Top

The journal of nutrition, health & aging

Published in:

01-06-2017

High prevalence of malnutrition among elderly veterans in home based primary care

Authors: Aung Zaw Win, C. Ceresa, K. Arnold, T. A. Allison

Published in: The journal of nutrition, health & aging | Issue 6/2017

Abstract

Introduction

Elderly Veterans enrolled in VA Home Based Primary Care (HBPC) programs suffer from many diseases including malnutrition. Nutrition screening tools exist in the VA system but they are inconsistently utilized across ambulatory care programs and are neither research validated nor comparable with non-VA populations. The Mini-Nutritional Assessment short-form (MNA-SF) has been validated in international studies in a variety of settings. The primary aim of this study was to find the prevalence of malnutrition among Veterans enrolled in HBPC programs. The secondary objective was to determine the feasibility of adopting a validated nutrition screening tool (Mini-Nutritional Assessment short-form (MNA-SF)).

Methods

2252 veterans age 65 and older from 18 HBPC programs from across the country participated in the study. The study period was between April and September 2012. WinPepi (version 11.25) was used for descriptive analysis.

Results

We found that the prevalence of malnutrition was 15% (344/2252) and the prevalence of at risk for malnutrition was 40.3% (909/2252).

Discussion

The MNA-SF is an efficient nutrition screening tool and it can be successfully used for the elderly veterans. The prevalence of malnutrition among veterans was high compared to the community dwelling U.S. civilian elderly population. By preventing and treating malnutrition, health care systems should be able to reduce overall health care costs.

Veterans Affairs.Veterans Health Administration. http://www.va.gov/health/Accessed 1 February 2016

Srivaths PR, Wong C, Goldstein SL. Nutrition aspects in children receiving maintenance hemodialysis: impact on outcome. Pediatr Nephrol 2009;24: 951–957.CrossRefPubMed

Kondrup J, Allison SP, Elia M et al. Educational and Clinical Practice Committee, European Society of Parenteral and Enteral Nutrition (ESPEN). ESPEN guidelines for nutrition screening 2002. Clin Nutr 2003;22: 415–421.PubMed

Calvo I, Olivar J, Martínez E et al. MNA® Mini Nutritional Assessment as a nutritional screening tool for hospitalized older adults; rationales and feasibility. Nutr Hosp 2012;27: 1619–1625.PubMed

Huhmann MB, Perez V, Alexander DD et al. A self-completed nutrition screening tool for community-dwelling older adults with high reliability: a comparison study. J Nutr Health Aging 2013;17: 339–344.CrossRefPubMed

Neelemaat F, Meijers J, Kruizenga H et al. Comparison of five malnutrition screening tools in one hospital inpatient sample. J Clin Nurs 2011;20: 2144–2152.CrossRefPubMed

Beck AM, Beermann T, Kjær S et al. Ability of different screening tools to predict positive effect on nutritional intervention among the elderly in primary health care. Nutrition 2013;19: 993–999.CrossRef

Tsai AC, Lee LC, Wang JY. Complementarity of the Mini-Nutritional Assessment and Activities of Daily Living for predicting follow-up mortality risk in elderly Taiwanese. Br J Nutr 2013;109: 658–666.CrossRefPubMed

Isenring EA, Banks M, Ferguson M et al. Beyond malnutrition screening: appropriate methods to guide nutrition care for aged care residents. J Acad Nutr Diet 2012;112: 376–381.CrossRefPubMed

10.

Vandewoude M, van Gossum A. Nutritional screening strategy in nonagenarians: the value of the MNA-SF (mini nutritional assessment short form) in NutriAction. J Nutr Health Aging 2013;17: 310–314.CrossRefPubMed

11.

Söderhamn U, Dale B, Sundsli K et al. Nutritional screening of older home-dwelling Norwegians: a comparison between two instruments. Clin Interv Aging 2012;7: 383–391.CrossRefPubMedPubMedCentral

12.

Vellas B, Lauque S, Andrieu S et al. Nutrition assessment in the elderly. Curr Opin Clin Nutr Metab Care 2001;4: 5–8.CrossRefPubMed

13.

Tsai AC, Chang M. Long-form but not short-form Mini-Nutritional Assessment is appropriate for grading nutritional risk of patients on hemodialysis—A crosssectional study. Int J Nurs Stud 2011;48: 1429–1435.CrossRefPubMed

14.

Veterans Affairs. Veterans Affairs Site Tracking (VAST). http://reports2.vssc.med.va.gov/ReportServer/Pages/ReportViewer.aspx?/PMR/VASTClassification/VASTFacilityCrosswalk&rs:Command=Render Accessed 1 February 2016

15.

Hamirudin AH, Charlton K, Walton K. Outcomes related to nutrition screening in community living older adults: A systematic literature review. Arch Gerontol Geriatr 2016;62: 9–25.CrossRefPubMed

16.

Dent E, Visvanathan R, Piantadosi C et al. Nutritional screening tools as predictors of mortality, functional decline, and move to higher level care in older people: a systematic review. J Nutr Gerontol Geriatr 2012;31: 97–145.CrossRefPubMed

17.

Ji L, Meng H, Dong B. Factors associated with poor nutritional status among the oldest-old. Clin Nutr 2012;31: 922–926.CrossRefPubMed

18.

Getty MD, Mueller M, Amella EJ et al. Differences in Medical and Life-style Risk Factors for Malnutrition in Limited-Resource Older Adults in a Rural U.S.State: A Descriptive Study. J Nutr Health Aging 2012;20: 121–127.CrossRef

19.

Das SR, Kinsinger LS, Yancy WS et al. Obesity Prevalence Among Veterans at Veterans Affairs Medical Facilities. Am J Prev Med 2005;28: 291–294.CrossRefPubMed

20.

Timpini A, Facchi E, Cossi S et al. Self-reported socio-economic status, social, physical and leisure activities and risk for malnutrition in late life: a cross-sectional population-based study. J Nutr Health Aging 2011;15: 233–238.CrossRefPubMed

21.

Beales JL, Edes T. Veteran’s Affairs Home Based Primary Care. Clin Geriatr Med 2009;25: 149–54, viii-ix.CrossRefPubMed

22.

Burnett-Zeigler I, Zivin K, Ilgen M et al. Depression treatment in older adult veterans. Am J Geriatr Psychiatry 2012;20: 228–238.CrossRefPubMed

23.

Yoshimura K, Yamada M, Kajiwara Y et al. Relationship between depression and risk of malnutrition among community-dwelling young-old and old-old elderly people. Aging Ment Health 2013;17: 456–460.CrossRefPubMed

24.

Ulger Z, Halil M, Cankurtaran M et al. Malnutrition in Turkish nursing homes: a correlate of short term mortality. J Nutr Health Aging 2013;17: 305–309.CrossRefPubMed

25.

Winter J, Flanagan D, McNaughton SA et al. Nutrition screening of older people in a community general practice, using the MNA-SF. J Nutr Health Aging 2013;17: 322–325.CrossRefPubMed

26.

Masheb RM, Lutes LD, Kim HM et al. High-frequency binge eating predicts weight gain among veterans receiving behavioral weight loss treatments. Obesity (Silver Spring) 2015;23: 54–61.CrossRef

27.

Wang A, Kinsinger LS, Kahwati LC et al. Obesity and Weight Control Practices in 2000 Among Veterans Using VA Facilities. Obesity Research 2005;13: 1405–1411.PubMed

28.

Thomas JM, Cooney LM, Fried TR. Systematic Review: Health-Related Characteristics of Elderly Hospitalized Adults and Nursing Home Residents Associated with Short-Term Mortality. J Am Geriatr Soc 2013;61: 902–911.CrossRefPubMedPubMedCentral

29.

Chang C, Jackson SS, Bullman TA et al. Impact of a home-based primary care program in an urban Veterans Affairs medical center. J Am Med Dir Assoc 2009;10: 133–137.CrossRefPubMed

30.

Russell C. The impact of malnutrition on healthcare costs and economic considerations for the use of oral nutritional supplements. Clin Nutr Supplements 2007;2: 25–32.CrossRef

31.

Abizanda P, Sinclair A, Barcons N, Lizán L, Rodríguez-Mañas L. Costs of Malnutrition in Institutionalized and Community-Dwelling Older Adults: A Systematic Review. J Am Med Dir Assoc 2016;17: 17–23.CrossRefPubMed

32.

Skates JJ, Anthony PS (2012) Identifying geriatric malnutrition in nursing practice: the Mini Nutritional Assessment (MNA®)-an evidence-based screening tool. J Gerontol Nurs 2012;38: 18–27.

Title: High prevalence of malnutrition among elderly veterans in home based primary care
Authors: Aung Zaw Win
C. Ceresa
K. Arnold
T. A. Allison
Publication date: 01-06-2017
Publisher: Springer Paris
Published in: The journal of nutrition, health & aging / Issue 6/2017
Print ISSN: 1279-7707
Electronic ISSN: 1760-4788
DOI: https://doi.org/10.1007/s12603-017-0918-z

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

High prevalence of malnutrition among elderly veterans in home based primary care

Abstract

Introduction

Methods

Results

Discussion

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Discussion

Please log in to get access to this content

Other articles of this Issue 6/2017

Trajectories of nutritional risk: The Manitoba follow-up study

Assessing the risk of sarcopenia in the elderly: The Mini Sarcopenia Risk Assessment (MSRA) questionnaire

“Eating together” is associated with food behaviors and demographic factors of older Japanese people who live alone

Cognitive frailty in Italian community-dwelling older adults: Prevalence rate and its association with disability

Does visual impairment affect social ties in late life? Findings of a multicenter prospective cohort study in Germany

Predictive factors associated with oral intake ability in gastrostomy patients under long-term care

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page