scholarly journals The research methodology for malnutrition risk identification and dietary practices among community living elderly

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.

Author(s):  
Jia-Yu Wei ◽  
Shu-Ting Shi ◽  
Dan Sun ◽  
Guo-Zhong Lyu

Abstract Objective Nutritional assessment can early identify patients who are malnourished and at risk of malnutrition. To examine the effect of nutritional status on wound healing in elderly burn patients, we used the MNA-SF to measure the nutritional status of elderly patients. This study aimed to examine the role of MNA-SF in elderly burn patients through the correlation analysis of wound-healing indicators and MNA-SF score. Design Prospective observational and cross-sectional study. Methods This study used the MNA-SF to investigate the elderly burn patients at the department of burn. According to the score, the patients fell into three groups: good nutritional status (more than 12 points), malnutrition risk (8~11 points), and malnutrition (0~7 points). At the same time, we measured and compared the wound-healing indicators among the three groups of patients, and detected the correlation. Results The statistical analysis found gender had a slight influence on the score of nutritional status. While age was negatively correlated with the MNA-SF score and nutrition-related indicators. There was a low positive linear correlation between the wound healing percent area change or wound healing rate of patients and the score of the MNA-SF. Conclusion This study finds malnutrition is common among hospitalized elderly burn patients. The application of the MNA-SF in elderly burn patients is efficient and accurate to identify malnutrition early and prevent further obstruction of the normal wound healing, which can provide reference points for early nutrition intervention programs.


Author(s):  
L. Wegener ◽  
S. James ◽  
A. Slattery ◽  
M. Satanek ◽  
M. Miller

Objectives: To identify the nutritional status of younger patients on admission to rehabilitation using the Mini Nutritional Assessment – Short Form (MNA-SF) and determine whether the MNA-SF has predictive validity for clinical outcomes in this setting. Design: Retrospective case note audit. Setting: Rehabilitation Unit, Repatriation General Hospital, Adelaïde, Australia. Participants: Fifty four patients under 65 years (mean age 52.9±10 years, 54% female). Measurements: Case notes for adults admitted consecutively to rehabilitation were reviewed. Risk of malnutrition was categorised using the MNA-SF. Outcomes measured were length of stay (LOS), complications and poor participation during admission, change in function, discharge to higher level of care, and acute readmissions and mortality 18 months post discharge. Results: Fourteen (26%) subjects were malnourished and 28 (52%) were at risk of malnutrition as classified by the MNA-SF. There were no significant differences in clinical outcomes between patients classified as malnourished or at risk of malnutrition and those of normal nutritional status. Conclusion: Over three quarters of subjects were classified as malnourished or at risk of malnutrition. These patients were more likely to have adverse clinical outcomes than their well-nourished counterparts but the difference was not significant. Further research is required to investigate the validity of the MNA-SF and other nutrition screening and assessment tools for adults under 65 years old undergoing rehabilitation.


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.


2011 ◽  
Vol 107 (11) ◽  
pp. 1707-1713 ◽  
Author(s):  
Li-Chin Lee ◽  
Alan C. Tsai

Nutrition is a key element in geriatric health and is important for functional ability. The present study examined the functional status-predictive ability of the Mini-Nutritional Assessment (MNA). We analysed the dataset of the ‘Survey of Health and Living Status of the Elderly in Taiwan’, a population-based study conducted by the Bureau of Health Promotion of Taiwan. Study subjects ( ≥ 65 years old) who completed both the 1999 and 2003 surveys were rated with the long form and short form of the MNA at baseline and with the Activities of Daily Living (ADL) and the Instrument Activities of Daily Living (IADL) scales 4 years later (end-point). The ability of the MNA to predict ADL or IADL dependency was evaluated with logistic regression models. The results showed that the elderly who were rated malnourished or at risk of malnutrition at baseline generally had significantly higher ADL or IADL scores 4 years later. Lower baseline MNA scores also predicted a greater risk of ADL or IADL dependency. These associations exist even among the elderly who were free of ADL or IADL dependency at baseline. The results clearly indicate that the MNA is able to predict ADL and IADL dependency (in addition to rating current nutritional status) of the elderly. The MNA, especially the short form, should be a valuable tool for identifying elderly at risk of functional decline and/or malnutrition in clinical practice or community programmes.


Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1951 ◽  
Author(s):  
Ai Kimura ◽  
Taiki Sugimoto ◽  
Kazuya Kitamori ◽  
Naoki Saji ◽  
Shumpei Niida ◽  
...  

We examined the nutritional status and its association with behavioral psychiatric symptoms of dementia (BPSD) among 741 memory clinic patients (normal cognition (NC), 152; mild cognitive impairment (MCI), 271; early-stage Alzheimer disease (AD), 318). Nutritional status and BPSD were assessed using the Mini Nutritional Assessment Short-Form (MNA-SF) and the Dementia Behavior Disturbance Scale (DBD), respectively. Compared to subjects with NC, more subjects with MCI and early-stage AD were at risk of malnutrition (MNA-SF, 8–11: NC, 34.2%; MCI, 47.5%; early-stage AD, 53.8%) and were malnourished (MNA-SF, 0–7: NC, 4.6%; MCI, 5.9%; early-stage AD, 8.2%). Among patients with MCI or early-stage AD, those at risk of/with malnutrition showed higher DBD scores than those well-nourished (12.7 ± 9.0 vs. 9.5 ± 7.3; p < 0.001). Moreover, analysis of covariance adjusting for confounders showed that nutritional status was significantly associated with specific BPSD, including “verbal aggressiveness/emotional disinhibition” (F = 5.87, p = 0.016) and “apathy/memory impairment” (F = 15.38, p < 0.001), which were revealed by factor analysis of DBD. Our results suggest that malnutrition is common among older adults with mild cognitive decline, and possibility that nutritional problems are associated with individual BPSD.


Author(s):  
J. Ares Blanco ◽  
L. Moreno Díaz ◽  
E. Fernández-Fernández ◽  
A.J. López-Alba

Background: There is an association between malnutrition and mortality. However, it is unclear if this association is truly independent of confounding factors. Objectives: The objective of this study is to evaluate nutritional status, defined according to the three categories defined in the Nutritional Screening Tool “Mini Nutritional Assessment”, and to investigate its prognostic involvement. Design, Setting and Participants: Single cohort retrospective observational study in hospitalized patients between December 2013 and January 2014, who were placed under observation until September 2015 (21 months) (n=144). Nutritional status was determined by MNA short form at the beginning of the study, as well as clinical and epidemiological data. Results: Based on categories defined by MNA SF, 59 (40.97%) were well nourished, 55 (38.19%) were at risk of malnutrition, and 30 (20.83%) patients showed malnutrition. 45 patients died during follow up (31.25%). Of them, 40% (18) were malnourished, 38% (17), at risk of malnutrition, and 22% (9), well nourished. After adjusting for confounding factors, hazard ratio (95% CI) for all-cause mortality was significantly greater in the malnourished group (3.44 (1,27-9,31: p 0,015)), comparing to the reference group (well-nourished patients). Conclusions: Nutritional status defined according to the 3 categories defined in MNA short form predicts the probability of mid-term death in hospitalized patients, after adjusting for confounding factors as age and comorbidities. These data show the importance of knowing nutritional status during hospitalization for avoiding potential complications and helping the patient to overcome them.


PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3345 ◽  
Author(s):  
Raimunda Montejano Lozoya ◽  
Nieves Martínez-Alzamora ◽  
Gonzalo Clemente Marín ◽  
Silamani J.A. Guirao-Goris ◽  
Rosa María Ferrer-Diego

Background Various scales have been used to perform a quick and first level nutritional assessment, and the MNA is one of the most used and recommended by experts in the elderly in all areas. This scale has a short form, the MNA-SF, revised and validated in 2009, which has two versions: the BMI-MNA-SF contains the first six items of the full scale including Body Mass Index while the CC-MNA-SF includes Calf Circumference instead of BMI. Objective To evaluate the predictive ability for nutritional status of the two versions of the MNA-SF against the MNA in free-living elderly in the province of Valencia. Methods Cross-sectional study of 660 free-living elderly in the province of Valencia selected in 12 community centres using stratified sampling by blocks. Inclusion criteria: being aged 65 or over, living at home, having functional autonomy, residing in the province of study for more than one year, regularly attending community centres and voluntarily wanting to take part. Results Of the 660 subjects studied, 319 were men (48.3%) and 341 (51.7%) women with a mean age of 74.3 years (SD = 6.6). In terms of nutritional assessment, using the BMI-MNA-SF and the CC-MNA-SF we found that 26.5% and 26.2% were at risk of malnutrition and 0.9% and 1.5% were malnourished respectively. With the full MNA, 23.3% were at risk of malnutrition. Spearman’s rank correlation coefficients indicate a high association between the full MNA score and the MNA-SFs scores (BMI-MNA-SF: ρ = 0.78p < 0.001; CC-MNA-SF: ρ = 0.78p < 0.001). In addition we obtained a very high correlation between the two MNA-SFs (ρ = 0.96p < 0.001). We evaluated the agreement between the full MNA and the MNA-SFs classification in three nutritional categories (normal nutritional status, risk of malnutrition, malnutrition) with Cohen’s kappa coefficients (BMI-MNA-SF: κ = 0.54p < 0.001; CC-MNA-SF: κ = 0.52p < 0.001). These values indicate moderate agreement with the full MNA. There is very good agreement between the BMI-MNA-SF and CC-MNA-SF (κ = 0.88p < 0.001). In order to determine the ability of both MNA-SFs to identify subjects not requiring any nutritional intervention, we considered the dichotomised categorisation of the full MNA and the MNA-SFs as “normal nutritional status” vs. “malnutrition and risk of malnutrition” Areas under the ROC curves using MNA as the gold standard indicate moderately high prognostic accuracy (BMI-MNA-SF: AUC = 0.88p < 0.001; CC-MNA-SF: AUC = 0.87 p < 0.001). Both versions of the MNA-SF showed similar sensitivity, specificity and diagnostic effectiveness (BMI-MNA-SF: 73.4%, 86.6%, 83.5%; CC-MNA-SF 73.4%, 86.2%, 83.2%). Conclusions In its two versions the MNA-SF presents useful predictive ability against the MNA. The advantage of the CC-MNA-SF is that using it requires fewer resources and less time in primary care, although always the characteristics of the population must take into account to make the right decision based on the MNA-SF scales.


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.


2013 ◽  
Vol 110 (6) ◽  
pp. 1126-1132 ◽  
Author(s):  
Alan C. Tsai ◽  
Tsui-Lan Chang ◽  
Jiun-Yi Wang

The present study was aimed to validate two normalised short-form (SF) Mini-Nutritional Assessments (MNA) that contained either BMI (Taiwan version 1, T1) or calf circumference (CC; Taiwan version 2, T2) for rating the nutritional status of elderly Taiwanese. Both versions adopted Taiwanese anthropometric cut-offs, but T2 further had the BMI item replaced by CC. We compared the ability of the two SF in rating the nutritional status of 2674 elderly Taiwanese in the 1999 ‘Taiwan Longitudinal Survey on Aging’ with their respective full versions. We evaluated the agreement between the SF and full scales with weighted κ and performed Cox regression analysis for the follow-up 4-year mortality according to nutritional status rated at baseline. The results showed that the agreements between the respective SF and the full MNA were good (weighted κ: 0·679 for T1 and 0·667 for T2). Both SF performed well in predicting follow-up 4-year mortality relative to the full MNA. In conclusion, MNA-T1-SF and -T2-SF have good consistency with the full MNA and have quite comparable abilities in rating the nutritional status of elderly Taiwanese. Both SF versions appear appropriate for functioning as stand-alone units for rating the nutritional status of the elderly in community-living settings or the general population.


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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