalence of malnutrition was 27.3%. A total of 30.8% were at risk of malnutrition, and 41.9% had a normal nutritional status. There were significant associations between nutritional status and chronic diseases, body mass index (BMI), mobility, psychological condition, mid-arm circumference (MAC), calf circumference, and more than three prescription drugs per day (P < 0.001). Conclusion: A satisfactory nutritional status was found among most hospitalized elderly. Future studies with follow-up during and after hospitalization are required.

Malnutrition in Elderly - A Predictor of Cognitive, Functional Decline, Depression and Prolonged Hospital Stay

Malnutrition in the elderly has been associated with deleterious effects on health care outcomes such as functional decline, cognitive impairment, depression, increased hospital stays, and increased morbidity and mortality. This cross-sectional study aims to determine the association of malnutrition with functional status and cognition and duration of hospitalization among 200 elderly patients admitted to medical wards of a tertiary care hospital in India. The nutritional screening was done using Mini Nutritional assessment- short form (MNA-SF). The functional activity was assessed using the Barthel’s Index. Cognitive assessment and screening for depression was done using the Mini-cog test and Geriatric Depression score – 4 respectively. Descriptive analyses were used to estimate the prevalence of malnutrition and associations were assessed using the Pearson chi square test. Among the total patients, 136 (68%) were malnourished. Of these, 45 (22.5%) were severely undernourished. The malnourished patients had poorer functional scores (p<0.001), were likely to be cognitively impaired (33%, 45 of 136) (p < 0.001) and stayed longer in the hospital (n= 9.13 days) compared to the normally nourished. The nutritional status of hospitalized elderly may therefore serve as a surrogate marker of disability and poor clinical outcome. Keywords: Malnutrition, Geriatric, Nutritional assessment, Undernourishment, Functional decline, Elderly

Management of Malnutrition Based on Multidisciplinary Team Decision-Making in Chinese Older Adults (3M Study): A Prospective, Multicenter, Randomized, Controlled Study Protocol.

BackgroundIn hospital settings, malnutrition affects 30–50% of aged inpatients and is related to a higher risk of hospital complications and death. This study aims to demonstrate the effectiveness of a tailored optimum nutritional therapy in malnourished, elderly inpatients based on multidisciplinary team recommendations in hopes of decreasing the incidence of deleterious clinical outcomes.Methods and DesignThis trial will be a multicenter, open-label, randomized control trial conducted in the geriatric wards of at least five hospitals in five different regions. We aim to include 500 inpatients over the age of 60 with or at risk of malnutrition based on a Mini Nutritional Assessment Short-Form (MNA-SF) score of ≤ 11 points and the Global Leadership Initiative on Malnutrition with an expected length of stay of ≥ 7 days. Eligible inpatients will be randomized into a 1:1 ratio, with one receiving a multidisciplinary team intervention and the other receiving standard medical treatment or care alone. A structured comprehensive assessment of anthropometry, nutritional status, cognition, mood, functional performance, and quality of life will be conducted twice. These assessments will take place on the day of group allocation and 1 year after discharge, and a structured screening assessment for elderly malnutrition will be conducted at 3 and 6 months after discharge using the MNA-SF. The primary outcome will be nutritional status based on changes in MNA-SF scores at 3, 6 months, and 1 year. The secondary outcome will be changes in cognition, mood, functional status, length of hospital stay, and all-cause mortality 1 year after discharge.DiscussionGuided by the concept of interdisciplinary cooperation, this study will establish a multidisciplinary nutrition support team that will develop an innovative intervention strategy that integrates nutritional screenings, evaluations, education, consultation, support, and monitoring. Moreover, nutritional intervention and dietary fortification will be provided to hospitalized elderly patients with or at risk of malnutrition. The nutrition support team will formulate a clinical map for malnutrition in elderly patients with standardized diagnosis and treatment for malnutrition in this population.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [ChiCTR2200055331].

An introduction to the Food-Based Dietary Guidelines for the Elderly in South Africa

Food-based dietary guidelines (FBDGs) are not a new concept and are being used in many countries to promote healthy eating and the prevention of diet-related chronic diseases. The Food and Agriculture Organization (FAO) recommended FBDGs as an approach to prevent malnutrition and promote healthy dietary behaviours in populations, taking into consideration local conditions, traditional dietary practices and socioeconomic and cultural factors whilst at the same time using evidence-based scientific principles. South Africa (SA) currently has two sets of guidelines, namely the paediatric food-based dietary guidelines and the South African FBDGs for the population aged seven years and older. The recognition that elderly malnutrition remains a major public health concern in SA led to the formulation of a specific set of guidelines for this vulnerable population group based on existing nutrition-related health issues, local dietary habits and barriers to food intake experienced by those aged 60 and above. This introductory paper on the development of the elderly food-based dietary guidelines (EFBDGs) will be followed by six technical papers motivating why these guidelines are suited to address nutrition-related issues among the elderly in SA.

Elderly malnutrition: brachial and leg perimeter as indicators of early intervention

Abstract Background The aged population are often malnourished especially if they live in a Nursing Home (NH) due to their health status, depression and environmental factors. An early and accurate diagnosis of malnutrition is essential so the nutritional therapy can be started as soon as possible. The aim is to study the relationship between the degree of malnutrition in aged population living in two NH and anthropometric measures like brachial perimeter (BP) and leg (PP). Methods Were included elderly people aged ≥65 years. The nutritional assessment status was through the application of the Mini Nutritional Assessment (MNA). Data analysis was performed using the IBM SPSS software with a descriptive and inferential analysis. The level of critical significance chosen was 5%. Results 83 seniors of both genders (78.3% female) were evaluated with a middle age of 83.4 ± 7.9 years. The application of MNA revealed that 33.7% of the seniors are in malnutrition risk and 43.4% malnourished. Older elderly people (P = 0.03) with less mobility (r = -0.722; P < 0.001) and bigger food dependency (r = -0.674; P < 0.001) have a higher risk of malnutrition. Individuals with lower BP (P = 0.024) and PP (P < 0.001) are more likely to be malnourished or at risk of malnutrition, and those who are more dependent on food, a lower PP (P < 0.001). Conclusions In the impossibility of applying MNA, BP and PP can be measured in the admission of the user, as determining factors of malnutrition, for an earlier intervention, despite the fact that the nutritionist’s presence in these institutions is crucial

Nutritional status in the elderly with fragility syndrome

During the twentieth century life expectancy has increased significantly and it was estimated that by 2030, 21% of the world’s population will be >65 years. According to observations, fragility syndrome and nutritional status problems are very common among the elderly population, especially in old age. Fragility syndrome has a multifactorial origin and is a fundamental risk factor for deteriorating health and the installation of disability in the elderly. The purpose of the study was to establish the interrelationship of nutritional status with fragility syndrome and the impact on the functionality of the elderly. The information was searched in the PubMed, Hinari, Cochrane, Elsevier, Springer databases, including the offi cial pages of the European Geriatric Society, European Society for Clinical Nutrition and Metabolism, to identify scientifi c journals dedicated to nutrition in the elderly with fragility syndrome. Studies published in the period 2010-2020, in romanian and english, were selected. Th e specialized literature, scientifi c journals, clinical studies were researched, from which the most relevant 34 were selected. Elderly malnutrition is currently a global problem, its prevalence in people is 10-40%. Th e diagnosis of malnutrition aims to identify it and elucidate the causes. Weight loss is a criterion of the development of fragility, and nutrition-focused interventions can prevent the progression of fragility syndrome and loss of autonomy with the onset of dependence. Fragility is a geriatric syndrome that aff ects several areas of physical status, and malnutrition is one of the risk factors for this syndrome.

Malnutrition assessed by mini nutritional assessment tool among Indian elderly: a systematic review and meta-analysis

Overall health and nutritional status of elderly population of India is not satisfactory. Therefore, present systematic review was conducted to determine the overall occurrence of malnutrition of Indian elderly and furthermore attempted to find out the underlying causes of malnutrition. Present review considered published article reported malnutrition of elderly as assessed by mini nutritional assessment (MNA) tool. Thus, literature searching, screening and data synthesis was made and recorded following preferred reporting items for systematic reviews and meta-analyses (PRISMA) protocol. All published literature looked through utilizing the accompanying keywords. The MedCalc software was applied to estimate the overall prevalence of malnutrition by using meta-analysis statistical method. Thirty of 147 articles were included in this analysis. Overall mean MNA scores was 19.47±4.17. Study found overall prevalence of malnutrition among elderly was 17.93% (95% CI: 14.23-21.84). The prevalence of malnutrition was significantly higher in rural elderly (21.67%, 95% CI: 16.44-27.40) than urban (14.23%, 95% CI: 10.02-19.05) elderly of India. Rural elderly more likely to be 1.8 (OR: 1.76; CI: 1.56-1.99) times greater chance to be developed malnutrition than the urban elderly. Moreover, present study estimated that about 18.6 million Indian elderly population was malnourished and expected to be 22 million by 2021 due to elderly population growth, morbidity, poverty and joblessness by COVID-19 pandemic. Given the expansion of elderly malnutrition in future, there is felt need a special nutrition intervention programme for the rural elderly population. Thus, a dedicated geriatric friendly nutrition rehabilitation center (GFNRC) may be setup at every community development block of India.

MON-PO486: The 10-Point Verbal and Visual Analogue Scales Fail to Assess Dietary Intakes and Malnutrition in Elderly Hospitalized in Acute Geriatrics Unit

MON-PO486: The 10-Point Verbal and Visual Analogue Scales Fail to Assess Dietary Intakes and Malnutrition in Elderly Hospitalized in Acute Geriatrics Unit

Physiological Determinants of Malnutrition in Elderly

Old age is associated with many changes, viz., physical, psychological, social and economic and age of 75 years or above is considered as autonomous risk factor for poor nutritional and health status. Body composition changes with ageing, fat mass and visceral fat increases, while lean muscle mass decreases. Physical activity goes down, and so does the bone mineral density. The age-related changes affect the food intake and nutritional status of older persons. Consequently, the elderly suffers from malnutrition, which along with co morbidities become life threatening issues. Inadequate nutrient intake and associated consequences in elderly can be effectively counteracted on having thorough understanding of the causes of malnutrition. Poor nutritional status has a multifactorial aetiology. This review examines the physiological risk factors responsible for malnutrition in the older adults. These include poor appetite, cachexia, oral health, micronutrient deficiencies and acute and chronic infections.

Risk factors for dietary deficiency and their probable role in elderly morbidities: a cross sectional study among elderly residing in rural field practice areas of S.N. Medical College, Bagalkot, North Karnataka

Background:Nutrition is an important element of health, among the elderly. They are prone for dietary deficiencies and thus suffer from a plethora of nutritional deficiency disorders due to various factors, prevalent from region to region. Estimating the risk factors for nutritional deficiencies, dietary patterns and their role in elderly morbidities is of utmost importance. Methods:140 Elderly, with the help from their caregivers, were screened for nutritional deficiencies by a detailed general physical examination and for signs of nutritional deficiencies namely: water soluble B-complex vitamins. Elderly were examined for the anthropometric measurements like height, weight, BMI, mid arm circumference, calf circumference and nutritional deficiency disorders. Elderly malnutrition was assessed using mini nutritional assessment (MNA)scale score, body mass index (BMI)and weight loss >10% of body weight. Results:Of the total elderly, 45 (32.1%) of elderly are underweight and 42 (30.0%) of elderly were obese. 63 (45%) each, had a waist hip ratio value of >0.95 in men and >0.85 in women. 69 (49.3%) of the elderly were having a Mid-arm circumference of <24 centimeters. 1 (43.6 %) elderly, was having 12-14 points (normal nutritional status) 76 (54.3 %) had a score of 8-11 points i.e. at risk of Malnutrition 03 (2.1%) had a score between 0-7 patients were malnourished. Conclusions: Dietary patterns of the elderly decreases with age and is affected by multiple determinants like psychosocial stress, dementia, delirium, poor economic status, poor dentition, chronic debilitating illnesses, smoking and alcohol, which play a vital role in elderly malnutrition.

Quality of life, functional impairment and social factors as determinants of nutritional status in older adults: The VERISAÚDE study

Malnutrition is an important and growing health problem in elderly people. The main aim of this research was to examine the relationship between socio-demographic factors, social resources, functional status and quality of life and malnutrition or risk of malnutrition in elders. A cross-sectional study was conducted with a representative sample of 749 community-dwelling elders aged 65 years and over. A comprehensive assessment was carried out, including the collection of socio-demographic factors, social resources by the Older Americans Resources and Services Scale, nutritional status by the Mini-Nutritional Assessment-Short Form, functional status by the Lawton's instrumental activities of daily living scale and quality of life by the World Health Organizations's Quality of Life measure-brief version (WHOQOL-BREF). Being female, the presence of totally impaired social resources and low scores in the physical health domain of the WHOQOL-BREF were the strongest determinants of malnutrition/risk of malnutrition. This model predicted 85.7% of the cases correctly. In men, the best determinants were being unmarried and having poor satisfaction with their health, with a percentage of 89.8% of cases of poor nutritional status correctly predicted. The best determinant for women was also the physical health domain of the WHOQOL-BREF, reaching a correct prediction of 83.0% of malnutrition/risk of it. Nutritional status assessment and potential determinant factors should be incorporated as part of comprehensive assessments for early identification of malnutrition and to determine appropriate intervention strategies to address this public health problem in older adults.

Oral Health Indicators for Risk of Malnutrition in Elders.

Using both clinical parameters and subjective measures of oral health, this study aimed to identify useful oral health indicators for the risk of malnutrition in elders. Cross-sectional study. Five community centers run by non-government organizations (NGOs). 195 community dwelling elders (65 or above). An interviewer-administered questionnaire was completed to collect information on elders' socio-demographic background and oral health perception and practice. Their number of teeth, number of occluding tooth pairs, dental caries, and periodontal condition were examined. General Oral Health Assessment Index (GOHAI), an instrument for assessing oral health related quality of life (OHQoL), was used as a subjective measure of oral health. The elders' nutritional status was evaluated by using the Mini-Nutritional Assessment (MNA). The mean (SD) DFT was 3.3 (3.1). Over 60% of elders had periodontal pockets; 33% had fewer than 20 teeth and 6% were edentulous. The mean (SD) of occluding tooth pairs was 7.1 (4.8). The mean (SD) total GOHAI score was 56.4 (8.0); 60% reported negative impact of oral health on their quality of life. The mean (SD) MNA score was 25.0 (2.9); 30% had malnutrition or were at risk. After controlling for socio-demographic factors, none of the clinical indicators (dental caries, periodontal status, number of teeth, and number of occluding tooth pairs) were associated with risk of malnutrition (all p>0.05). Poorer OHQoL indicated a higher chance for malnutrition in both adjusted models (OR of 0.914; 95% CI of 0.850-0.982; p=0.014 and OR of 0.915; 95% CI of 0.852-0.984; p=0.017). Tooth loss and untreated decayed teeth (DT) were significant/marginally significant determinants of poor OHQoL. Elders' tooth loss and unmet treatment need for dental caries were associated with compromised quality of life, which indicated increased likelihood for malnutrition.

SUN-PP095: Systemic Muscle Dysfunction in Chronic Heart Failure Is Associated with Enhanced Myofibrillar Protein Breakdown but Preserved Muscle Mass

to analyze body mass index (BMI) with nutritional and body composition parameters in institutionalized older people. Methods: Cross-sectional study in 104 normal-weight older people (73% female, mean of: age 86.4±6.2 years, time on institutionalization 25.7±21.7 months). Nutritional assessment by Mini-Nutritional Assessment, anthropometric measures and biochemical parameters. Body composition analysis measured bioelectrical impendance (BIVA-RJL System). Sample was classified into BMI tertiles (Tn): T1:26.2; T2: 26.3 29.7, y T3: 29.8 kg/m2. Statistical analysis by SPSS v. 19. Results: Mean of BMI 28.4±4.6 and obesity 31.7%. Prevalence of nutritional risk or malnutrition was 60.6 and 11.5%, respectively. BMI showed significant differences into tertiles with: mid-arm muscle circumference, triceps-skinfold thickness, total body water (all, P< 0.001). Comparison between BMI tertiles (T1 vs. T2 and T3) and nutritional status showed that subjects into T1 had significantly higher nutritional risk or malnutrition (Mean BMI T1 vs. T2 and T3: 23.7 vs. 27.7 and 33.7). Linear regression analysis showed significant relation between BMI and waist circumference, calf-circumference (both, p < 0.01) and inverse with total body water (p < 0.001) (R = 0.71). Conclusion: The current classification of BMI should be evaluated in older people. Overweight and obesity measured by BMI is not an exclusion criteria of nutritional risk or malnutrition in elders. Further longitudinal analyses are required to define cut-off points of BMI in elderly population.

Milk-soluble formula increases food intake and reduces Il6 expression in elderly rat hypothalami.

Malnutrition in the elderly is accompanied by several metabolic dysfunctions, especially alterations in energy homeostasis regulation and a loss of insulin responsiveness. Nutritional recommendations aim to enrich food with high protein and energy supplements, and protein composition and lipid quality have been widely studied. Despite the numerous studies that have examined attempts to overcome malnutrition in the elderly through such nutritional supplementation, it is still necessary to study the effects of a combination of protein, lipids, and vitamin D (VitD). This can be done in animal models of elderly malnutrition. In the present study, we investigated the effects of several diet formulae on insulin responsiveness, inflammation, and the hypothalamic expression of key genes that are involved in energy homeostasis control. To mimic elderly malnutrition in humans, elderly Wistar rats were food restricted (R, -50%) for 12 weeks and then refed for 4 weeks with one of four different isocaloric diets: a control diet; a diet where milk soluble protein (MSP) replaced casein; a blend of milk fat, rapeseed, and DHA (MRD); or a full formula (FF) diet that combined MSP and a blend of MRD (FF). All of the refeeding diets contained VitD. We concluded that: (i) food restriction led to the upregulation of insulin receptor in liver and adipose tissue accompanied by increased Tnfα in the hypothalamus; (ii) in all of the refed groups, refeeding led to similar body weight gain during the refeeding period; and (iii) refeeding with MSP and MRD diets induced higher food intake on the fourth week of refeeding, and this increase was associated with reduced hypothalamic interleukin 6 expression.

Malnutrition in Community-Dwelling Elderly in Turkey: A Multicenter, Cross-Sectional Study.

BackgroundThis study aimed to investigate the prevalence of malnutrition and explore the somatic, psychological, functional, and social or lifestyle characteristics linked to malnutrition in elderly people at a hospital in Turkey.Material/MethodsThis study included 1030 patients older than 65 years of age who were seen at the internal medicine and geriatrics outpatient clinics of the study centers in Istanbul, Ankara, Duzce, Corum, Mardin, Malatya, and Diyarbakir provinces between January and December 2014. All patients underwent Mini Nutritional Assessment (MNA) and Geriatric Depression Scale (GDS) tests via one-on-one interview method. The demographic properties of the patients were also recorded during this interview.ResultsAmong 1030 patients included in this study, 196 (19%) had malnutrition and 300 (29.1%) had malnutrition risk. The malnutrition group and the other groups were significantly different with respect to mean GDS score, income status, educational status, the number of children, functional status (ADL, IADL), the number of patients with depression, and the number of comorbid disorders. According to the results of the logistic regression analysis, age (OR=95% CI: 1.007–1.056; p=0.012), BMI (OR=95% CI: 0.702–0.796; p<0.001), educational status (OR=95% CI: 0.359–0.897; p=0.015), comorbidity (OR=95% CI: 2.296–5.448; p<0.001), and depression score (OR=95% CI: 1.104–3.051; p=0.02) were independently associated with malnutrition.ConclusionsOur study demonstrates that age, depression, BMI, comorbidity, and the educational status were independently associated with malnutrition in an elderly population.

Short form of the mini nutritional assessment is a better proxy for nutritional status in elderly than the body mass index: cross-sectional study

Background: Malnutrition increases with age, but elderly nutritional status is difficult to ascertain and may be region-specific. The objective of this study was to define the cut-off value for body mass index (BMI) indicative of malnutrition in the elderly Croatian population. Methods: This was a cross-sectional study of the multicenter, randomized controlled trial conducted in 59 Croatian general practices between May 2008 - August 2010 (Cardiovascular Risk and Intervention Study in Croatia [CRISIC-fm], trial Registration Code: ISRCTN31857696). A total of 738 participants aged ≥ 65 were surveyed using a CRISIC-fm questionnaire, including the Mini Nutritional Assessment-Short Form (MNA-SF) scale and body weight and height. The association between BMI and MNA-SF was tested using the chi-squared test and contingency coefficient. Receiver Operating Characteristic Curve (ROC) analysis was used to assess predictive value of BMI for malnutrition in relation to MNA-SF and ROC curve to determine the best cut-off value of BMI relative to the MNA-SF. Results: Twelve (2.4%) participants were “at risk of malnutrition” by the MNA-SF. ROC curve indicated that a BMI threshold as high as 26.5 kg/m 2 is needed to identify 66% of these “at risk for malnutrition” elderly according to the MNA-SF (area under the curve [AUC]: 0.80, P<0.001). A BMI cut-off value of 24.5 kg/m 2 has a sensitivity of 50% and a specificity of 86%. Conclusions: Higher BMI values, up to 24.5 kg/m 2 , should be considered as thresholds for better detecting elderly malnutrition. The current BMI cut-off value (<18.5 kg/m 2 ) is not applicable to elderly Croatians.

Simplifier le dépistage de la dénutrition du sujet âgé en médecine générale : test de concordance entre un outil simple, le « Malnutrition Universal Screening Tool » (« MUST ») et le « Mini Nutritional Assessment-Short Form » (« MNA-SF »)

ObjectiveThe main goal of this study is to assess how results from two clinical tools, the Mini Nutritional Assessment-Short Form (MNA-SF) and the Malnutrition Universal Screening Tool (MUST), correlate in the framework of nutritional status evaluation of elderly under ambulatory care. Additionally, determinants of nutritional risk have been analyzed. MethodsThe evaluation of a multicentric diagnostic test has been carried out with 81 patients over 70-years-old, while consulting at their general practitioner's office, or at home. For each patient, MUST and MNA-SF scores were calculated and compared with the kappa coefficient. Subjects were classified into two groups according to the absence or presence of nutritional risk. Univariate comparative analyses were realized between MUST and MNA-SF data. ResultsRespectively, MNA-SF and MUST screened 33.3% and 18.5% of the patients at nutritional risk. Consistency between both tools was moderate: κ=0.438±0.2058. Compared with subjects at nutritional risk, patients with a good nutritional status were younger, took less drugs, their body mass index was higher (for a limit at 23), they were less lonely and tended to have a higher weight. ConclusionsMUST isn’t a satisfying screening tool of elderly malnutrition in ambulatory primary care. Thus, MNA-SF remains the gold standard.