[MALNUTRITION SCREENING TOOLS FOR ELDERLY IN GENERAL PRACTICE].

Abstract

Malnutrition of elderly is an unrecognized condition, which can be effectively treated. It is associated with increased morbidity, hospitalizations, lower quality of life, increased mortality and significant costs. Body mass index (BMI) is not a sufficient measure of nutritional status of the elderly as it does not take into account changes in body structure and composition caused by aging. Various validated screening tools are recommended to use in elderly. General practitioner (GP) provides health care for all the elderly living in the community and therefore has an ideal opportunity to screen them for malnutrition. The objective of the article is to show malnutrition screening tools for elderly, with an emphasis on those with sufficient sensitivity and specificity, applicable in family medicine. We searched databases Medline, Library of Congress and the Web of Science using selected keywords. The search was limited to articles published in the last 20 years, with no language restrictions. We found 37 articles: in initial screening we excluded 20 and 17 articles remained. After retrieving all 17 full texts, one more was excluded so that the final number of analyzed articles was 16. Among reviewed studies, following malnutrition screening tools were used for elderly: Geriatric Nutritional Risk Index (GNRI), Malnutrition Screening Tool (MST), Mini Nutritional Assessment-Short Form (MNA-SF), Nutritional Risk Screening 2002 (NRS 2002), Malnutrition Universal Screening Tool (MUST), Short Nutritional Assessment Questionnaire 65+ (SNAQ(65+)) and Australian Nutrition Screening Initiative (ANSI). The most frequently used tool (in nine articles) was MNA-SF, for its convenience, simplicity, sufficient sensitivity and specificity. Screening for malnutrition is the first step in nutritional care for the elderly. For the purpose of screening, GP has many tools available and should choose a simple one with sufficient sensitivity and specificity and easy to incorporate in the course of consultation with an elderly patient. It seems that such a tool for GP is MNA-SF.