[Evaluation of nutritional risk in ambulatory elderly patients]. / Evaluación del riesgo nutricional en pacientes ancianos ambulatorios.

ABSTRACT

OBJECTIVE: The purpose of this study was to evaluate the nutritional risk in ambulatory elderly people (> or = 65 years old) and determine influential factors. METHODS: A questionnaire was provided to 400 Spanish pharmacists to gather data from ambulatory elderly people in a one-visit prospective study. Data collected included age, gender, body mass index, environment and nutritional assessment using the Nutrition Screening Initiative panel, a subjective nutritional evaluation and nutritional therapy. ANOVA and Mann-Whitney tests were used to evaluate differences and correlations. Logistic regression analysis was used to calculate association with risk factors. RESULTS: Data were collected from 1320 elderly subjects (60.0% female, mean +/- SD, age = 75.6 +/- 7.4). Moderate to high nutritional risk was present in 79.1%, without gender differences, and 18.6% were undergoing nutritional therapy of whom 93% consumed a complementary enteral diet. The following nutritional risk factors were identified (Odds ratio -95% confidence interval-) having three or more glasses of beer or wine in men (10.70, -6.11 to 18.70-), eating usually alone for women (1.96, -1.52 to 2.52-) and physical weakness for cooking, shopping or feeding in women (1.7, -1.34 to 2.16-). The assessment of nutritional status with the Nutrition Screening Initiative panel showed a linear significant correlation with age (p < 0.01). There was poor correlation between the objective (panel) and subjective evaluations (kappa index, 0.0822). The environment was not associated with nutritional status, but women showed a poorer subjective nutritional valuation than men (p < 0.001). Although chronic diseases and drug therapy are usually the most frequent risk factors, in our subjects, alcohol consumption was the most frequent risk factor. Poor fitness showed a very close association with a moderate to high nutritional risk. There is a high rate of elderly people at risk and a very low percentage of subjects undergoing nutritional therapy. CONCLUSIONS: The moderate to high nutritional risk rate in ambulatory Spanish elderly persons is higher than expected. Both physical and social issues influence nutritional status. Awareness of the high rate of nutritional risk, should prompt consideration of early, appropriate therapy to prevent malnutrition and deteriorating quality of life.