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Prevalence of risk of undernutrition is associated with poor health status in older people in the UK

Abstract

Objective: To establish the prevalence of the risk of undernutrition, using criteria similar to those used by the Malnutrition Advisory Group (MAG), in people aged 65 y and over, and to identify relationships between risk of undernutrition and health and demographic characteristics.

Design: A cross-sectional nationally representative sample of free-living and institutionalized older people in the UK (65 y of age and over). Secondary analysis of the National Diet and Nutrition Survey based on 1368 people aged 65 y and over.

Results: About 14% (21% in those living in institutions) were at medium or high risk of undernutrition based on a composite measure of low body mass index and recent reported weight loss. Having a long-standing illness was associated with a statistically significantly increased risk of undernutrition (odds ratio: men 2.34, 95% CI 1.20–4.58; women 2.98; 1.58–5.62). The risk of undernutrition increased: in women reporting bad or very bad health status; in men living in northern England and Scotland; for those aged 85 y and older; for those hospitalized in the last year, and those living in an institution. Lower consumption of energy, meat products or fruit and vegetables and lower blood measures of zinc, vitamins A, D, E and C were associated with statistically significantly increased risk of undernutrition.

Conclusion: A substantial proportion of the older population of the UK is at risk of undernutrition. High-risk subjects are more likely to have poorer health status. It is unlikely that the individuals at high risk are being detected currently, and therefore effective care is not being provided, either in the community or in institutions.

Sponsorship: This analysis was partly funded by a grant from the Department of Health. We are grateful for helpful comments from Professor MJ Wiseman and the anonymous reviewers.

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References

  • Beck, AM, Ovesen, L & Schroll, M (2001). A six months' prospective follow-up of 65+-y-old patients from general practice classified according to nutritional risk by the Mini Nutritional Assessment. Eur. J. Clin. Nutr., 55, 1028–1033.

    CAS  Article  Google Scholar 

  • Chen, C-HC, Schilling, LS & Lyder, CH (2001). A concept analysis of malnutrition in the community. J. Adv. Nurs., 36, 131–142.

    CAS  Article  Google Scholar 

  • Edington, J, Perkins, A & Griffin, CVB et al (2000). Prevalence of malnutrition on admission to four hospitals in England. Clin. Nutr., 19, 191–195.

    CAS  Article  Google Scholar 

  • Elia, M (2001). Obesity in the elderly. Obes. Res., 4, (Suppl) 244S–248S.

    Article  Google Scholar 

  • Elia, M (ed.) (2000). Guidelines for detection and management of malnutrition, A report by the Malnutrition Advisory Group Maidenhead: BAPEN

    Google Scholar 

  • Finch, S, Doyle, W, Lowe, C, Bates, CJ, Prentice, A & Smithers, G et al (1998). National Diet and Nutrition Survey: People aged 65 Years and Over, London: The Stationery Office

    Google Scholar 

  • Guigoz, Y, Vellas, B & Garry, PJ (1994). Mini nutritional assessment: a practical tool for grading the nutritional state of elderly patients. Facts Res. Gerontol., (Suppl 2) 15–81.

  • Holland, B, Welch, AA, Unwin, ID, Buss, DH, Paull, AA & Southgate, DAT (1991). McCance and Widdowson's the Composition of Foods, 5th edn London: Royal Society of Chemistry

    Google Scholar 

  • McWhirter, JP & Pennington, CR (1994). Incidence and recognition of malnutrition in hospital. Br. Med. J., 308, 945–948.

    CAS  Article  Google Scholar 

  • Meltzer, AA & Everhart, JE (1995). Unintentional weight loss in the United States. Am. J. Epidemiol., 142, 1039–1046.

    CAS  Article  Google Scholar 

  • Office for Health Economics (1997). Morbidity and Mortality Rates in the UK, London: Her Majesty's Stationery Office

  • Pearson, JM, Sclettwein-Gsell, D, Brzozowska, A, van Staveren, WA & Bjornsbo, K (2001). Life style characteristics associated with nutritional risk in elderly subjects aged 80–85 y. J. Nutr. Health Aging, 5, 278–283.

    CAS  PubMed  Google Scholar 

  • Posner, BM, Jett, AM, Smigelski, CG, Miller, D & Mitchell, P (1994). Nutritional risk in New England Elders. J. Gerontol. A Biol. Sc. Med. Sci., 49, M123–M132.

    CAS  Article  Google Scholar 

  • Pullinger, J (ed.) (1999). Office for National Statistics. Social Trends 29, London: The Stationery Office

    Google Scholar 

  • SENECA Investigators (1996). Longitudinal changes in anthropometric characteristics of elderly Europeans. Eur. J. Clin. Nutr., 50, (Suppl 2) S9–S15.

  • Shatenstein, B, Kergoat, MJ & Nadon, S (2001a). Weight change, nutritional risk and its determinants among cognitively intact and demented elderly Canadians. Can. J. Public Health, 92, 143–149.

    CAS  PubMed  Google Scholar 

  • Shatenstein, B, Kergoat, MJ & Nadon, S (2001b). Anthropometric changes over 5 y in elderly Canadians by age, gender, cognitive status. J. Gerontol. A Biol. Sci. Med. Sci., 56, M483–488.

    CAS  Article  Google Scholar 

  • Shetty, PS & James, WPT (1994). Body mass index. A measure of chronic energy deficiency in adults, FAO Food and Nutrition paper 56 Rome: FAO

    Google Scholar 

  • Stewart, AL (1982). The reliability and validity of self-reported weight and height. J. Chron. Dis., 35, 295–309.

    CAS  Article  Google Scholar 

  • Stratton, RJ & Elia, M (2002). Cocurrent validity of three nutrition screening tools for use in the community. Proc. Nutr. Soc., (in press)

  • Wannamethee, SG, Shaper, AG, Whincup, PH & Walker, M (2000). Characteristics of older men who lose weight intentionally or unintentionally. Am. J. Epidemiol., 151, 667–675.

    CAS  Article  Google Scholar 

  • Weekes, CE & Elia, M (2002). Identifying patients with nutritional problems: a comparison of two screening tools. Proc. Nutr. Soc., (in press)

  • Wellman, NS (1994). The nutrition screening initiative. Nutr. Rev., 52, S44–47.

    CAS  Article  Google Scholar 

  • Willett, WC (1997). Weight loss in the elderly: cause or effect of poor health?. Am. J. Clin. Nutr., 66, 737–738.

    CAS  Article  Google Scholar 

Download references

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Correspondence to B M Margetts.

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Margetts, B., Thompson, R., Elia, M. et al. Prevalence of risk of undernutrition is associated with poor health status in older people in the UK. Eur J Clin Nutr 57, 69–74 (2003). https://doi.org/10.1038/sj.ejcn.1601499

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Keywords

  • undernutrition
  • weight loss
  • BMI
  • illness
  • poor health

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