[PHNUTR-L] Diagnosing malnutrition in the elderly.
Kathrynne Holden, MS, RD
fivestar at nutritionucanlivewith.com
Fri Feb 3 06:58:36 PST 2006
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Dtsch Med Wochenschr. 2006 Feb 3;131(5):223-7.
[Diagnosing malnutrition in the elderly.]
[Article in German]
Bauer JM, Volkert D, Wirth R, Vellas B, Thomas D, Kondrup J,
Pirlich M, Werner H, Sieber CC.
Medizinische Klinik 2, Klinikum Nurnberg, Lehrstuhl fur Innere
Medizin - Geriatrie, Universitat Erlangen-Nurnberg.
Summary. The concept of malnutrition in the geriatric population
describes a deficient state of energy and nutrient intake with harmful
clinical consequences. Despite of having a significant effect on
morbidity and mortality, there are no generally accepted criteria for
diagnosing malnutrition in the elderly. With increasing age the general
recognition of the nutritional status becomes more important for the
diagnosis of malnutrition than isolated parameters. Recording a
patient"s history must include any weight loss and changes in appetite.
Reasons for a diminished nutritional intake must be explored
systematically as well. As part of physical examination one has to pay
attention to clinical signs of malnutrition (general muscular atrophy,
loss of subcutaneous fat) and to signs of micronutritient deficiencies.
The documentation of oral intake can supply important evidence for
deficient intake of energy and nutrients. Of special relevance among
anthropometric values are a BMI of less than 20 kg/m and calf
circumference of less than 31 cm. Individual follow-up data are superior
to isolated measurements Laboratory diagnostic tests (for example
albumin) are of minor importance for the diagnosis of malnutrition
because of their low specificity. As a consequence of unsolved
methodical problems, bioelectrical impedance analysis can currently be
recommended only to those who are experienced with this method and its
limitations. Screening and assessment tools like Mini Nutritional
Assessment (MNA) and Nutritional Risk Screening(NRS) are helpful for a
quick and simple identification of malnourished patients and those who
are at risk. The MNA is especially applicable for people who live
independently and for cooperative residents of nursing homes. The NRS is
a valuable alternativefor hospital patients and those unable to
cooperate. Screening for malnutrition should be routine practice in the
elderly population, especially for those at high risk for it like in
hospitals and in nursing homes.
PMID: 16440271 [PubMed - in process]
Kathrynne Holden, MS, RD < fivestar at nutritionucanlivewith.com >
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