In this article, we are going to be talking about the nutritional assessment of the elderly.
Like any other nutritional assessment, the nutritional assessment of the elderly uses multiple sources of information that include historical data, nutritional history, anthropometric data, biochemical analysis of blood and urine and the presence of any disease process. In some cases nutritional information may be obtained from significant others.
Parameters For Understanding The Nutritional Assessment of The Elderly
Below are the parameters used to asses the nutritional status of the elderly;
1. Nutritional History
Nutritional histories helps identify the elderly who are or may be at risk of malnutrition. It investigates the adequacy of recent food intake and also identifies any diet selection that has impaired adequate selection, preparation, ingestion, digestion, absorption and excretion of nutrients.
The following are included in the nutritional history
- Comprehensive review of usual dietary intake, including food allergies, food aversion and use of nutritional supplement including vitamin and alternative therapy.
- Recent unplanned weight loss or gain.
- Chewing or swallowing difficulty.
- Nausea, vomiting or pains with eating.
- Altered pattern of elimination (constipation or diarrhea)
- Chronic disease affecting utilization of nutrients e.g malabsorption, pancreatitis, diabetes mellitus.
- Recent trauma, surgery or sepsis
- Se of medications such as laxatives, antacids, antibiotics, anti-neoplastic drugs and much more.
2. Physical Assessment
Most physical findings are not conclusive for a particular nutritional deficiency. This findings must be compared with former conditions like;
- Loss of muscle and adipose tissue.
- Work and muscular endurance
- Change in hair, skin and neuro-muscular function.
Read Also: Basic Guidelines on Geriatric Nutrition
3. Anthropometric Data
Anthropometric is the movement of the body its part. The following parameters are used to collect anthropometric data;
- Height: this is used to determine ideal weight and body mass index.
- Weight: it is a good indicator of nutritional status that can be compared with previous weight. It is used in calculating body mass index, changes in weight may reflect retention(edema) or dehydration.
- Body mass index: it is used to evaluate adult weight. BMI(kg/m²) = weight/height x height
- values of 20-25 are optimal
- Values greater than 25 but less than 30 is over weight
- value greater than 30 is obesity
- value less than 20 is underweight.
- Triceps skin-fold thickness (TSF): measure of the midpoint surgical calipers are used to measure skinfold. Due of variation in the site of measurement, variation in position, age and status, it is only trained clinicians who should perform this assessment for more accurate result.
4. Laboratory Test
No laboratory test specifically measures the nutritional status but the following can be used to estimate it;
(A) Protein status: this is evaluated in the following test
- Serum albumin (3.5 – 5.5 g/dl)
- Transferrin (180-260 mg/dl)
- Thyroxin binding prealbumin (20-30 mg/dl)
- Retinol binding protein 94.5 mg/dl)
Albumin and transferrin have relatively long half lives of 19 and 9 days respectively, whereas thyroxin binding prealbumin and retinol binding protein have very short half life of 24 -48 hrs and 10 hrs respectively. If hydration stats is normal and anaemia is absent, albumin and transferrin level can be used as an indicator of adequacy of protein intake and synthesis.
(B) Nitrogen Balance: if more nitrogen is taken into the body, then excreted nitrogen is said to be positive and an anabolic state exists. If more nitrogen is excreted than taken in, nitrogen balance is said to be negative and a catabolic state exist. Most nitrogen loss occurs through the urine with a small constant amount loss via skin and feaces. Nitrogen balance study should be performed by specialist because of the accurate measurement of 24 hours food intake and urine output required.
(C) creatinine height index: comparison of a patient’s 24hours urinary creatinine excretion with a predicted urinary creatinine for individuals with the same height. This test evaluates body muscle mass. The quantity of creatinine produced is directly related to skeletal muscle wasting. The validity of results is affected by occurrence in the urine collection procedure and a lack of age-reformed norms.
We hope this information was helpful. Feel free to ask your questions in the comment section below.
