Nutrition and prevalence of undernutrition assessed by different diagnostic criteria in nursing homes for elderly people.

BACKGROUND: Undernutrition is the state produced by the intake of insufficient energy, macronutrients or micronutrients. The present study aimed to assess the prevalence of undernutrition using 10 different diagnostic criteria described in the literature and to assess its association with energy intake in an institutionalised elderly population. METHODS: The cross-sectional study included 213 subjects, aged 65-96 years (135 women and 78 men), who lived in seven nursing homes in the province of Murcia, on the Mediterranean coast of Spain. Dietary intake and anthropometric and biochemical parameters were assessed, and 10 different diagnostic criteria, taken from studies of elderly subjects similar to our population, were applied. RESULTS: The mean dietary intakes appeared to cover the recommended dietary intake for a Spanish elderly population. However, only 58.2% of the studied subjects consumed 100% of the recommended dietary intake and 15.5% of the subjects had an energy intake below 80% of the recommended dietary intake. Depending on the criteria used for the diagnosis, the proportion of patients with undernutrition varied between 2% and 57%. When the relationship between undernourishment, as defined by the different methods and intake deficiency, was assessed, a statistically significant relationship was only found for five of the 10 diagnostic criteria assessed. CONCLUSIONS: Research needs to focus on the development and evaluation of specific nutritional assessment tools for application to older people aiming to improve the detection of those suffering (or who are at risk of suffering) undernutrition.

Dietary intake and iron status of institutionalized elderly people: relationship with different factors.

OBJECTIVES: Aims of the study were to investigate iron status in institutionalized elderly subjects and to determine its association with different factors including: age, gender, body mass index, dietary intake, consumption of iron supplements, functional status and disease. DESIGN: A cross-sectional study. SETTING: Seven public nursing homes. PARTICIPANTS: 252 subjects, aged 65-96 years. MEASUREMENTS: Food intake was assessed by a 4-day weighed-food record. Iron status indices were measured. Barthel' s Index was used to evaluate functional status. Illnesses were ascertained from medical records. RESULTS: Anemia was found in 25.4% of subjects studied. Average dietary intakes fulfilled the amounts of Recommended Dietary Intake for Spanish elderly population, except for folate. A substantial percentage of subjects exhibited folate dietary deficit (89.2%). Mean (SD) BMI was 27.8 (6.4) kg/m2, and functional status 78.1 (26.5). Taking into account hematocrit, red blood cell count and serum iron concentration values, poor iron status was significantly more common in men (59.4, 61.4 and 16.8%, respectively) than in women (36.4, 36.4 and 6.0%, respectively). Hemoglobin concentration was positively associated with the energy and nutrient dietary intake, and negatively with age, BMI and functional status. CONCLUSIONS: Based on World Health Organization criteria, anemia was found in 25.4% of elderly subjects studied. Iron deficiency seems to be the main cause of anemia, and chronic disease the second cause of anemia. Dietary intake is not one of the principal causes of anemia in the study population, except for folate intake.