Elsevier

Clinical Nutrition

Volume 29, Issue 6, December 2010, Pages 745-748
Clinical Nutrition

Original Article
Malnutrition in the elderly and its relationship with other geriatric syndromes

https://doi.org/10.1016/j.clnu.2010.04.006Get rights and content

Summary

Background & Aims

Age related decline in food intake is associated with various physiological, psychological and social factors. Our aim was to assess the nutritional status of our elderly patients and its association with other geriatric syndromes.

Methods

In this cross-sectional population based study, Mini Nutritional Assessment (MNA) test was used to evaluate nutritional status of 413 elderly patients who were admitted to our outpatient clinic in the last 12 months. MNA test results were compared with the laboratory findings and established geriatric syndromes.

Results

Poor nutritional status was found in 44% of the patients (n = 181: 13% malnutrition, 31% malnutrition risk). Malnutrition rate was higher among those with subsequent hospitalization (n = 122, 25% vs 8%). Patients with poor nutritional status had lower blood haemoglobin, serum total protein and albumin, and revealed more chronic diseases and geriatric syndromes (6 ± 2 vs 3 ± 2, p < 0.0001). Patients with depression, fecal incontinence, decreased cognitive function and functional dependence showed poor nutritional status according to MNA test results.

Conclusions

Malnutrition rate of our patients was comparable with the previous data. Malnutrition risk showed positive correlation with the number of existing geriatric syndromes. Depression, dementia, functional dependence and multiple co-morbidities were associated with poor nutritional status.

Introduction

Aging causes alterations in the body composition, organ functions, adequate energy intake and ability to eat or access food. Abdominal obesity or weight loss together with sarcopenia cause immobility, skeletal disorders, insulin resistance, hypertension, atherosclerosis and disorders of the glucose/lipid metabolism. Chronic diseases (diseases that interfere with the ability of the person to eat food such as stroke and dental problems, malabsorption syndromes, cardiac cachexia, chronic obstructive pulmonary disease, malignancies, hypermetabolic state, neurologic disorders, dementia and drugs such as anti-neoplastic drugs), psychological disturbances and social problems can result in decreased food intake.1 Therefore, early detection of malnutrition should be a key component of the geriatric assessment to stop this vicious cycle. Mini Nutritional Assessment (MNA) was developed as a reliable screening test to detect malnutrition in old-aged people. Without any laboratory data, nutritional status of the patients can be easily predicted with questions and anthropometric measurements.2 Because of its validity in screening malnutrition, MNA was integrated in our Comprehensive Geriatric Assessment (CGA) tool. In this study, we evaluated nutritional status of our elderly patients and examined its relationship with other geriatric syndromes and laboratory parameters.

Section snippets

Materials and methods

This study was conducted in our Geriatrics Outpatient Clinic between October 2007 and October 2008. Elderly patients (65 years or older) who were admitted to Department of Geriatrics or referred by other services for CGA were included in the study. Characteristics of the patients are given in Table 1 together with their previous medical history and reasons for admission. CGA was performed to all patients including patient’s general information, social support, review of the systems, physical

Results

A total of 413 patients (female/male:1.93) were included into the study. Mean age of the patients was 75 ± 7 years (65–97). According to different age groups 205 patients were young old (50%), 169 patients were middle old (41%) and 39 patients were oldest old (9%). Subsequent hospitalization was done in 122 patients (30%) for further examination and/or treatment. Their mean age was 76 ± 7 years (65–97). BMI was <20.00 kg/m2 in 31 patients (8%), 20.00–24.99 kg/m2 in 149 patients (36%) and

Discussion

The elderly are the fastest-growing segment of the population in most industrialized countries. In 1985, the total number of senior citizens (65 year old and over) was 2.2 million (4.2% of the population) in Turkey. It was registered as 3.8 million (5.6%) in 2002 and 5.0 million (7%) in 2007. Their number is expected to reach 10% in the near future.9, 10

Malnutrition has emerged as an important problem among elderly. Estimated prevalence in the general population is 2 ± 0.1%, but rises to 29–61%

Conclusion

Malnutrition rate of our patients was found comparable with the previous data, and malnutrition risk showed positive correlation with the number of existing geriatric syndromes. Malnutrition risk was significantly increased in patients with low mood, impaired cognitive functions, functional dependency and malignant diseases. Therefore increased risk of malnutrition in the elderly is multifactorial. An understanding of these causes is essential to formulate appropriate treatment strategies.

Conflict of interest & statement of authorship

Authors did not have any financial and personal relationships with other people or organisations that could inappropriately influence their work. All of the authors have made substantial contributions to the design of the study, acquisition, analysis and interpretation of data, drafting the article or revising it and final approval of the version to be submitted. All authors read and approved the final manuscript.

Acknowledgements

BS participated in the design of the study, carried out the studies and data analyses and wrote the manuscript. OK helped to collect data and carried out the samples analyses. GBO, NE and MA participated in the design of the study and helped to draft the manuscript. All of the authors have made substantial contributions to interpretation of the data and revision of the article critically for important intellectual content. All authors read and approved the final manuscript.

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