title: Malnutrition among cognitively intact, noncritically ill older adults in the emergency department.
abstract: OBJECTIVE
  We estimate the prevalence of malnutrition among older patients presenting to an emergency department (ED) in the southeastern United States and identify subgroups at increased risk.
  
  
  METHODS
  We conducted a cross-sectional study with random time block sampling of cognitively intact patients aged 65 years and older. Nutrition was assessed with the Mini Nutritional Assessment Short-Form (0 to 14 scale), with malnutrition defined as a score of 7 or less and at risk for malnutrition defined as a score of 8 to 11. The presence of depressive symptoms was defined as a Center for Epidemiological Studies Depression-10 score of 4 or more (0 to 10 scale).
  
  
  RESULTS
  Among 138 older adults, 16% (95% confidence interval [CI] 11% to 23%) were malnourished and 60% (95% CI 52% to 68%) were either malnourished or at risk for malnutrition. Seventeen of the 22 malnourished patients (77%) denied previously receiving a diagnosis of malnutrition. The prevalence of malnutrition was not appreciably different between men and women, across levels of patient education, or between those living in urban and rural areas. However, the prevalence of malnutrition was higher among patients with depressive symptoms (52%), those residing in assisted living (44%), those with difficulty eating (38%), and those reporting difficulty buying groceries (33%).
  
  
  CONCLUSIONS
  Among a random sample of cognitively intact older ED patients, more than half were malnourished or at risk for malnutrition, and the majority of malnourished patients had not previously received a diagnosis. Higher rates of malnutrition among individuals with depression, difficulty eating, and difficulty buying groceries suggest the need to explore multifaceted interventions.
authors.affiliation: Department of Nutrition, UNC Gillings School of Global Public Health, Chapel Hill, NC.
authors.forename: Greg F
authors.initials: GF
authors.lastname: Pereira
authors.affiliation: Department of Nutrition, UNC Gillings School of Global Public Health, Chapel Hill, NC; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Bulik
authors.affiliation: Departments of Medicine and Biostatistics, University of North Carolina, Chapel Hill, NC.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Weaver
authors.affiliation: Department of Biology, University of North Carolina, Chapel Hill, NC.
authors.forename: Wesley C
authors.initials: WC
authors.lastname: Holland
authors.affiliation: Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC. Electronic address: tplattsm@med.unc.edu.
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Platts-Mills
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D015596:Nutrition Assessment; D015995:Prevalence; D012307:Risk Factors; D015144:Southeastern United States / Q000453:epidemiology