Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Assessment of Nutritional Status in Elderly Patients:
- Screen elderly patients at initial registration and when there is clinical concern such as unintentional weight loss, poor appetite, muscle wasting, or prolonged illness.
- Use screening tools like the Malnutrition Universal Screening Tool (MUST) which assesses body mass index (BMI), percentage of unintentional weight loss, and duration of reduced nutrient intake.
- Calculate BMI as weight in kilograms divided by height in metres squared.
- Consider screening also during other opportunities such as health checks or flu vaccinations.
Criteria Indicating Malnutrition or Risk:
- BMI less than 18.5 kg/m².
- Unintentional weight loss greater than 10% within the last 3 to 6 months.
- BMI less than 20 kg/m² with unintentional weight loss greater than 5% within the last 3 to 6 months.
- Reduced or no food intake for more than 5 days or likely to continue.
- Conditions causing poor absorption, high nutrient losses, or increased nutritional needs.
Recommended Interventions:
- For patients who can swallow safely and are malnourished or at risk, consider oral nutrition support including fortified foods, snacks, oral nutritional supplements, altered meal patterns, and dietary advice.
- Ensure oral nutrition support provides a balanced mixture of protein, energy, fibre, electrolytes, vitamins, and minerals.
- If micronutrient intake is inadequate, consider a complete oral multivitamin and mineral supplement, guided by a healthcare professional trained in nutrition support.
- For patients with inadequate or unsafe oral intake but a functional gastrointestinal tract, consider enteral tube feeding.
- Coordinate care through a multidisciplinary team including dietitians, nurses, and other relevant professionals.
- Monitor nutritional intake, weight, BMI, and gastrointestinal tolerance regularly to adjust interventions as needed.