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Poor nutritional habits are predictors of poor outcome in very old hospitalized patients^1,2

¹ From the Department of Geriatric Medicine, Kaplan-Harzfeld Medical Center, Rehovot-Gedera, affiliated with the Hebrew University–Hadassah School of Medicine, Jerusalem, Israel (NK, LP, and SL); the Department of Geriatric Medicine, Meir Hospital, Sapir Medical Center, Kfar Saba, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University (YB); the Division of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, Tel-Aviv University, Israel (NK-M); and the Metabolic Unit, Kaplan Medical Center (HK)

Background: Malnutrition is prevalent in elderly populations. Recommended methods of nutritional screening are often too complicated and time-consuming for routine application in frail, very old, hospitalized patients.

Objective: Our aims were to identify risk factors for development of malnutrition in very old hospitalized patients and to evaluate the total Mini Nutritional Assessment (MNA) score and MNA subscores as predictors of in-hospital and long-term mortality.

Design: A prospective cohort study of patients aged 75 y was conducted in a geriatric hospital. Assessment included demographic, clinical, and laboratory data and cognitive, functional, and nutritional status. Follow-up was conducted for 2.7 y.

Results: Of the 414 patients studied, only 73 (17.6%) were well-nourished. Low serum albumin and phosphorus concentrations, dementia, and cerebrovascular accident (CVA) were significant risk factors for malnutrition. Survival was significantly lower in malnourished patients and patients at risk of malnutrition than in well-nourished patients (P < 0.0001). Low MNA-3 subscores (dietary habits) were significantly correlated with laboratory indexes of malnutrition and were significantly lower in patients with infections, malignancy, pressure ulcers, dementia, recent orthopedic surgery, and CVA. Multivariate analysis showed that a low MNA-3 score was an independent predictor of mortality; scores <7.5 increased the risk of death 2.05-fold.

Conclusions: The prevalence of malnutrition was high in elderly hospitalized patients. Dietary habits were significant predictors of poor hospitalization outcome. A questionnaire on dietary habits can serve as a useful tool in assessing nutritional status and prognosis in elderly patients.

Key Words: Nutritional habits • elderly • hospitalization • Mini Nutritional Assessment

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