The Journal of Nutrition Health and Aging

, Volume 12, Issue 1, pp 39–43 | Cite as

Prevalence of eating difficulties and malnutrition among persons within hospital care and special accommodations

  • A. Westergren
  • C. Lindholm
  • C. Axelsson
  • K. Ulander
Geriatric Science


Objectives: The aim of this study was to explore the prevalence of eating difficulties and malnutrition among persons in hospital care and in special accommodations.Design: The cross-sectional observational study was performed in Nov. 2005.Setting: Hospitals and special accommodations.Participants: Out of 2945 persons, 2600 (88%) agreed to participate (1726 from special accommodations and 874 from hospitals). In total all special accommodations in six municipalities and six hospitals were involved.Measurements: Risk of undernutrition was estimated as at least two of: body mass index below recommendation, weight loss and/or eating difficulties. Overweight was graded based on body mass index (if 69 years or younger: 25 or above: if 70 years or older: 27 or above).Results: The mean age of those living in hospitals was 69 years and 53% were women, while the corresponding figures for those in special accommodations were 85 years and 69% women. In hospitals and special accommodations, eating difficulties were common (49% and 56% respectively) and about one quarter had a body mass index (BMI) below the limits (20% and 30% respectively) and one-third above the limit (39% and 30% respectively) thus only about 40% had a BMI within the limits. Both in hospitals and in special accommodations 27% were considered to have a moderate or high risk of undernutrition. Conclusion: Only about 40% in special accommodations and hospital care have a BMI within the recommended limits. As both low and high BMI are frequent in both settings, the focus of care should not only be on undernutrition but also on overweight. Using the Swedish criteria for defining risk of undernutrition seems to give a slightly lower prevalence than has been shown in previous Swedish studies, but this can be due to an underestimation of the occurrence of eating difficulties.

Key words

Hospital special accommodation eating difficulties malnutrition undernutrition overweight 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    SNUS, Samarbetsgruppen for nutritionens utveckling i Sverige. [Co-operation group for the nutrition development in Sweden] (2004) Nutritionsbehandling i sjukvård och omsorg. [Nutritional treatment in care and service] Dietisternas Riksförbund, Nutritionssällskapet för sjuksköterskor, Svensk Förening för Klinisk Nutrition, SWESPEN, Stockholm. In Swedish.Google Scholar
  2. 2.
    Elmståhl, S. (2001) Malnutrition i svensk sjukvård och omsorg. [Malnutrition in Swedish care and service] Socialmedicinsk tidskrift 4: 356–364. In Swedish.Google Scholar
  3. 3.
    Tierney, A. J. (1996) Undernutrition and elderly hospital patients: a review. Journal of Advanced Nursing 23: 228–236.PubMedCrossRefGoogle Scholar
  4. 4.
    Lindström, M., Isacsson, S. O.& Merlo, J. (2003) Increasing prevalence of overweight, obesity and physical inactivity: two population-based studies 1986 and 1994. European Journal of Public Health 13: 306–312.PubMedCrossRefGoogle Scholar
  5. 5.
    Eiben, G., Dey, D. K., Rothenberg, E., Steen, B., Bjorkelund, C., Bengtsson, C. & Lissner, L. (2005) Obesity in 70-year-old Swedes: secular changes over 30 years. International Journal of Obesity 29: 810–817.PubMedCrossRefGoogle Scholar
  6. 6.
    WHO (1998) Obesity: preventing and managing the global epidemic. Report of a WHO Consultation on Obesity. World Health Organization., Geneva, Switzerland.Google Scholar
  7. 7.
    Heiat, A., Vaccarino, V. & Krumholz, H. M. (2001) An evidence-based assessment of federal guidelines for overweight and obesity as they apply to elderly persons. Archives of Internal Medicine 161: 1194–1203.PubMedCrossRefGoogle Scholar
  8. 8.
    Sorkin, J. D., Muller, D. C. & Andres, R. (1999) Longitudinal change in height of men and women: implications for interpretation of the body mass index: the Baltimore Longitudinal Study of Aging. American Journal of Epidemiology 150: 969–977.PubMedGoogle Scholar
  9. 9.
    Westergren, A., Unosson, M., Ohlsson, O., Lorefalt, B. & Hallberg, I. R. (2002) Eating difficulties, assisted eating and nutritional status in elderly (> or = 65 years) patients in hospital rehabilitation. International Journal of Nursing Studies 39: 341–351.PubMedCrossRefGoogle Scholar
  10. 10.
    Westergren, A. (2006) Detection of eating difficulties after stroke: a systematic review. International Nursing Review 53: 143–149.PubMedCrossRefGoogle Scholar
  11. 11.
    Vellas, B., Guigoz, Y., Garry, P. J., Nourhashemi, F., Bennahum, D., Lauque, S. & Albarede, J. L. (1999) The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition 15: 116–122.PubMedCrossRefGoogle Scholar
  12. 12.
    Calle, E. E., Thun, M. J., Petrelli, J. M., Rodriguez, C. & Heath, C. W., Jr. (1999) Body-mass index and mortality in a prospective cohort of U.S. adults. New England Journal of Medicine 341: 1097–1105.PubMedCrossRefGoogle Scholar
  13. 13.
    Allison, D. B., Gallagher, D., Heo, M., Pi-Sunyer, F. X. & Heymsfield, S. B. (1997) Body mass index and all-cause mortality among people age 70 and over: the Longitudinal Study of Aging. International Journal of Obesity and Related Metabolic Disorders 21: 424–431.PubMedCrossRefGoogle Scholar
  14. 14.
    Cornoni-Huntley, J. C., Harris, T. B., Everett, D. F., Albanes, D., Micozzi, M. S., Miles, T. P. & Feldman, J. J. (1991) An overview of body weight of older persons, including the impact on mortality. The National Health and Nutrition Examination Survey I — Epidemiologic Follow-up Study. Journal of Clinical Epidemiology 44: 743–753.PubMedCrossRefGoogle Scholar
  15. 15.
    Harris, T., Cook, E. F., Garrison, R., Higgins, M., Kannel, W. & Goldman, L. (1988) Body mass index and mortality among nonsmoking older persons. The Framingham Heart Study. The Journal of the American Medical Association 259: 1520–1524.CrossRefGoogle Scholar
  16. 16.
    Horani, M. H. & Mooradian, A. D. (2002) Management of obesity in the elderly: special considerations. Treatments in Endocrinology 1: 387–398.PubMedCrossRefGoogle Scholar
  17. 17.
    Villareal, D. T., Apovian, C. M., Kushner, R. F. & Klein, S. (2005) Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. The American Journal of Clinical Nutrition 82: 923–934.PubMedGoogle Scholar
  18. 18.
    Mowe, M. & Böhmer, T. (2002) Reduced appetite. A predictor for undernutrition in aged people. The Journal of Nutrition, Health & Aging 6: 81–83.Google Scholar
  19. 19.
    Christensson, L., Unosson, M. & Ek, A. C. (1999) Malnutrition in elderly people newly admitted to a community resident home. Journal of Nutrition, Health & Aging 3: 133–139.Google Scholar
  20. 20.
    Axelsson, K. (1988) Eating problems and nutritional status after stroke. Umeå University, Umeå. Thesis.Google Scholar
  21. 21.
    Jacobsson, C. (2000) Eating training after stroke and its cost-effectiveness. Umeå University, Umeå. Thesis.Google Scholar
  22. 22.
    Sidenvall, B. (1995) The meal in geriatric care: Habits, values and culture. Linköping University, Linköping. Thesis.Google Scholar

Copyright information

© Spinger-Verlag France and Serdi Éditions 2008

Authors and Affiliations

  • A. Westergren
    • 1
    • 2
    • 3
  • C. Lindholm
    • 3
  • C. Axelsson
    • 3
  • K. Ulander
    • 3
  1. 1.Research and Development UnitCentral Hospital KristianstadKristianstadSweden
  2. 2.The Vårdal Institute, the Swedish Institute for Health ScienceLund UniversityLundSweden
  3. 3.The Department of Health SciencesKristianstad UniversitySweden

Personalised recommendations