the elderly people are often identified as a vulnerable group who appear susceptible to malnutrition and disease. At the moment there are no standards for assessing the nutritional status of the elderly. In adults, body size and nutritional status are calculated using Body Mass Index (BMI is weight divided by height squared). The problem with doing the same for the elderly is that it can be difficult to measure their height because of spinal curvature or osteoporosis...
I agree with you about the convenience to use other more precise parameters
Carole C Tranchant I am sure that the challenges are very real, and that the results will help us all in our investigations. That's why I'm interested in knowing the proposals you're making. Thank you
I would use the MUST screening tool as it is quick and has higher sensitivity and specificity than the MNA. Although there is no ‘gold standard‘ most screening tools are either compared against BMI or the SGA.
Micronutrient deficiencies can also be checked to be double sure that they are safe. BMI usually depicts the status of Macronutrients and therefore its good to do a thorough investigation, from the physical examinations , dietary intake and the plasma levels of micronutrients.
Consult with a registered dietitian nutritionist who is trained on diagnosing malnutrition. They are able to provide a nutrition assessment, diagnosis, and intervention. The assessment includes analysis of weight changes, muscle or fat loss, muscle function/dysfunction, diet adequacy, and more. BMI is used informationally but not in diagnosing malnutrition.
Objective measures I recommend is the dynamomter and calf circumference.
As well as poor diet choices for convenience or cost, lower tolerance for ideal preparation techniques and times, especially in those living alone, the elderly digest and absorb a gamut if nutirients poorly. Malnutrion can be assessed by diet questionaires including using software packages. Even on what might appear to be a good diet, the elderly are still at risk. For example zinc deficiency is common.
“All disease begins in the gut”--Hippocrates (460-377 BC) Known as the “Father of Modern Medicine”.
Think about all the medications the elderly get--naming just one-->proton pump inhibitors (PPIs) that block stomach acid (needed to absorb minerals & protein). PPIs were only meant to be used short term (2-3 months) to heal an ulcer or Barrett's esophagus. I see patients on them for years!
Long term they are known to cause (among other things-check a search engine): Osteoporosis ,Hip fracture Kidney/liver disease Muscle cramping IBS or other problems with bowel Dysbiosis Dementia Heart disease/heart attack/stroke Pneumonia
There are several parapetes, but the simples one is to use BMI serial determinaciones
The serial BMI determinaciones is the easiest and simplest way to evaluarte
Arvind Singh thank you for your contribution. Very interesting the conclusion of the paper 4.Inadequate diet and malnutrition are associated with a decline in functional status, impaired muscle function, decreased bone mass, immune dysfunction, anemia, reduced cognitive function, poor wound healing, delay in recovering from surgery, and higher hospital and readmission rates and mortality.
I am wondering if visceral protein status is being used by anyone for assessment of malnutrition and if anyone is using the Nutrition Focused Physical Examination (NFPE).
BMI evaluation and of course if oponible a broad amalytical study to detecta possible deficiencias
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