Promoting food intake in older adults living in the community: a review

Keller, Heather

doi:10.1139/h07-067

Cited by 81 publications

(68 citation statements)

References 51 publications

(141 reference statements)

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“…As nutrition risk is conceptualized to precede malnutrition (Keller 2007) it should be more common. However, prevalence of risk is elusive not only due to the different tools and populations assessed, but also as tools designed for screening are sometimes referred to as assessment tools (Bales 2001).…”

Section: Prevalence Of Malnutrition and Nutrition Riskmentioning

confidence: 99%

“…CNST contains only 2 questions, and has been demonstrated to be valid and reliable for this setting when compared with the SGA . Other screening tools specific to older adults that provide a more upstream view of nutrition risk are available; these are designed for and are potentially more appropriate for a community-based or primary-care population (Akhtar et al 2015;Keller 2007;Keller et al 2001).…”

Section: Nutrition Assessment and Screening Toolsmentioning

confidence: 99%

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Malnutrition or frailty? Overlap and evidence gaps in the diagnosis and treatment of frailty and malnutrition

Laur

McNicholl

Valaitis

et al. 2017

Appl. Physiol. Nutr. Metab.

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123

116

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Abstract:There is increasing awareness of the detrimental health impact of frailty on older adults and of the high prevalence of malnutrition in this segment of the population. Experts in these 2 arenas need to be cognizant of the overlap in constructs, diagnosis, and treatment of frailty and malnutrition. There is a lack of consensus regarding the definition of malnutrition and how it should be assessed. While there is consensus on the definition of frailty, there is no agreement on how it should be measured. Separate assessment tools exist for both malnutrition and frailty; however, there is intersection between concepts and measures. This narrative review highlights some of the intersections within these screening/assessment tools, including weight loss/decreased body mass, functional capacity, and weakness (handgrip strength). The potential for identification of a minimal set of objective measures to identify, or at least consider risk for both conditions, is proposed. Frailty and malnutrition have also been shown to result in similar negative health outcomes and consequently common treatment strategies have been studied, including oral nutritional supplements. While many of the outcomes of treatment relate to both concepts of frailty and malnutrition, research questions are typically focused on the frailty concept, leading to possible gaps or missed opportunities in understanding the effect of complementary interventions on malnutrition. A better understanding of how these conditions overlap may improve treatment strategies for frail, malnourished, older adults.Key words: frailty, malnutrition, screening, assessment, diagnosis, handgrip strength, oral nutritional supplements, older adult.Résumé : Les effets néfastes de la fragilité des personnes âgées sur leur santé ainsi que la forte prévalence de malnutrition dans cette strate de la population suscitent une prise de conscience grandissante. Les experts dans ces deux domaines doivent être au fait du chevauchement des construits, du diagnostic et du traitement de la fragilité et de la malnutrition. Il n'y a pas encore de consensus au sujet de la définition de la malnutrition et de son évaluation. Concernant la fragilité, on s'entend sur sa définition, mais pas sur sa mesure. Il existe pourtant des outils distincts de mesure de la malnutrition et de la fragilité et, d'ailleurs, les concepts et mesures présentent une intersection. Cette revue narrative souligne les intersections entre les outils de dépistage et d'évaluation comme la perte de poids/diminution de la masse corporelle, de la capacité fonctionnelle et la faiblesse (force de préhension manuelle). En guise de tentative, on propose un ensemble minimal de mesures objectives pour la détermination ou, à tout le moins, l'identification d'un risque dans les deux conditions. La fragilité et la malnutrition aboutissent, études à l'appui, à des problèmes de santé similaires justifiant des stratégies communes de traitement tels les suppléments nutritionnels oraux. Alors que plusieurs résultats du traitement c...

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Section: Prevalence Of Malnutrition and Nutrition Riskmentioning

confidence: 99%

Section: Nutrition Assessment and Screening Toolsmentioning

confidence: 99%

Malnutrition or frailty? Overlap and evidence gaps in the diagnosis and treatment of frailty and malnutrition

Laur

McNicholl

Valaitis

et al. 2017

Appl. Physiol. Nutr. Metab.

Self Cite

123

116

View full text Add to dashboard Cite

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“…This In Canada, considerable work has been done surrounding the development and validation of the SCREEN II tool. However, an identified barrier in Canadian screening is that nutrition promotion does not hold a prominent place in national policy [93]. Additionally, the prevalence of malnutrition is unknown in Canadian older adults [94].…”

Section: Learning From International Experiencesmentioning

confidence: 99%

Nutrition as a Vital Sign: Progress Since the 1990 Multidisciplinary Nutrition Screening Initiative and Opportunities for Nursing

Farrell¹

2015

J Nurs Care

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Vital signs provide critical information about health and help form the baseline for clinical care. Twenty years ago, the Nutrition Screening Initiative posed nutrition screening as a vital sign for older Americans but this has still not occurred. Nursing is on the frontline for monitoring as well as working to improve nutrition intake in collaboration with dietitians and other healthcare professionals. This article describes the importance of malnutrition screening, key indicators of elder well-being, and how the older American population has changed in the last few decades. The article also chronicles the multidisciplinary Nutrition Screening Initiative, its accomplishments, challenges, and new developments including new screening data collection instruments and the frailty index. Other developments described are the Alliance to Advance Patient Nutrition's intervention framework and documentation of the economic value of nutrition intervention. Opportunities and next steps for nurses to help malnutrition screening become a vital sign are identified. These include the need to make malnutrition screening and intervention part of the core training for nurses. In the hospital setting, the Joint Commission requires that all patients be screened for malnutrition within 24 hours, however malnutrition interventions are often lacking. Thus another opportunity is for malnutrition measurement and documentation to be developed as a summative measure and included as part of the standardized nursing language, with a specific section in the Electronic Health Record. Becoming part of national health goals, such as the Healthy People 2020 objectives, is an additional important step for the evolution of malnutrition screening as a vital sign as is integrating malnutrition screening and intervention into healthcare incentives, including the Patient Protection and Affordable Care Act, transitions of care, and community intervention. Finally, committing funding for malnutrition screening, such as through reauthorization of the Older Americans Act, and gaining key learning from international experiences are important.

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“…SCREEN II Ó , and its forerunner SCREEN I Ó , typically identify early nutrition risk as the screening items focus on reported weight change, food intake, and challenges that could decrease one's intake (Keller 2007). Other screening tools which include anthropometric measurements and biochemical data are designed to identify older adults at greater nutrition risk, showing some evidence of more advanced nutrition problems.…”

Section: Introductionmentioning

confidence: 99%

Learning you are “at risk”: seniors’ experiences of nutrition risk screening

2011

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Nutrition risk screening can help identify community-dwelling older adults who may benefit from nutrition education and interventions to improve food intake. Research has shown, however, that older adults who are found ''at risk'' through nutrition screening commonly do not see themselves at risk, and many do not follow through with accessing recommended nutrition services. Thus, the purpose of this qualitative study was to examine older adults' experiences of learning they were at risk through nutrition screening and to identify what influenced their perspectives and responses to their screening results. Face-to-face interviews were conducted with 22 older adults who had screened at risk (SCREEN II Ó scores \ 54) through a nutrition screening process conducted by mail. Participants received their screening results in a personalized letter before the interview, along with some recommendations to help improve food intake and decrease their nutrition risk. Interviews were transcribed and analyzed for themes. When participants reflected about receiving their screening results, some described feeling surprised or even upset by the message that they were at increased risk, whereas others felt unconcerned or reacted with heightened attentiveness to their nutrition. They also began to rationalize their screening score and found ways to explain away their risk. The message that they were at increased risk was poorly understood and not well received because it contradicted their perspective: they felt they were doing the right things, they saw room for improvement rather than seeing themselves at risk, and they tended to make comparisons that helped support the view that they were not truly at risk. Further, even though participants saw room for improvement, they described barriers to change and commonly felt that the recommendations were more applicable for others than themselves. Strategies to improve communication of nutrition screening results and recommendations are discussed to help seniors better understand their risk and take steps to improve their nutrition.

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Promoting food intake in older adults living in the community: a review

Cited by 81 publications

References 51 publications

Malnutrition or frailty? Overlap and evidence gaps in the diagnosis and treatment of frailty and malnutrition

Malnutrition or frailty? Overlap and evidence gaps in the diagnosis and treatment of frailty and malnutrition

Nutrition as a Vital Sign: Progress Since the 1990 Multidisciplinary Nutrition Screening Initiative and Opportunities for Nursing

Learning you are “at risk”: seniors’ experiences of nutrition risk screening

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