[Nutritional assessment of the fragile elderly in primary care].
OBJECTIVE
To determine in primary care the nutritional status of elderly people at risk of malnutrition and to evaluate their evolution after an intervention.


METHODS
Descriptive, with follow-up.


METHODS
Urban health centre.


METHODS
Patients over 65, with criteria as fragile elderly or incapacitated and registered on a doctor's list (N=131). Nutritional risk factors were identified in the consultation or at home in 46 of those included in the study (March-September 2003).


METHODS
Age, sex. Factors in risk of malnutrition: loss of weight, acute or chronic illness associated with malnutrition, social factors. Anthropometric indices: Body Mass Index (BMI), tricipital fold (TF) and percentage, brachial perimeter (BP), calf perimeter (CP), arm muscular circumference (AMC), and percentage. Analytic indices: lymphocytes, transferrin, albumin. Malnutrition: when at least 2 of the above parameters were disturbed. Type: calories, protein, mixed. Degree: light, moderate, or severe.


METHODS
special diets and/or nutritional supplements. Parameters were re-assessed at 6 months (t test, paired samples).


RESULTS
Average age of 83, with 63% women. Nutritional risk factors: loss of weight 41%, acute illness 39%, chronic illness 10.5%, cognitive deterioration 4%, social risk 2%. 80.4% suffered malnutrition (32.5% calories, 46% mixed, 21.5% protein; 27% light, 56.7% moderate, 16.3% severe). Mean values on anthropometric parameters: BMI 21, TF 11.3 mm (TF% 72%), BP 22 cm, AMC 19.4 (%AMC 90%), CP 28 cm (%CP 87%). Mean analytic values were: transferrin 243, albumin 3.7, lymphocytes 1600. Nutritional supplements were indicated in 11 cases. 32 cases were re-evaluated later and no significant improvement was found for any parameter (=.05).


CONCLUSIONS
Malnutrition is common in the elderly with risk factors (loss of weight and acute illness), with calorie or mixed malnutrition the most common kinds. There was no improvement in anthropometric parameters at 6 months follow-up.
Muñoz Cobos
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F
Médico de familia, Centro de Salud El Palo, Unidad Docente de MFyC de Málaga, Málaga, España. franciscam@supercable.es
Ortiz Fernández
M D
MD
Vega Gutiérrez
P
P
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D044342:Malnutrition / Q000453:epidemiology; D009752:Nutritional Status; D011320:Primary Health Care; D012307:Risk Factors