The nutritional status of frail elderly with care needs according to the mini-nutritional assessment

BACKGROUND AND AIMS: Although malnutrition is common in the geriatric population, the relationship between frail elderly with various care needs and nutritional status remains unknown. The purpose of this study was to analyze the association between subjects with higher care needs and poorer nutritional status in the Japanese community-dwelling frail elderly. METHODS: A total of 281 community-dwelling elderly subjects from day-care centers (81.9+/-7.2yr of age mean+/-SD; 72 men and 209 women) who were eligible for Long-Term Care Insurance were enrolled in this study to evaluate their nutritional status using the mini-nutritional assessment. The levels of care needs of participants were classified into six levels according to the Long-Term Care Insurance program. RESULTS: According to the mini-nutritional assessment classification, 39.9%, 51.2%, and 8.9% of the participants were assessed as well-nourished, at-risk of malnutrition, and malnourished, respectively. There were significant differences among the six groups with regard to the nutritional status; subjects with higher care needs were associated with poorer nutritional status. In the higher care needs group, more than half of the subjects did not know their weight change during 3-month intervals. CONCLUSIONS: The population of elderly with higher care needs in the community is associated with a higher prevalence of malnutrition.     

Mini Nutritional Assessment (MNA) is Rather a Reliable and Valid Instrument to Assess Nutritional Status in Iranian Healthy Adults and Elderly with a Chronic Disease

This study aimed to evaluate the usefulness of the Mini Nutritional Assessment (MNA) to assess nutritional status of Iranian population and to compare its psychometric properties between patients suffering from a chronic disease, healthy elderly and younger adults. As a group of elderly with a chronic disease, 143 Parkinson’s disease (PD) patients and as the control group, 467 healthy persons were enrolled. The Persian-translated version of MNA was filled-up through interviews together with anthropometric measurements. Cronbach’s α coefficient of entire MNA was 0.66 and 0.70 in healthy individuals and PD patients, respectively. The total MNA score could significantly discriminate the ones with BMI ≥ 24kg/m² in both groups. In general, MNA was a valid and reliable tool for nutritional assessment. We acknowledge study limitations including lack of serum measurements and a selection bias towards mild-to-moderate PD. MNA is a more reliable tool in older healthy individuals and rather younger elderly with PD.     

Assessment of Nutritional Risk in Community-Dwelling Older Adults (65 to 75 Years) in Kolkata,India

This study was conducted to profile nutritional risk factors in a population of community-dwelling older adults in Kolkata, India. We applied the short version of the Mini Nutritional Assessment–Short Form (MNA-SF) questionnaire among 500 participants (65 to 75 years)—263 males and 237 females. The prevalence of undernutrition was 8.8% in females and 4.9% in males; a risk of undernutrition was found in 24.5% females and 17.5% males. All those with undernutrition or at-risk were studied further using the full version of the MNA. Data regarding education, occupation, socioeconomic status, and food intake pattern were also collected. Females had a significantly lower (P < 0.01) education level than males; 73.4% males were financially independent, whereas 72.7% females were financially dependent on others. Moderate appetite loss was commonly found (64.9%), and in 24.3% of the participants appetite loss was severe. Digestive and chewing problems were present in 32.4% and 21.6% of study participants, respectively. The rate of psychological stress and/or acute disease 3 months prior to study was 47%, and 62.2% of the study population were taking 3 or more medicines per day. Weight loss of greater than 3 kg and of 1 to 3 kg during past 3 months of the study period was observed in 27% and 32.5% of the population, respectively. Undernourished individuals were also found to consume fewer protein-rich foods. We hypothesize that low education levels and lack of financial independence were the strongest underlying causes of high undernutrition in this population, particularly, among females.