Prevalence of Protein-energy Malnutrition in a Large Population of Elderly People at Home

Thorslund, S.; Toss, Göran; Nilsson, Inga Marie; Schenck, H von; Symreng, Tommy; Zetterqvist, H.

doi:10.3109/02813439008994966

Cited by 27 publications

(13 citation statements)

References 21 publications

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“…Eight percent were classified as being malnourished which is in line with findings reported in previous studies investigating similar populations [4,[10][11][12]. A major finding of our study was that the MNA had a prognostic value in home-living elderly subjects, as the 3-year mortality increased with low MNA scores.…”

Section: Discussionsupporting

confidence: 81%

Nutritional Status and a 3-Year Follow-Up in Elderly Receiving Support at Home

et al. 2005

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Background: Elderly receiving public services and care are often frail, suffer from chronic diseases, and sustain a high risk for malnutrition. Objective: To evaluate nutritional status and long-term outcome in elderly living at home. Methods: Of 507 eligible subjects receiving home care in five Swedish municipalities, we examined 353 (age 82 ± 7 years, 64% females). The subjects were interviewed, and the nutritional status was assessed by means of the Mini Nutritional Assessment (0–30 points; the lower the score, the greater the risk). The Mini Nutritional Assessment consists of 18 questions concerning, e.g., anthropometry (body mass index or BMI; kg/m²) and global and dietary issues. The mortality was evaluated in 224 study participants after a 3-year period. In one municipality, 31 of 64 elderly were reexamined after 3 years. Results: 8 and 41% of the elderly were assessed as malnourished or at risk of malnutrition, respectively. BMIs <20 and <23 were found in 12 and 31% of the subjects, respectively. Chewing and swallowing problems and reduced appetite were more often reported by those at risk of being malnourished compared with the well-nourished study participants (p < 0.001). Meals-on-wheels services were given to one third, of whom 66% used one portion for several meals. The 3-year mortality was 50% for those who were malnourished, 40% for those at risk of malnutrition, and 28% for the well-nourished group (p < 0.05). The corresponding mortality was 50% for subjects with a BMI <20, 35% for those with BMIs 20–28, and 27% for those with a BMI >28 (p = 0.05). After 3 years, a weight loss of 4.0 ± 5.8 kg was registered (p < 0.001). Conclusions: About half of the home-living elderly with public support were malnourished or were at risk of malnutrition. The malnourished subjects often had problems during mealtimes and seldom ate full meals. Elderly with a BMI >28 displayed the lowest risk of death within 3 years.

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Section: Discussionsupporting

confidence: 81%

Nutritional Status and a 3-Year Follow-Up in Elderly Receiving Support at Home

et al. 2005

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“…Previous studies involving other tests for nutritional screening have also shown that only 1-5% of free-living elderly Swedes are malnourished (Thorslund et al, 1990;Cederholm and Hellstrom, 1992). The median MNA score of *P-value for the difference between the subjects with MNA p23.5 (n ¼ 28) and subjects with MNA X24 (n ¼ 323).…”

Section: Discussionmentioning

confidence: 98%

Nutritional status, as determined by the Mini-Nutritional Assessment, and osteoporosis: a cross-sectional study of an elderly female population

Salminen

Sääf

et al. 2005

Eur J Clin Nutr

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Objective: To investigate the relationship between osteoporosis and nutritional status as determined by the Mini-Nutritional Assessment (MNA). Design: A cross-sectional study. Setting: Stockholm, Sweden. Subjects: A total of 351 elderly free-living women (mean age 7372.3 years). Methods: MNA (range 0-30 points; o17 indicates malnutrition, 17.5-23.5 risk of malnutrition and X24 well nourished), measurements of bone mineral density of the left hip and lumbar spine using Hologic QDR 4500, and of the heel using Calscan DEXA-T. Results: The median MNA score was 27 (range 12.5-30). One woman was classified as malnourished and 7.4% were at risk of malnutrition. Osteoporosis of the femoral neck was observed in 22% and a fracture after the age of 50 was reported by 31% of the participants. The following items in the MNA questionnaire exhibited an increased risk of having osteoporosis in the femoral neck and/or total hip: an MNA score of o27 (odds ratio (OR) ¼ 2.09; CI ¼ 1.14-3.83); a mid-arm circumference of less than 28 cm (OR ¼ 2.97; CI ¼ 1.29-6.81); and regular use of more than 3 drugs each day (OR ¼ 2.12; CI ¼ 1.00-4.50). A body weight of more than 70 kg exhibited a decreased risk of having osteoporosis (OR ¼ 0.31; CI ¼ 0.14-0.70). Conclusions: In general, the nutritional status was good in this population of free-living elderly women. Nevertheless, half of the women who displayed an MNA score o27 points had a twofold increased risk of having osteoporosis.

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“…In addition, insufficient dietary routines in care-giving institutions may contribute to the risk [3,4]. Swedish studies [5,6] have shown that 3-7% of elderly subjects living at home have signs of malnutrition. Corresponding figures for elderly admitted to hospital are 20-40% [2,5,7,8].…”

Section: Introductionmentioning

confidence: 99%

Nutritional Status According to Mini Nutritional Assessment in an Institutionalized Elderly Population in Sweden

et al. 2000

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Background: In 1992, local municipalities in Sweden took over full responsibility for the long-term care of elderly. This has led to an increased care burden for the various assisted accommodation services run by the municipalities. Objective: Since ageing and chronic diseases are risk factors for protein-energy malnutrition, we evaluated the nutritional status of all individuals in assisted accommodation, i.e., service flats (SF), old people’s homes (OPH), group living for the demented (GLD), and nursing homes (NH), in three Swedish municipalities. Methods: Of 994 eligible subjects, 872 were examined; the average age was 84.5 ± 8 years, and 69% were female. The Mini Nutritional Assessment (MNA) scale (0–30 points) was used, consisting of 18 point-weighted questions in four categories, i.e., anthropometry, global and dietary issues, and self-assessment. Results: MNA <17, i.e., malnutrition, was noted in 36% of the study population. Divided according to accommodation type, the MNA scores were <17 in 21% of individuals in SF, 33% of those in OPH, 38% of those in GLD, and 71% of those in NH. The corresponding values for MNA scores 17–23.5 (risk for malnutrition) were 49, 51, 57, and 29%, respectively. Average body mass index (BMI) values were 24.2 ± 5 (SF), 23.6 ± 5 (OPH), 23.9 ± 4 (GLD), and 22.3 ± 4 (NH). BMI values ≤20 were found in 18% of those in SF, in 25% of those in OPH, in 19% of those in GLD, and in 33% of those in NH. Both MNA and BMI correlated with upper arm and calf circumference, with r values ranging from 0.4 to 0.7 (p < 0.001). MNA and BMI correlated significantly (r = 0.52, p < 0.001). Age correlated with MNA and BMI with r values of 0.1 (p < 0.01) and 0.14 (p < 0.001), respectively. Subjects with signficant help requirements during meals ate fewer whole meals per day than those who could feed themselves. Conclusions: Based on the MNA, one third of the study subjects living in assisted accommodation, and more than half of those living in NH, appeared to be malnourished. Further studies are necessary to assess to what extent these nutritional disturbances are reversible.

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Prevalence of Protein-energy Malnutrition in a Large Population of Elderly People at Home

Cited by 27 publications

References 21 publications

Nutritional Status and a 3-Year Follow-Up in Elderly Receiving Support at Home

Nutritional Status and a 3-Year Follow-Up in Elderly Receiving Support at Home

Nutritional status, as determined by the Mini-Nutritional Assessment, and osteoporosis: a cross-sectional study of an elderly female population

Nutritional Status According to Mini Nutritional Assessment in an Institutionalized Elderly Population in Sweden

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