Clinical application of the basic definition of malnutrition proposed by the European Society for Clinical Nutrition and Metabolism (ESPEN): Comparison with classical tools in geriatric care

• Published in: Archives of gerontology and geriatrics Vol. 76; pp. 210 - 214
• Main Authors: Sánchez-Rodríguez, Dolores, Annweiler, Cédric, Ronquillo-Moreno, Natalia, Tortosa-Rodríguez, Andrea, Guillén-Solà, Anna, Vázquez-Ibar, Olga, Escalada, Ferran, Muniesa, Josep M., Marco, Ester
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.05.2018; Elsevier
• Subjects: Aged; Aged, 80 and over; Cohort Studies; Cross-Sectional Studies; Female; Geriatric Assessment; Humanities and Social Sciences; Humans; Male; Malnutrició; Malnutrition; Malnutrition - diagnosis; Malnutrition - epidemiology; Nutrition Assessment; Older people; Persones grans; Postacute; Prevalence; Sensitivity; Serum Albumin - analysis; Specificity; LR; GLIM; ICD; k; Postacute; MNA-SF; SD; Sensitivity; Specificity; NPV; Older people; AND; PPV; ESPEN; FFMI; Malnutrition; ASPEN; BMI; WHO; 80 and over; Geriatric Assessment; Serum Albumin; Prevalence; Cross-Sectional Studies; Humans; Female; Male; Aged; Cohort Studies; Nutrition Assessment
• ISSN: 0167-4943; 1872-6976
• DOI: 10.1016/j.archger.2018.03.007

•Malnutrition was twice as prevalent when diagnosed by the ESPEN consensus, compared to classical assessment methods.•Classical methods showed fair validity and poor agreement with the ESPEN consensus in assessing malnutrition in geriatric postacute care.•Further studies incorporating the ESPEN consensus definition are needed to assess nutrition-related longitudinal outcome measures.•Further research is required to clarify its effects by nutritional treatments, impact on functional status and survival.•Determining the most current gold standard for nutritional assessment could improve delivery of geriatric care. Malnutrition is a prevalent condition related to adverse outcomes in older people. Our aim was to compare the diagnostic capacity of the malnutrition criteria of the European Society of Parenteral and Enteral Nutrition (ESPEN) with other classical diagnostic tools. Cohort study of 102 consecutive in-patients ≥70 years admitted for postacute rehabilitation. Patients were considered malnourished if their Mini-Nutritional Assessment-Short Form (MNA-SF) score was ≤11 and serum albumin <3 mg/dL or MNA-SF ≤ 11, serum albumin <3 mg/dL, and usual clinical signs and symptoms of malnutrition. Sensitivity, specificity, positive and negative predictive values, accuracy likelihood ratios, and kappa values were calculated for both methods: and compared with ESPEN consensus. Of 102 eligible in-patients, 88 fulfilled inclusion criteria and were identified as “at risk” by MNA-SF. Malnutrition diagnosis was confirmed in 11.6% and 10.5% of the patients using classical methods,whereas 19.3% were malnourished according to the ESPEN criteria. Combined with low albumin levels, the diagnosis showed 57.9% sensitivity, 64.5% specificity, 85.9% negative predictive value,0.63 accuracy (fair validity, low range), and kappa index of 0.163 (poor ESPEN agreement). The combination of MNA-SF, low albumin, and clinical malnutrition showed 52.6% sensitivity, 88.3% specificity, 88.3%negative predictive value, and 0.82 accuracy (fair validity, low range), and kappa index of 0.43 (fair ESPEN agreement). Malnutrition was almost twice as prevalent when diagnosed by the ESPEN consensus, compared to classical assessment methods: Classical methods: showed fair validity and poor agreement with the ESPEN consensus in assessing malnutrition in geriatric postacute care.