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Malnutrition in elderly: Social and economic determinants

  • Published:
The journal of nutrition, health & aging

Abstract

Malnutrition occurs frequently in the frailest groups of the population, especially in people who are on a low income and elderly subjects, overall if they are institutionalized. The aim of this study was to assess the prevalence of malnutrition in a sample of elderly people living in different settings and to identify the determinants of malnutrition.

Methods

A total of 718 subjects, 472 females (F) and 246 males (M), were recruited from nursing homes or were free living in three different regions in Italy. Nutritional status, depression, social, functional and cognitive status, were evaluated.

Results

According to the Mini Nutritional Assessment (MNA), a high prevalence of malnutrition was found out in both genders: 26% of F and 16.3% of M were classified as being malnourished (MNA<17); 40.9% of F and 35% of M were at risk of malnutrition (MNA 17–23,5). The prevalence of malnutrition was significantly higher in NH subjects in both sexes. Moreover, a relationship was shown between malnutrition and inability to shop, prepare and cook meals because of a low income, distance from markets or supermarkets as well as impossibility to drive the car or to use public transportation. This study confirms the necessity to routinely perform nutritional status evaluation in elderly subjects, to carry out training courses for health workers (doctors, nurses, psychologists, dietitians), to implement nutritional education of the geriatric population, to develop tools and guidelines for health workers and caregivers, to identify and reduce clinical, functional, social or economic risk factors for malnutrition.

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References

  1. Stratton RJ, Green CJ, Elia M. Related Malnutrition: an Evidence Based Approach to Treatment Oxford: CABI; 2003.)

    Google Scholar 

  2. Lattanzio F, Laino I, Pedone C, Corica F, Maltese G, Salerno G, Garasto S. Corsonello A, Incalzi RA; on behalf of the PharmacosurVeillance in the elderly Care (PVC) Study Group.: Geriatric Conditions and Adverse Drug Reactions in Elderly Hospitalized Patients. Am Med Dir Assoc. 2011 May 27)

  3. Joseph ML, Carriquiry A.: A measurement error approach to assess the association between dietary diversity, nutrient intake, and mean probability of adequacy. J Nutr. 2010 Nov;140(ll):2094S–2101S;.

    PubMed  CAS  Google Scholar 

  4. Torheim LE, Ferguson EL, Penrose K, Arimond M: Women in resource-poor settings are at risk of inadequate intakes of multiple micronutrients. J Nutr. 2010 Nov;140(ll):2051S–2058S; Lee MR, Berthelot ER. Community covariates of malnutrition based mortality among older adults. Ann Epidemiol. 2010 May;20(5):371–9)

    PubMed  CAS  Google Scholar 

  5. Office of National Statistics. Population trends. FT 118, table 1,4.(population age and sex) London: ONS;2004.)

  6. Office of National Statistics. Living in Britain: results from the 2002 General Household Survey. London: ONS; 2004).

  7. Paraielee PA, Thuras PD, Katz IR, Lawton MP: Validation of the Cumulative Illness Rating Scale in a geriatric residential population. J Am Geriatr Soc 1995, 43(2): 130–137).

    Google Scholar 

  8. Guigoz Y, Vellas B, Garry PJ. Facts, research and intervention in gerontology. In: The Mini Nutritional Assessment: a practical assessment tool for grading the nutritional state of elderly persons. 3rd ed. Paris: Serdi Publishing Company, 1997: 15–60.

    Google Scholar 

  9. Pfeiffer E: A short portable mental status questionnaire for the assessment of organic brain deficit in elderly subjects. J Am Geriatr Soc 1975, 23(10):433–441)

    PubMed  CAS  Google Scholar 

  10. Yesavage JA, Brink TL, Rose TL. Development and validation of a geriatric depression screening scale. A preliminary report. J Psych Res 1983; 17: 37–49

    Article  CAS  Google Scholar 

  11. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969; 9(3): 179–186

    Article  PubMed  CAS  Google Scholar 

  12. Katz S. Assessing self-maintenance: activities of daily living, mobility, and instrumental activities of daily living. J Am Geriatr Soc 1983; 31:721–727.).

    PubMed  CAS  Google Scholar 

  13. Rosen SL, Reuben DB: Geriatric assessment tools. Mt Sinai J Med. 2011 Jul;78(4):489–497

    Article  PubMed  Google Scholar 

  14. Cereda E, Pedrolli C, Zagami A, Vanotti A, Piffer S, Opizzi A, Rondanelli M, Caccialanza R: Nutritional screening and mortality in newly institutionalised elderly: A comparison between the Geriatric Nutritional Risk Index and the Mini Nutritional Assessment. Clin Nutr. 2011 Jun 30)

  15. Volkert D, Pauly L, Stehle P, Sieber CC: Prevalence of malnutrition in orally and tube-fed elderly nursing home residents in Germany and its relation to health complaints and dietary intake. Gastroenterol Res Pract. 2011;2011:247315.

    PubMed  Google Scholar 

  16. Donini LM, Savina C, Piredda M, Cucinotta D, Fiorito A, Inelmen EM, Sergi G, Domiguez LJ, Barbagallo M, Cannella C. Senile anorexia in acute-ward and rehabilitations settings. J Nutr Health Aging. 2008 Oct;12(8):511–517

    Article  PubMed  CAS  Google Scholar 

  17. De Lorenzo A, Deurenberg P, Pietrantuono M, Di Daniele N, Cervelli V, Andreoli A: How fat is obese? Acta Diabetol 2003, 40Suppl 1:S254–S257

    Article  PubMed  Google Scholar 

  18. Kagansky N, Beraer Y, Koren-Morag N, Perelman L, Knobler H, Levy S: Poor nutritional habits are predictors of poor outcome in very old hospitalized subjects. Am J Clin Nutr 2005, 82(4):784–791; quiz 913–784)

    PubMed  CAS  Google Scholar 

  19. Webber CB, Splett PL. Nutrition risk factors in a home health population. Home Health Care Serv Q 1995; 15: 97–110

    Article  PubMed  CAS  Google Scholar 

  20. Wellman NS, Weddle DO, Kranz S, Brain CT. Elder insecurities: poverty, hunger, and malnutrition. J Am Diet Assoc 1997; 97(10 Suppl 2): S120–S122

    Article  PubMed  CAS  Google Scholar 

  21. Macintosh C, Morley JE, Chapman IM. The anorexia of aging. Nutrition 2000; 16: 983–995

    Article  PubMed  CAS  Google Scholar 

  22. Marcus EL, Berry EM. Refusal to eat in the elderly. Nutr Rev 1998; 56: 163–171

    Article  PubMed  CAS  Google Scholar 

  23. Donini LM, Savina C, Piredda M, et al. Senile anorexia in acute-ward and rehabilitation settings. J Nutr Health Aging 2008; 12: 511–517

    Article  PubMed  CAS  Google Scholar 

  24. Morley JE. Decreased food intake with aging. J Gerontol A Biol Sci Med Sci 2001; 56Spec No 2: 81–88

    Article  PubMed  Google Scholar 

  25. Ramie E, Pranjic N, Batic-Mujanovic O, Karic E, Alibasic E, Alic A.: The effect of loneliness on malnutrition in elderly population. Med Arh. 2011;65(2):92–95

    Google Scholar 

  26. German L, Kahana C, Rosenfeld V, Zabrowsky I, Wiezer Z, Fraser D, Shahar DR.: Depressive symptoms are associated with food insufficiency and nutritional deficiencies in poor community-dwelling elderly people. J Nutr Health Aging. 2011;15(l):3–8).

    Article  PubMed  Google Scholar 

  27. Morley JE. Anorexia of aging: physiological and pathological. Am J Clin Nutr. 1997;66:760–773

    PubMed  CAS  Google Scholar 

  28. Donini LM, Savina C, Cannella C. Appetite and ageing. In: Raats M, van Staveren W, de Groot L, eds. Food for the ageing population. Cambridge (England): Woodhead Publishing Limited, 2009: 43–72

    Chapter  Google Scholar 

  29. Morley JE. Anorexia, sarcopenia, and aging. Nutrition 2001; 17: 660–673

    Article  PubMed  CAS  Google Scholar 

  30. Morley JE, Thomas DR. Anorexia and aging: pathophysiology. Nutrition 1999; 15: 499–503

    Article  PubMed  CAS  Google Scholar 

  31. Savina C, Donini LM, Cannella C. Anorexia of Aging. In: Randal LO, ed. Aging and the Elderly. New York: Nova Science Publisher, 2007: 139–151

    Google Scholar 

  32. Rivière S, Gillette-Guyonnet S, Voisin T, et al. A nutritional education program could prevent weight loss and slow cognitive decline in Alzheimer’s disease. J Nutr Health Aging 2001; 5: 295–299

    PubMed  Google Scholar 

  33. Webber CB, Splett PL. Nutrition risk factors in a home health population. Home Health Care Serv Q 1995; 15: 97–110

    Article  PubMed  CAS  Google Scholar 

  34. Wellman NS, Weddle DO, Kranz S, Brain CT. Elder insecurities: poverty, hunger, and malnutrition. J Am Diet Assoc 1997; 97(10 Suppl 2): S120–S122

    Article  PubMed  CAS  Google Scholar 

  35. UNDP. Human Development Report 2008. New York: UNDP, 2008

    Google Scholar 

  36. ISTAT. La povertà assoluta in Italia nel 2007. Roma: ISTAT, 2009 www.istat.it

    Google Scholar 

  37. ISTAT 2009. La situazione del Paese nel 2008. Rapporto Annuale. Roma: ISTAT, 2009 www.istat.it

    Google Scholar 

  38. Casper RC. Nutrition and its relationship to aging. Exp Gerontol 1995; 30(3–4):299–314

    Article  PubMed  CAS  Google Scholar 

  39. Donini LM, Savina C, Cannella C. Eating habitus and appetite control in the elderly: the anorexia of aging. Intern Psychogeriatr 2003; 15: 73–87

    Article  Google Scholar 

  40. Sun LJ, Frongillo, EA. Nutritional and health consequences are associated with food insecurity among US elderly persons. J Nutr 2001; 131:1503–1509

    Google Scholar 

  41. Wolfe, WS, Frongillo, EA, Valois, P. Understanding the experience of food insecurity by elders suggests ways to improve its measurement. J Nutr 2003; 133: 2762–2769

    PubMed  CAS  Google Scholar 

  42. Che J, Chen J. Food insecurity in Canadian households. Health Rep 2001; 12: 11–22

    PubMed  CAS  Google Scholar 

  43. Bouis HE, Eozenou P, Rahman A.: Food prices, household income, and resource allocation: socioeconomic perspectives on their effects on dietary quality and nutritional status. Food Nutr Bull. 2011 Mar;32(l Suppl):S14–S23)

    PubMed  Google Scholar 

  44. Ferdous T, Cederholm T, Kabir ZN, Hamadani ID, Wahlin A. Nutritional status and cognitive function in community-living rural Bangladeshi older adults: data from the poverty and health in ageing project. J Am Geriatr Soc. 2010 May;58(5):919–924

    Article  PubMed  Google Scholar 

  45. L.M. Donini, MR De Felice, L. Tassi, L. De Beraardini, A Pinto, AM Giusti, C. Cannella: A proportional and objective score for the Mini Nutritional Assessment in long-term geriatric care. J Nutr Health & Aging 2002, 6, 2141–2146

    Google Scholar 

  46. Tsai AC, Chang TL, Wang YC, Liao CY.: Population-specific short-form mini nutritional assessment with body mass index or calf circumference can predict risk of malnutrition in community-living or institutionalized elderly people in taiwan. J Am Diet Assoc. 2010 Sep; 110(9): 1328–1334.

    Article  PubMed  Google Scholar 

  47. Kaiser MJ, Bauer JM, Uter W, Donini LM, Stange I, Volkert D, Diekmann R, Drey M, Bollwein J, Tempera S, Guerra A, Ricciardi LM, Sieber CC. Prospective validation of the modified mini nutritional assessment short-forms in the community, nursing home, and rehabilitation setting. J Am Geriatr Soc. 2011 Nov;59(11):2124–2128.

    Article  PubMed  Google Scholar 

  48. Cudennec T, Lagrandeur J, Moulias S, Moussous W, Colombier B, Teillet L.: Should caregivers be concerned with the nutritional state of elderly patients?. Soins Gerontol. 2011 May–Jun;(89):24–26.

  49. Seligman HK, Laraia BA, Kushel MB.: Food insecurity is associated with chronic disease among low-income NHANES participants J Nutr. 2010 Feb;140(2):304–310

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Sapienza University of Rome (Italy — Experimental Medicine Department, Medical Physiopathology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, Rome, Italy

    Lorenzo M. Donini, R. Asprino & A. R. Proietti

  2. Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà (INMP), Rome, Italy

    P. Scardella, L. Piombo & A. Morrone

  3. Rehabilitation Clinical Institute “Villa delle Querce” — Nemi, Rome, Italy

    B. Neri, S. Carcaterra & E. Cava

  4. “Villa Laura”, Bologna, Italy

    S. Cataldi & D. Cucinotta

  5. Dipartimento di Medicina Interna e Patologie Emergenti, UO Geriatria, Università degli Studi di Palermo, Palermo, Italy

    G. Di Bella & M. Barbagallo

Authors
  1. Lorenzo M. Donini
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  2. P. Scardella
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  3. L. Piombo
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  7. S. Carcaterra
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  9. S. Cataldi
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  10. D. Cucinotta
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  11. G. Di Bella
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  12. M. Barbagallo
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  13. A. Morrone
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Correspondence to Lorenzo M. Donini.

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Donini, L.M., Scardella, P., Piombo, L. et al. Malnutrition in elderly: Social and economic determinants. J Nutr Health Aging 17, 9–15 (2013). https://doi.org/10.1007/s12603-012-0374-8

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  • DOI: https://doi.org/10.1007/s12603-012-0374-8

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