Beyond malnutrition screening: Appropriate methods to guide nutrition care for aged care residents

Isenring, Elisabeth A., Ferguson, Maree, Banks, Marrilyn and Bauer, Judith D. (2012) Beyond malnutrition screening: Appropriate methods to guide nutrition care for aged care residents. Journal of the Academy of Nutrition and Dietetics, 112 3: 376-381. doi:10.1016/j.jada.2011.09.038

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Author Isenring, Elisabeth A.
Ferguson, Maree
Banks, Marrilyn
Bauer, Judith D.
Title Beyond malnutrition screening: Appropriate methods to guide nutrition care for aged care residents
Journal name Journal of the Academy of Nutrition and Dietetics   Check publisher's open access policy
ISSN 2212-2672
Publication date 2012-03
Sub-type Article (original research)
DOI 10.1016/j.jada.2011.09.038
Open Access Status
Volume 112
Issue 3
Start page 376
End page 381
Total pages 6
Place of publication New York, United States
Publisher Elsevier
Collection year 2013
Language eng
Formatted abstract
Background Malnutrition is common in older adults and early and appropriate nutrition intervention can lead to positive quality of life and health outcomes.
Objective The purpose of our study was to determine the concurrent validity of several malnutrition screening tools and anthropometric parameters against validated nutrition assessment tools in the long-term-care setting.
Study design This work was a cross-sectional, observational study.
Participants/setting Older adults (aged >55 years) from two long-term-care facilities were screened.
Main outcomes Nutrition screening tools used included the Malnutrition Screening Tool (MST), Malnutrition Universal Screening Tool (MUST), Mini Nutritional Assessment-Short Form (MNA-SF), and the Simplified Nutritional Assessment Questionnaire. Nutritional status was assessed by Subjective Global Assessment (SGA), Mini Nutritional Assessment (MNA), body mass index (BMI), corrected arm muscle area, and calf circumference. Residents were rated as either well nourished or malnourished according to each nutrition assessment tool.
Statistical analysis A contingency table was used to determine the sensitivity and specificity of the nutrition screening tools and objective measures in detecting patients at risk of malnutrition compared with the SGA and MNA.
Results One hundred twenty-seven residents (31.5% men; mean age 82.7±9 years, 57.5% high care) consented. According to SGA, 27.6% (n=31) of residents were malnourished and 13.4% were rated as malnourished by MNA. MST had the best sensitivity and specificity compared with the SGA (sensitivity 88.6%, specificity 93.5%, κ=0.806), followed by MNA-SF (85.7%, 62%, κ=0.377), MUST (68.6%, 96.7%, κ=0.703), and Simplified Nutritional Assessment Questionnaire (45.7%, 77.2%, κ=0.225). Compared with MNA, MNA-SF had the highest sensitivity of 100%, but specificity was 56.4% (κ=0.257). MST compared with MNA had a sensitivity of 94.1%, specificity 80.9% (κ=0.501). The anthropometric screens ranged from κ=0.193 to 0.468 when compared with SGA and MNA.
Conclusions MST, MUST, MNA-SF, and the anthropometric screens corrected arm muscle area and calf circumference have acceptable concurrent validity compared with validated nutrition assessment tools and can be used to triage nutrition care in the long-term-care setting.
Keyword Dietetics
Nutrition screening
Aged care
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Formerly known as Journal of the American Dietetic Association (0002-8223)

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Human Movement and Nutrition Sciences Publications
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Citation counts: TR Web of Science Citation Count  Cited 26 times in Thomson Reuters Web of Science Article | Citations
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Created: Fri, 23 Mar 2012, 15:33:46 EST by Dr Liz Isenring on behalf of School of Human Movement and Nutrition Sciences