Journals of Gerontology Series A: Biological Sciences and Medical Sciences, Vol 55, Issue 2 M57-M63, Copyright © 2000 by The Gerontological Society of America
Risk of malnutrition in retirement homes elderly persons measured by the "mini-nutritional assessment"
MI Griep, TF Mets, K Collys, I Ponjaert-Kristoffersen and DL Massart
Department of Medicine, Academic Hospital, Brussel, Belgium.
BACKGROUND: The combined influence of age-associated factors such as
general health, degree of dependency, diminished odor perception, and poor
oral health on the risk for malnutrition was explored. METHODS: A total of
81 persons living in retirement homes took part in the study (mean age 83.4
years, SD = 6.6, range 61-98). The Mini-Nutritional Assessment (MNA) was
used to evaluate the risk of malnutrition. Odor perception was measured by
the detection threshold for isoamylacetate. The number of drugs taken by
each person was counted. General health status was determined by the
Medical Outcome Study (MOS) scores. Oral examinations were carried out to
count the number of natural teeth and type of dentures. RESULTS: On
average, women had slightly, but significantly, lower MNA scores than men
(respectively, 23.4, SD = 2.8; and 24.6, SD = 2.6; p = .048). The
correlations between age and MNA score and between odor perception and MNA
score were not significant. Significant correlations were found between age
and number of natural teeth (r = -.26, p = .001) and between MNA score and
number of natural teeth (r = .27, p = .001). The mean MNA score of complete
denture wearers (22.8, SD = 2.9) was significantly lower than that of
partial denture wearers (25.8, SD = 2.9; p = .0005). The total MOS and MNA
scores were not correlated, but a significant correlation was found with
the subscales mental functioning (r = .29, p = .003), social functioning (r
= . 19, p = .045), and perceived health (r = .19, p = .047). No relation
was found between the activities of daily living (ADL) and MNA scores. A
significant negative correlation was observed between number of drugs taken
and the MNA score (r = -.34, p = .001). When participants without risk of
malnutrition (MNA > or = 24) were compared with those at risk (MNA =
17-23.5), again, the number of drugs taken was significantly different (on
average, respectively, 4.5, SD = 2.9; and 7.0, SD = 2.6; p < .0005).
Using multiple regression to test the separate effects of the different
independent variables, the number of drugs taken showed a significant
negative regression coefficient (beta = -.31, p = .008), as did the mental
health score (beta = .27, p =.02), giving a total R2 = .32. The other
parameters did not contribute significantly. CONCLUSION: Among the elderly
in retirement homes, the health state (as measured by the MOS subscale
mental health and by the medication use) appears to be the most clinically
relevant parameter to explain the risk for malnutrition. Loss of natural
teeth and perceived health are less independently contributing, whereas no
contribution derives from decline of odor perception, degree of dependency,
and age itself.
