Revisiting the concept of malnutrition in older people.

AIM

The aim of this study is to revisit the concept of malnutrition in older people, trace the new development and test the use of refined framework with empirical data.

BACKGROUND

Malnutrition in older people is a common and significant problem worldwide. Continuing Chen's earlier work in 2001, a refinement was conducted and a prospective study was designed to test the use of this refined framework.

DESIGN

A cohort study of 114 hospitalized older patients in Northern Taiwan.

METHODS

The sample consists of 114 older patients aged 65 years and older, who were admitted for the cardiac and orthopaedic services at a tertiary 2300-bed hospital. From March to August 2004, assessed by one trained nurse, participants completed a structured face-to-face interview evaluating their age, visual/hearing impairments, oral health, cognitive status, comorbidities, medication use, social economic status, functional status, social support, depressive symptoms and nutritional status within 48 hours of admission. Participants who stayed >5 days were reassessed before discharge (n = 70). The data from admission were the main focus of this report.

RESULTS

Regression analysis revealed that that more medication taken, female gender, lower functional status (beta = 0.34, P < 0.001) and higher depressive symptoms were independent predictors of poor nutritional status, with the full model accounting for 48.2% of the variance. The result is in-line with the original theoretical underpinnings and it suggests that this refined framework detailing sub-concepts and measurable indices appears to fit the empirical data and suitable for clinical use.

CONCLUSION

The findings lend support to the use of this framework in managing malnutrition in older people.

RELEVANCE TO CLINICAL PRACTICE

Nurses have an essential role in providing care for older people a framework like this would provide a road map guiding the intervention efforts.