Prevalence of malnutrition and risk factors in geriatric patients of a convalescent and rehabilitation hospital

Abstract

Objectives. To investigate the prevalence and risk factors of malnutrition in geriatric patients admitted to a convalescent and rehabilitation hospital. Design. Cross-sectional study. Setting. Regional hospital, Hong Kong. Patients. A total of 120 patients (aged 60 years or older) referred to Tung Wah Eastern Hospital. Main outcome measures. Anthropometric, biochemical, and haematological parameters were measured for nutritional assessment. Malnutrition was defined as a body mass index of lower than 18.5 kg/m2 and serum albumin level of lower than 35 g/L. The clinical outcomes of patients were also recorded. The predictive value of the Chinese Mini Nutritional Assessment as a nutritional screening tool was assessed. Potential risk factors associated with malnutrition were evaluated according to established protocols. Results. The mean age of patients was 80.3 years (standard deviation, 7.4 years), and the mean body mass index was 21.9 kg/m2 (standard deviation, 4.4 kg/m2). The prevalence of malnutrition was 16.7%. The age distribution of malnourished patients (mean, 86.2 years; standard deviation, 7.0 years; n=20) was significantly different to those nourished (mean, 79.1 years; standard deviation, 6.9 years; n=100) [P=0.0001]. Mortality was also higher in malnourished patients (25%) than nourished patients (4%) [P=0.001]. Based on the Chinese Mini Nutritional Assessment, 16.9% of patients were classified as malnourished (cut-off value, 18.5). The Chinese Mini Nutritional Assessment was useful as a screening tool to exclude patients who were not malnourished, ie it had a high negative predictive value (95%). Being totally dependent for the performance of activities of daily living, living in a home for the elderly, and being chair- or bed-bound posed a significantly increased risk of malnutrition. The presence of mental depression (geriatric depression scale score of 8 or higher), moderately or severely impaired cognitive function (abbreviated mental test score of lower than 7), or polypharmacy (five medications or more) did not significantly affect risk of malnutrition. Conclusions. Malnutrition was common in the geriatric patients studied and was associated with an increased mortality. The Chinese Mini Nutritional Assessment was a useful screening tool to exclude malnutrition. Significant risk factors of malnutrition were total dependence, living in a home for the elderly, and being chair- or bed-bound.