Original Article

European Journal of Clinical Nutrition (2009) 63, 292–296; doi:10.1038/sj.ejcn.1602916; published online 19 September 2007

How well do nurses recognize malnutrition in elderly patients?

M H Suominen1, E Sandelin2, H Soini3,4 and K H Pitkala1,5

  1. 1The Central Union for the Welfare of the Aged, Helsinki, Finland
  2. 2Department of Health Care, City of Helsinki, Helsinki, Finland
  3. 3Section of Social and Health Services, Elderly Care, City of Espoo, Finland
  4. 4Department of Nursing Science, The University of Turku, Turku, Finland
  5. 5Unit of General Practice, Department of General Practice and Primary Health Care, University Hospital of Helsinki, University of Helsinki, Helsinki, Finland

Correspondence: MH Suominen, The Central Union for the Welfare of the Aged, Malmin kauppatie 26, Helsinki 700, Finland. E-mail: merja.suominen@vanhustyonkeskusliitto.fi

Received 14 December 2006; Revised 26 June 2007; Accepted 20 July 2007; Published online 19 September 2007.



Background and objective:


Malnutrition is a common and underrecognized clinical problem among aged institutionalized patients. The aim of this study was to investigate how well nurses recognize malnutrition in elderly patients in long-term care hospitals in Helsinki.

Subjects and methods:


In this descriptive, cross-sectional study, the nutritional status of 1043 elderly patients was assessed with the Mini Nutritional Assessment (MNA), their body mass indices (BMIs) (kgm−2) were counted, and factors related to their nutritional care were queried using a structured questionnaire. In addition, we asked the opinions of 53 nurses on whether they considered their patients to suffer from malnutrition. All the long-term care hospitals in Helsinki, Finland participated in this study.



The mean age of the patients was 81 years. The nurses considered only 15.2% of the patients to be malnourished, although the MNA showed that 56.7% were malnourished (MNA<17 points). Those recognized as malnourished were truly anorectic, with a mean BMI of 17.2. Of those patients having a BMI<20 and MNA<17, the nurses considered only one-third to be malnourished. Of those having a BMI>24 but MNA<17, only 2% were recognized as having malnutrition. Even those patients considered to be malnourished received snacks and nutritional supplements less than the patients that the nurses considered to have normal nutritional status. However, only one in six of the malnourished patients received oral nutritional supplements.



The nurses recognized malnutrition in their aged patients poorly. Nutrition education for nurses is urgently needed, as malnutrition and weight loss have been considered significant problems, and the benefits of nutritional care are well established.


malnutrition, Mini Nutritional Assessment test (MNA), aged patients, nurses’ recognition

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