Original ArticleMalnutrition in the elderly and its relationship with other geriatric syndromes☆
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.
References (28)
Anorexia of aging: physiologic and pathologic
Am J Clin Nutr
(1997)- et al.
The mini nutritional assessment (MNA) and its use in grading the nutritional state of elderly patients
Nutrition
(1999) - et al.
Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician
J Psychiatr Res
(1975) - et al.
Development and validation of geriatric depression screening scale: a preliminary report
J Psychiatr Res
(1983) - et al.
ESPEN guidelines on enteral nutrition: geriatrics
Clin Nutr
(2006) - et al.
Identifying the elderly at risk for malnutrition. The Mini Nutritional Assessment
Clin Geriatr Med
(2002) Nutritional factors relevant to Alzheimer’s disease
J Am Diet Assoc
(1989)- et al.
Malnutrition and depression among community-dwelling elderly people
J Am Med Dir Assoc
(2007) - et al.
Prevalence and causes of undernutrition in medical outpatients
Am J Med
(1998) - et al.
Falls in older adults: risk assessment, management and prevention
Am J Med
(2007)
Hospital malnutrition: the Brazilian national survey (IBRANUTRI): a study of 4000 patients
Nutrition
Nutritional deterioration in cancer: the role of disease and diet
Clin Oncol (R Coll Radiol)
Assessment of older people: self-maintaining and instrumental activities of daily living
Gerontologist
Introducing the oldest old
Millbank Memorial Fund
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Abstract of this manuscript was presented (oral presentation) in 31st ESPEN Congress in Vienna on 31st Aug 2009.