Causes, assessment and treatment of malnutrition in older people

Willis, Helen

doi:10.7748/nop.2017.e883

Cited by 15 publications

(9 citation statements)

References 5 publications

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“…Malnutrition and poor functional performance are closely interrelated-malnutrition is associated with a higher risk of sarcopenia [38] and, consequently, poorer functional status. Malnutrition in older people is due to multiple factors [39], led by medical illnesses, mental health conditions, psychological causes, or social isolation [40]. Additionally, malnutrition or risk of malnutrition in older people is directly associated with multiple negative outcomes, including increased mortality [41], longer hospital stays, and poorer quality of life [42,43].…”

Section: Participant Characteristicsmentioning

confidence: 99%

Determinants of participation in a post-hospitalization physical exercise program for older adults

et al. 2020

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Background Older patients often experience a decline in physical function and cognitive status after hospitalization. Although interventions involving physical exercise are effective in improving functional performance, participation in physical exercise interventions among older individuals is low. We aimed to identify factors that contribute to exercise refusal among post-hospitalized older patients. Methods A cross-sectional study of recruitment data from a randomized controlled trial was conducted involving 495 hospitalized people ≥70 years old. Sociodemographic and clinical data were obtained from the Basque Public Health System database. We determined physical function with the Short Physical Performance Battery (SPPB), nutritional status with the Mini-Nutritional Assessment, frailty according to the Fried phenotype criteria, and cognitive function with the Short Portable Mental Status Questionnaire (SPMSQ). Student’s t, Mann-Whitney U, or chi-squared tests were applied for bivariate analysis. Parameters significantly associated with participation were introduced in a logistic multivariate regression model. Results Among the analyzed patients, 88.8% declined participation in the physical exercise program. Multivariate regression revealed that older age (OR: 1.13; 95% CI: 1.07–1.19), poor nutritional status (OR: 0.81; 95% CI: 0.69–0.95), and reduced home accessibility (OR: 0.27; 95% CI: 0.08–0.94) were predictors of participation refusal. Moreover, patients who declined participation had worse performance on the SPPB (P < 0.05) and its tests of balance, leg strength, and walking speed (P < 0.05). No differences were found between groups in other variables. Conclusions This study confirms low participation of older adults in a post-hospitalization physical exercise program. Non-participation was associated with increased age, poor nutritional status, and reduced home accessibility. Our findings support the need for intervention design that accounts for these factors to increase older patient participation in beneficial exercise programs. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12619000093189, (date: January 22, 2019, retrospectively registered).

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Section: Participant Characteristicsmentioning

confidence: 99%

Determinants of participation in a post-hospitalization physical exercise program for older adults

et al. 2020

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“…Malnutrition and poor functional performance are closely interrelated-malnutrition is associated with a higher risk of sarcopenia (39) and, consequently, poorer functional status. Malnutrition in older people is due to multiple factors (40), led by medical illnesses, mental health conditions, psychological causes, or social isolation (41). Additionally, malnutrition or risk of malnutrition in older people is directly associated with multiple negative outcomes, including increased mortality (42), longer hospital stays, and worse quality of life (43,44).…”

Section: Participant Characteristicsmentioning

confidence: 99%

Determinants of participation in a post-hospitalization physical exercise program for older adults

Urquiza

Echeverria

Besga

et al. 2020

Preprint

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BACKGROUND: Older patients often experience a decline in functional and cognitive status after hospitalization. Although interventions involving physical exercise are effective in improving functional performance, participation in physical exercise interventions among older individuals is low. We aimed to identify the factors that contribute to exercise refusal among post-hospitalized older patients.METHODS: A cross-sectional study of recruitment data from a randomized controlled trial was conducted involving 495 hospitalized people ≥70 years old. Sociodemographic and clinical data were obtained from the Basque Public Health System database. We determined physical function with the Short Physical Performance Battery (SPPB), nutritional status with the Mini-Nutritional Assessment, frailty according to the Fried phenotype criteria, and cognitive function with the Short Portable Mental Status Questionnaire (SPMSQ). Student’s t, Mann-Whitney U, or chi-squared tests were applied for bivariate analysis. Parameters significantly associated with participation were introduced in a logistic multivariate regression model.RESULTS: Among the analyzed patients, 88.8% declined participation in the physical exercise program. Multivariate regression revealed that older age (OR: 1.13; 95% CI: 1.07 - 1.19), poor nutritional status (OR: 0.81; 95% CI: 0.69 - 0.95), and reduced home accessibility (OR: 0.27; 95% CI: 0.08 - 0.94) were predictors of participation refusal. Moreover, patients who declined participation had worse performance on the SPPB (P < 0.05) and its tests of balance, leg strength, and walking speed (P < 0.05). No differences were found between groups in other variables. CONCLUSIONS: This study confirms low participation of older adults in a post-hospitalization physical exercise program. Non-participation was associated with increased age, poor nutritional status, and reduced home accessibility. Our findings support the need for intervention design that accounts for these factors to increase older patient participation in beneficial exercise programs.TRIAL REGISTRATION: ACTRN12619000093189 (retrospectively registered): Registered January 22, 2019.

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“…Observation is an essential part of assessment, although Willis (2017) notes that observing the signs of malnutrition becomes easier with more interaction with the patient. The Malnutrition Universal Screening Tool (MUST) identifies unintentional weight loss as a key indicator of risk (British Association of Parenteral and Enteral Nutrition 2017) but identifying this can rely on previous knowledge of the patient, information gained from the patient or carer, or the more subjective observation of the fit of clothing.…”

Section: Evidence Basementioning

confidence: 99%

“…There are many issues that can affect a person's ability to maintain nutritional health and they may not all be identified through the screening tool. Booker and Nicol (2011) discuss the importance of an initial nursing assessment that identifies dietary history and changes in appetite, as well as the need to consider individual lifestyle issues such as ability to carry shopping, distance to grocery stores and limited budgets (Willis 2017). Willis (2017) added that frailty in older people and social isolation can also affect nutritional intake therefore must considered; frailty however is not inevitable and full assessment which identifies nutritional risk can impact positively on frailty (Wallington 2016).…”

Section: Evidence Basementioning

confidence: 99%

How to undertake a nutritional assessment in adults

Johnstone¹

2018

Nursing Standard

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Short description Reading this module will help you to update your knowledge and skills in nutritional assessment Rationale and key points This module aims to assist healthcare practitioners to perform a nutritional assessment. It focuses on:  Supporting patients with their nutritional needs is a fundamental aspect of nursing care but it is not always considered a high priority.  Observation is an essential part of assessment, but a patient's nutritional status cannot be ascertained on appearance alone.  A structured approach to nutritional assessment, such as the MUST (Malnutrition Universal Screening Tool) or Mini Nutritional Assessment (MNA), should be undertaken.

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Causes, assessment and treatment of malnutrition in older people

Cited by 15 publications

References 5 publications

Determinants of participation in a post-hospitalization physical exercise program for older adults

Determinants of participation in a post-hospitalization physical exercise program for older adults

Determinants of participation in a post-hospitalization physical exercise program for older adults

How to undertake a nutritional assessment in adults

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