ASSESSMENT OF NUTRITIONAL RISK IN THE ELDERLY

To enhance physicians' awareness of nutritional problems in the elderl y, a nutritional risk assessment scale was developed and validated. 12 6 patients (mean age 82.0 +/- 6.7, range 65-96 years) admitted from ho me to a geriatric hospital were enrolled in the study. After informed consent was obtained, they underwent a comprehensive geriatric assessm ent of physical, emotional, and cognitive functions, overall functiona l capacity, and social situation. The nutritional status was assessed by the nutritional risk assessment scale. This scale consists of items relating to gastrointestinal disorders, chronic diseases with pain, i mmobility, alterations in body weight, appetite, difficulties in eatin g, cognitive or emotional problems, medication, smoking and drinking h abits, and social situation. The maximum score which indicates a high risk is 12. The scores from the nutritional risk assessment scale were compared with a physician's clinical judgement (patients being graded as 'obese', 'well-nourished', 'undernourished') as the 'gold standard ' and with body mass index, other anthropometric findings, and serum a lbumin and prealbumin levels. The nutritional risk assessment scale wa s reliable (inter- and intrarater) and showed construct and concurrent validity. There was a significant correlation with clinical judgement (p < 0.01) and other parameters of nutritional status (p < 0.05). The scores of undernourished patients (n = 37; 5.35 +/- 1.60, range 3-8) were significantly different (p < 0.05) from those who were classified as well nourished (n = 63; 2.66 +/- 1.59, range 0-7) or obese (n = 26 ; 2.73 +/- 1.76, range 0-7). When implemented as part of a comprehensi ve geriatric assessment, this questionnaire can be completed within 5- 10 min. The nutritional risk assessment scale is simple and reliable a nd helps in the identification of elderly patients at risk of poor nut rition.