Assessment of Malnutrition in Community-dwelling Elderly People: Cooperation among General Practitioners and Public Health
AbstractBackground: Malnutrition, a very common condition in the elderly, is known to increase their vulnerability to adverse health events. This study aimed to estimate the prevalence of malnutrition in the over 75-yr-old community-dwelling population in the “Chiavarese” Local Health Unit district (North West Italy).Methods: The short version of the Mini Nutritional Assessment (MNA-SF) was used by General Practitioners (GP) as a screening tool to investigate the nutritional status of elderly people (1039 subjects). The study was conducted in 2012- 2013 in the Local Health Unit of Chiavari (Liguria Region), Italy. The malnutrition was subsequently confirmed by means of biochemical parameters. Subjects at risk of malnutrition or malnourished (n=22) received personalized dietary counseling by the GP.Results: The MNA-SF recognized 21% of the elderly people being at risk of malnutrition and biochemical tests confirmed a malnutrition prevalence of 3.5%. The dietary counseling improved the MNA-SF score and biochemical parameters, but the difference was statistically significant only for the MNA-SF score (P=0.00613).Conclusion: Malnutrition can be evaluated with a simple tool such as the MNA-SF, recognized at the earliest stage and successfully treated by the GP.
Lochs H, Allison SP, Meier R et al (2006). Introductory to the ESPEN Guidelines on enteral nutrition: terminology, defini-tions and general topics. Clin Nutr, 25: 180-186.
Bales CW, Buhr G (2008). Is obesity bad for older persons? A systematic review of the pros and cons of weight reduction in lat-er life. J Am Med Dir Assoc, 9 (5): 302-12.
Morley JE (2010). Nutrition and the aging male. Clin Ger Med, 26(2): 287-99.
Morley JE (2012). Undernutrition in older adults. Family Pratice, 29: i89-i93.
Morley JE, Miller DK, Perry HM et al (1999). Anorexia of aging, leptin, and the Mini Nutritional Assessment. Nestle Nutr Workshop Ser Clin Perform Programme,1: 67-76.
Edington J, Boorman J, Durrant ER et al (2000). Prevalence of malnutrition on admission to four hospitals in England. The Malnutrition Prevalence Group. Clin Nutr, 19 (3): 191-195.
Visvanathan R, Macintosh C, Callary M et al (2003). The nutritional status of 250 older Australian recipients of domiciliary care services and its association with out-comes at 12 months. J Am Geriatr Soc, 51(7): 1007-1011.
Neumann SA, Miller MD, Daniels L et al (2005). Nutritional status and clinical out-comes of older patients in rehabilitation. J Hum Nutr Diet,18(2): 129-136.
Rasheed S, Woods RT (2013). Malnutrition and quality of life in older people: A sys-tematic review and meta-analysis. Ageing Res Rev, 12:561-566.
Agarwal E, Miller , Yaxley A et al (2013). Malnutrition in the elderly: a narrative re-view. Maturitas, 76: 296-302.
Sullivan DH, Bopp MM, Roberson PK (2002). Protein-energy undernutrition and life-threatening complications among the hospitalized elderly. J Gen Intern Med, 17(12): 923-932.
Kaiser MJ, Bauer JM, Rämsch C et al (2010). Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc, 58(9):1734-1738.
Thomas DR, Zdrowski CD, Wilson MM et al (2002). Malnutrition in subacute care. Am J Clin Nutr, 75(2): 308-313.
Visvanathan R. (2003). Under-nutrition in older people: a serious and growing global problem! J Postgrad Med, 49(4), 352-360.
Saletti A, Johansson L, Yifter-Lindgren E et al (2005). Nutritional status and a 3-year follow-up in elderly receiving support at home. Gerontology, 51(3),192-198.
Iizaka S, Tadaka E, Sanada H (2008). Com-prehensive assessment of nutritional sta-tus and associated factors in the healthy, community-dwelling elderly. Geriatr Geron-tol Int, 8(1), 24-31.
Leggo M, Banks M, Isenring E et al (2008). A quality improvement nutrition screen-ing and intervention program available to home and community care eligible clients. Nutrition & Dietetics, 65: 162-167.
Cuervo M, García A, Ansorena D et al (2009). Nutritional assessment interpreta-tion in 22,007 Spanish community-dwelling elders through the Mini Nutri-tional Assessment test. Public Health Nutr, 12: 82-90.
Timpini A, Facchi E, Cossi S et al (2011). Self-reported socio-economic status, so-cial, physical and leisure activities and risk for malnutrition in late life: a cross-sectional population-based study. J Nutr Health Aging, 15(3): 233-238.
Turconi G, Rossi M, Roggi C et al (2013). Nutritional status, dietary habits, nutri-tional knowledge and self-care assess-ment in a group of older adults attending community centres in Pavia, Northern It-aly. J Human Nutr Diet, 26: 48–55.
Gallo F, Lucarini S, Boicelli R et al (2012). Sorveglianza nutrizionale e prevenzione della malnutrizione nella popolazione istituzionalizzata della ASL4 Chiavarese. G Gerontol, 60: 264-271.
Donini LM, Scardella P, Piombo L et al (2013). Malnutrition in elderly: social and economic determinants. J Nutr Health Ag-ing, 17(1): 9-15.
Edington J, Barnes R, Bryan F et al (2004). A prospective randomised controlled trial of nutritional supplementation in mal-nourished elderly in the community: clini-cal and health economic outcomes. Clin Nutr, 23(4): 195-204.
Bissoli L, Zamboni M, Sergi G et al (2001). Linee Guida per la valutazione della malnutrizione nell’anziano. G Gerontol, 49: 4-12.
Bauer JM, Kaiser MJ, Anthony P et al (2008). The Mini Nutritional Assessment--its history, today’s practice, and future perspectives. Nutr Clin Pract, 23(4): 388-96.
Rubenstein LZ, Harker JO, Salvà A et al (2001). Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci, 56(6): M366-M372.
Vellas B, Villars H, Abellan G et al (2006). Overview of the MNA--Its history and challenges. J Nutr Health Aging, 10(6): 456-463.
Sergi G, Coin A, Enzi G et al (2006). Role of visceral proteins in detecting malnutrition in the elderly. Eur J Clin Nutr, 60(2): 203-209.
Gallo F, Haupt E, Devoto GL et al (2011). Seriate prealbumin and C-reactive protein measurements in monitoring nutritional intervention in hospitalized patients: a prospective observational study. Mediterr J Nutr Metab, 4:191-195.
Schilp J, Kruizenga HM, Wijnhoven HA et al (2013). Effects of a dietetic treatment in older, undernourished, community-dwelling individuals in primary care: a randomized controlled trial. Eur J Nutr, 52(8), 1939-1948.
Nykänen I, Rissanen TH, Sulkava R et al (2014). Effects of individual dietary coun-seling as part of a comprehensive geriat-ric assessment (CGA) on nutritional sta-tus: a population-based intervention study. J Nutr Health Aging, 18(1): 54-58.