Poor nutritional habits are predictors of poor outcome in very old hospitalized patients.
BACKGROUND
Malnutrition is prevalent in elderly populations. Recommended methods of nutritional screening are often too complicated and time-consuming for routine application in frail, very old, hospitalized patients.


OBJECTIVE
Our aims were to identify risk factors for development of malnutrition in very old hospitalized patients and to evaluate the total Mini Nutritional Assessment (MNA) score and MNA subscores as predictors of in-hospital and long-term mortality.


METHODS
A prospective cohort study of patients aged > or =75 y was conducted in a geriatric hospital. Assessment included demographic, clinical, and laboratory data and cognitive, functional, and nutritional status. Follow-up was conducted for < or =2.7 y.


RESULTS
Of the 414 patients studied, only 73 (17.6%) were well-nourished. Low serum albumin and phosphorus concentrations, dementia, and cerebrovascular accident (CVA) were significant risk factors for malnutrition. Survival was significantly lower in malnourished patients and patients at risk of malnutrition than in well-nourished patients (P < 0.0001). Low MNA-3 subscores (dietary habits) were significantly correlated with laboratory indexes of malnutrition and were significantly lower in patients with infections, malignancy, pressure ulcers, dementia, recent orthopedic surgery, and CVA. Multivariate analysis showed that a low MNA-3 score was an independent predictor of mortality; scores <7.5 increased the risk of death 2.05-fold.


CONCLUSIONS
The prevalence of malnutrition was high in elderly hospitalized patients. Dietary habits were significant predictors of poor hospitalization outcome. A questionnaire on dietary habits can serve as a useful tool in assessing nutritional status and prognosis in elderly patients.
Kagansky
Nadya
N
Department of Geriatric Medicine, Kaplan-Harzfeld Medical Center, Rehovot-Gedera, Israel. nadya_k@clalit.org.il
Berner
Yitshal
Y
Koren-Morag
Nira
N
Perelman
Luiza
L
Knobler
Hilla
H
Levy
Shmuel
S
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015331:Cohort Studies; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods*; D006305:Health Status Indicators; D006760:Hospitalization; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D009752:Nutritional Status; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*; D016896:Treatment Outcome