Malnutrition in geriatric patients: diagnostic and prognostic significance of nutritional parameters

• Published in: Annals of nutrition and metabolism Vol. 36; no. 2; pp. 97 - 112
• Main Authors: Volkert, D, Kruse, W, Oster, P, Schlierf, G
• Format: Journal Article
• Language: English
• Published: Switzerland 1992
• Subjects: Activities of Daily Living; Aged; Aged, 80 and over; anthropometric measurements; Anthropometry; blood proteins; Blood Proteins - analysis; body weight; Cardiovascular Diseases - epidemiology; Comorbidity; Diabetes Mellitus - epidemiology; disease diagnosis; elderly; Female; Germany - epidemiology; hematologic tests; Hospitalization; Humans; Immunologic Deficiency Syndromes - epidemiology; indicator species; Male; malnutrition; men; Mental Disorders - epidemiology; mortality; Nutrition Disorders - diagnosis; Nutrition Disorders - epidemiology; Nutrition Disorders - immunology; Nutrition Disorders - pathology; Nutritional Status; Obesity - epidemiology; Predictive Value of Tests; Prevalence; Prognosis; Prospective Studies; risk; Sensitivity and Specificity; Severity of Illness Index; Survival Analysis; vitamins; Vitamins - blood; women; German Federal Republic; Germany
• ISSN: 0250-6807; 1421-9697
• DOI: 10.1159/000177704

Nutritional status was assessed in 300 geriatric patients aged 75 years or more using clinical, anthropometric, biochemical and immunologic methods. Relations between different assessment methods and their prognostic significance with regard to 18-month mortality were examined. For biochemical variables 10% (prealbumin, vitamin B6) to 37% (vitamins A and C) were below conventional limits. In 44% of the patients lymphocytes were diminished. 44% were anergic. Judgement of nutritional status by clinical impression resulted in 22% being deemed undernourished. Clinical diagnosis of undernutrition was associated with low anthropometric measurements (p < 0.05 for all parameters) and a high prevalence of low biochemical values (p < 0.05 for albumin, prealbumin, transferrin, vitamin A, vitamin B1). The mean values of all anthropometric variables, plasma proteins, vitamins A and C were significantly lower in patients who died within the following 18 months compared to survivors. The greatest prognostic significance was related to the clinical diagnosis of malnutrition. We conclude that clinical assessment is useful for the evaluation of nutritional status in geriatric patients and the best of numerous nutritional parameters to estimate risk of long-term mortality.