Nutritional Status According to Mini Nutritional Assessment in an Institutionalized Elderly Population in Sweden

Abstract

Background: In 1992, local municipalities in Sweden took over full responsibility for the long-term care of elderly. This has led to an increased care burden for the various assisted accommodation services run by the municipalities. Objective: Since ageing and chronic diseases are risk factors for protein-energy malnutrition, we evaluated the nutritional status of all individuals in assisted accommodation, i.e., service flats (SF), old people’s homes (OPH), group living for the demented (GLD), and nursing homes (NH), in three Swedish municipalities. Methods: Of 994 eligible subjects, 872 were examined; the average age was 84.5 ± 8 years, and 69% were female. The Mini Nutritional Assessment (MNA) scale (0–30 points) was used, consisting of 18 point-weighted questions in four categories, i.e., anthropometry, global and dietary issues, and self-assessment. Results: MNA <17, i.e., malnutrition, was noted in 36% of the study population. Divided according to accommodation type, the MNA scores were <17 in 21% of individuals in SF, 33% of those in OPH, 38% of those in GLD, and 71% of those in NH. The corresponding values for MNA scores 17–23.5 (risk for malnutrition) were 49, 51, 57, and 29%, respectively. Average body mass index (BMI) values were 24.2 ± 5 (SF), 23.6 ± 5 (OPH), 23.9 ± 4 (GLD), and 22.3 ± 4 (NH). BMI values ≤20 were found in 18% of those in SF, in 25% of those in OPH, in 19% of those in GLD, and in 33% of those in NH. Both MNA and BMI correlated with upper arm and calf circumference, with r values ranging from 0.4 to 0.7 (p < 0.001). MNA and BMI correlated significantly (r = 0.52, p < 0.001). Age correlated with MNA and BMI with r values of 0.1 (p < 0.01) and 0.14 (p < 0.001), respectively. Subjects with signficant help requirements during meals ate fewer whole meals per day than those who could feed themselves. Conclusions: Based on the MNA, one third of the study subjects living in assisted accommodation, and more than half of those living in NH, appeared to be malnourished. Further studies are necessary to assess to what extent these nutritional disturbances are reversible.

Malnutrition and associated factors among aged residents in all nursing homes in Helsinki

“…In various institutional settings, the proportion of the resident population suffering from malnutrition has varied between 15 and 71% and the proportion at risk of malnutrition has been between 40 and 60% (Lauque et al, 2000;Van Nes et al, 2001;Christensson et al, 2002;Gerber et al, 2003). In a Swedish study, 33% of the aged residents living in old people's homes that correspond to our nursing homes suffered from malnutrition (Saletti et al, 2000). In the Swedish study those with the lowest MNA values ate less than the others just like our malnourished residents.…”

“…Thus, the studied, aged residents are representative of those old people who permanently live in nursing homes. It was already known from previous studies that malnutrition is a common problem among aged residents in institutional care facilities (Abbasi & Rudman, 1993;Lesourd, 1997;Saletti et al, 2000). However, large-scale studies performed with the validated MNA in nursing home populations are still scarce (Saletti et al, 2000;Van Nes et al, 2001).…”

“…It was already known from previous studies that malnutrition is a common problem among aged residents in institutional care facilities (Abbasi & Rudman, 1993;Lesourd, 1997;Saletti et al, 2000). However, large-scale studies performed with the validated MNA in nursing home populations are still scarce (Saletti et al, 2000;Van Nes et al, 2001). In addition, even though patient-related factors such as dementia and ADL impairment are known to be associated with malnutrition, much less is known about the impact of care-related factors on malnutrition.…”

“…In Sweden, one-third of aged residents living in old people's homes were malnourished (Saletti et al, 2000). Malnutrition, low body mass index (BMI) and unintentional weight loss are risk factors for mortality and have a negative influence on the functional status and psychosocial well-being of the aged population (Takala et al, 1994;Dey et al, 2001;Crogan & Pasvogel, 2003).…”

Nutritional status, as determined by the Mini-Nutritional Assessment, and osteoporosis: a cross-sectional study of an elderly female population

“…Furthermore, low body weight has consistently been shown to be associated with an enhanced risk of osteoporosis (DargentMolina et al, 2000). The Mini-Nutritional Assessment (MNA), a test developed to determine the risk of malnutrition in older people (Guigoz et al, 1996), has been employed to detect nutritional deficiencies in institutional settings (Saletti et al, 2000) as well as in healthy general populations (Scheirlinckx et al, 1999). Moreover, this test has been found to predict mortality in geriatric patients (Persson et al, 2002) and in both an elderly Danish population and among free-living elderly Swedish subjects receiving public services and care (Beck et al, 2001;Saletti et al, 2005).…”