Abstract
Objectives
To identify older subjects at risk of malnutrition using the most appropriate tool available for the specific setting and to evaluate the Mini Nutritional Assessment short form (MNA-SF) in a sample of nonagenarians.
Design
Questionnaire based national screening week for the risk and prevalence of malnutrition in older people (NutriAction).
Setting
Older people in the community (CD) and in nursing homes (NH).
Participants
General practices (n=70) and Nursing Homes (n=70).
Measurements
Questionnaire based on items from validated screening instruments: the MNA-SF, the Short Nutritional Assessment Questionnaire (SNAQ) and additional clinically relevant parameters (mobility, independence, social isolation and co-morbidities).
Results
In total 5,334 people were screened of which 16% were aged over 90 years. In this age group, 66% of the screened individuals were at risk of malnutrition (MNA ≤ 11), and women were affected significantly more than men (p<0.001). Actual malnutrition was present in 22% (BMI <20), 20% (SNAQ) and 25% (clinical evaluation). The MNA appeared to be very sensitive but had a low specificity as well in the nonagenarians (98% and 44%) as in the younger old (97% and 52%). The SNAQ was not a sensitive tool for detecting malnutrition in this study population (25%). Although clinical impression had a low sensitivity (60–61%) it has a good specificity (86% in 90+ and 91% below 90yr).
Conclusion
The overall risk of and the prevalence of malnutrition is common in older people. The prevalence is higher in women, in nursing homes and in older age groups. The MNA-SF followed by a clinical subjective evaluation seems to be the preferred strategy for detecting malnutrition in nonagenarians.
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Abbreviations
- MNA-SF:
-
Mini-Nutritional Assessment-Short Form
- SNAQ:
-
Short Nutritional Assessment Questionnaire
- CD:
-
community dwelling
- NH:
-
nursing home
References
Pirlich M, Schutz T, Kemps M, Luhman N, Burmester GR, Baumann G et al. Prevalence of malnutrition in hospitalized medical patients: impact of underlying disease. Dig Dis 2003; 21(3): 245–251.
Elia M, Stratton RJ, Russell C, Green CJ, Pang F. The cost of disease-related malnutrition in the UK and economic considerations for the use of oral nutritional supplements in adults. Redditch: BAPEN; 2005.
Kondrup J, Allison SP, Elia M, Vellas B and Plauth M. ESPEN guidelines for nutrition screening 2002. Clin Nutr 2003; 22(4): 415–421.
Stratton RJ, Green CJ and Elia M. Disease-related malnutrition: an evidence-based approach to treatment. Wallingford: CABI Publishing; 2003.
Hébuteme X, Broussard JF and Rampai P. Acute renutrition by cyclic enteral nutrition in elderly and younger patients. JAMA 1995; 273: 638–643.
Schneider S, Al-Jaouni R, Pivot X, Bender Baulio V, Rampai P and Hébuteme X. Lack of adaptation to severe malnutrition in elderly patients. Clin Nutr 2002; 21: 499–504.
http://statbel.fgov.be/nl/statistieken/cijfers; consulted May 25th 2012
Philips MB, Foley AL, Barnard R, Isenring EA and Miller MD. Nutritional screening in community-dwelling older adults: a systematic literature review. Asia Pac J Clin Nutr 2010; 19(3): 440–449.
Vandewoude M, Nutritional assessment in geriatric cancer patients, Support Care Cancer 2010; 18(Suppl 2):S51–S56.
Kondrup J, Allison SP, Elia M, Vellas B, Plauth M. ESPEN guidelines for nutrition screening 2002. Clin Nutr 2003;22(4): 415–421.
Kruizenga HM, Seidell JC, de Vet HCW, Wierdsma NJ, van Bokhorst-de van der Schueren MAE. Development and validation of a hospital screening tool for malnutrition: the short nutritional assessment questionnaire (SNAQ). Clin Nutr 2005; 24: 75–82.
Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Anthony P et al. World-wide data on malnutrition in the elderly according to the mini nutritional assessment (MNA)-insights from an international pooled database. Clin Nutr 2009; 4(Suppl 2): 113
Hoeck S, François G, Geeits J, Van der Heyden J, Vandewoude M, Van Hal G. Health-care and home-care utilization among frail elderly persons in Belgium. Eur J Public Health, 2012,22(5):671–677.
Rubenstein L, Hacker J, Salva A, Guigoz Y, Vellas B. Screening for undernutrition in geriatric practice: developing the short-form mini nutritional assessment (MNA-SF). J Gerontol 2001; 56A: M366–M372.
Neelemaat F, Kruizenga H, de Vet H, Seidell J, Butterman M, Van Bokhorst-de, Van der Schueren M. Screening malnutrition in hospital oupatients. Can the SNAQ malnutrition screening tool also be applied to this population? Clin Nutr 2008; 27: 439–446.
Charlton K, Kolbe-Alexander T, Nel J. The MNA but not the DETERMINE, screening tool is a valid indicator of nutritional status in elderly Africans. Nutrition 2007;23:533–542.
Patterson A, Young A, Powers J, Brown W, Byles J. Relationship between nutrition screening checklists and the health and well-being of older Australian women. Publ Health Nutr 2002; 5: 65–71.
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Vandewoude, M., Van Gossum, A. Nutritional screening strategy in nonagenarians: The value of the MNA-SF (Mini Nutritional Assessment short form) in NutriAction. J Nutr Health Aging 17, 310–314 (2013). https://doi.org/10.1007/s12603-013-0033-8
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DOI: https://doi.org/10.1007/s12603-013-0033-8