NUTRIENTS INTAKE EVALUATION IN COMMUNITY-DWELLING ADULT PATIENTS REQUIRING NUTRITIONAL ASSESSMENT.

Nutrition ◽  
2021 ◽  
Vol 87-88 ◽  
pp. 111332
Author(s):  
V. Amato ◽  
R. Ingenito ◽  
V. Zurlo
Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2183
Author(s):  
Aleksandra Kaluźniak-Szymanowska ◽  
Roma Krzymińska-Siemaszko ◽  
Marta Lewandowicz ◽  
Ewa Deskur-Śmielecka ◽  
Katarzyna Stachnik ◽  
...  

Up to 28% of elderly residents in Europe are at risk of malnutrition. As uniform diagnostic criteria for malnutrition have not been formulated, in autumn 2018, the Global Leadership Initiative on Malnutrition (GLIM) presented a consensus on its diagnosis. According to the consensus, the diagnosis of malnutrition requires a positive screening test result for the risk of malnutrition, and the presence of at least one etiologic and one phenotypic criterion. This study aimed to assess the diagnostic performance and accuracy of the Mini Nutritional Assessment—Short Form (MNA-SF) against GLIM criteria. The analysis involved 273 community-dwelling volunteers aged ≥ 60 years. All participants were screened for malnutrition with the MNA-SF questionnaire. Next, the GLIM phenotypic and etiologic criteria were assessed in all subjects. Based on the presence of at least one phenotypic and one etiologic criterion, malnutrition was diagnosed in more than one-third of participants (n = 103, 37.7%). According to the MNA-SF, only 7.3% of subjects had malnutrition, and 28.2% were at risk of malnutrition. The agreement between the MNA-SF score and the GLIM criteria were observed in only 22.3% of the population. The sensitivity and specificity of MNA-SF against the GLIM criteria were fair (59.2% and 78.8%, respectively). The area under the curve (AUC) was 0.77, indicating the fair ability of MNA-SF to diagnose malnutrition. Based on the present study results, the best solution may be an optional replacement of the screening tool in the first step of the GLIM algorithm with clinical suspicion of malnutrition.


2014 ◽  
pp. 1-6
Author(s):  
C.O. KIM

Background:Protein-energy malnutrition is a major cause of functional decline in the elderly and isclearly an important component of frailty. However, limited evidence is available about how to select frailindividuals most benefiting from protein-energy supplementation. Objectives:1) To investigate factors associatedwith stronger benefits from protein-energy supplementation, and 2) to test the hypothesis that the severity offrailty is associated with the efficacy of protein-energy supplementation. Design:Secondary analysis of data froma pre-post-intervention study and a clinical trial. Setting:National Home Healthcare Services in Gangbuk-gu,Seoul, South Korea. Participants:123 community-dwelling frail older adults [usual gait speed (UGS) <0.6m/secand Mini Nutritional Assessment (MNA) <24]. Intervention:Each participant was received with two 200 mL perday of commercial liquid formula (providing additional 400 kcal of energy and 25 g of protein per day) for 12weeks. Measurements:Relative change in the Physical Functioning (PF) and Short Physical Performance Battery(SPPB) score between the baseline and 12-week follow-up assessments were measured. Results:Multilevelmixed-effect linear regression analysis showed that a lower level of baseline UGS was associated with a greaterimprovement in PF and SPPB score after adjustment for age, gender, education, living status, beneficiary ofpublic assistance, number of chronic diseases, compliance, and type of dataset (p<0.001). A lower level ofbaseline MNA score was associated with greater change in PF and SPPB score after adjustment for multiplecovariates (p<0.045). Participants with severe frailty (UGS <0.3 m/sec + MNA <17) showed 52.4% and 44.6%more relevant improvements in PF and SPPB score, respectively, than those with mild frailty (UGS 0.3-0.6 m/sec+ MNA 17-24) (p<0.001). Conclusion:Slower UGS and lower MNA score are independently associated with thegreater efficacy of protein-energy supplementation on functional status.


2020 ◽  
Vol 81 (9) ◽  
pp. 1-8
Author(s):  
Kerry Cheah ◽  
Amy Illsley

Malnutrition is the disturbance of normal form or function, arising from the deficiency of one or more nutrients, and is a significant issue in the older adult population. Despite their reduced energy requirements, older patients need the same protein intake and micronutrients as younger patients, but age-related changes may impact the ability to meet these requirements. The cause of malnutrition in individuals is likely to be multifactorial and can therefore be complex to manage. Adequate nutrition is important for both community dwelling patients and inpatients, as malnutrition increases the risk of complications and the likelihood of needing residential or nursing home care on discharge. This article discusses the risk factors for the development of malnutrition in older patients and the different nutritional assessment tools available. Management strategies for optimising nutrition can be divided into systems and supplementation. With an ageing population, most doctors will inevitably become increasingly involved with treating older patients and this article highlights the need to consider a patient's nutritional status. Nutrition should be considered during every ward round and the multidisciplinary team as a whole should maintain an awareness and responsibility for managing malnutrition.


2017 ◽  
Vol 20 (4) ◽  
pp. 598-610 ◽  
Author(s):  
Renata Damião ◽  
Álvaro da Silva Santos ◽  
Alicia Matijasevich ◽  
Paulo Rossi Menezes

ABSTRACT: Objective: The aim of this study was to evaluate the prevalence of malnutrition risk and its association with socioeconomic, behavioral, and health characteristics in the community-dwelling elderly. Methods: A cross-sectional study with individuals aged ≥ 60 years. Nutritional status was evaluated using the Mini Nutritional Assessment. Socioeconomic, behavioral, and health information was also collected from all participants. The association between each variable and the risk of malnutrition was calculated and adjusted using Poisson hierarchical regression. Results: The initial sample consisted of 3,101 elderly people, of whom 28.3% (95%CI 25.3 - 31.4%) were at risk of malnutrition. The multivariate analysis showed that the risk of malnutrition was significantly higher in women without formal education, who did not live with a partner, and identified as black-skinned. The risk of malnutrition was twice as high in individuals with no family income as compared to those who earned at least three minimum wages. Smokers were also more likely to be at risk of malnutrition than individuals who had never smoked. Participants suffering from kidney, respiratory or heart disease were at higher risk of malnutrition than those with no history of such illnesses. Conclusion: These findings could be used to help in the development of health policies and in the establishment of adequate programs aimed at reducing the risk of malnutrition in this population.


BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e033661 ◽  
Author(s):  
Ana Rita Sousa-Santos ◽  
Cláudia Afonso ◽  
Nuno Borges ◽  
Alejandro Santos ◽  
Patrícia Padrão ◽  
...  

ObjectivesTo investigate the coexistence of sarcopenia, frailty, undernutrition and obesity and to identify the factors associated with the cooccurrence of these conditions in an older population.DesignCross-sectional.SettingPortugal.Participants1454 older adults with 65 years or older, from Nutrition UP 65 study.Primary and secondary outcome measuresSarcopenia was identified using the European Working Group on Sarcopenia in Older People 2 guidelines and physical frailty using Fried phenotype. Mini-Nutritional Assessment-Short Form was used to ascertain undernutrition, and obesity was evaluated by body mass index.Results57.3% presented at least one condition, 38.0% were identified with one and 19.3% were identified with two or more conditions. When all preconditions were considered, 95.7% of the older adults presented at least one of these preconditions or conditions. Multinomial logistic regression multivariate analysis revealed that being male (OR 0.61; 95% CI 0.43 to 0.88), being married or in a common-law marriage (OR 0.58; 95% CI 0.40 to 0.84) and having a higher educational level (OR 0.23; 95% CI 0.07 to 0.73) were inversely associated with having two or more conditions, while age >75 years (OR 1.60; 95% CI 1.14 to 2.24), a poor self-perception of health status (OR 5.61; 95% CI 3.50 to 9.01), ≥5 medications (OR 3.11; 95% CI 1.77 to 5.46) and cognitive impairment (OR 1.84; 95% CI 1.37 to 2.48) were directly associated.ConclusionsAlmost three out of five older adults presented at least one of the conditions related to nutritional status, and about one in five had two or more of these occurrences. However, the low coexistence observed between all of these reinforces the need to assess them all individually during the geriatric assessment.


2020 ◽  
Vol 20 (S1) ◽  
Author(s):  
Agnieszka Guligowska ◽  
◽  
Andrea Corsonello ◽  
Małgorzata Pigłowska ◽  
Regina Roller-Wirnsberger ◽  
...  

Abstract Background Different mechanisms connect the nutritional status with the occurrence and the course of chronic kidney disease (CKD). The end-stage renal disease is complicated by catabolic inflammatory reactions and cachexia which leads to malnutrition (undernutrition). On the other hand, obesity is an important risk factor for the development and acceleration of CKD. Methods In the SCOPE study, community-dwelling persons aged 75 years and over, from 6 European countries and Israel were examined at the baseline phase. We assessed the relationship between anthropometric measures (Body Mass Index (BMI), circumferences of arm (AC), waist (WC), hip (HC), and calf (CC), waist-to-hip ratio - WHR, waist-to-height ratio - WHtR, risk of malnutrition (Mini Nutritional Assessment - MNA), serum albumin) and estimated glomerular filtration rate (eGFR) calculated by Berlin Initiative Study (BIS) equation. Results We studied 2151 subjects (932 men and 1219 women) with a mean age of 79.5 ± 5.9 years. A total of 1333 (62%) participants had CKD (GRF < 60 ml/min/1.73 m2). Negative correlations between eGFR and weight, AC, WC, HC, CC, BMI, WHtR were observed. Positive correlation occurred between eGFR and MNA score (Spearman’s rho = 0.11) and albumin concentration (rho = 0.09). Higher weight, AC, WC, HC, CC, BMI and WHtR increased the odds ratio of CKD; higher MNA (OR = 0.98, 95% CI 0.94–1.0) and higher serum albumin (OR = 0.73, 95% CI 0.53–1.0) were weakly associated with reduced odds. The risk of malnutrition was the highest with eGFR < 30 as compared to eGFR > 60 (OR = 2.95, 95%CI = 1.77–4.94 for MNA < 24; OR = 5.54, 95%CI = 1.66–18.5 for hypoalbuminemia < 3.5 g/dL). Conclusion The population of community dwelling people aged 75+ with CKD shows general features of overweight and obesity with a small prevalence of malnutrition. For anthropometric measures, the strongest association with eGFR and the highest odds of CKD were identified using WC, HC, CC and WHtR. Albumin level and MNA, but not MNA Short Form, indicated an increased odds of malnutrition with a decrease in eGFR.


2009 ◽  
Vol 13 (9) ◽  
pp. 1328-1332 ◽  
Author(s):  
Aditya Vedantam ◽  
Vijay Subramanian ◽  
Nicholas Vijay Rao ◽  
KR John

AbstractObjectiveTo estimate the prevalence of malnutrition among free-living elderly in a rural population of south India.DesignCross-sectional study. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) questionnaire, which is an eighteen-item nutritional screening instrument used in the elderly.SettingKaniyambadi block, a rural development block in the state of Tamil Nadu, south India.SubjectsCommunity-dwelling elderly (aged 60 years and above).ResultsAs evaluated by the MNA, 14 % of the 227 subjects were malnourished and 49 % were at risk of malnourishment. No significant difference was found between men and women. The majority of the elderly were living with their children, had no income and consumed three meals per day. Older age (P < 0·001), decreased food intake (P < 0·001) and consuming fewer meals (P < 0·001) were independently associated with lower MNA scores.ConclusionsMore than 60 % of the subjects had low MNA scores (<23·5) indicating that deficient protein–energy intake is common among rural elderly of south India and requires more attention.


2020 ◽  
Author(s):  
Mohammad Rahanur Alam ◽  
Md. Shahadat Hossain ◽  
Akibul Islam Chowdhury ◽  
Marufa Akhter ◽  
Abdullah Al Mamun ◽  
...  

Background: The average life expectancy of the Bangladeshi population has been rising over the last decade due to the economic growth along with improved medicare. Although the increased number of geriatric people and their health is a matter of great concern, this issue remains unnoticed here. Objectives: To assess the nutritional status of the functionality and to analyze the association between nutritional status and functional ability of the selected Bangladeshi geriatric population. Methods: A community-based cross-sectional study was conducted among 400 participants, covering Chittagong, Noakhali, Comilla, and Jessore district of Bangladesh from December 2019 to February 2020. A standard and pretested questionnaire containing Mini Nutritional Assessment (MNA), Tinetti Performance Oriented Mobility Assessment (POMA), Activities of daily living scale (ADL), Lawton-Brody Instrumental Activities of Daily Living Scale (IADL), was used. Results: According to our study, The prevalence of malnutrition and people at risk of malnutrition have been 25.4% and 58.8%, respectively. In the case of functionality, 63.3% of subjects have high falling risk, and 61.8% of subjects can independently do their daily activities while 38.3% are dependent. Furthermore, almost 80% of people are dependent in terms of doing living skills. High risk of falling (OR=10.823; 95% CI: 5.846-20.37; p<0.001), poor skill in doing ADL (OR=6.206; 95% CI: 4.021-9.581; p<0.001), along with dependency in performing IADL (OR=4.477; 95% CI: 2.833-7.075; p<0.001) are significantly associated with malnutrition. Conclusions: Geriatric malnutrition can accelerate disability conditions, which can lead to early functional aging and subsequent loss in the quality of life.


Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4239
Author(s):  
Mathuramat Seesen ◽  
Wachiranun Sirikul ◽  
Jetsada Ruangsuriya ◽  
Jiranan Griffiths ◽  
Penprapa Siviroj

Cognitive frailty (CF) is defined by the coexistence of physical frailty and mild cognitive impairment. Malnutrition is an underlying factor of age-related conditions including physical frailty. However, the evidence associating malnutrition and cognitive frailty is limited. This cross-sectional study aimed to determine the association between malnutrition and CF in the elderly. A total of 373 participants aged 65–84 years were enrolled after excluding those who were suspected to have dementia and depression. Then, 61 CF and 45 normal participants were randomly selected to measure serum prealbumin level. Cognitive function was assessed using the Montreal Cognitive Assessment-Basic (MoCA-B). Modified Fried’s criteria were used to define physical frailty. Nutritional status was evaluated by the Mini Nutritional Assessment–short form (MNA-SF), serum prealbumin, and anthropometric measurements. The prevalence of CF was 28.72%. Malnourished status by MNA-SF category (aOR = 2.81, 95%CI: 1.18–6.67) and MNA-SF score (aOR = 0.84, 95%CI = 0.74–0.94) were independently associated with CF. However, there was no correlation between CF and malnutrition assessed by serum prealbumin level and anthropometric measurements. Other independent risk factors of CF were advanced age (aOR = 1.06, 95%CI: 1.02–1.11) and educational level below high school (aOR = 6.77, 95%CI: 1.99–23.01). Malnutrition was associated with CF among Thai elderly. High-risk groups who are old and poorly educated should receive early screening and nutritional interventions.


Sign in / Sign up

Export Citation Format

Share Document