Risk Factors For Malnutrition Research Articles

The role of unconditional cash transfers during a nutritional emergency in Maradi region, Niger: a pre-post intervention observational study.

To assess the effect of an unconditional cash transfer (CT) implemented as part of an emergency response to food insecurity during a declared state of emergency. Pre-post intervention observational study involving two rounds of data collection, i.e. baseline (April 2012) and final survey (September 2012), on the same cohort of 'poor' and 'very poor' households enrolled by Save the Children in an unconditional CT programme. Aguié district, Maradi, Niger. Households with a non-acutely malnourished child aged 6-36 months (n 412). The study showed that the living standards of 'poor' and 'very poor' households improved, as indicated by a reduction in poverty-related indicators and an improvement in household food security. Anthropometric outcomes for children aged 6-36 months improved significantly, despite a decline in child health and women's well-being and autonomy. Risk factors for becoming acutely malnourished post-intervention were being from a very poor household at baseline, starting the lean season with low weight-for-height Z-score (WHZ <-1) and the presence of co-morbidity. The results of the study are consistent with the published evidence regarding the general impact of CT and suggest it is plausible that giving cash during an emergency can help safeguard living standards of the very poor and poor. While improvements in childhood nutrition status were seen it is not possible to attribute these to the CT programme. However, knowledge of the risk factors for acute malnutrition in a particular setting can be used to influence the design of future CT interventions for which a controlled trial would be recommended if feasible.

Malnutrition and Neurodegenerative Diseases

With the aging population, the prevalence of the two most common neurodegenerative disorders, namely Parkinson’s disease and Alzheimer’s disease, is likely to increase. Given the presence of disease symptoms that are also risk factors for poor nutritional status, weight loss and malnutrition are commonly reported as issues. However, a consensus has not been reached regarding the prevalence and significance of poor nutritional status. Using validated nutrition screening and assessment tools, 14.1–55.9% and 0–12.6% of people with mild Alzheimer’s disease are at risk of malnutrition and malnourishment, respectively, while 17.2–23.5% and 0–40% of people with mild to severe Parkinson’s disease are at risk of malnutrition and malnourishment, respectively. Disease-specific factors are predictive of nutritional status, and greater disease severity is particularly important. Nutrition intervention data are lacking, but needed, for both diseases. Nutrition screening should occur early in the disease by health professionals with regular patient contact.

Development and Validation of a Nutritional Health Education Program for Health Care Providers in Geriatric Homes

Objectives: To develop and implement a health education program for health care providers (HCPs) in geriatric homes about nutrition in Elderly and to evaluate the program in terms of: HCP‘s knowledge before and after the program, and to assess nutritional status of elderly served by HCP before and after the program and also to measure the frequency of different malnutrition risk factors in elderly at geriatric homes. Subjects and methods: Randomized Clustered Controlled Clinical Trial was conducted on 240 elderly residing in 6 geriatric homes randomly selected. Three homes were assigned randomly to study group and three for control group. Elderly residing in the assessd geriatric homes aged between 60-75 years were included in the study. Health care providers (HCP) recruited was subdivided into 2 groups; study group and control group. HCP in the study group were subjected to a nutrition education program that was not administered to the control group. Results: There was improvement in knowledge of HCPs after the intervention health education program regarding elderly nutrition compared to the baseline knowledge and also to control group (p 30 (67.1%). Nearly half of the elderly (52.9%) were at risk of malnutrition with the MNA (Mini Nutritional Assessment) score (17.1-23.5). The majority of the elderly 98.8 % were at risk of significant weight loss of at least 5% within 6 months by using the Appetite Assessment tool score with sum of score =2 by using Dental screening tool. There was improvement in physical aspect of quality of life in terms of activities and instrumental activities of daily living after implementation of the nutrition health education program in the study group compared to control group (p<0.001) Conclusion: Geriatric homes need continuous monitoring and reinforcement of health education of the health care providers and this will be reflected on the nutritional status and well being of the elderly residing in these Geriatric homes. Raising the awareness of the elderly is needed to improve not only the nutritional state but also the physical and psychological aspects of quality of life to have better health outcomes and good healthy elders.

Assessment of risk factors and test performance on malnutrition prevalence at admission using four different screening tools.

Malnutrition is very common in patients when admitted to the hospital. The aim of the present study was: a) to determine the prevalence of malnutrition at admission in a tertiary care hospital and identify risk factors for malnutrition, and b) to test the sensitivity and specificity of different screening tests for malnutrition compared to subjective global assessment (SGA). We conducted a prospective study at 24h of admission in order to assess malnutrition in 537 adult subjects (56.4% males, mean age of 61.3±17.7 years) using 4 different screening tools: mininutritional assessment short form (MNA-SF), nutritional risk screening 2002 (NRS2002), malnutrition universal screening tool (MUST), and SGA. Anthropometrics and co-morbidities were registered. The overall rate of undernutrition was 47.3%. Specific rates were 54.2% in patients > 65y vs. 40.7% < 65y (p = 0.002) and 63.4% in medical vs. 34.0% surgical department (p < 0.001). Identified risk factors of malnutrition at admission were: the presence of heart disease (OR 1.74 CI 95% 1.16-2.60 p = 0.007) for MNASF (AUC 0.62); liver disease (OR 4.45 CI 95% 1.9410.22 p < 0.001), > 65y (OR 2.10 CI 95% 1.19-3.93 p = 0.011), medicine department (OR 3.58 CI 95% 1.93-6.62 p < 0.001) for SGA (AUC 0.96); lung disease (OR 3.34 CI 95% 1.45-7.73 p = 0.005), medicine department (OR 2.55 CI 95%1.09-5.98 p = 0.032) for NRS 2002 (AUC 0.97). Recent unintentional weight loss was a common factor. Undernourishment at hospital admission is frequent. Comorbidities may contribute to the presence of undernutrition at admission. Nonetheless, SGA, NRS2002, MNA-SF or MUST can be used in our setting.

Prevalence and determinants of child undernutrition and stunting in semiarid region of Brazil.

OBJECTIVETo analyze the evolution in the prevalence and determinants of malnutrition in children in the semiarid region of Brazil.METHODSData were collected from two cross-sectional population-based household surveys that used the same methodology. Clustering sampling was used to collect data from 8,000 families in Ceará, Northeastern Brazil, for the years 1987 and 2007. Acute undernutrition was calculated as weight/age < -2 standard deviation (SD); stunting as height/age < -2 SD; wasting as weight/height < -2 SD. Data on biological and sociodemographic determinants were analyzed using hierarchical multivariate analyses based on a theoretical model.RESULTSA sample of 4,513 and 1,533 children under three years of age, in 1987 and 2007, respectively, were included in the analyses. The prevalence of acute malnutrition was reduced by 60.0%, from 12.6% in 1987 to 4.7% in 2007, while prevalence of stunting was reduced by 50.0%, from 27.0% in 1987 to 13.0% in 2007. Prevalence of wasting changed little in the period. In 1987, socioeconomic and biological characteristics (family income, mother’s education, toilet and tap water availability, children’s medical consultation and hospitalization, age, sex and birth weight) were significantly associated with undernutrition, stunting and wasting. In 2007, the determinants of malnutrition were restricted to biological characteristics (age, sex and birth weight). Only one socioeconomic characteristic, toilet availability, remained associated with stunting.CONCLUSIONSSocioeconomic development, along with health interventions, may have contributed to improvements in children’s nutritional status. Birth weight, especially extremely low weight (< 1,500 g), appears as the most important risk factor for early childhood malnutrition.

Factors Associated with Malnutrition among Tribal Children in India: A Non-Parametric Approach

The purpose of this study is to identify the determinants of malnutrition among the tribal children in India. The investigation is based on secondary data compiled from the National Family Health Survey-3. We used a classification and regression tree model, a non-parametric approach, to address the objective. Our analysis shows that breastfeeding practice, economic status, antenatal care of mother and women's decision-making autonomy are negatively associated with malnutrition among tribal children. We identify maternal malnutrition and urban concentration of household as the two risk factors for child malnutrition. The identified associated factors may be used for designing and targeting preventive programmes for malnourished tribal children.

Efficiency at the Resident's Level of the NABUCCOD Nutrition and Oral Health Care Training Program in Nursing Homes

ObjectivesTo assess the impact of a nutrition and oral care training program on nursing home (NH) policies and residents. DesignCross-sectional surveys before/after intervention. ParticipantsOne hundred thirty-eight NHs participated in the initial training. InterventionTraining sessions for staff, director, and medical practitioners for nutritional and oral care in NH. MeasurementsTwo waves of self-assessments over a 6- to 8-month interval described NH policies (Institution questionnaire), quality of care in newly admitted residents (Admission questionnaire), and in those present for more than 6 months (Stay questionnaire). ResultsQuestionnaires were completed at both waves in 24 NHs (17.8%) for Institution, in 42 NHs including 646 residents for Admission, and in 34 NHs including 287 residents for Stay. There was no significant difference in bed capacity and resident dependency between NHs, which performed both assessments, and nonresponders. No change was observed for Institution. Malnutrition screening was carried out in almost all residents. Two risk factors were better screened after training: pressure ulcers (39.4% to 49.1%, P = .014) and dysphagia (33.5% to 41.0%, P = .049). Oral examination improved quantitatively (38.5% of residents to 48.5%) and qualitatively: risk factors for malnutrition and dysphagia were better sought (loss of posterior teeth (P < .0001), asialia (P < .0001), and candidosis (P = .002)). Similar improvements were seen in Stay assessments. Actions to counteract weight loss or low dietary intake records were not found in one third of resident records. ConclusionsTraining program improved staff knowledge with positive results at the level of residents but no significant changes were seen within NH policies.

Nutritional Status and Risk Factors of Malnutrition among 0-24 Months Old Children Living in Mezam Division, North West Region, Cameroon

Introduction: Childhood malnutrition especially under nutrition is one of the most frequent causes of child morbidity and mortality. The consequences of malnutrition are more apparent in adulthood; it results in poor physical development and diminished cognitive abilities. Objective: To evaluate the nutritional status of supposedly healthy children aged 0 to 2 years old, attending vaccination clinics in Mezam division, North West Region, Cameroon. Methods: It was a descriptive survey using structured questionnaires, which covered socioeconomic and demographic information, breastfeeding practices, socio-cultural and economic factors and anthropometric data. Anthropometric measurements were taken (weight, height, head circumference). The total number of children was 990 (561 girls and 429 boys) all from diverse ethnic groups and Backgrounds. The anthropometric indicator used was the weight-for-age. The nutritional status of these children was evaluated with respect to a number of factors which are: age range, the sex of the children, milk feeding, socio-economic and demographic factors. The results obtained were expressed in percentages. Results: Comparison of the growth patterns of the study population with that of the NCHS references revealed that none of the children grew exactly according to the NCHS references. The prevalence rate of both under nutrition and over nutrition among the 0-2 year’s old children living in Mezam division was high. Children aged 0 to 6 months were more affected by under nutrition while those aged 6-12 months were more affected by over nutrition. Risk factors of under nutrition in these infants were as a result of factors such as: Nature of parents’ profession, parents’ educational level, inappropriate child feeding practices such as exclusive breastfeeding practiced incorrectly and mixed feeding started too early. Conclusion: The study revealed a high prevalence rate of both under nutrition and over nutrition among children aged 0-2 year’s old living in the Mezam division.

Assessment of Knowledge of Primary School teachers Regarding Malnutrition Among Children

Children are the most important segments for a nation for the optimal physical, mental, emotional development of its future worthy citizens. The Present study aimed to assess the knowledge of Primary school teachers regarding malnutrition among children in selected schools of Ambala, Haryana and to determine the association of knowledge of primary school teachers with selected sample characteristics. The research approach was non-experimental with Descriptive Survey Design. The final data was collected in the month of March after getting formal permission from principals of schools of Ambala Haryana. Total enumeration Technique was used for primary school teachers. The data was collected from 50 primary school teachers by structured knowledge questionnaire. The 30 items having minimum rating score of 0 and maximum rating score of 30. Analysis was done in accordance with study. Tool was validated from seven experts and tools were found reliable. Major Findings of the Study revealed that Majority 20 (40%) of primary school teachers were from the age group 26-30 years , 36(72%) of primary school teachers were females , 28 (56%) had completed their education with B.ED ,35 (70%) were married ,31(62%) of primary school teachers were had experience less than 5year, 45(90%) of primary school teachers did not come across child with malnutrition . There is significant association of level of knowledge of primary school teachers with educational status. Maximum 28(56%) Primary school teachers were having good knowledge regarding malnutrition while 17(34%) were having average knowledge malnutrition followed by 6(10%) were in category of very good and no were having below average. Primary school teachers had good knowledge in the area of sign and symptoms of malnutrition(73%), causes of malnutrition(72%), introduction and definition of malnutrition(69%)and treatment of malnutrition(61%), while average knowledge in prevention of malnutrition(59%) and risk factors of malnutrition(51%).

Nutritional status and risk factors for malnutrition in low-income urban elders

The purpose of this study was to evaluate the nutritional status of low-income urban elders by diversified ways, and to analyze the risk factors for malnutrition. The participants in this study were 183 low-income elders registered at a visiting healthcare facility in a public health center. Data were collected using anthropometric measurements, and a questionnaire survey. For data analysis, descriptive statistics, χ²-test, t-test, Fisher's exact test, multiple logistic regression analysis were performed using SPSS 20.0. Regarding the nutritional status of low-income elders as measured by the Mini Nutritional Assessment (MNA), 10.4% of the elders were classified as malnourished; 57.4% as at high risk for malnutrition; and 32.2% as having normal nutrition levels. The main factors affecting malnutrition for low-income elders were loss of appetite (OR=3.34, 95% CI: 1.16~9.56) and difficulties in meal preparation (OR=2.35, 95% CI: 1.13~4.88). In order to effectively improve nutrition in low-income urban elders, it is necessary to develop individual intervention strategies to manage factors that increase the risk of malnutrition and to use systematic approach strategies in local communities in terms of a nutrition support system.

Knowledge Discovery in a Community Data Set: Malnutrition among the Elderly

ObjectivesThe purpose of this study was to design a prediction model that explains the characteristics of elderly adults at risk of malnutrition.MethodsData were obtained from a large data set, 2008 Korean Elderly Survey, in which the data of 15,146 subjects were entered. With nutritional status a target variable, the input variables included the demographic and socioeconomic status of participants. The data were analyzed by using the SPSS Clementine 12.0 program's feature selection node to select meaningful variables.ResultsAmong the C5.0, C&R Tree, QUEST, and CHAID models, the highest predictability was reported by C&R Tree with the accuracy rate of 77.1%. The presence of more than two comorbidities, living alone status, having severe difficulty in daily activities, and lower perceived economic status were identified as risk factors of malnutrition in elderly.ConclusionsA reliable decision support model was designed to provide accurate information regarding the characteristics of elderly individuals with malnutrition. The findings demonstrated the good feasibility of data mining when used for a large community data set and its value in assisting health professionals and local decision makers to come up with effective strategies for achieving public health goals.

Prevalence of Severe Acute Malnutrition in Children Aged 6 -60 Months Admitted at Mother of Christ Specialist Hospital Ogui, Enugu, Nigeria

Background: Prevalence of severe acute malnutrition in children aged 6 - 60 months in mother of Christ hospital Ogui Enugu was studied. The study was aimed: to determine the social demographic profile of severely malnourished children and/or parents of children with severe acute malnutrition, to determine the risk factors for severe acute malnutrition in admitted children with Severe Acute Malnutrition (SAM) and to know the prevalence of wasting, stunting and under-weight of children from 6 - 60months. Methodology: Random selection was used to select the population studied. The data collected include the patients' mothers' biography, patients anthropometry, biochemical results and family size. The NCHS reference standard were used to determined the nutritional status of the children.SPSS version 16 was used to determine the descriptive statistics (percentages and frequencies).Result: The result of the survey revealed that there was a relationship between education attainment of mothers and child's conditional status which was significant (p < 0.05). Prevalence of severe acute malnutrition occurs mainly in families that have limited access to nutritious food and are living in unhygienic condition, which increases risk of repeated infections. Malnutrition was common in the first and second year of life as a result of inadequate breastfeeding of the child and high rate of infection. The study revealed that large households have significant (P< 0.05) influence on the nutritional status of the children than smaller household. Conclusion: In this study results indicated that malnutrition is a problem among children in the area. The prevalence of malnutrition such as wasting, stunting and underweight was high within the ages of 0-11 months and 12- 17 months. Child feeding practices were inadequate. Mother's characteristics and household feeding characteristics appear to influence children's nutritional status. Effort to improve feeding practices and to relieve the constraints to the adoption of exclusive breastfeeding and optimal feeding practices will have significant effects on child nutritional status in the population.

Factors Associated with Acute Malnutrition among Children Admitted to a Diarrhoea Treatment Facility in Bangladesh.

To assess the risk factors for acute malnutrition (weight-for-height z-score (WHZ) < −2), a case-control study was conducted during June–September 2012 in 449 children aged 6–59 months (178 with WHZ < −2 and 271 comparing children with WHZ ≥ −2 and no edema) admitted to the Dhaka Hospital of icddr,b in Bangladesh. The overall mean ± SD age was 12.0 ± 7.6 months, 38.5% (no difference between case and controls). The mean ± SD WHZ of cases and controls was −3.24 ± 1.01 versus −0.74 ± 0.95 (P < 0.001), respectively. Logistic regression analysis revealed that children with acute malnutrition were more likely than controls to be older (age > 1 year) (adjusted OR (AOR): 3.1, P = 0.004); have an undernourished mother (body mass index < 18.5), (AOR: 2.8, P = 0.017); have a father with no or a low-paying job (AOR: 5.8, P < 0.001); come from a family having a monthly income of <10,000 taka, (1 US$ = 80 taka) (AOR: 2.9, P = 0.008); and often have stopped predominant breastfeeding before 4 months of age (AOR: 2.7, P = 0.013). Improved understanding of these characteristics enables the design and targeting of preventive-intervention programs of childhood acute malnutrition.

Assessment of Nutritional Status by Dual-Energy X-Ray Absorptiometry in Chronic Kidney Disease Patients without Dialysis

Objective: The objective was to evaluate the assessment of nutritional status by dual-energy X-ray absorptiometry (DEXA) in chronic kidney disease (CKD) patients not receiving dialysis. Patients and Methods: A total of 143 patients in stage 4-5 without receiving dialysis were enrolled and classified into well-nourished and malnourished groups by subjective global assessment. Biochemical and anthropometric measurements were performed. Simultaneously, body composition including lean body mass (LBM) and fat mass (FM) was evaluated by DEXA. Results: Compared with well-nourished patients, malnourished patients showed lower pre-albumin (ALB) levels, but higher C-reactive protein (CRP) levels. There was no significant difference in serum ALB between both groups. For either men or women, body weight, body mass index, and glomerular filtration rate (GFR) were lower in the malnourished group. For the men, triceps skin-fold thickness (TSFT), mid-arm circumference (AC), mid-arm muscle circumference (AMC), LBM-DEXA and FM-DEXA were significantly lower in the malnourished patients. For the women, TSFT, mid-AC and FM-DEXA, but mid-AMC and LBM-DEX, were not significantly lower in the malnourished patients. There was a significant correlation between LBM-DEXA and mid-AMC. A significant correlation also existed between FM-DEXA and TSFT. Multiple logistic regressions showed that low percentage of FM, high serum CRP level and low GFR were independent risk factors for malnutrition. Conclusions: Low percentage of FM, high serum CRP and low GFR are independent risk factors for malnutrition. Estimation of LBM and FM by dual X-ray absorptiometry is in consistent with traditional anthropometric measurements. It's noteworthy that DEXA, a reliable and easy-to-perform assessment method, can sensitively detect early malnutrition and may be useful in monitoring nutrition changes in CKD patients.

NUTRITION STATUS IN COMMUNITY DWELLING OLDER POPULATION IN AN EGYPTIAN URBAN AREA

Objectives: To evaluate the nutrition status in community dwelling Egyptian older subjects, living in Cairo, and the factors that may be associated with malnutrition. Design: A cross-sectional study. Setting: Egyptian social clubs, in Cairo. Participants: 318 older subjects, 60 years old and above. Measurements: Comprehensive Geriatric Assessment and Mini Nutritional Assessment. Results: The nutrition status of the sample was: 44 % (140 subjects) were well nourished, 41.5% (132 subjects) had risk of malnutrition and 14.5 % (46 subjects) were malnourished. the mean age of the well-nourished patients was 64 ± 3.16, while for malnourished patients was 72.3 ± 4.83 [P: &lt;0.001]. Sex did not show a significant difference between well-nourished and malnourished patients [P: 0.35]. Also marital status did not show significant affection of nutritional status [P: 0.254]. While education level and employment status showed significant difference between well-nourished and malnourished patients [P: &lt;0.001]. The functional state assessed by ADL showed a significant difference between well-nourished and malnourished patients [P: &lt;0.007]. Also the Cognitive impairment was more among malnourished than well-nourished patients [P: 0. &lt;0.001]. Depression and polypharmacy were significantly found more among malnourished than well-nourished patients [P: 0.009, 0. 001] respectively. logistic regression analysis revealed that increased age, low score of MMSE, less years of education and increased number of medications were independent risk factor for malnutrition. Conclusion: Malnutrition and risk of malnutrition were prevalent in community dwelling older population, especially with increased age, less education, living alone, unemployment, cognitive impairment, depression and taking multiple medications. So we recommend that nutritional assessment to be included in any assessment of elderly person.

Évaluation d’un score prédictif de dénutrition chez les patients pris en charge par irradiation pour un cancer des voies aérodigestives supérieures : étude rétrospective chez 127 patients

PurposeThe purpose of this study was to establish a pre-therapeutic score that could predict which patients would be at high risk of enteral tube feeding during (chemo)-radiotherapy for head and neck cancer. Patients and methodsA monocentric study was conducted retrospectively on patients receiving a radiotherapy or concurrent chemoradiotherapy for a head and neck cancer. A logistic model was performed in order to assess clinical or therapeutic risk factors for required artificial nutrition during treatment. Significant parameters, issued from multivariate analysis, were summed and weighted in a score aiming at estimating a malnutrition risk during radiotherapy. ResultsAmong the 127 evaluated patients, 59 patients required artificial nutrition during radiotherapy. In multivariate analysis, predictive factors for malnutrition were weight loss superior to 5% in the 3 months before radiotherapy, advanced tumor stage (III–IV vs. I–II), and pain requiring strong analgesics (step II–III vs. I). Concurrent chemotherapy was identified as a significant risk factor also, but it was strongly correlated with the tumor stage. The score, estimated from these previous factors, allowed a prediction of a risk of enteral feeding with a sensitivity of 90% and a specificity of 85%. ConclusionA predictive score of enteral nutrition before radiotherapy of head and neck cancer should be a useful clinical tool to target the patients who would need a prophylactic gastrostomy. Our study evidenced some risk factors of malnutrition requiring artificial feeding. However, we need a prospective study to confirm the validity of this score.

Neuogenic and oropharyngeal dysphagia

Oropharyngeal dysphagia (OD) is a swallowing disorder caused by congenital abnormalities and structural damage and disease‐associated damage of the oral cavity, pharynx, and upper esophageal sphincter. Patients with OD lack the protective mechanisms necessary for effective swallowing, exhibiting difficulty controlling food in the mouth and initiating a swallow, leading to choking, coughing, and nasal regurgitation. OD is a major risk factor for malnutrition, dehydration, and aspiration pneumonia. The following on OD includes commentaries on the application of simulation of oropharyngeal transient receptor potential vanilloid 1 (TRPV1) and maneuvers like the Shaker exercise to improve the safety and efficacy of swallow in OD patients; the prevalence of esophageal pathologies in OD patients and the need to evaluate the esophagus, esophagogastric junction, and stomach; and strategies for clinical screening to detect OD and aspiration among high‐risk patients and to improve oral health care, maintain nutrition and hydration, and prevent aspiration pneumonia.

PP187-MON WHAT DO TURKISH SURGEONS DO IN THE PERIOPERATIVE PERIOD?

questionnaire covering a 3-day period were used. The patients were re-assessed after 3 and 6 months. Results: 500 patients were assessed. 57% of they were malnourished, 27% in risk of malnoutrition. None have received nutritional counseling before. BMI ranged from 14.5 to 23 kg/m2. Deficiencies ingested food was found in 89% of patients. Low body mass correlated with fatigue, depression, and depletion in labs. 67% of patients displayed at least two risk factors of malnutrition: 37% suffered from gastroenterological etiologies, 27% oncological, 17% neurogenic, 18% geriatric, 14% psychogenic. Modification of oral nutrition (oral supplementsin 67% of cases) has allowed for improvement in nutritional status and labs in 78%, UWL was stopped in 18% of cases. 12 patients were referred for EN and TPN Conclusion: Regular assessment of nutritional status and professional nutritional counseling among adult outpatients who had suffered UWL has improves their nutritional status and QOL. The program was supported by Lower Silesian Marshal Department. Disclosure of Interest: None Declared

PP041-MON UNDERNUTRITION ACCORDING TO MNA® AT HOSPITAL ADMISSION AND IN NURSING HOMES

Rationale: Geriatric patients show a high prevalence of chronic diseases and a high number of risk factors for malnutrition which both can be influenced by nutritional support. This project aimed to describe the nutritional support in geriatric patients, and the changes for hospital personnel after establishment of a nutrition support team. Methods: We retrospectively assessed the characteristics, nutritional status, and nutritional therapy of 1252 patients (57.2% of all geriatric patients) attended by a nutrition support team in 2010 at a geriatric ward. Additionally, the changes through the establishment of a nutrition support team have been analysed. Results: Patients were impaired in the activities of daily living, mobility, and cognition. A total of 17.7% were well nourished, 58.7% showed a risk for malnutrition, and 23.6% were malnourished. The mean BMI was at 25.3±5.6 kg/m2 (MD 24.5, MIN 14.0, MAX 54.5). A low calcidiol level has been found in 97.4% of the patients, a low folate level in 60.5%. The most frequent reason for nutrition counselling was malnutrition and the risk for malnutrition. After establishment of the nutrition support team, number of diagnoses related to nutrition, and supplementation of at-risk nutrients increased. In 96.3% of the patients a malnutrition risk-screening has been executed, and in 93.8% of the patients the weight at hospital admission and discharge has been documented. Conclusion: The high percentage of patients attended by the nutrition support team underpins previous results emphasising the need for nutritional support for geriatric patients. It could be shown that the establishment of a nutrition support team is associated with a number of changes and improvements in patient care which are not only important for nutritional support, but also for medical treatment.

Malnutrition in an Elderly Population without Cognitive Impairment Living in Nursing Homes in Spain: Study of Prevalence Using the Mini Nutritional Assessment Test

Background: The prevalence of malnutrition in institutionalized elderly people is generally high. A good nutritional status is related to a decrease in mortality and costs of morbidity treatments. Therefore, it is essential to know the nutritional status in order to establish action policies. However, there are not enough studies about malnutrition in institutionalized elderly in Spain. Objectives: The objectives of this survey were to assess the prevalence of malnutrition and risk of malnutrition in elderly people living in nursing homes in the province of Albacete (Spain) using the Mini Nutritional Assessment (MNA®) test, to analyze their distribution according to age, gender and different nursing home features, and to identify the MNA items that best predict the MNA total score. Methods: A cross-sectional study was conducted with data collected from 895 elders living in 34 nursing homes all over the province of Albacete, including facilities located in the main city, towns and villages. Prevalence of malnutrition and risk of malnutrition were assessed using the MNA full form test. Groups of malnutrition were compared by using mean MNA scores. Stepwise linear regression analyses were used to identify the items in the MNA which best predicted the MNA total scores. Results: According to the MNA, the prevalence of malnutrition among elderly people staying in Albacete province nursing homes was 2.8%, and the prevalence of being at risk of malnutrition was 37.3%. MNA total score was significantly higher in men (24.3 ± 2.9) than in women (23.7 ± 3.3) and significantly higher in residents living in nursing homes located in towns and villages (24.2 ± 2.8) than in those who were living in institutions placed in the main city (23.7 ± 3.4). The MNA score was found to decrease with increasing age, except for individuals aged 90 years or older. Conclusions: The prevalence of malnutrition and risk of malnutrition was 40.1%. Female gender and living in institutions located in the main city were identified as malnutrition risk factors. In general, an increase in malnutrition with age was detected, except for people in the last years of their lives. The MNA questions that best predicted the nutritional status were the ones relating to the anthropometrical and self-assessments.