Abstract
Malnutrition occurs frequently in the frailest groups of the population, especially in people who are on a low income and elderly subjects, overall if they are institutionalized. The aim of this study was to assess the prevalence of malnutrition in a sample of elderly people living in different settings and to identify the determinants of malnutrition.
Methods
A total of 718 subjects, 472 females (F) and 246 males (M), were recruited from nursing homes or were free living in three different regions in Italy. Nutritional status, depression, social, functional and cognitive status, were evaluated.
Results
According to the Mini Nutritional Assessment (MNA), a high prevalence of malnutrition was found out in both genders: 26% of F and 16.3% of M were classified as being malnourished (MNA<17); 40.9% of F and 35% of M were at risk of malnutrition (MNA 17–23,5). The prevalence of malnutrition was significantly higher in NH subjects in both sexes. Moreover, a relationship was shown between malnutrition and inability to shop, prepare and cook meals because of a low income, distance from markets or supermarkets as well as impossibility to drive the car or to use public transportation. This study confirms the necessity to routinely perform nutritional status evaluation in elderly subjects, to carry out training courses for health workers (doctors, nurses, psychologists, dietitians), to implement nutritional education of the geriatric population, to develop tools and guidelines for health workers and caregivers, to identify and reduce clinical, functional, social or economic risk factors for malnutrition.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Stratton RJ, Green CJ, Elia M. Related Malnutrition: an Evidence Based Approach to Treatment Oxford: CABI; 2003.)
Lattanzio F, Laino I, Pedone C, Corica F, Maltese G, Salerno G, Garasto S. Corsonello A, Incalzi RA; on behalf of the PharmacosurVeillance in the elderly Care (PVC) Study Group.: Geriatric Conditions and Adverse Drug Reactions in Elderly Hospitalized Patients. Am Med Dir Assoc. 2011 May 27)
Joseph ML, Carriquiry A.: A measurement error approach to assess the association between dietary diversity, nutrient intake, and mean probability of adequacy. J Nutr. 2010 Nov;140(ll):2094S–2101S;.
Torheim LE, Ferguson EL, Penrose K, Arimond M: Women in resource-poor settings are at risk of inadequate intakes of multiple micronutrients. J Nutr. 2010 Nov;140(ll):2051S–2058S; Lee MR, Berthelot ER. Community covariates of malnutrition based mortality among older adults. Ann Epidemiol. 2010 May;20(5):371–9)
Office of National Statistics. Population trends. FT 118, table 1,4.(population age and sex) London: ONS;2004.)
Office of National Statistics. Living in Britain: results from the 2002 General Household Survey. London: ONS; 2004).
Paraielee PA, Thuras PD, Katz IR, Lawton MP: Validation of the Cumulative Illness Rating Scale in a geriatric residential population. J Am Geriatr Soc 1995, 43(2): 130–137).
Guigoz Y, Vellas B, Garry PJ. Facts, research and intervention in gerontology. In: The Mini Nutritional Assessment: a practical assessment tool for grading the nutritional state of elderly persons. 3rd ed. Paris: Serdi Publishing Company, 1997: 15–60.
Pfeiffer E: A short portable mental status questionnaire for the assessment of organic brain deficit in elderly subjects. J Am Geriatr Soc 1975, 23(10):433–441)
Yesavage JA, Brink TL, Rose TL. Development and validation of a geriatric depression screening scale. A preliminary report. J Psych Res 1983; 17: 37–49
Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969; 9(3): 179–186
Katz S. Assessing self-maintenance: activities of daily living, mobility, and instrumental activities of daily living. J Am Geriatr Soc 1983; 31:721–727.).
Rosen SL, Reuben DB: Geriatric assessment tools. Mt Sinai J Med. 2011 Jul;78(4):489–497
Cereda E, Pedrolli C, Zagami A, Vanotti A, Piffer S, Opizzi A, Rondanelli M, Caccialanza R: Nutritional screening and mortality in newly institutionalised elderly: A comparison between the Geriatric Nutritional Risk Index and the Mini Nutritional Assessment. Clin Nutr. 2011 Jun 30)
Volkert D, Pauly L, Stehle P, Sieber CC: Prevalence of malnutrition in orally and tube-fed elderly nursing home residents in Germany and its relation to health complaints and dietary intake. Gastroenterol Res Pract. 2011;2011:247315.
Donini LM, Savina C, Piredda M, Cucinotta D, Fiorito A, Inelmen EM, Sergi G, Domiguez LJ, Barbagallo M, Cannella C. Senile anorexia in acute-ward and rehabilitations settings. J Nutr Health Aging. 2008 Oct;12(8):511–517
De Lorenzo A, Deurenberg P, Pietrantuono M, Di Daniele N, Cervelli V, Andreoli A: How fat is obese? Acta Diabetol 2003, 40Suppl 1:S254–S257
Kagansky N, Beraer Y, Koren-Morag N, Perelman L, Knobler H, Levy S: Poor nutritional habits are predictors of poor outcome in very old hospitalized subjects. Am J Clin Nutr 2005, 82(4):784–791; quiz 913–784)
Webber CB, Splett PL. Nutrition risk factors in a home health population. Home Health Care Serv Q 1995; 15: 97–110
Wellman NS, Weddle DO, Kranz S, Brain CT. Elder insecurities: poverty, hunger, and malnutrition. J Am Diet Assoc 1997; 97(10 Suppl 2): S120–S122
Macintosh C, Morley JE, Chapman IM. The anorexia of aging. Nutrition 2000; 16: 983–995
Marcus EL, Berry EM. Refusal to eat in the elderly. Nutr Rev 1998; 56: 163–171
Donini LM, Savina C, Piredda M, et al. Senile anorexia in acute-ward and rehabilitation settings. J Nutr Health Aging 2008; 12: 511–517
Morley JE. Decreased food intake with aging. J Gerontol A Biol Sci Med Sci 2001; 56Spec No 2: 81–88
Ramie E, Pranjic N, Batic-Mujanovic O, Karic E, Alibasic E, Alic A.: The effect of loneliness on malnutrition in elderly population. Med Arh. 2011;65(2):92–95
German L, Kahana C, Rosenfeld V, Zabrowsky I, Wiezer Z, Fraser D, Shahar DR.: Depressive symptoms are associated with food insufficiency and nutritional deficiencies in poor community-dwelling elderly people. J Nutr Health Aging. 2011;15(l):3–8).
Morley JE. Anorexia of aging: physiological and pathological. Am J Clin Nutr. 1997;66:760–773
Donini LM, Savina C, Cannella C. Appetite and ageing. In: Raats M, van Staveren W, de Groot L, eds. Food for the ageing population. Cambridge (England): Woodhead Publishing Limited, 2009: 43–72
Morley JE. Anorexia, sarcopenia, and aging. Nutrition 2001; 17: 660–673
Morley JE, Thomas DR. Anorexia and aging: pathophysiology. Nutrition 1999; 15: 499–503
Savina C, Donini LM, Cannella C. Anorexia of Aging. In: Randal LO, ed. Aging and the Elderly. New York: Nova Science Publisher, 2007: 139–151
Rivière S, Gillette-Guyonnet S, Voisin T, et al. A nutritional education program could prevent weight loss and slow cognitive decline in Alzheimer’s disease. J Nutr Health Aging 2001; 5: 295–299
Webber CB, Splett PL. Nutrition risk factors in a home health population. Home Health Care Serv Q 1995; 15: 97–110
Wellman NS, Weddle DO, Kranz S, Brain CT. Elder insecurities: poverty, hunger, and malnutrition. J Am Diet Assoc 1997; 97(10 Suppl 2): S120–S122
UNDP. Human Development Report 2008. New York: UNDP, 2008
ISTAT. La povertà assoluta in Italia nel 2007. Roma: ISTAT, 2009 www.istat.it
ISTAT 2009. La situazione del Paese nel 2008. Rapporto Annuale. Roma: ISTAT, 2009 www.istat.it
Casper RC. Nutrition and its relationship to aging. Exp Gerontol 1995; 30(3–4):299–314
Donini LM, Savina C, Cannella C. Eating habitus and appetite control in the elderly: the anorexia of aging. Intern Psychogeriatr 2003; 15: 73–87
Sun LJ, Frongillo, EA. Nutritional and health consequences are associated with food insecurity among US elderly persons. J Nutr 2001; 131:1503–1509
Wolfe, WS, Frongillo, EA, Valois, P. Understanding the experience of food insecurity by elders suggests ways to improve its measurement. J Nutr 2003; 133: 2762–2769
Che J, Chen J. Food insecurity in Canadian households. Health Rep 2001; 12: 11–22
Bouis HE, Eozenou P, Rahman A.: Food prices, household income, and resource allocation: socioeconomic perspectives on their effects on dietary quality and nutritional status. Food Nutr Bull. 2011 Mar;32(l Suppl):S14–S23)
Ferdous T, Cederholm T, Kabir ZN, Hamadani ID, Wahlin A. Nutritional status and cognitive function in community-living rural Bangladeshi older adults: data from the poverty and health in ageing project. J Am Geriatr Soc. 2010 May;58(5):919–924
L.M. Donini, MR De Felice, L. Tassi, L. De Beraardini, A Pinto, AM Giusti, C. Cannella: A proportional and objective score for the Mini Nutritional Assessment in long-term geriatric care. J Nutr Health & Aging 2002, 6, 2141–2146
Tsai AC, Chang TL, Wang YC, Liao CY.: Population-specific short-form mini nutritional assessment with body mass index or calf circumference can predict risk of malnutrition in community-living or institutionalized elderly people in taiwan. J Am Diet Assoc. 2010 Sep; 110(9): 1328–1334.
Kaiser MJ, Bauer JM, Uter W, Donini LM, Stange I, Volkert D, Diekmann R, Drey M, Bollwein J, Tempera S, Guerra A, Ricciardi LM, Sieber CC. Prospective validation of the modified mini nutritional assessment short-forms in the community, nursing home, and rehabilitation setting. J Am Geriatr Soc. 2011 Nov;59(11):2124–2128.
Cudennec T, Lagrandeur J, Moulias S, Moussous W, Colombier B, Teillet L.: Should caregivers be concerned with the nutritional state of elderly patients?. Soins Gerontol. 2011 May–Jun;(89):24–26.
Seligman HK, Laraia BA, Kushel MB.: Food insecurity is associated with chronic disease among low-income NHANES participants J Nutr. 2010 Feb;140(2):304–310
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Donini, L.M., Scardella, P., Piombo, L. et al. Malnutrition in elderly: Social and economic determinants. J Nutr Health Aging 17, 9–15 (2013). https://doi.org/10.1007/s12603-012-0374-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12603-012-0374-8