Original ArticleComprehensive assessment of malnutrition risk and related factors in a large group of community-dwelling older adults☆
Introduction
Malnutrition is a serious and frequent condition in older adults. The prevalence of malnutrition which is 5–10% among independently living older individuals is considerably higher (30–60%) in hospitalized or institutionalized older adults.1 There are many psychological, social and organic conditions related with malnutrition in older adults.
Malnutrition can adversely affect the well-being of older persons mainly by causing a decline in functional status, worsening of existing medical problems and even increases in mortality. Therefore routine screening for malnutrition has to be considered as a diagnostic standard for all those involved in the care of elder persons. The predictive validity of Mini Nutritional Test (MNA) has been evaluated by demonstrating its association with adverse health outcome,2 social functioning,3 mortality4 and a higher rate of visits to the general practitioner.5 The MNA has gained world-wide acceptance and shows a high prevalence of malnutrition in different settings. Due to its specific geriatric focus, the MNA should be recommended as the basis for nutritional screening in older people, at times supplemented by laboratory values, antropoemetric parameters or determination of body composition. The Mini Nutritional Assessment (MNA) is a validated assessment instrument for nutritional problems, but its length limits its usefulness for screening. Therefore Mini Nutritional Test-short form (MNA-SF) has been developed.
Correlation between MNA-SF and full MNA version was high in previous study.6, 7 It was confirmed that the MNA-SF in its original form is reliable as a nutritional screening tool. The MNA-SF increases the applicability of the rapid screen in clinical practice (Bauer J. The MNA-New Insights from an Internationally Pooled Database. 31th ESPEN Congress, Vienna, 2009).
The aim of this study was to investigate the malnutrition risk and related factors among the older adults.
Section snippets
Population and setting
The study was carried out at outpatient clinics of Division of Geriatric Medicine, Department of Internal Medicine, at Hacettepe University Hospital in Turkey between February 2002 and December 2004. All patients 65 years-of-age or older who were admitted for a comprehensive geriatric assessment as a routine clinical follow-up were included in this cross-sectional study (n = 2327). The inclusion criteria was being 65 years and older.
Measurements
All patients underwent a complete and a standardized
Results
A total of 2327 patients were included in this study. Mean age of patients was 72.14 ± 6.11, 32.5% of the study population was ≥75 years and 4.1% was ≥85 years. Most of the subjects were female 1479 (63.6%). The most frequent co-morbid disorder was hypertension (71.1%). Overall, within the study group, 651 (28%) were found to have nutritional risk. The mean S-MNA score was 12.31 ± 2.18. Baseline characteristics of the study population are shown in Table 1.
Discussion
The results of this study suggest that approximately 28% of geriatric outpatients are at the risk of malnutrition using a valid instrument, the MNA-SF and that poor nutritional status has a significant association with seven factors: Depression, IADL, Hct, PFG, albumin, triglycerides, ESR, and f-total. This result revealed the importance of comprehensive geriatric assessment including mental health and life situation for prevention of malnutrition.
Malnutrition is a frequent condition, both
Conflict of interest statement
None of the authors of this manuscript have any financial and personal relationships with other people or organisations that could inappropriately influence (bias) their work. None of the coauthors has any direct or indirect conflicts of interest, financial or otherwise, relating to the subject of our report.
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Conference presentation: 31st ESPEN Congress, Vienna, Austria, 2009. (Awarded an ESPEN 2009 Travel Fellowship).