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Prevalence of malnutrition and risk factors in
geriatric patients of a convalescent and rehabilitation hospital
NC Shum, WWH Hui, FCS Chu,
J Chai, TW Chow
Department of Medicine and Rehabilitation, Tung Wah Eastern Hospital,
Causeway Bay, Hong Kong
OBJECTIVES. To investigate the prevalence and risk
factors of malnutrition in geriatric patients admitted to a convalescent
and rehabilitation hospital.
DESIGN. Cross-sectional study.
SETTING. Regional hospital, Hong Kong.
PATIENTS. A total of 120 patients (aged 60 years
or older) referred to Tung Wah Eastern Hospital.
MAIN OUTCOME MEASURES. Anthropometric, biochemical,
and haematological parameters were measured for nutritional assessment.
Malnutrition was defined as a body mass index of lower than 18.5
kg/m2 and serum albumin level of lower than 35 g/L. The
clinical outcomes of patients were also recorded. The predictive
value of the Chinese Mini Nutritional Assessment as a nutritional
screening tool was assessed. Potential risk factors associated with
malnutrition were evaluated according to established protocols.
RESULTS. The mean age of patients was 80.3 years
(standard deviation, 7.4 years), and the mean body mass index was
21.9 kg/m2 (standard deviation, 4.4 kg/m2).
The prevalence of malnutrition was 16.7%. The age distribution of
malnourished patients (mean, 86.2 years; standard deviation, 7.0
years; n=20) was significantly different to those nourished (mean,
79.1 years; standard deviation, 6.9 years; n=100) [P=0.0001]. Mortality
was also higher in malnourished patients (25%) than nourished patients
(4%) [P=0.001]. Based on the Chinese Mini Nutritional Assessment,
16.9% of patients were classified as malnourished (cut-off value,
18.5). The Chinese Mini Nutritional Assessment was useful as a screening
tool to exclude patients who were not malnourished, ie it had a
high negative predictive value (95%). Being totally dependent for
the performance of activities of daily living, living in a home
for the elderly, and being chair- or bed-bound posed a significantly
increased risk of malnutrition. The presence of mental depression
(geriatric depression scale score of 8 or higher), moderately or
severely impaired cognitive function (abbreviated mental test score
of lower than 7), or polypharmacy (five medications or more) did
not significantly affect risk of malnutrition.
CONCLUSIONS. Malnutrition was common in the geriatric
patients studied and was associated with an increased mortality.
The Chinese Mini Nutritional Assessment was a useful screening tool
to exclude malnutrition. Significant risk factors of malnutrition
were total dependence, living in a home for the elderly, and being
chair- or bed-bound.
Hong Kong Med J 2005;11:234-42
Key words: Aged; Geriatric assessment; Nutrition
assessment; Nutritional status; Risk factors
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