Malnutrition in subacute care

Thomas, David; Zdrowski, Carolyn D; Wilson, Margaret‐Mary G.; Conright, Kelly C; Lewis, Cecelia; Tariq, Syed H.; Morley, John E.

doi:10.1093/ajcn/75.2.308

Cited by 221 publications

(152 citation statements)

References 25 publications

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“…Using MNA, Persson et al 31 report similar prevalences of PEM (26%) and moderate PEM or at risk of being PEM (56%) among Swedish geriatric patients as found in our study. Thomas et al 32 describe malnutrition to have reached epidemic proportions in a sub-acute care facility in St. Louis, USA, with the prevalence of either malnourished or at risk of malnutrition among its geriatric patients reported as more than 90%, a figure similar to that in the present study. Among studies of non-institutionalised elderly persons in the USA and Europe, the prevalence of nutritional risk is reported to range between 18% and 41%, whereas none were found to suffer from malnutrition 33 -35 .…”

Section: Who Are Undernourished?supporting

confidence: 86%

Mini Nutritional Assessment of rural elderly people in Bangladesh: the impact of demographic, socio-economic and health factors

Kabir

Ferdous

Cederholm

et al. 2006

PHN

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Objective: In stating the Millennium Development Goals, the United Nations aims to halve malnutrition around the world by 2015. Nutritional status of the elderly population in low-income countries is seldom focused upon. The present study aimed to evaluate the magnitude of malnutrition among an elderly population in rural Bangladesh. Design and setting: Data collection for a multidimensional cross-sectional study of community-based elderly people aged 60 years and over was conducted in a rural area in Bangladesh. Subjects: Of 850 randomly selected elderly individuals, 625 participated in home interviews. Complete nutritional information was available for 457 individuals (mean age 69^8 years, 55% female). Nutritional status was assessed using an adapted form of the Mini Nutritional Assessment (MNA) including body mass index (BMI). Age, sex, education, household expenditure on food and self-reported health problems were investigated as potential predictors of nutritional status. Results: BMI , 18.5 kg m 22 , indicating chronic energy deficiency, was found in 50% of the population. MNA revealed a prevalence of 26% for protein -energy malnutrition and 62% for risk of malnutrition. Health problems rather than age had a negative impact on nutritional status. Level of education and food expenditure were directly associated with nutritional status. Conclusion: In order to reduce world hunger by half in the coming decade, it is important to recognise that a substantial proportion of the elderly population, particularly in low-income countries, is undernourished. Keywords Mini Nutritional Assessment Malnutrition Elderly BangladeshAll 191 member states of the United Nations have pledged to meet the Millennium Development Goals by 2015, only a decade away 1 . The first of the eight stated goals is to eradicate extreme poverty and hunger. One of the indicators of this is to halve the number of people who are undernourished 2 . In order to achieve this goal, Svedberg 3 notes that five Ws will need to be addressed: what constitutes undernutrition; who the undernourished are; where they are located; when they are undernourished; and why they are undernourished. This study focuses on the 'who' and to some extent the 'why' questions.Of the 852 million people estimated to be undernourished during 2000 -2002 worldwide, 95% lived in developing countries 4 . Nearly one-third of the Bangladeshi population, or more than 42 million people, is malnourished in terms of undernutrition, with a daily dietary energy supply of less than 2190 kcal per capita 4 .In Western societies, elderly persons are more likely than younger adults to suffer from malnutrition 5 . A variety of functional, psychological, economic and social factors result in poor diet, qualitatively and quantitatively, that negatively influences the nutritional status of older people 6 . Malnourishment in the older population is also reported to be a consequence of inadequate food intake, underlying illnesses, gender (with women being at higher risk) and economic vulner...

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Section: Who Are Undernourished?supporting

confidence: 86%

Mini Nutritional Assessment of rural elderly people in Bangladesh: the impact of demographic, socio-economic and health factors

Kabir

Ferdous

Cederholm

et al. 2006

PHN

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“…Such finding suggests that it may be not necessary to fulfil more than the two subjective questions to screen as not having undernutrition in a very high percentage of community-dwelling elderly population. It is assumed that in a clinical setting, like a hospital, nursing home, etc., where it is expected an undernutrition prevalence higher than among free-living elderly Kagansky et al, 2005;Mowe, 2002;Pauly et al, 2007;Thomas et al, 2002), the proportion of discard subjects will be lower. Therefore, more studies are needed to demonstrate it.…”

Section: Discussionmentioning

confidence: 99%

Impact of global and subjective mini nutritional assessment (MNA) questions on the evaluation of the nutritional status: The role of gender and age

Cuervo

Ansorena

Martínez‐González

et al. 2009

Archives of Gerontology and Geriatrics

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Undernutrition is a quite common condition in the elderly, often identified using the mini nutritional assessment (MNA) test. The aim of this research was to study the independent value of the global and the subjective MNA questions to predict the undernutrition according to the full MNA score, and to analyze the influence of gender and age on such items. A total of 22,007 Spanish people 65 years of age or older were evaluated using the MNA test. These data were obtained by trained community pharmacists by using receiver Operating Characteristic (ROC) curves. About 4.3% of the studied population were classified as undernourished according to the full MNA test. The subjective subscore (two questions) presented better predictive value than the global one (six questions). Indeed, 99.5% of subjects detected as well nourished using the MNA test were also correctly classified using the two subjective questions. In the present study, it was identified that the two subjective MNA questions can be an efficient tool for a quick screening to rule out non undernourished subjects.

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“…Ever since Dr Charles Edwin Butterworth Jr's seminal 1974 article "The Skeleton in the 41 Hospital Closet", there has been a positive movement in clinical health care to address Nutrition screening and nutrition assessment are essential parts of the nutrition care process, 48 as accurate identification and diagnosis of malnutrition is required in order for patients to be 49 adequately treated, and for nutrition resources to be used efficaciously [4]. However, it is 50 essential that the nutrition screening tools and nutrition assessment tools used to complete 51 these steps have undergone adequate evaluation for validity so that the most appropriate tool 52 can be selected for the patient group [2].…”

Section: Introductionmentioning

confidence: 99%

“…America or Africa, and only one study reported the prevalence in North America [48]. Only 275 two studies, both Australian, reported the prevalence of malnutrition in a rural population, 276 where the prevalence was high but varied according to type of nutrition assessment 277 (SGA=65% in one sample; ICD-10-AM criteria=46%, Scored PG-SGA=53%, MNA=28% in 278 a second sample) [38,56].…”

mentioning

confidence: 99%

Protein-energy malnutrition in the rehabilitation setting: Evidence to improve identification

Marshall

2016

Maturitas

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Malnutrition in subacute care

Cited by 221 publications

References 25 publications

Mini Nutritional Assessment of rural elderly people in Bangladesh: the impact of demographic, socio-economic and health factors

Mini Nutritional Assessment of rural elderly people in Bangladesh: the impact of demographic, socio-economic and health factors

Impact of global and subjective mini nutritional assessment (MNA) questions on the evaluation of the nutritional status: The role of gender and age

Protein-energy malnutrition in the rehabilitation setting: Evidence to improve identification

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