Assessment of nutritional status of medical ward patients aged more than 65 years using mini nutrition assessment tool

Abstract

Mini nutrition assessment tool (MNA) was developed to rapidly assess the nutritional status of elderly people which can be used as part of a standard evaluation of such patients in the wards. This is a validated tool, already in practice in western countries which show the prevalence of malnutrition among hospitalised patients to be 20.5%- 21.5%. Currently MNA tool is not used for this purpose in Sri Lanka and data on prevalence of malnutrition in hospital settings is also not available. Early detection of patients who are at risk of malnutrition helps health care workers to take necessary preventive actions. This present study applies MNA tool to find the prevalence of malnutrition in hospitalised geriatric patients and also according to their age and gender. A cross-sectional hospital based study was conducted at the Medical wards 07 and 08 in Teaching Hospital, Peradeniya in August and September 2011 using an interviewer administered questionnaire. All the patients > 65 years were included in the study. Left calf circumference was measured instead of body mass index (8MI). Responses to the questions and the calf circumference were given different scores and finally the total score was calculated. If the total score fell between the range of 0-7 points patient was categorised as malnourished, 8-11at risk of malnutrition and 12-14 normal nutritional status. Of the total 175 patients (99 male, 76 female) included in the study, 20 (11.4%) were in the normal nutritional status, 74 (42.3%) were at risk of malnutrition and 81 (46.3%) in the malnutrition categories. Out of 99 males, 15 (15.15%) had normal nutritional status, 46 (46.46%) were at risk of malnutrition and 38 (38.38%) were malnourished. Out of 76 females, five (6.57%) had normal nutritional status, 28 (36.84%) were in at risk malnutrition category and 43 (56.57%) had malnutrition. Out of 95 patients in the 66y-75y age group, 14 (14.73%) had normal nutritional status, 46 (48.42%) were at risk of malnutrition, 35 (36.84%) had malnutrition. Out of 70 patients in the 76y-85y age group, 6 (8.57%) had normal nutritional status, 25 (35.71%) were at risk of malnutrition, 39 (55.71%) had malnutrition. In the age group of > 86y, none had normal nutritional status, 3 (30%) were at risk of malnutrition, 7 (70%) were malnourished. This study shows 46.3% of hospitalised patients were malnourished and 42.3% were at risk of malnutrition. These figures are much higher than the western figures. Female malnourished group contain more patients than their male counterparts, but male patients were at a higher risk of malnutrition than females. As the age increases, the number with malnutrition and risk of malnutrition increased. As admissions of malnourished elderly patients into medical wards are high in Teaching Hospital Peradeniya, it is a major health care problem. Health care workers should pay more attention to identify patients who are malnourished and at risk of malnutrition patients and take action to improve their nutritional status, which will lead to rapid recovery of patients.