scholarly journals Problems of nutritional assessment in the community

1999 ◽  
Vol 58 (1) ◽  
pp. 47-51 ◽  
Author(s):  
Jacqueline Edington

The present paper explores the problems associated with assessment of nutritional status in the community and reviews the literature related to this subject. The first problem is one of terminology, since a logical first step before assessment is screening, which identifies characteristics known to be associated with dietary or nutritional problems. Its purpose is to differentiate individuals who are at high nutritional risk or have poor nutritional status. There are certain factors which should alert the primary health care team to the fact that nutritional intake may be reduced and that risk of malnutrition is increased. These include disease condition, functional disabilities, inadequate or inappropriate food intake, poor dentition or difficulty swallowing, polypharmacy, alcoholism, depression, poor social circumstances or recent discharge from hospital. Patients suffering from these factors need to be identified so that screening becomes a routine part of their medical treatment. At-risk groups include the elderly, the chronically ill, those with cancer and neurological disorders, post-surgical patients and children with developmental disabilities. In the community, practice and community nurses see the majority of at-risk patients and should carry out screening. A number of screening tools have been developed for community use. Most are aimed at the elderly population, but there are others designed to assess nutritional risk in children with developmental disabilities and the general population. These are reviewed and problems of content and validity identified. Some problems associated with nutritional assessment are also reviewed.

Author(s):  
D. J. Patil ◽  
M. M. Shindhe

Background: Worldwide the elderly population gradually increasing and that will definitely pose several challenges. Malnutrition is one of the major but neglected problem in elderly. They are at risk of malnutrition due to physical, psychological, social, dietary and environmental risk factors. Malnutrition in elderly is associated with adverse health effects. Hence to study the nutritional status of elderly.Methods: The study was carried out between January 2016- June 2017. 545 elderly were included in the study. Out of the 6 subcentres, 1 subcentre (Uchagaon) was selected by simple random sampling technique and house to house survey was carried out to select eligible elderly participants in the villages of selected subcentre. Data was collected from eligible elderly by using mini nutritional assessment (MNA) tool.Results: Majority of the participants (65.1%) were between the age group of 60-69 years. 55% were females. 23.5% were malnourished, 49% were at risk of malnutrition and 27.5% had normal nutritional status.Conclusions: The present study concluded that majority of the elderly were at risk of malnutrition. There is a need of actions to improve the nutritional status of the elderly.


Parasite ◽  
2020 ◽  
Vol 27 ◽  
pp. 74
Author(s):  
Zhan Wang ◽  
Jin Xu ◽  
Ge Song ◽  
MingQuan Pang ◽  
Bin Guo ◽  
...  

Background: Echinococcosis is a chronic consumptive liver disease. Little research has been carried out on the nutritional status of infected patients, though liver diseases are often associated with malnutrition. Our study investigated four different nutrition screening tools, to assess nutritional risks of hospitalized patients with echinococcosis. Methods: Nutritional Risk Screening 2002 (NRS 2002), Short Form of Mini Nutritional Assessment (MNA-SF), Malnutrition Universal Screening Tool (MUST), and the Nutrition Risk Index (NRI) were used to assess 164 patients with alveolar echinococcosis (AE) and 232 with cystic echinococcosis (CE). Results were then compared with European Society for Clinical Nutrition and Metabolism (ESPEN) criteria for malnutrition diagnosis. Results: According to ESPEN standards for malnutrition diagnosis, 29.2% of CE patients and 31.1% of AE patients were malnourished. The malnutrition risk rates for CE and AE patients were as follows: NRS 2002 – 40.3% and 30.7%; MUST – 51.5% and 50.9%; MNA-SF – 46.8% and 44.1%; and NRI – 51.1% and 67.4%. In patients with CE, MNA-SF and NRS 2002 results correlated well with ESPEN results (k = 0.515, 0.496). Area-under-the-curve (AUC) values of MNA-SF and NRS 2002 were 0.803 and 0.776, respectively. For patients with AE, NRS 2002 and MNA-SF results correlated well with ESPEN (k = 0.555, 0.493). AUC values of NRS 2002 and MNA-SF were 0.776 and 0.792, respectively. Conclusion: This study is the first to analyze hospitalized echinococcosis patients based on these nutritional screening tools. Our results suggest that NRS 2002 and MNA-SF are suitable tools for nutritional screening of inpatients with echinococcosis.


F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 173
Author(s):  
Hoda Atef ◽  
Rasha Abdel-Raouf ◽  
Ahmed S. Zeid ◽  
Eman H. Elsebaie ◽  
Shaimaa Abdalaleem ◽  
...  

Background: Nutritional screening, intervention and assessment in patients with undernutrition are key components of any nutritional care. The goal of any nutritional assessment is to determine the specific nutritional risk(s). Presently, there are no guidelines on any ideal screening tool to be used on admission for identification of children that are at risk of developing malnutrition during their hospital stay. The objective of the study was to develop a valid and simple nutritional screening tool which can be used on hospital admission to identify pediatric patients at risk of malnutrition. Methods: This study was cross sectional analytical that enrolled children (n:161) admitted with acute illness to the general wards at Cairo University Children Hospitals (CUCH). The answers to the developed questionnaire were compared to the Subjective Global Assessment (SGA), those with high accuracy (≥80%) were used for validity with anthropometric measures. Results: In the ‘less than two years of age’ group, the simple and valid nutritional screening tools were the following questions: (Is there a problem during breast-feeding?), (Is there scanty breast milk?), (Is there appetite loss?). The simple and valid nutritional screening tools during the ‘early childhood’ group were the following questions: (Is there appetite loss?), (Is there any skipping of meals?), (Are they watching TV, videotapes and/or playing computer games for more than two hours/day?). The simple and valid  nutritional screening tools during the ‘late childhood’ group were the following questions: (Is there appetite loss?), (Are they watching TV, videotapes and/or playing computer games for more than two hours/day?). Conclusion: The simple and valid nutritional screening tools differ according to age groups. The one which is valid in all ages is the question about the appetite loss.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Teresa Madeira ◽  
Catarina Peixoto-Plácido ◽  
Nuno Sousa-Santos ◽  
Nuno Mendonça ◽  
Osvaldo Santos ◽  
...  

AbstractBoth malnutrition (which here refers to undernutrition) and obesity are prevalent in older adults, but they are frequently seen as mutually exclusive. In fact, a low body mass index (BMI) is one of the aetiological diagnostic criteria for malnutrition. On the contrary, the concomitant presence of malnutrition and obesity has been less studied. The aim of this study was to characterise the nutritional status of community-dwelling older adults (≥ 65 years old) living in Portugal. The study included a nationally representative sample of randomly selected community-dwelling older adults. Trained nutritionists collected data through face-to-face structured interviews regarding sociodemographic characteristics, nutritional status and anthropometric measures (namely, weight and height), among other variables of the PEN-3S study. Nutritional status was assessed by the 18-item Mini Nutritional Assessment (full MNA®), in which a lower score indicates worse nutritional status. The World Health Organisation's (WHO) BMI cut-offs for adults were followed (obesity: BMI ≥ 30Kg/m2). MNA and BMI categories estimates (95% CI) were obtained using Complex Samples analysis (SPSS® 24.0). Non-difference between sexes was analysed with Chi-square tests. Complete information was available for 1110 community-dwelling participants (mean age: 75.9 ± 8.1 years; 48.9% women; 71.4% attended school for < 5 years). According to the MNA, 0.5% (95%CI: 0.2–1.7) were classified as malnourished and 16.0% (12.9–19.7) were at risk of malnutrition. Following WHO's BMI criteria, 0.6% (0.2–1.5) had a BMI ≤ 18.5Kg/m2, 41.9% (37.9–46.0) had a BMI between 25–30Kg/m2, and 36.7% (32.8–40.9) presented a BMI ≥ 30Kg/m2. The prevalence of risk of malnutrition was significantly higher for women (20.1%, 95%CI: 15.4–25.9) than men (10.4%, 7.6–14.1; p < 0.001). The prevalence of obesity was also significantly higher for women (42.2%, 35.9–48.7 versus 29.3%, 24.8–34.2; p = 0.007). Moreover, 13.9% (9.2–20.4) were simultaneously at risk of malnutrition and had a BMI ≥ 30Kg/m2, while no one in this BMI category was classified as malnourished. Although appropriate BMI cut-offs for older adults are still uncertain, these results highlight that a high BMI does not exclude the risk of malnutrition, particularly in women. Therefore, health professionals should routinely screen for malnutrition using multi-component, validated screening tools, irrespective of the BMI. In fact, malnutrition is preventable if detected on time and effective interventions exist. The concomitant presence of malnutrition and obesity may pose additional challenges to the treatment.


Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1306 ◽  
Author(s):  
Julia Traub ◽  
Ina Bergheim ◽  
Angela Horvath ◽  
Vanessa Stadlbauer

Malnutrition in liver cirrhosis is frequently underestimated. To determine if a patient is at risk of malnutrition, several screening tools have been established. However, most of them are not validated for patients with liver cirrhosis. Therefore, we compared the RFH-NPT (Royal Free Hospital Nutritional Prioritizing Tool) as the validated gold standard for malnutrition screening in cirrhosis patients with GMS (Graz Malnutrition Screening), NRS-2002 (Nutritional Risk Screening) and MNA-SF (Mini Nutritional Assessment-Short Form). Based on common validity criteria for screening tools, only the MNA-SF showed fair correlation (12/15 points) with the RFH-NPT, whereas NRS-2002 and GMS performed worse (6/15 points). Taken together, our results suggest that NRS-2002 and GMS are not suitable for screening of malnutrition in cirrhosis patients. A cirrhosis-specific screening tool like RFH-NPT should be used to assess malnutrition and to identify those at risk of malnutrition.


2004 ◽  
Vol 7 (1) ◽  
pp. 69-76 ◽  
Author(s):  
Alan C Tsai ◽  
Jack MC Chang ◽  
Harvey Lin ◽  
Yi-Li Chuang ◽  
Shu-Hui Lin ◽  
...  

AbstractObjective:The study was conducted to gain an understanding of the status of potential nutrition risks in > 53-year-old men and women in Taiwan.Methods:The study employed a validated nutrition-risk screening questionnaire, the Mini Nutritional Assessment, to assess the potential risk of undernutrition in the elderly population in Taiwan. The questionnaire was translated into the local language, Chinese, and was modified slightly based on cultural considerations. It was administered to 4440 randomly selected subjects by means of face-to-face interviews. The questionnaire included questions on subjective self-evaluations, global parameters, simple dietary assessment and some anthropometric measurements.Results:Results show that the questionnaire can be used effectively as a tool to screen for individuals who are at risk of undernutrition. It showed that the proportion of the elderly population at risk of nutritional inadequacy is relatively low, but does increase with advanced ageing. The proportion of the elderly considered at high risk of undernutrition was found to increase with age, ranging from 0.88% for 53–60-year-old subjects to 1.86% for subjects aged 60–70 years, 3.6% for 70–80-year-olds and 5.3% for >80-year-old subjects.Conclusion:The study showed that a simple questionnaire adopted from the Mini Nutritional Assessment can be employed to provide a preliminary screening and to identify individuals who are potentially at increased risk of nutritional inadequacy in the elderly population in Taiwan.


2020 ◽  
Vol 11 (4) ◽  
pp. 7213-7219
Author(s):  
Aarthy Marimuthu ◽  
Balaji Ramraj

Nutrition is the single most important determinant of the health of an individual and provides essential support during the ageing process. Malnutrition is not a consequence of ageing and should never be considered as a normal process. Early detection of nutritional problems is vital to ensure the quality of life throughout these extended years. This study aimed, at assessing the nutritional status among the elderly (60 years and above), in the rural field practice area of SRM Medical College Hospital and Research Centre (Kalivanthapattu village), and to identify the correlates of malnutrition. A Community-based Cross-sectional study was conducted for assessing the Nutritional status of the elderly population (≥ 60 years) in Kalivanthapattu village using MNA (Mini Nutritional Assessment) scale. Data analysed using SPSS 22. Descriptive data were presented in percentages, mean, standard deviation. Chi-square test was used to prove the association between categorical variables. p-value < 0.05 is considered statistically significant. Among 102 participants, 33% are with normal nutritional status, 59% were at risk, and 8% of individuals were malnourished. Both males and females were >50% at risk of malnutrition. The association of age, spouse status, whether alive or dead and the type of house were found to be statistically significant (p <0.05). This study stresses on the nutritional assessment of elderly followed by anthropometric, clinical, biochemical and functional assessments in malnourished individuals and those at risk of malnutrition. Like immunisation schedule for under-five children, it is essential to rope Malnutrition scale to assess the nutritional status at or over the age of 60 years.


2021 ◽  
Vol 9 (02) ◽  
pp. 320-326
Author(s):  
Zeynel Abidin Erbesler ◽  
Tufan Ulcay

Background: Various screening tools are used to identify elderly individuals who are malnourished or at risk for malnutrition based on their nutritional status. Anthropometric measurements are important indicators of an individual’s nutritional status. In this study, we aimed to establish anthropometric standards for the Turkish elderly population and to investigate any significant relationship between anthropometric characteristics and nutritional status. Materials and Methods: Age, sex, weight, height, waist-to-hipratio (WHR) and body massindex (BMI) were recorded. We also administered the Mini Nutritional Assessment (MNA) and a hand grip test. Results: In our study, 72% of males and 84% of females were in the overweight group, 24% of males and 16% of females were in the normal weight group, and only 4% of males were in theweak group. For males, 76% were not at risk for malnutrition, 20% were at risk, and 4% were determined to have malnutrition. For females, 68% were not at risk for malnutrition, and 32% were at risk. There were no females who had malnutrition. With regard to muscle strength, 80% of males and 92% of females did not have sufficient strength. Weight, grip strength and WHR were significantly related to MNA (p < 0.05). Conclusion: We provided sex-specific distributions for many anthropometric measurements for the elderly which can be used as reference values for the Turkish elderly population to identify individuals at greater risk for nutritional disorders.


2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Aliza Haslinda Hamirudin ◽  
Nor Azlina A. Rahman ◽  
Suriati Sidek ◽  
Norain Zainudin

Introduction: Nutrition screening is an initial procedure to identify malnutrition, whilst subsequent nutrition intervention is warranted for at risk individuals. However, none of nutrition screening studies conducted among Malaysian elderly, accompanied by individualized nutrition intervention. The objective here is to describe the methodology to determine malnutrition risk and nutritional status of elderly in community at baseline and after 3 months of nutrition intervention; and to assess perception of elderly on their dietary practices. Methods: Elderly aged ≥ 60 years will be recruited as participants at several FELDA in Terengganu and Pahang with the calculated sample size of 416. Nutrition screening will be performed to identify malnutrition risk using a validated nutrition screening tool for the elderly in the community; the Mini Nutritional Assessment-Short Form. Dietary intake will be assessed using the diet history method and individualized nutrition intervention will be provided to improve nutritional status. Nutrition screening and assessment will be repeated after three months for malnourished and at risk elderly. An in-depth individual interview will be conducted to assess perception on dietary practices particularly prophetic food intake. Quantitative and qualitative data will be analyzed using IBM SPSS software and NVivo software, respectively. Results: Nutritional status of the elderly is anticipated to improve after 3 months of nutrition intervention and the elderly will perceive that their dietary practices are good. Conclusions: This research is at the forefront to provide individualized nutrition intervention following nutrition screening among Malaysian community elderly. It can potentially prevent further health complications associated with malnutrition through timely malnutrition identification and nutrition intervention.


2008 ◽  
Vol 100 (1) ◽  
pp. 152-158 ◽  
Author(s):  
Alan C. Tsai ◽  
Pei-Yu Ku

The study was conducted to determine the effectiveness of a modified Mini Nutritional Assessment (MNA) for assessing the nutritional status and predicting follow-up mortality of institutionalized elderly Taiwanese. The study was conducted in a large long-term care centre in central Taiwan. Trained interviewers assisted by the caregivers elicited sociodemographic data, healthcare and disease history, and answers to the MNA screen from each subject. One researcher performed all subjects' anthropometric measurements. Plasma albumin and cholesterol concentrations were determined. Results showed that the MNA without BMI, modified according to population-specific mid-arm circumference and calf circumference cut-points, effectively predicted the nutritional risk status of the elderly regardless of cognitive status. Substituting caregiver's assessments for self-viewed nutrition and health status (questions O and P of MNA) improved the predicting power of the tool in cognition-normal subjects. Results showed that 21·9 % of the elderly were malnourished, 59·2 % were at risk of malnutrition and 18·9 % were normal according to self-assessment whereas 14·2 % were malnourished, 59·2 % were at risk of malnutrition, and 26·6 % were normal according to caregiver's evaluation. The tool was also effective in predicting 12- and 6-month follow-up mortality in cognition-normal and cognition-impaired elderly, respectively. Results indicate that a population-specific MNA can effectively predict the nutritional status and 6-month follow-up mortality of elderly Taiwanese regardless of cognitive condition. Easier and wider application of the tool will enable early detection of emerging nutritional problems and timely intervention to prevent the development of severe malnutrition in the elderly.


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