Model of nutritional care in older adults: improving the identification and management of malnutrition using the Mini Nutritional Assessment–Short Form (MNA

Abstract

Despite clinical guidelines recommending routine nutrition screening, malnutrition in community-living older adults remains under-recognised. This study evaluated the uptake of a model of nutritional care in older adults designed to improve the identification and management of malnutrition. A pragmatic quasi-experimental study was conducted in eight general practices in regional New South Wales between January 2017 and June 2018. Study participants comprised GPs and practice nurses who participated in a training event on the identification and management of malnutrition and patients (aged >65 years) attending the practices recruited to the study. Nutritional screening was conducted using the Mini Nutritional Assessment–Short Form. The specific objectives of the study were to: (1) evaluate the effects of the intervention on knowledge, attitudes and practices of staff related to malnutrition screening using questionnaires and in-depth interviews; and (2) identify patients’ experiences and outcome measures following malnutrition screening through self-completed surveys. Across the eight practices, 11 healthcare professionals completed in-depth interviews. Post-training knowledge surveys (n = 25) identified that knowledge increased in 96% of staff (P < 0.001). Fifty-five older adults who were screened (two malnourished, 10 ‘at risk of malnutrition’) reported an increased awareness of risk factors for malnutrition. This study provides proof-of-concept that a model of care that includes routine malnutrition screening and accompanying pathways for management is acceptable to general practice staff and has promising effects on patient outcomes. However, the low number of patients screened suggests that additional processes are required to improve feasibility (e.g. incorporation into Medicare-funded nurse-led consultations such as the 75+ Health Assessment).

Long Term Physical Activity Improves Quality of Life Perception, Healthy Nutrition, and Daily Life Management in Elderly: A Randomized Controlled Trial

“…The combined aerobic and resistance training was the recommended protocol for the elderly by previous studies over time [18,[48][49][50] and resulted in efficient improvements to nutritional behaviors and maintained the feeling of motor and cognitive competence [14,15]. The amount of food intake, as well as the components of the diet, could represent a warning bell to identify early psychological problems in the elderly [51]. The PA protocol performed in this study positively influenced the nutritional status of participants, favoring a good QoLP.…”

Perspective Chapter: Early Diagnosis of Malnutrition

“…Charlton et al evaluated the adoption of a nutrition care model for older adults designed to improve the detection and management of malnutrition [29]. A systematic review aimed at assessing the effectiveness of nutritional interventions on frailty and frailty-related factors (e.g., malnutrition, sarcopenia, functional capacity) in community-dwelling older adults concluded that multifactorial interventions are more effective than nutritional interventions alone in improving frailty and physical performance [30].…”

Communication about Disease-Related Malnutrition in the Perspective of Health Professionals in General Practice and Patients

“…Furthermore, the study identified good communication between hospital and general practice, financial incentive and interventions adapted to the individual practice as facilitators, while they identified lack of time, skills and education about DRM among the health professionals as barriers for managing DRM [16]. Intervention studies regarding DRM in general practice are sparse and superficial [17]. Studies from other settings found that psychosocial, physical and practical challenges among patients may affect their participation in the prevention of DRM [18][19][20][21][22].…”