Social Determinants of Health (Social Risk) and Nutritional Status Among Community-Dwelling Older Adults Living in a Rural Setting: The Atahualpa Project.

BACKGROUND: Several studies have attempted to clarify the role of social determinants of health (SDH) on nutritional status of older adults, but results are inconsistent due to differences in SDH assessments at different levels of population development. In this study, we assessed this association in community-dwelling older adults living in rural Ecuador. Methods: SDH were measured by the Gijon's Social-Familial Evaluation Scale (SFES) and nutritional status by the Mini Nutritional Assessment (MNA®). Multivariate logistic regression models were fitted to assess the association between SDH components and nutritional status. Locally weighted scatterplot smoothing (LOWESS) and a generalized linear model were used to evaluate the potential non-linearity of the association between the Gijon's SFES and MNA® scores. RESULTS: A total of 295 individuals (mean age: 72.1 ± 7.6 years; 58% women) were enrolled. There was an inverse association between the total Gijon's SFES and nutritional status (OR: 0.75; 95% C.I.: 0.65-0.86; P < .001). Three of five components of the Gijon's SFES (family situation, social relationships, and support networks) were inversely associated with nutritional status in multivariate logistic regression models. A LOWESS plot, together with a generalized linear model, showed an inverse linear relationship between the continuous Gijon's SFES and MNA® scores. One standard deviation of increase in the continuous Gijon's SFES score (2.39 points) decreased the MNA® score by 0.78 points. CONCLUSION: Study results show a significant inverse association between high social risk and a good nutritional status. Components of the Gijon's SFES measuring social isolation are responsible for this association.

Malnutrition Risk among Older Mexican Adults in the Mexican Health and Aging Study.

Few studies assess the malnutrition risk of older Mexican adults because most studies do not assess nutritional status. This study proposes a modified version of the Mini Nutritional Assessment (MNA) to assess the risk of malnutrition among older Mexicans adults in the Mexican Health and Aging Study (MHAS). Data comes from the 2012, 2015, and 2018 waves of the MHAS, a nationally representative study of Mexicans aged 50 and older. The sample included 13,338 participants and a subsample of 1911 with biomarker values. ROC analysis was used to calculate the cut point for malnutrition risk. This cut point was compared to the definition of malnutrition from the ESPEN criteria, BMI, low hemoglobin, or low cholesterol. Logistic regression was used to assess predictors of malnutrition risk. A score of 10 was the optimal cut point for malnutrition risk in the modified MNA. This cut point had high concordance to identify malnutrition risk compared to the ESPEN criteria (97.7%) and had moderate concordance compared to BMI only (78.6%), and the biomarkers of low hemoglobin (56.1%) and low cholesterol (54.1%). Women, those older than 70, those with Seguro Popular health insurance, and those with fair/poor health were more likely to be malnourished. The modified MNA is an important tool to assess malnutrition risk in future studies using MHAS data.

Riesgo de desnutrición y factores asociados en una muestra de adultos mayores en la comunidad e institucionalizados de Yucatán, México / Malnutrition risk and associated factors in a sample of older adults in the community and institutionalized in Yucatan, Mexico

Evaluar la prevalencia de riesgo de desnutrición (RD) en adultos mayores de dos municipios de Yucatán, México, e identificar algunos factores asociados. Estudio transversal con muestreo intencional no probabilístico en 6 centros de atención geriátrica, una clínica universitaria y visitas domiciliares. Noventa y seis adultos mayores de 60 años (76% mujeres), 42 residentes de estancias geriátricas y 54 no institucionalizados. Se evaluó el RD con la escala de Valoración Mínima del Estado de Nutrición (VMEN), junto con variables demográficas, de funcionalidad, comorbilidades, depresión y apetito. La composición corporal se evaluó con ecuaciones basadas en antropometría e impedancia bioeléctrica. Se realizaron análisis descriptivos, t de Student, Kolmogorov-Smirnov, chi cuadrado, análisis univariado y análisis de regresión múltiple. El 47,9 % (46 sujetos; 37 mujeres y 9 varones) presentaron RD de acuerdo con la VMEN y 52,1% de los participantes fueron clasificados con estado nutricio normal de acuerdo con dicha escala. Los valores promedio de la masa corporal libre de grasa y la masa muscular esquelética en extremidades de sujetos con RD, fueron más bajos que en aquellos con estado de nutrición normal (p< 0,05). El análisis de regresión logístico múltiple ajustado por género indicó que la edad (OR=1,08, p=0,005) y la depresión (OR=3,79, p=0,017) fueron factores predictores asociados con RD. El 47,9 % de los participantes presentaron RD. Se requieren acciones para diagnosticar y atender el RD y evitar que progrese a desnutrición. La edad y la depresión se debieran incluir como posibles marcadores tempranos de desnutrición en futuros estudios poblacionales e intervenciones nutricionales en adultos mayores en comunidad e institucionalizados en Yucatán(AU)

To assess the prevalence of Malnutrition Risk (MR) in older adults from two municipalities of Yucatan, Mexico, and to identify some associated factors. Cross-sectional study, using non-probabilistic sample in six geriatric care centers, a university clinic, and home visits. Ninety-six adults over 60 years (76% women), 42 residents of geriatric care homes, and 54 non-institutionalized. The MR was assessed by the Mini Nutritional Assessment scale (MNA), along with demographic, functionality, comorbidities, depression, and appetite variables. Body composition was also assessed by bioelectrical impedance analysis. Descriptive analyzes, Student's t, Kolmogorov-Smirnov, chi-square, univariate, and multiple regression analysis were performed. Of the total sample, 47.9% (46 subjects; 37 women and 9 men) presented RD according to the VMEN and 52.1% of the participants were classified with normal nutritional status according to the scale. Mean values of fat-free mass and appendicular skeletal muscle mass were lower in subjects with MR than in those with normal nutritional status (p <0.05). The multiple logistic regression analysis adjusted by gender indicated that age (OR = 1.08, p = 0.005) and depression (OR = 3.79, p = 0.017) were predictor associated factors with MR. Almost forty eight percent of the participants present MR. Actions are required to diagnose and treat MR, avoiding progressing to malnutrition. Age and depression should be included as possible early markers of malnutrition in future population studies and nutritional interventions, in the community and institutionalized older adults in Yucatan(AU)

Relación entre estado nutricional y síntomas depresivos en personas de 50 años o más, Sabaneta (Antioquia-Colombia) 2015 / Relation between nutritional status and depression symptoms in people 50 years and older, Sabaneta (Antioquia-Colombia) 2015

RESUMEN Antecedentes: determinar el estado nutricional y los síntomas depresivos en personas adultas, son factores importantes a tener en cuenta para el diseño de estrategias que contribuyan a mejorar las condiciones de vida. Objetivo: describir la relación entre factores sociodemográficos, nutricionales y síntomas depresivos en adultos de 50 o más años. Materiales y métodos: estudio descriptivo transversal, en el cual se determinaron variables sociodemográficas, antropométricas, nutricionales y de salud mental en 168 adultos de 50 o más años, pertenecientes al Programa Adulto Mayor (PAM) de Sabaneta (Antioquia). Resultados: se encontraron diferencias significativas entre las variables Índice de Masa Corporal (IMC), sexo y estado civil, al igual que en el puntaje de la Minivaloración Nutricional (MNA) en relación con el estado civil (p<0,05); en cuanto al puntaje de depresión de Beck no se determinaron relaciones significativas con las variables sociodemográficas (p>0,05), pero sí con el MNA (p<0,001). Conclusiones: los hallazgos permiten establecer según el IMC y el MNA, que los participantes en general presentan una situación socioeconómica favorable y un estado nutricional adecuado; además la frecuencia de síntomas depresivos que se encontró fue mínima, lo cual contribuye al estado de salud y bienestar de los adultos pertenecientes al PAM.

ABSTRACT Background: To determine nutritional status and symptoms of depression in adults, factors which are importantto consider in the design of strategies that contribute to increasing quality of life. Objetive: To describe the relationbetween sociodomographic, nutritional, and depression factors in adults 50 years of age and older. Materials and methods: Descriptive cross-sectional study, in which sociodemographic, anthropometric, nutritional and mental healthvariables were determined in 168 adults aged 50 years and over, who belong to the Older Adult Program (PAM) of thecity of Sabaneta, Antioquia. Results: We found significant differences between the variables body mass index (BMI),sex, and marital status, as well as in the nutritional minivaloration score (MNA) in relation to marital status (p <0.05).With the Beck depression score no significant relationships were found with sociodeomograhpic variables (P> 0.05),but significance was found with with MNA score (p <0.001). Conclusions: The findings make it possible to establishaccording to BMI and MNA, that participants generally have a favorable socioeconomic situation and an adequatenutritional status; In addition, the frequency was low of depression symptoms, contributing to the health status andwell-being of adults belonging to the PAM.

Nutritional assessment and factors associated to malnutrition in older adults: a cross-sectional study in Bogotá, Colombia.

OBJECTIVE: To determine the nutritional status and factors associated to malnutrition in older adults. METHOD: Data come from the SABE Bogotá study (Health, Well-Being, and Aging), a cross-sectional survey conducted in Bogotá, Colombia, in 2012 in community-dwelling adults aged 60 years and older. Using the Mini Nutritional Assessment (MNA), we evaluated the nutritional status and factors associated to malnutrition in this population with regression models. RESULTS: From the 1,573 older adults interviewed, 4.58% were malnourished and 34.27% were at risk of malnourishment. Factors associated to malnourishment were older age (odds ratio [OR] =1.02, 95% confidence interval [CI] = [1.00, 1.04]), perceived poor health (OR = 1.46, 95% CI = [1.13, 1.88]), comorbidities (OR = 1.16, 95% CI = [1.04, 1.30]), and low calf circumference (OR = 2.63, 95% CI = [1.86, 3.72]). Having dentures, perception of being well-nourished, and higher functionality decreased the odds for malnourishment (p < .05). CONCLUSION: The MNA is useful to evaluate factors associated with malnutrition among older adults in Bogotá. Malnutrition is associated with perception of poor health, comorbidities, number of medications, and cognitive impairment.

Evaluación del estado nutricional de adultos mayores que viven en un centro geriátrico en Caracas, basada en técnicas de despistaje de desnutrición Mini Nutritional Assessment (MNA) / Evaluation of the nutritional status of older adults living in a geriatric center in Caracas, based on malnutrition screening techniques Mini Nutritional Assessment (MNA)

La valoración del estado nutricional constituye un aspecto clave en la atención de la población adulta mayor, aunque no existe una herramienta de referencia que permita definir de forma inequívoca la situación nutricional de un paciente, la intervención nutricional a través del diagnóstico-planificación-acción-evaluación, mejora la calidad de vida y garantiza la salud. Con el propósito de realizar diagnostico nutricional de 66 adultos mayores, que se encuentran viviendo en un centro geriátrico de larga estancia de Caracas, se elaboró y aplicó un formato de historia nutricional que incluiría la encuesta MNA y otros parámetros de interés. Este instrumento detectó de forma rápida, sencilla, económica y poco invasiva 25,76% casos de malnutrición y 40,91% riesgo de malnutrición en los evaluados, así como las posibles condiciones que las generan como demencia senil tipo Alzheimer, hipertensión arterial que requiere polimedicación y discapacidad motora. La evaluación antropométrica permitió detectar que el 70,59% de la malnutrición es de tipo calórica protéica. La dificultad para vivir sólos, el envejecimiento y la poca ingesta de alimentos, especialmente de aceite de oliva y frutos secos, influyen en el deterioro de la salud de estos pacientes. Un IMC promedio inferior a 23 kg/m² y la circunferencia de pantorrilla inferior a 31cm, demuestran un socavado estado nutricional y un déficit protéico. La información obtenida, permitió realizar un informe nutricional individualizado que se incluyó en la historia médica de cada paciente, que podrían ser utilizada en un futuro para realizar cambios al menú, recomendaciones, suplementación e interconsultas médicas a quienes requirieran mayor intervención de acuerdo a cada caso.

The assessment of nutritional status is a key aspect in the care of older adults, although there is no reference tool that can unmistakenly define the nutritional status of a patient, nutritional intervention through diagnosis-planning-actionevaluation improves the quality of life and guarantees health. In order to perform nutritional diagnosis to 66 older adults, who are living in a long stay nursing home in Caracas, a format of nutritional history was developed and applied, which included the MNA survey and other factors of interest. This method detected in a quick, simple, inexpensive and minimally invasive manner 25.76% cases of malnutrition and 40.91% cases of malnutrition at risk within the assessed, as well as the possible conditions that generate them such as senile dementia (Alzheimer’s type), high blood pressure which requires multiple medication, and motor disabilities. The anthropometric assessment allowed us to detect that 70.59% of malnutrition is of a protein calorie kind. The difficulty of living alone, aging and a low intake of food, particularly olive oil and nuts, influence the deteriorating health of these patients. An average BMI below 23 kg/m² and the circumference of less than 31cm calf, show an undercut nutritional status and a protein deficit. The information obtained allowed an individualized nutritional report that was included in the medical history of each patient, one which could be used in the future to make changes to the menu, to give recommendations, supplementation and medical interconsultations to those who require greater intervention according to each case.

Caracterización del estado nutricional de la población centenaria de Cuba / Characterization of the nutritional state of Cuban centenarian population

La esperanza de vida ha aumentado considerablemente en las últimas décadas y con ella la demanda de conocimiento sobre el proceso de envejecimiento. Cuba muestra indicadores demográficos similares al mundo desarrollado con una esperanza de vida al nacer en mujeres de 80.02 y en hombres de 76 y un grado de envejecimiento de su población al cierre del 2010 de 17.8%. De esta situación emerge otro aspecto: la supervivencia excepcional siendo más frecuente las personas que llegan a la centuria de vida. Los centenarios cubanos alcanzaban los 1488 a finales del 2007. Esta investigación forma parte del proyecto Centenarios en Cuba dirigida por el Ministerio de Salud Pública teniendo como objetivos caracterizar la población de ancianos centenarios desde el punto de vista somatofisiológico y nutricional y a partir de ellos determinar el comportamiento de indicadores antropométricos y nutricionales, pretendiendo identificar determinantes biológicos y socioculturales responsables de las diferencias del comportamiento en la longevidad de hombres y mujeres.

Life expectancy has increased considerably in recent decades and with it the need to understand the aging process. Cuba's demographic indicators are similar to those of the developed world with an 80.02 life expectancy at birth for women and 76 for men. At the close of 2010, seniors made up 17.8% of the population. This situation has led to the emergence of another phenomenon: more individuals reaching 100 years of age. There were 1,488 Cuban centenarians by the end of 2007. This investigation forms part of the Cuban Centenarians project sponsored by the Ministry of Public Health. One of the project's many objectives is to characterize centenarian populations from a somatophysiological and nutritional point of view and then to determine the behavior of the anthropometric and nutritional indicators, in an attempt to identify biological and socio-cultural determinants responsible for the differences in longevity between men and women.

A comparison of abundance estimators for small mammal populations

A major difficulty in the application of probabilistic models to estimations of mammal abundance is obtaining a data set that meets all of the assumptions of the model. In this paper, we evaluated the concordance correlation among three population size estimators, the minimum number alive (MNA), jackknife and the model suggested by the selection algorithm in CAPTURE (the best-fit model), using long-term data on three Brazilian small mammal species obtained from three different studies. The concordance correlation coefficients between the abundance estimates indicated that the probabilistic and enumeration estimators were highly correlated, giving concordant population estimates, except for one species in one of the studies. The results indicate the adequacy of using enumeration estimates as indexes for population size when scarce data do not allow for the use of probabilistic methods. Differences observed in the behavior of enumeration and probabilistic methods among species and studies can be related to the exclusive sampling design of each area, species-specific movement characteristics and whether a significant portion of the population could be sampled.

A comparison of abundance estimators for small mammal populations

A major difficulty in the application of probabilistic models to estimations of mammal abundance is obtaining a data set that meets all of the assumptions of the model. In this paper, we evaluated the concordance correlation among three population size estimators, the minimum number alive (MNA), jackknife and the model suggested by the selection algorithm in CAPTURE (the best-fit model), using long-term data on three Brazilian small mammal species obtained from three different studies. The concordance correlation coefficients between the abundance estimates indicated that the probabilistic and enumeration estimators were highly correlated, giving concordant population estimates, except for one species in one of the studies. The results indicate the adequacy of using enumeration estimates as indexes for population size when scarce data do not allow for the use of probabilistic methods. Differences observed in the behavior of enumeration and probabilistic methods among species and studies can be related to the exclusive sampling design of each area, species-specific movement characteristics and whether a significant portion of the population could be sampled.(AU)

A comparison of abundance estimators for small mammal populations

A major difficulty in the application of probabilistic models to estimations of mammal abundance is obtaining a data set that meets all of the assumptions of the model. In this paper, we evaluated the concordance correlation among three population size estimators, the minimum number alive (MNA), jackknife and the model suggested by the selection algorithm in CAPTURE (the best-fit model), using long-term data on three Brazilian small mammal species obtained from three different studies. The concordance correlation coefficients between the abundance estimates indicated that the probabilistic and enumeration estimators were highly correlated, giving concordant population estimates, except for one species in one of the studies. The results indicate the adequacy of using enumeration estimates as indexes for population size when scarce data do not allow for the use of probabilistic methods. Differences observed in the behavior of enumeration and probabilistic methods among species and studies can be related to the exclusive sampling design of each area, species-specific movement characteristics and whether a significant portion of the population could be sampled.

Caracterización del estado nutricional de la población centenaria de Cuba / Characterization of the nutritional status of the Cuban centenarian population

La esperanza de vida ha aumentado considerablemente en las últimas décadas y con ella la demanda de conocimiento sobre el proceso de envejecimiento. Cuba muestra indicadores demográficos similares al mundo desarrollado con una esperanza de vida al nacer en mujeres de 80,02 y en hombres de 76 y un grado de envejecimiento de su población al cierre del 2010 de 17,8 porciento. De esta situación emerge otro aspecto: la supervivencia excepcional, pues cada vez va siendo más frecuente las personas que llegan a la centuria de vida. Los centenarios cubanos alcanzaban los 1 488 a finales del 2007. Esta investigación forma parte del proyecto Centenarios en Cuba dirigida por el Ministerio de Salud Pública, cuyo objetivos es caracterizar la población de ancianos centenarios desde el punto de vista somatofisiológico y nutricional, y a partir de ellos determinar el comportamiento de indicadores antropométricos y nutricionales, así como se pretende identificar determinantes biológicos y socioculturales responsables de las diferencias del comportamiento entre la longevidad de hombres y mujeres(AU)

The considerable increase in life expectancy witnessed by recent decades has resulted in a greater need for information about the aging process. Cuba's demographic indicators are similar to those of developed countries, with a life expectancy at birth of 80.02 for women and 76 for men, and an aging rate of 17.8 percent at the close of 2010. Another aspect emerging from this situation is exceptional survival, for an ever increasing number of persons now live to be one hundred years old or more. By the end of 2007 there were 1 488 centenarians in Cuba. This research is part of the project Centenarians in Cuba, led by the Ministry of Public Health. The project is aimed at characterizing the centenarian population from a somatophysiological and nutritional point of view, determining the behavior of anthropometric and nutritional indicators, and identifying biological and sociocultural determinants responsible for the differences between male and female longevity(AU)

Caracterización del estado nutricional de la población centenaria de Cuba / Characterization of the nutritional status of the Cuban centenarian population

La esperanza de vida ha aumentado considerablemente en las últimas décadas y con ella la demanda de conocimiento sobre el proceso de envejecimiento. Cuba muestra indicadores demográficos similares al mundo desarrollado con una esperanza de vida al nacer en mujeres de 80,02 y en hombres de 76 y un grado de envejecimiento de su población al cierre del 2010 de 17,8 porciento. De esta situación emerge otro aspecto: la supervivencia excepcional, pues cada vez va siendo más frecuente las personas que llegan a la centuria de vida. Los centenarios cubanos alcanzaban los 1 488 a finales del 2007. Esta investigación forma parte del proyecto Centenarios en Cuba dirigida por el Ministerio de Salud Pública, cuyo objetivos es caracterizar la población de ancianos centenarios desde el punto de vista somatofisiológico y nutricional, y a partir de ellos determinar el comportamiento de indicadores antropométricos y nutricionales, así como se pretende identificar determinantes biológicos y socioculturales responsables de las diferencias del comportamiento entre la longevidad de hombres y mujeres

The considerable increase in life expectancy witnessed by recent decades has resulted in a greater need for information about the aging process. Cuba's demographic indicators are similar to those of developed countries, with a life expectancy at birth of 80.02 for women and 76 for men, and an aging rate of 17.8 percent at the close of 2010. Another aspect emerging from this situation is exceptional survival, for an ever increasing number of persons now live to be one hundred years old or more. By the end of 2007 there were 1 488 centenarians in Cuba. This research is part of the project Centenarians in Cuba, led by the Ministry of Public Health. The project is aimed at characterizing the centenarian population from a somatophysiological and nutritional point of view, determining the behavior of anthropometric and nutritional indicators, and identifying biological and sociocultural determinants responsible for the differences between male and female longevity

Evaluación del riesgo nutricional mediante el MNA en una población anciana no institucionalizada / Nutritional risk in no-institutionalized older, determined for the mini nutritional assessment (MNA)

En este trabajo se evaluó el estado nutricional de las personas mayores de 65 años de la provincia de Ourense con el fin de detectar posibles riesgos de desnutrición. Participaron 728 ancianos (63,6 por ciento mujeres y 36,4 por ciento hombres) de edad media 80,7±7,4 años. Se midieron parámetros antropométricos (peso, distancia talón-rodilla y circunferencia del antebrazo y de la pantorrilla) y se utilizó el cuestionario Mini Nutritional Assessment (MNA). Se observó que el 70 por ciento de la población no presentaba un estado nutricional adecuado (el 57,5 por ciento está en situación de riesgo de desnutrición y el 12,5 por ciento desnutridos); esta situación empeora entre las personas de 65 a 70 años y los mayores de 81 años y entre la población femenina. Los ítems que se observan con mayor frecuencia en la población estudiada son la pérdida involuntaria de peso, ingerir proteínas sólo en una de las comidas del día, consumir poco líquido, pérdida de apetito, tomar más de tres medicamentos al día y tener una movilidad limitada que no le permite salir de casa.

The objective of this study was to determine the prevalence of the risk of undernutrition by evaluating the nutritional status in a representative sample of older people in Ourense. The total sample was 728 subjects (63,6 percent woman and 36,4 percent men) with a mean age of 80,7±7,4 years old. Anthropometric parameters (weight, distance heel-knee, calf circumference and mid-arm circumference) were determined and the MNA (Mini Nutritional Assessment) was applied and 70 percent of individuals with nutritional problems were identified (57.5 percent with nutritional risk and 12.5 percent malnourished). The subjects aged between 65 and 70 years old, 81 and over, and females presented higher nutritional problems. The items that were observed most frequently in the studied population and therefore responsible for this nutritional situation were the involuntary loss of weight, consumption of at least one serving of protein per day, low daily liquid intakes, loss of appetite, taking more than 3 prescription drugs per day and to have a limited mobility.

Estado nutricional de la población mayor de Cataluña de diferentes niveles asistenciales / Nutritional status of Catalonia’s elderly people with different health care needs

Los objetivos de este estudio fueron evaluar la prevalencia de desnutrición a través de la Mini Encuesta Nutricional del Anciano (MNA) en la población mayor de Lleida (Cataluña) de diferentes niveles asistenciales y valorar si dicha escala es un buen método de monitorización en nuestro medio. Para ello se diseñó un estudio transversal en el que se incluyeron personas de ambos sexos, igual o mayores de 65 años, procedentes del centro de salud, del hospital de agudos de la residencia asistida y de centros socio-sanitarios. Se utilizó la MNA en su versión corta (cribado) y versión íntegra (MNA total). Este cuestionario está diseñado para la valoración nutricional de los individuos mayores tanto a la admisión en hospitales e instituciones como para la monitorización durante su estancia. Se incluyeron 398 individuos (184 hombres), con una edad media de 77 años. Según las categorías de la MNA, la prevalencia de desnutrición del total de la muestra fue del 22,6 por ciento y de riesgo de desnutrición del 35,4 por ciento. La MNA ha sido validada en nuestro medio obteniendo una sensibilidad del 77 por ciento y una especificidad del 70 por ciento. Se podría afirmar como conclusión que existe una elevada prevalencia de riesgo de desnutrición y desnutrición establecida en Cataluña sobretodo en los centros socio-sanitarios y en el servicio de medicina interna del hospital de agudos. Los resultados son similares a otros estudios contrastados. La MNA es una herramienta útil para el monitoreo nutricional en los distintos niveles asistenciales tanto en el cribado como en su versión íntegra.

The aims of this study were to assess the prevalence of malnutrition through the Mini Nutritional Assessment (MNA) in the elder population of Lleida (Catalonia) from different levels of care and to determine if that scale is a good way of monitoring our population. A cross-sectional study was designed. It included men and women of 65 years or more users of primary health care centre, the acute hospital, nursing home and health and assisted social services. The MNA was used in your short form (MNA-SF) and MNA total (MNA). This questionnaire is designed to screen the nutritional status of elderly people, when they arrived to the hospital and during their stay. Three hundred and ninety-eight individuals (184 men) were included aging 77 on average. According to the categories of the MNA, the prevalence of malnutrition of the total sample was 22.6 percent and risk of malnutrition of 35.4 percent. The MNA has been validated in our population getting a sensitivity of 77 percent and specificity of 70 percent. In conclusion, it can be affirmed that there was a high prevalence of undernourishment, foremost in health and social care services and in the medicine service of acute hospital. The MNA is a useful tool for monitoring nutritional care at different levels in both the short form and in total form.

La Mini Encuesta Nutricional del Anciano en la práctica de un Servicio hospitalario de Geriatría: Introducción, validación y características operacionales / The Mini Nutritional Assessment of the elderly in the practice of a hospital geriatrics service: inception, validation and operational characteristics

Se presentan los resultados de la administración de la Mini Encuesta Nutricional del Anciano (MNA) a 197 pacientes (Mujeres: 62.5%; Edades entre 60 – 75 años: 55.4%; Mayores de 85 años: 9.7%; Blancos: 73.7%) que ingresaron consecutivamente en el Servicio de Geriatría del Hospital Clínico-Quirúrgico “Hermanos Ameijeiras” (La Habana, Cuba). El 69.6% de los pacientes tenía entre 2 – 7 problemas de salud concurrentes. Predominaron las neoplasias y los procesos linfoproliferativos (22.8%), las afecciones del corazón y los vasos sanguíneos (15.7%), y las infecciones (12.2%). El estado de los indicadores nutricionales antropométricos y bioquímicos fue como sigue: Indice de Masa Corporal < 21 kg.m2: 30.9%; Circunferencia del Brazo < 22 cm: 19.3%; Circunferencia de la Pantorrilla < 31 cm: 42.6%; Albúmina < 35 g.L-1: 20.3%. El 68.5% de los pacientes recibió puntajes < 24 después de administrada la MNA. Es de notar que el 19.3% de los encuestados estaba desnutrido al recibir puntajes < 17. Los puntajes < 24 se concentraron en: Afecciones neurológicas (80.0%), Neoplasias y procesos linfoproliferativos (77.8%), Corazón y vasos sanguíneos (74.2%), Enfermedades gastrointestinales (70.6%), Infecciones (69.7%), Diabetes mellitus (66.7%). Los pacientes con los puntajes nutricionales más bajos presentaron los valores más bajos de los indicadores antropométricos y bioquímicos. El puntaje nutricional fue independiente del sexo del enfermo, color de la piel o el número de problemas de salud concurrentes. La edad no influyó en el puntaje nutricional, pero se observaron puntajes más bajos entre los pacientes más ancianos. El puntaje asignado mediante la MNA coincidió en un 80.0% con el diagnóstico nutricional hecho independientemente mediante indicadores bioquímicos y antropométricos, utilizados por separado o combinados. El envejecimiento de la población cubana, unido a una geriatrización de las áreas hospitalarias, obligan a considerar el estado nutricional del paciente may...

The results of the administration of the Mini Nutritional Assessment (MNA) of the Elderly to 197 patients (Women: 62.5%; Ages between 60 – 75 years: 55.4%; Older than 85 years: 9.7%; Whites: 73.7%) consecutively admitted to the Geriatrics Service of the “Hermanos Ameijeiras” Hospital (La Habana, Cuba) are presented. Sixty-nine percent of the patients had between 2 – 7 concurrent health problems. Neoplasms and lymphoproliferative processes (22.8%), heart and blood vessels diseases (15.7%), and infections (12.2%) were prevalent. The state of nutritional anthropometric and biochemical markers was as follows: Body Mass Index < 21 kg.m-2: 30.9%; Mid-arm Circumference < 22 cm: 19.3%; Leg Circumference < 31 cm: 42.6%; Serum Albumin < 35 g.L-1: 20.3%. Sixty-eight percent of the patients received scores < 24 after administering the MNA. It is to be noticed that 19.3% of the patients was malnourished after receiving scores < 17. MNA scores < 24 were concentrated in: Neurological disorders (80.0%), Neoplasms and lymphoproliferative processes (77.8%), heart and blood vessels diseases (74.2%), gastrointestinal disorders (70.6%), infections (69.7%), Diabetes mellitus (66.7%). Patients with the lowest scores also exhibited the lowest values of anthropometric and biochemical markers. MNA score was independent from the patient’s sex, skin colour, or number of concurrent health problems. Age had not any influence upon MNA score, although lower scores were observed among the oldest patients. MNA scoring was 80.0% coincident with nutritional diagnosis independently done with anthropometric and biochemical markers used either separately or combined. Aging of the Cuban population, along with increased proportions of elder patients in hospital areas should lead to consider the nutritional status of patients older than 60 years as an important predictor of the success of medical interventions and the quality of medical assistance.