Malnutrition in Older People: How to Screen for Malnutrition
This is part 3 of 4 in a series written by KovirPage LLC's social work intern, Brianna Burke of Traverse City, Michigan.
With a greater understanding of what malnutrition is, the next step in helping older people is to increase screening and assessments for malnutrition. One of the most common ways to screen for malnutrition in seniors is through BMI (body mass index), which is used primarily to measure body weight and fat. However, researchers DiMaria-Ghalili and Amella (2005) state that BMI is not a reliable measure of malnutrition. Despite BMI measuring the amount of fat on the body, it does not provide any insight into the nutritional status of an individual.
Researchers state that taking measures of visceral protein levels is a more accurate depiction of a person’s nutritional status (DiMaria-Ghalili and Amella, 2005). Visceral protein levels can indicate how large a person’s pool of visceral proteins is, which can help to establish if the person is receiving adequate nutrition (DiMaria-Ghalili and Amella, 2005). Albumin, retinol-binding protein and transferrin are commonly measured to assess an individual’s visceral protein pool; if any of these levels measured are outside the normal range, this could indicate that the patient is experiencing malnutrition (DiMaria-Ghalili and Amella, 2005).
Although measuring protein levels could be an accurate measure of malnutrition, it may not be possible for all facilities or care partners to have access to this scientific equipment.
A more accessible way to screen for malnutrition in older adults is to monitor for weight changes. According to researchers DiMaria-Ghalili and Amella (2019), frequently [asking or] taking older adults’ weight can help to establish a baseline for the person, and moving forward, caregivers and care partners can take measurements of weight to monitor for any excessive changes in body weight. Significant changes in body weight could indicate to care partners or health care workers that there are changes in the client’s eating habits, which could be an early sign of malnutrition. Early assessments for malnutrition are important because they can help to address the situation before it progresses any farther.
The conclusion tomorrow...
Written by Brianna Burke, BSW Candidate, KovirPage LLC Intern
[A Note from WizeCove: Only doctors, dietitians, and clinicians can diagnose malnutrition. Should you have concerns about your senior members or meals on wheels clients, alert the client and, if applicable, the listed care partner to be seen by a medical professional. Our friends at Meals on Wheels America created a 50-page document that goes even more in-depth on the screening process.]
DiMaria-Ghalili, R. & Amella, E. (2005). Nutrition in older adults: Intervention and assessment can help curb the growing threat of malnutrition. The American Journal of Nursing, 105(3), 40–50. https://doi.org/10.1097/00000446-200503000-00020
Griffin, O. (2020). The prevalence of malnutrition and impact on patient outcomes among older adults presenting at an Irish emergency department: a secondary analysis of the OPTI-MEND trial. BMC Geriatrics, 20(1), 455. https://doi.org/10.1186/s12877-020-01852-w
Landi, C. (2016). Anorexia of Aging: Risk Factors, Consequences, and Potential Treatments. Nutrients, 8(2), 69–69. https://doi.org/10.3390/nu8020069
Marshall, B. (2013). Are informal carers and community care workers effective in managing malnutrition in the older adult community? A systematic review of current evidence. The
Journal of Nutrition, Health & Aging, 17(8), 645–651. https://doi.org/10.1007/s12603-013-0341-z
National Institute on Aging. (2020). How smell and taste change as you age. U.S. Department of Health & Human Services. https://www.nia.nih.gov/health/smell-and-taste
Volkert, D. (2013). Malnutrition in older adults - urgent need for action: A plea for improving the nutritional situation of older adults. Gerontology. 59(4). 328-333. doi: 10.1159/000346142
Wolters, M., Volkert, D., Streicher, M., Kiesswetter, E., Torbahn, G., O’Connor, E., O’Keeffee, M., Kelly, M., O’Herlihy, E., O’Toole, P., Timmons, S., O’Shea, E., Kearney, P., Van Zwienon-Pot, J., Visser, M., Maitre, I., Van Wymelbeke, V., Sulmont-Rossé, C., Nagel, G., Flechtner-Mors, M., Goisser, S., Teh, R., and Hebestreit, A. (2019). Prevalence of malnutrition using harmonized definitions in older adults from different settings- a MaNuEl study. Clinical Nutrition. 38(5). 2389-2398. https://doi.org/10.1016/j.clnu.2018.10.020.