Nutritional status according to Mini Nutritional Assessment is related to functional status in geriatric patients--independent of health status.

OBJECTIVES: The aim of this study was to investigate the relationship between nutritional and functional status in acute geriatric patients including mobility and considering health status. DESIGN: Cross-sectional study. SETTING: Hospital. PARTICIPANTS: 205 geriatric patients (median age 82.0 (IQR: 80-86) years, 69.3% women). MEASUREMENTS: Nutritional status was determined by Mini Nutritional Assessment (MNA) and patients were categorized as well-nourished (≥ 24 points), at risk of malnutrition (17-23.5 points) or as malnourished (< 17 points). Functional status was determined by Barthel Index (BI) and Timed 'Up and Go' Test (TUG) and related to MNA categories. Using binary multiple logistic regression the impact of nutritional status on functional status was examined, adjusted for health status. RESULTS: 60.3% of the patients were at risk of malnutrition and 29.8% were malnourished. Ability to perform basic activities of daily living (ADL) decreased with declining nutritional status. The proportion of patients unable to perform the TUG increased with worsening of nutritional status (45.0% vs. 50.4% vs. 77.0%, p<0.01). After adjusting for age, gender, number of diagnoses, disease severity and cognitive function, a higher MNA score significantly lowered the risk of being dependent in ADL (OR 0.85, 95 % CI 0.77-0.94) and inability to perform the TUG (OR 0.90, 95 % CI 0.82-0.99). CONCLUSION: Nutritional status according to MNA was related to ADL as well as to mobility in acute geriatric patients. This association remained after adjusting for health status.

Undiagnosed malnutrition and nutrition-related problems in geriatric patients.

BACKGROUND & AIMS: Malnutrition is common in geriatric patients and associated with poor outcome. If recognised, effective treatment is possible. In recent years, low nutritional awareness among health care professionals (HCPs) has been deplored with respect to the general hospital population. The aim of the present cross-sectional study was to assess to which extent malnutrition and nutrition-related problems are documented by physicians and nursing staff in geriatric patients and whether nutrition support is used in daily clinical routine. METHODS: Patient's characteristics, nutritional status (BMI, Subjective Global Assessment, Mini Nutritional Assessment) and several nutrition-related problems (e.g. weight loss, poor appetite, chewing and swallowing problems) were assessed in 205 patients consecutively admitted to the geriatric ward of a community hospital on the first day after admission. After discharge, all documented information in the medical folders about nutritional status, nutrition-related problems and nutrition support was systematically collected. RESULTS: According to BMI (< 22 kg/m(2)) and Subjective Global Assessment (C), malnutrition was observed in 25.4 %, according to Mini Nutritional Assessment (< 17 points) in 30,2 % of the patients. In daily routine, clinical judgement of nutritional status by physicians was performed in 187 patients (91.2 %) of whom 6.4 % (5.9 % of all) were classified as malnourished. Weight was documented in 54.1 %, height in 25.9 %. BMI was not calculated. Nutrition-related problems were present in up to half of the patients and only partly documented by HCPs. Seventeen patients (8.3 %) received nutrition support, mostly in the form of oral supplements (3.9 %), followed by enteral (2.9 %) and parenteral nutrition (1.5 %). CONCLUSION: Despite high prevalence rates among geriatric patients, malnutrition and nutrition-related problems are rarely recognised and treated. In order to improve nutritional care, routine screening and standard protocols for nutritional therapy should be implemented in geriatric hospital wards.