The predictive value of weight evolution in screening for (risk of) malnutrition in community-dwelling elderly (70+): a follow up study

Abstract

Background Malnutrition is a heavily underestimated but frequently occurring pathology. Due to aging of the population and the increasing survival rate for a number of pathologies, the prevalence of malnutrition is increasing. Malnutrition in the home situation will increase due to the decrease in the hospitalization length and the shift of care to primary care. Screening for malnutrition is indispensable, as only half of malnourished patients are recognized by health care providers. Experience and research show that screening in primary care mainly takes place by monitoring the weight parameter and that validated screening instruments are hardly used. With this study we want to investigate how effective and predictive weight evolution is in screening for (risk of) malnutrition in older people living at home, in comparison with the gold standard, namely the MNA-SF. Methods This project is a prospective, longitudinal study with quantitative data. The outcome measure is the weight evolution over six months compared with the score on the MNA-SF at month six. The target group of this study consists of people over 70 living at home and receiving help from a nurse on a regular basis (at least once a month). Weight is measured and recorded once a month during 6 months. At the last weight measurement, the MNA-SF is administered. In order to assess their own nutritional state, three additional questions are asked after taking the MNA-SF Results A total of 143 patients consented to participate. Based on the MNA-SF score measured after six months, 37.8% (54/143) was at risk of malnutrition and 4.9% (7/ 143) was malnourished. In order to detect people with (risk of) malnutrition, a sensitivity of 19.3% and a specificity of 96.0% were established with a weight evolution of ≥5% weight loss at six months. To detect malnutrition, this was 71.4% and 92.3%, respectively. Conclusion Weight evolution has a low sensitivity in screening for malnutrition in people over 70 living at home compared to the MNA-SF as the gold standard. In order to detect people with malnutrition, weight loss seems to have a considerable predictive value in this study.