• Journal of Korean Clinical Nursing Research
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• v.27 no.1
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• pp.77-84
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• 2021

Purpose: Malnutrition affects all age groups, but older adults are particularly more vulnerable to nutritional deficiencies. This study evaluated the age-specific factors affecting malnutrition in hospitalized older adults. Methods: A retrospective study was conducted on inpatient elderly people who received artificial nutrition from 2010 to 2017. Data of demographics, diagnosis, type of nutrition therapy, number of comorbidity, fall risk assessment, Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) score, and intensive care unit admission were collected. Malnutrition was defined as a body mass index (BMI) of less than 18.5 kg/m². Patients were classified as the young-old (65~74 years old), the old-old (75~84 years old), or the oldest-old (85 years old or older). Results: A total of 7,130 older adults were included, and 4,028 patients were classified as the young-old, 2,506 into the old-old, and 596 into the oldest-old. Proportion of malnutrition was higher in the oldest-old compared to the other groups. In multivariate analysis, parenteral nutrition, alcohol, and high risk of falls were factors affecting malnutrition in all groups. Parenteral nutrition and alcohol in the young-old, high risk of falls in the old-old, and male sex in the oldest-old were the factors affecting malnutrition by the age group. Conclusion: Older age was the most significant factor affecting malnutrition. Specific strategies by age are needed to improve nutritional status in hospitalized older adults as influencing factors for malnutrition vary among different age groups.

• Nutrition Research and Practice
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• v.15 no.4
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• pp.504-515
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• 2021

BACKGROUND/OBJECTIVES: Malnutrition risk and malnutrition among the elderly is a public health concern. In combating this health-related problem, it is critically important to evaluate the risk factors in a multidimensional way and to apply appropriate nutrition intervention based on the results. SUBJECTS/METHODS: A cross-sectional study was conducted on 215 elderly patients (32.6% male, 67.4% female) in a geriatric outpatient clinic of a hospital in Turkey. Nutritional questionnaires that incorporated the 24-h recall method were applied to determine general characteristics of patients, their health status, nutritional habits, and daily energy and nutrient intakes. Mini Nutritional Assessment was used to determine nutritional status. Relevant anthropometric measurements were obtained. RESULTS: The subjects' mean age was 76.1 ± 7.0 years, and the prevalence of malnutrition (n = 7) and risk of malnutrition (n = 53) among the 215 subjects was 3.2% and 24.7%, respectively. Patients with malnutrition or risk of malnutrition were found to be single, have a depression diagnosis, in an older age group, have less appetite, more tooth loss, have more frequent swallowing/chewing difficulty, and have more frequent meal skipping. In addition, mean daily energy, carbohydrate, fat, fiber, vitamin E, vitamin B1, vitamin B2, vitamin B6, vitamin C, folates, potassium, magnesium, phosphorus, iron intake, and water consumption were found to be statistically significantly low in subjects with malnutrition or risk of malnutrition. After performing regression analysis to determine confounding factors, malnutrition risk was significantly associated with marital status, loss of teeth, appetite status, and depression. CONCLUSIONS: Routine nutritional screening and assessment of the elderly should be performed. If nutritional deficiencies cannot be diagnosed early and treated, self-sufficiency in the elderly may deteriorate, resulting in increased institutionalization.

• The Korean Journal of Health Service Management
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• v.11 no.3
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• pp.79-90
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• 2017

Objectives : The purpose of this study was to identify the prevalence of malnutrition and to explore its association with socioeconomic and social support factors among Korean elderly in the community. Methods : The study sample was a weighted population of 10,160 elderly who participated in the 2014 Korean Elderly Living Conditions and Welfare Survey. Multiple logistic regression analyses were performed to assess the association socioeconomic and social support factors have with malnutrition. Results : Of the Korean elderly 18.6% were at risk of malnutrition. Being uneducated (OR=1.40) and having a lower household income (OR=1.97) were significantly associated with malnutrition even after adjusting for other socio-demographic and health-related covariates. Elderly who lived alone (OR=1.86) and who had poor relationships with their children (OR=1.97) were at much higher risk of malnutrition than their counterparts. Their having poor relationships with acquaintances and poor social participation were also associated with malnutrition. Conclusions : Socioeconomic and social support resources are important factors in the nutritional status of the elderly.

• Nutrition Research and Practice
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• v.9 no.6
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• pp.637-643
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• 2015

BACKGROUND/OBJECTIVES: Malnutrition in the elderly is a serious problem, prevalent in both hospitals and care homes. Due to the absence of a gold standard for malnutrition, herein we evaluate the efficacy of five nutritional screening tools developed or used for the elderly. SUBJECTS/METHODS: Elected medical records of 141 elderly patients (86 men and 55 women, aged $73.5{\pm}5.2years$) hospitalized at a geriatric care hospital were analyzed. Nutritional screening was performed using the following tools: Mini Nutrition Assessment (MNA), Mini Nutrition Assessment-Short Form (MNA-SF), Geriatric Nutritional Risk Index (GNRI), Malnutrition Universal Screening Tool (MUST) and Nutritional Risk Screening 2002 (NRS 2002). A combined index for malnutrition was also calculated as a reference tool. Each patient evaluated as malnourished to any degree or at risk of malnutrition according to at least four out of five of the aforementioned tools was categorized as malnourished in the combined index classification. RESULTS: According to the combined index, 44.0% of the patients were at risk of malnutrition to some degree. While the nutritional risk and/or malnutrition varied greatly depending on the tool applied, ranging from 36.2% (MUST) to 72.3% (MNA-SF). MUST showed good validity (sensitivity 80.6%, specificity 98.7%) and almost perfect agreement (k = 0.81) with the combined index. In contrast, MNA-SF showed poor validity (sensitivity 100%, specificity 49.4%) and only moderate agreement (k = 0.46) with the combined index. CONCLUSIONS: MNA-SF was found to overestimate the nutritional risk in the elderly. MUST appeared to be the most valid and useful screening tool to predict malnutrition in the elderly at a geriatric care hospital.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1621-1626
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• 2012

Background and objectives: Weight loss and malnutrition are common among cancer patients, these two factors greatly affecting survival and quality of life during treatment. Since cancer is becoming increasingly common in the world and in order to provide better treatment measures, it is important to identify and prevent side effects. The present study has been conducted in 2010 on a sample of cancer patients in the oncology center of Shahid Beheshti University of Medical Sciences to determine the prevalence rates of malnutrition and the factors affecting it. Methods: The PG-SGA standard questionnaire was administered to 416 cancer patients to evaluate their nutrition status and determine the frequency of each malnutrition stage. Correlations and ANOVA tests were used to analyze the relationship between factors and weight loss and how they might affect the development of malnutrition. Results: The prevalence of malnutrition among the patients was 53.1% out of which 29.1% had moderate and 24% had severe malnutrition. The most common factors inducing nutritional symptoms were depression and anorexia. Some 35 % of the patients had over 5% weight loss in the last mouth. The average PG-SGA score was 10.1 with 49 being the highest. 46.1 percent of the patients scored over 9 (requiring critical nutrient intervention). Malnutrition has a high correlation with weight loss, activity limitations, nutritional symptoms, and cancer stage, but low correlation with treatment and pathologic type. Conclusion: Malnutrition has a high prevalence in Iranian cancer patients and has a close relationship with mortality, morbidity and treatment-related problems and also quality of life. Therefore, periodical assessment by PG-SGA to detect malnutrition in patients should be made so that appropriate nutritional interventions can be provided.

• Journal of Korean Academy of Nursing
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• v.37 no.6
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• pp.941-948
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• 2007

Purpose: The purpose of this study was to investigate the risk of malnutrition and its relationship with depression and perceived health status. Methods: A total number of 154 elderly over 60 years participated in the study through a community elderly center. The risk of malnutrition was measured by NSI (Nutritional Screening Initiative), depression by CES-D, and health status by a self-rated Likert scale. Results: About one fourth (22.7%) of the subjects had a high risk, and 31.2% had a moderate risk of getting malnutrition. Regarding depression, 34.4% (53 elderly) of the subjects had a high risk. Overall health status had a mean of 3.46 within the range of 1 to 5. In relation to demographic factors, female elderly (${\chi}^2=6.68$, p= .04), aged younger than 75 years old (${\chi}^2=8.60$, p= .01), and having co-morbidity (F=9.81, p= .001) were significantly related to a high risk of malnutrition. Having a higher depression score, higher number of co-morbidity, and lower perceived health status were significantly related to a higher risk of becoming malnourished. Conclusion: The elderly's risk of getting malnutrition was significantly related to their depression and perceived health status. With these findings nursing interventions focusing on these factors should be developed in order to improve the elderly's multidimensional well-being.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.9 no.2
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• pp.69-77
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• 2002

The purpose of this study was to assessment of hospitalized patients. Nutritional assessment was performed on 353 hospitalized patients before TPN support by ideal body weight. albumin, total lymphocyte count, cholesterol. The data analysis were performed on frequency, percentage, means and standard deviation. The major findings as follows: 1. Everage NPO duration was $6.77\pm5.39$day and $\geq5$days 48.9%, >5days 51.1%. NPO duration of 1M, NL, GS, Others prolonged. 2. %IBW was everge $94.86\pm17.21%$ 43.1% normal. 37.8% low weight. There were low weight IM 44.8%. TS 47.8%, Others 44.0%. 3. Albumin was everage $2.93\pm0.51$g/dl. moderate malnutrition 45.4%, mild malnutrition 30.9%. All session were malnutrition status. 4. Total lymphocyte count was ever age $960.41\pm721.32cell/mm^2$. severe malnutrition 43.9%. moderate malnutrition 29.0%, mild malnutrition 24.4%, normal 2.7%. All session were malnutrition status. 5. Cholesterol was everage $123.02\pm45.67$mg/dl 58.4% low level. 41.2% normal. 0.4% high level. 1M, GS and TS were low level. NL, NS, DR, Others were normal. It was very poor nutritional status before TPN support of patients. The malnutrition decrease immunity, slowly cure injury, cause abnormality organs, increase the complication and obstruct the recovery. Therefore, Evaluating and correcting are very important.

• Korean Journal of Community Nutrition
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• v.11 no.6
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• pp.779-784
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• 2006

Several studies about hospital malnutrition have been reported that about more than 40% of hospitalized patients are having nutritional risk factors and hospital malnutrition presents a high prevalence. People in a more severe nutritional status ended up with a longer length of hospital stay and higher hospital cost. Nutrition screening tools identify individuals who are malnourished or at risk of becoming malnourished and who may benefit from nutritional support. For the early detection and treatment of malnourished hospital patients , few valid screening instruments fur Koreans exist. Therefore, the aim of this study was to develop a simple, reliable and valid malnutrition screening tool that could be used at hospital admission to identify adult patients at risk of malnutrition using medical electrical record data. Two hundred and one patients of the university affiliated medical center were assessed on nutritional status and classified as well nourished, moderately or severely malnourished by a Patient-Generated subjective global assessment (PG-SGA) being chosen as the 'gold standard' for defining malnutrition. The combination of nutrition screening questions with the highest sensitivity and specificity at prediction PG-SGA was termed the nutrition screening index (NSI). Odd ratio, and binary logistic regression were used to predict the best nutritional status predictors. Based on regression coefficient score, albumin less than 3.5 g/dl, body mass index (BMI) less than $18.5kg/m^2$, total lymphocyte count less than 900 and age over 65 were determined as the best set of NSI. By using best nutritional predictors receiver operating characteristic curve with the area under the curve, sensitivity and 1-specificity were analyzed to determine the best optimal cut-off point to decide normal or abnormal in nutritional status. Therefore simple and beneficial NSI was developed for identifying patients with severe malnutrition. Using NSI, nutritional information of the severe malnutrition patient should be shared with physicians and they should be cared for by clinical dietitians to improve their nutritional status.

• Korean Journal of Community Nutrition
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• v.13 no.4
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• pp.573-581
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• 2008

Although it is well known that cancer patients suffer from malnutrition, there are few published studies on malnutrition in outpatients receiving chemotherapy in Korea. This study aimed to evaluate nutritional risk in oncology outpatients receiving chemotherapy and to show the baseline data to set up nutritional management programs for cancer patients. This is a retrospective observational analysis on 1,962 patients referred for nutritional education before or during chemotherapy at Seoul National University Hospital Cancer Center from January 2006 to May 2007. According to a malnutrition screening tool, the proportion of patients having malnutrition risk was 23.0%. In the case of upper gastrointestinal cancer, more than 50% of patients were assessed as being at the risk of malnutrition. They showed more than 7% weight loss compared to their usual body weight and poor oral intake; energy intake was less than 100% of Basal Energy Expenditure(BEE) and protein intake was less than or equal to 0.77 g/kg/d. However, only 6.3% of breast cancer patients had risk of malnutrition and their oral intake was better; energy intake was 121% of BEE, and protein intake was 0.90 g/kg/d. Outpatients receiving chemotherapy had different nutritional risk depending on their cancer site. Nutritional management program should be conducted differently, depending on the cancer site and upper gastrointestinal cancer patients at high risk of malnutrition should basically have nutritional assessment and intervention.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.2
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• pp.171-180
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• 2019

Purpose: Malnutrition may influence neurocognitive development in children by directly affecting the brain structural development, or indirectly by affecting the children's cognition experience. Malnutrition alters the cell numbers, cell migration, synaptogenesis, and neurotransmission due to inadequate availability of necessary micronutrients to support cell growth. We aimed to analyze neurocognitive development in infants with malnutrition and its association with long chain polyunsaturated fatty acids (LC-PUFA), micronutrients levels and magnetic resonance spectroscopy (MRS) findings. Methods: The study included two groups; group 1, infants with malnutrition (n=24), group 2; healthy infants (n=21). Peripheral blood was obtained from the participants for studying micronutrients and LC-PUFA levels. The neurocognitive development was analyzed by the use of an Ankara Developmental Screening Inventory test. MRS were performed on all infants. Results: All parameters of neurocognitive development and serum calcium ($9.6{\pm}0.9mg/dL$ vs. $10.4{\pm}0.3mg/dL$, p<0.05) and magnesium ($2.02{\pm}0.27mg/dL$ vs. $2.2{\pm}0.14mg/dL$, p<0.05) levels were noted as being low in infants with marked malnutrition. No difference was found in LC-PUFA levels between healthy and malnourished infants. Thalamic choline/creatine levels were significantly high in infants with malnutrition ($1.33{\pm}0.22$ vs. $1.18{\pm}0.22$, p<0.05). Total neurocognitive development in infants was positively correlated with serum calcium levels (p<0.05, r=0.381). Conclusion: Calcium supplementation may improve neurocognitive development in malnourished infants.