Introduction Nutrition screening is an initial procedure in which the risk of malnutrition is identified. The aims of this review were to identify malnutrition risk from nutrition screening studies that have used validated nutrition screening tools in community living older adults; and to identify types of nutrition interventions, pathways of care and patient outcomes following screening. Methods A systematic literature search was performed for the period from January 1994 until December 2013 using SCOPUS, CINAHL Plus with Full Text, PubMed and COCHRANE databases as well as a manual search. Inclusion and exclusion criteria were determined for the literature searches and the methodology followed the PRISMA guidelines. Results Fiftyfour articles were eligible to be included in the review and malnutrition risk varied from 0% to 83%. This large range was influenced by the different tools used and heterogeneity of study samples. Most of the studies were cross sectional and without a subsequent nutrition intervention component. Types of nutrition intervention that were identified included dietetics care, nutrition education, and referral to Meals on Wheels services and community services. These interventions helped to improve the' nutritional status of older adults. Conclusions Timely nutrition screening of older adults living in the community, if followed up with appropriate intervention and monitoring improves the nutritional status of older adults. This indicates that nutrition intervention should be considered a priority following nutrition screening for malnourished and at risk older adults. Further evaluation of outcomes of nutrition screening and associated interventions, using structured pathways of care, is warranted. Abstract IntroductionNutrition screening is an initial procedure in which the risk of malnutrition is identified. The aims of this review were to identify malnutrition risk from nutrition screening studies that have used validated nutrition screening tools in community living older adults; and to identify types of nutrition interventions, pathways of care and patient outcomes following screening. MethodsA systematic literature search was performed for the period from January 1994 until December 2013 using SCOPUS, CINAHL Plus with Full Text, PubMed and COCHRANE databases as well as a manual search. Inclusion and exclusion criteria were determined for the literature searches and the methodology followed the PRISMA guidelines. ResultsFifty-four articles were eligible to be included in the review and malnutrition risk varied from 0 % to 83%. This large range was influenced by the different tools used and heterogeneity of study samples. Most of the studies were cross sectional and without a subsequent nutrition intervention component. Types of nutrition intervention that were identified included dietetics care, nutrition education, and referral to Meals on Wheels services and community services. These interventions helped to improve the' nutritional status of older adults. ConclusionsTimely ...

Aim To determine if a model of home-based dietetic care improves dietary intake and weight status in a specific group of older adults post-hospitalisation. MethodsThe Department of Veterans' Affairs clients aged 65 years and over were recruited from hospitals in a regional area of New South Wales, Australia (n = 32 men, n = 36 women). Nutritional status was assessed at home at baseline (within two weeks post-discharge) and three months post-discharge using a diet history, a food frequency checklist and Mini Nutritional Assessment (MNA). Personalised dietary advice was provided by a single dietitian according to participants' nutritional status.Results Mean body weight improved significantly (P = 0.048), as well as mean MNA score (21.9 ± 3.5 vs 25.2 ± 3.1) (P < 0.001). Mean energy, protein and micronutrient intakes were adequate at baseline and three months, except for vitamin D. At three months, the underweight group (body mass index (BMI) < 23 kg/m 2 ) had significantly higher mean protein intake per body weight (1.7 ± 0.4 g/kg) compared to those who were a desirable weight (BMI 23-27 kg/m 2 ) (1.4 ± 0.3 g/kg) or overweight (BMI>27 kg/m 2 ) (1.1 ± 0.3 g/kg) peers (P < 0.001). There was significant improvement in energy intake contributed from oral nutrition supplements (+95.5 ± 388.2 kJ/day) and milk (+259.6 ± 659.8 kJ/day).Conclusions Dietetic intervention improved nutritional status 3 months after hospital discharge in older adults living in the community. Methods: Department of Veterans' Affairs (DVA) patients aged 65 years and over were recruited from hospitals in a regional area of New South Wales, Australia (n=32 men, n=36 women). Nutritional status was assessed at home at baseline (within 2 weeks post discharge) and 3 months post discharge using a diet history, food frequency checklist There was a significant improvement in energy intake contributed from oral nutrition supplements (+95.5±388.2kJ/day) and milk (+259.6±659.8 kJ/day). Conclusions:Dietetic intervention improved nutritional status 3 months after hospital discharge in older adults living in the community.

In Australia, older adults aged 75+ years are encouraged to avail themselves of the comprehensive 75+ health assessment (75+ HA) to identify medical conditions and highlight potential risk factors for poor health. However, uptake of this item has been reported to be low. This study aimed to identify the uptake of the 75+ HA within regional areas of New South Wales and compare this against state and national trends over an 11-year period. Data on uptake of the 75+ HA for item numbers 700 and 702, from 1999 until 2010, were obtained from the Medicare Australia portal and Department of Health and Ageing databases. Trends over time were collated and compared at the regional, state and national level. The study found that an increasing number of the 75+ HAs were performed from 1999 to 2009. Overall, the uptake of the 75+ HA is generally low across Australia, at ~20% of the eligible population, but varied across states and even regions within states. The study also revealed that despite low uptake encouraging trends were evident over a decade of 75+ HA implementation. It is argued that strategies in improving the uptake should be targeted for early identification of health risk and overall improved quality of health in older adults. KeywordsGeneral practice, older adults, primary health care, primary prevention . Overall, the uptake of the 75+ HA was generally low across Australia, at ~20% of the eligible population, but varied across states and even regions within states. The study also revealed that despite low uptake encouraging trends were evident over a decade of 75+ HA implementation. It is argued that strategies in improving the uptake should be targeted for early identification of health risk and overall improved quality of health in older adults.

BackgroundNutrition screening in older adults is not routinely performed in Australian primary care settings. Low awareness of the extent of malnutrition in this patient group, lack of training and time constraints are major barriers that practice staff face. This study aimed to demonstrate the feasibility of including a validated nutrition screening tool and accompanying nutrition resource kit for use with older patients attending general practice. Secondary aims were to assess nutrition-related knowledge of staff and to identify the extent of malnutrition in this patient group.MethodsNine general practitioners, two general practice registrars and 11 practice nurses from three participating general practices in a rural, regional and metropolitan area within a local health district of New South Wales, Australia were recruited by convenience sampling.Individual in-depth interviews, open-ended questionnaires and an 11-item knowledge questionnaire were completed three months following in-practice group workshops on the Mini Nutritional Assessment Short Form (MNA-SF). Staff were encouraged to complete the MNA-SF within the Medicare-funded 75+ Health Assessment within this time period. Staff interviews were digitally recorded, transcribed verbatim and analysed thematically using qualitative analysis software QSR NVivo 10.ResultsFour key themes were determined regarding the feasibility of performing MNA –SF: ease of use; incorporation into existing practice; benefit to patients’ health; and patients’ perception of MNA-SF. Two key themes related to the nutrition resource kit: applicability and improvement. These findings were supported by open ended questionnaire responses. Knowledge scores of staff significantly improved from baseline (52% to 66%; P < 0.05). Of the 143 patients that had been screened, 4.2% (n = 6) were classified as malnourished, 26.6% (n = 38) ‘at risk’ of malnutrition and 69.2% (n = 99) as well-nourished.ConclusionIt is feasible to include the MNA-SF and a nutrition resource kit within routine general practice, but further refinement of patients’ electronic clinical records in general practice software would streamline this process.

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Purpose: This research aims to identify malnutrition risk and perception of malnourished and at-risk elderly individuals on their dietary practices. Design/methodology/approach: In Phase 1, a cross-sectional study was conducted among 413 elderly individuals aged 60 years and above in agricultural settlements in Kuantan, Pahang, Malaysia. Malnutrition risk was assessed using the Mini Nutritional Assessment Short-Form (MNA-SF). In Phase 2, indepth semi-structured interviews were conducted among 21 elderly individuals identified in Phase 1. The interviews ceased when data saturation was achieved. Findings: 25.7 per cent (n = 106) of elderly individuals were identified as malnourished and at-risk (MNA-SF score = <12). Age, smoking, income and living status were significantly associated with malnutrition risk (p < 0.05). Thematic analysis revealed four themes that represent elderly individuals' perception on their dietary practices: the impact of aging on dietary intake; food restriction according to health condition; poor dietary intake due to feeling of loneliness; and perceived benefits of foods for health. Research limitations/implications: Strategies from multidisciplinary healthcare professionals to eliminate improper dietary practice are required for the maintenance of health, functional independence and quality of life among the elderly. Originality/value: This research is at the forefront in reporting the elderly individuals' perception on dietary practice in agricultural settlement. Attention to individual's health issues and the associated factors that may influence their dietary practices is essential to provide appropriate interventions to achieve optimum nutritional status and healthy aging.

The low intake of fruits and vegetables is a global issue. This research aimed to determine the association of fruit and vegetable intake with waist circumference and barriers of intake. A total of 279 female students from the International Islamic University Malaysia, Kuantan, were recruited through convenience sampling and provided with a set of questionnaires to identify their fruits and vegetable intake. The waist circumference of respondents was measured. The majority of students consumed only one serving of fruit and vegetable per day, which is less than the levels recommended by the Malaysian Dietary Guideline. Only 9.0% of students had a fruits intake of two servings/day, while 6.5% had a vegetable intake of three servings/day which meets the recommendation. There was no significant association of fruits and vegetable intake with waist circumference among female students. Non-availability and not delicious were identified as major barriers to fruit and vegetable consumption respectively. In conclusion, the fruit and vegetable intake among the majority of female university students is inadequate. Thus, there is a need to increase awareness and develop strategies to promote adequate fruit and vegetable intake among this specific target group.

Purpose This study aims to investigate dietary intake among elderly living in agricultural settlements in comparison with a recent nutritional recommendation. Design/methodology/approach This cross-sectional study was carried out among elderly living in five agricultural settlements in Kuantan, Pahang, Malaysia. Participants were interviewed on socio-demographic information such as age, gender, marital status, smoking status, household income, education level and living status. Data on individual dietary intake were obtained through diet history method. Dietary intake data were analyzed using Nutritionist Pro software and compared to the recommended nutrient intakes (RNI) for Malaysia version 2017. Statistical analyses were performed using SPSS software version 21. Findings A total of 413 participants (male 32.4 per cent and female 67.6 per cent) with the mean age of 69.4 ± 7.9 years participated in this study. Dietary intake results demonstrated that participants did not meet the Malaysian RNI for energy and most nutrients (p < 0.05). This study also found that energy, carbohydrate, protein, fat, folate and iron intake were significantly higher in male than female (p < 0.05). Meanwhile, calcium and vitamin A intake were significantly higher in female than male (p < 0.05). Research limitations/implications Integrated nutrition education and health promotion programme with a multidisciplinary approach are essential to be designed and executed to improve dietary intake of the elderly, which can further lead to appropriate dietary practices and knowledge improvement related to healthy food choices. Factors associated with inadequate dietary intake and awareness on the importance of adequate nutrients intake among the elderly warrant further investigation. Originality/value This research is at the forefront, which indicated that the dietary intake of elderly individuals living in the agricultural settlement was inadequate in comparison to the latest recommendation. Strategies to improve their intakes need to be developed and implemented accordingly to improve nutritional status and prevent adverse effects to health.