Nutritional And Functional Status Of Hospitalized Elderly Patients


Affiliations

  • Masina Hospital, Dietician, Mumbai, India

Abstract

Objective: To assess the nutritional and functional status of hospitalized elderly patients and whethertheir nutritional status was affecting functional status. Methodology: An observational study conducted on 50 elderly patients (>60 years old) admitted at Masina Hospital for medical treatment. Nutritional assessments include Mini nutritional assessment (MNA) and Nutritional checklist (NCL) whereas Barthel index were used for functional assessment and symptoms, biochemical parameter was also noted. Information was collected from the patients, their relatives and responsible staff. Chi Square test was used to compare the nutritional and functional assessment. Result: According to the NCL 38% of participants were at high risk, 40% were at moderate risk of malnutrition, and 22% had good nutrition. There was a high nutritional risk in patients with low income. As per MNA grading, 28% were at risk of malnutrition, 46% were malnourished and 26% were having normal nutritional status. There was significant correlation (p<0.05) found between nutritional and functional status of patients. Barthel index score was significantly lower in those at high riskof malnutrition. Weight loss and Gastrointestinal symptoms were majorly observed. Conclusion: Hospitalized elderly were at riskof malnutrition due to poor intake and gastrointestinal symptoms which might affect their functional status. Therefore, early nutritional assessment and nutritional care plan is important forthis vulnerable group.

Keywords

Nutritional Checklist, Mini Nutritional Assessment, Barthel Index, Elderly Patients, Malnutrition

Full Text:

References

Andre MB, Dumavibhat N, Ngatu NR, Eitoku M, Hirota R, Suganuma N.Mini Nutritional Assessment and functional capacity in community-dwelling elderly in rural. Geriatric Gerontology International. 2013 Jan; 13(l):35-42.

Kleinpell RM, Fletcher K, Jennings BM. Reducing functional decline in hospitalized elderly. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook For Nurses. Chapter 11. AHRQ Publication; 2008.

Joshi K, Kumar R, Avasthi A. Morbidity profile and its relationship with disability and psychological distress among elderly people in Northern India. International Journal Epidemiology. 2003;32:978-87.

World Health Organization. The World Health Report 2008: Primary Health Care (Now more than ever); 2008. Available from :. [Last cited on 2014 Jul 12].

United Nations. World population prospects, the 2012 revision [Internet]. 2012 [cited 2007 Jan 1]. Available from : http://esa.un.org/unpd/wpp/Documentatio n/pdf/WPP2012_Volume-ll-DemographicProfiles.pdf.)

Zeanandin G, Molato O, Le Duff F, Guerin 0, Hebuterne X, Schneider SM. Impact of restrictive diets on the risk of undernutrition in a free-living elderly population. Clinical Nutrition. 2012 Feb; 31(l):69-73.

World Health Organization. The World Health Report 2004; 2004. Available from: . [Last cited on 2014 Jul 12].

Semwal J, Vyas S, Juyal R, Sati HC. Nutritional status and associated comorbidities among the elderly in Doiwala block, Dehradun. Indian Journal Community Health 2014;26:197-203.

Natarajan VS, R avindran S, Sivashanmugam, Thyagarajan, Kailash K, Krishnaswamy B, et al. Assessment of nutrient intake and associated factors in an Indian elderly population. Age Ageing 1993;22:1038.

Fang S, Long J, Tan R, et al. A multicenter assessment of malnutrition, nutritional risk, and application of nutritional support among hospitalized patients in Guangzhou hospitals. Asia Pacific Journal of Clinical Nutrition. 2013;22(1):5459.

Ahmed T, Haboubi N. Review: Assessment and management of nutrition in older people and its importance to health. Clinical Intervention in Aging. 2010 Aug9; 5{):207-16.

Flodin L, Svensson S, Cederholm T. mass index as a predictor of 1 year mortality in geriatric patients. Clinical Nutrition. 2000 Apr; 19(2):121-5.

De Morais C, Oliveira B, Afonso C, Lumbers M, Raats M, de Almeida MD. Nutritional risk of European elderly. European Journal Clinical N utrition. 2013 Nov; 67(ll):1215-9.

Van Bokhorst-de van der Schueren MA, Lonterman-Monasch S, de Vries OJ, Danner SA, Kramer MH, Muller M. Prevalence and determinants for malnutrition in geriatric outpatients. Clinical Nutrition. 2013 Dec; 32(6):1007-11.

Mann T, Heuberger R, Wong H. The association between chewing and swallowing difficulties and nutritional status in older adults. Australian Dental Journal. 2013 Jun; 58(2):200-6.

Howell S, Loeb M. Nutritional needs of the older adult. Gerontologist. 1969;9:17-30

Orrevall Y, Tishelman C, Permert J, Cederholm T. Nutritional support and risk status among cancer patients in palliative home care services. Support Care Cancer. 2009 Feb; 17(2):153-61.

Payne-James J, Grimble G, Silk D. Clinical Practice. 2nd e d itio n . London, UK: Greenwich Medical; 2001. Artificial nutrition support; pp. 243244.

Emam M. M. Esmayel, Mohsen M. Eldarawy, Mohamed M. M. Hassan, Hassan Mahmoud Hassanin, Walid M. Reda Ashour, and Wael Mahmoud. N utritional and Functional Assessment of Hospitalized Elderly: Impact of Sociodemographic Variables. 2013. Journal of Aging Research; Article ID 101725,7 pages

The Nutrition Screening Initiative. A Project of: American Academy of Family Physicians, The American Dietetic Association, The National Council on the Aging, Washington, DC, USA, 2007.

Mahoney Fi, Barthel Dw. Functional Evaluation: The Barthel Index. Md State Med J. 1965 Feb; 14():61-5.

Granger CV, Dewis LS, Peters NC, Sherwood CC, Barrett JE Arch Stroke rehabilitation: analysis of repeated Barthel index measures. Phys Med Rehabil. 1979 Jan; 60(l):14-7.

Quinn TJ, Langhorne P, Stott DJ. Barthel index for stroke trials: development, properties, and application. Stroke; a journal of cerebral circulation. 2011;42(4):114651. Epub2011/03/05.10.1161/STROKEAHA.110.598540.

Guigoz Y. The Mini nutritional assessment (MNA) review of the literature what does it tell us? J Nutr Health Aging. 2006; 10(6) :46687.

Kuppuswamy B. Manual of socioeconomic Status (urban). Delhi: Manasyan;1981.

Johansson Y, Bachrach-Lindstrom M, Carstensen J, Ek AC Malnutrition in a home-living older population: prevalence, incidence and risk factors. A prospective study. J Clin Nurs. 2009 May; 18(9): 1354-64.

van Nie-Visser NC, Meijers J, Schols J, Lohrmann C, Bartholomeyczik S, Spreeuwenberg M, Halfens R. Which characteristics of nursing home residents influence differences in malnutrition prevalence? An international comparison of The Netherlands, Germany and Austria. Br J Nutr. 2014 Mar28; lll(6):1129-36.

Andre MB, Dumavibhat N, Ngatu NR, Eitoku M, Hirota R, Suganuma N.Mini Nutritional Assessment and functional capacity in community-dwelling elderly in rural areas. Geriatric Gerontology International. 2013 Jan; 13(l):35-42

Kyle UG, Unger P, Mensi N, Genton L, Pichard C. Nutrition status in patients younger and older than 60 y at hospital admission: a controlled population study in 995 subjects. Nutrition. 2002 Jun; 18(6):463-9.

Payette H, CyrR. Les ressources communautaires en alimentation pour les personnesagees : Etude des services offerts et des caracteristiques de la clientele (rapport de recherche). [Community resources for nourishment for the elderly: study of the services and the characteristics of the customer (research report)].

Centre de recherche en gerontologie et geriatrie, Institut universitaire de geriatrie de Sherbrooke: Sherbrooke (Canada). 1996;p.63.

Payette H, Cyr R. Les ressources communautaires en alimentation pour les personnes agees : Etude des services offerts et des caracteristiques de la clientele (rapport de recherche). [Community resources for nourishment for the elderly: study of the services and the characteristics of the customer (research report)] Centre de recherche en gerontologie et geriatrie, Institut universitaire de geriatrie de Sherbrooke: Sherbrooke (Canada). 1996;p.63.

Mamhidir AG, Ljunggren G, Kihlgren M, Kihlgren A, Wimo A. Underweight, weight loss and related risk factors among older adults in sheltered housinga Swedish follow-up study J Nutr Health Aging 2006;10:25562.

Kleinpell RM, Fletcher K, Jennings BM. Reducing functional decline in hospitalized elderly. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook For Nurses, chapter 11. AHRQ Publication; 2008.

Joshi K, Kumar R, Avasthi A. Morbidity profile and its relationship with disability and psychological distress among elderly people in Northern India. International Journal Epidemiology. 2003;32:978-87.

World Health Organization. The World Health Report 2008: Primary Health Care (Now more than ever); 2008. Available from : [Last cited on 2014 Jul 12].

Zeanandin G, Molato 0, Le Duff F, Guerin 0, H6buterne X, Schneider SM.Impact of restrictive diets on the risk of undernutrition in a free-living elderly population. Clinical Nutrition. 2012 Feb; 31(l):69-73.

Screening for nutritional risk among community-dwelling elderly on Prince Edward Island. MacLellan DL, Van Til LD Can J Public Health. 1998Sep-Oct; 89(5):342-6.

Baweja S, Agarwal H, Mathur A, et al. Assessment of nutritional status and related risk factors in community dwelling elderly in Western Rajastha. Journal of the Indian Academy of Geriatrics. 2008;4(1):513.

Fang S, Long J, Tan R, et al. A multicenter assessment of malnutrition, nutritional risk, and application of nutritional support among hospitalized patients in Guangzhou hospitals. Asia Pacific Journal of Clinical Nutrition. 2013;22(1):5459.

Elmadbouly MA, AbdElhafez AM. Assessment of nutritional status of hospitalized elderly patients in Makkah governorate. Pakistan Journal of Nutrition. 2012;11(10):886892.

Payne-James J, Grimble G, Silk D. Clinical Practice. 2nd edition. London, UK: Greenwich Medical; 2001. Artificial nutrition support; pp. 243244.

Fang S, Long J, Tan R, Mai H, Lu W, Yan F, Peng J. A multicentre assessment of malnutrition, nutritional risk, and application of nutritional support among hospitalized patients in Guangzhou hospitals. Asia Pac J Clin Nutr. 2013; 22(l):54-9.

Yap KB, Niti M, NgTP. Nutrition screening among community-dwelling older adults in Singapore. Singapore Med J. 2007 Oct; 48(10):911-6.

Yap KB, Niti M, NgTP. Nutrition screening among community-dwelling older adults in Singapore. Singapore Med J. 2007 Oct; 48(10):911-6.

Hairi NN, Bulgiba A, Cumming RG, Naganathan V, Mudla. Prevalence and correlates of physical disability and functions I limitation among community dwelling older people in rural Malaysia, a middle income country. BMC Public Health. 2010 Aug 18; 10():492.

Oliveira MR, Fogaga KC, Leandro-Merhi VA. Nutritional status and functional capacity of hospitalized elderly. Nutr J. 2009 Nov 17; 8(2):54.

Cereda E, Valzolgher L, Pedrolli C. Mini nutritional assessment is a good predictor of functional status in institutionalised elderly at risk of malnutrition. Clin Nutr. 2008 Oct; 27(5):700-5.

Zakai NA, Katz R, Hirsch C, Shlipak MG, Chaves PH, Newman AB, Cushman M.A prospective study of anemia status, hemoglobin concentration, and mortality in an elderly cohort: the Cardiovascular Health Study. Arch Intern Med. 2005 Oct 24; 165(19):2214-20

Joosten E, Pelemans W, Hiele M, Noyen J, Verhaeghe R, Boogaerts MA. Prevalence and causes of anaemia in a geriatric hospitalized population. Gerontology. 1992;38:111117.

Joosten E, Pelemans W, Hiele M, Noyen J, Verhaeghe R, Boogaerts MA. Prevalence and causes of anaemia in a geriatric hospitalized population.Gerontology. 1992; 3 8 (l-2 ):lll-7 .

Ershler WB. Biological interactions of aging and anemia: a focus on cytokinesJ Am GeriatrSoc. 2003 Mar; 51(3 Suppl):S18-21.

Lawrence Tim Goodnough and Stanley L. Schrier. Evaluation And Management Of Anemia In The Elderly. Am J Hematol. Author manuscript; available in PMC 2015 Jan 10.

Cabrerizo S, Cuadras D, Gomez-Busto F, Artaza-Artabe I, Marfn-Ciancas P Malafarina V. Serum albumin and health in older people: Review and meta analysis. Maturitas. 2015 M a y;8 1(l):17 -2 7. doi:10.1016/j.maturitas.2015.02.009. Epub 2015 Feb 28.

Salgado FXC, Vianna LG, Giavoni A, Melo GF, Karnikowski MGO. Albuminemia e terapia medicamentosa no prognostico de idosos hospitalizados. Rev Assoc Med Bras. 2010;56(2):145150.


Refbacks

  • There are currently no refbacks.