Risk of malnutrition in retirement homes elderly persons measured bythe "mini-nutritional assessment"

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Abstract
BACKGROUND: The combined influence of age-associated factors such asgeneral health, degree of dependency, diminished odor perception, and poororal health on the risk for malnutrition was explored. METHODS: A total of81 persons living in retirement homes took part in the study (mean age 83.4years, SD = 6.6, range 61-98). The Mini-Nutritional Assessment (MNA) wasused to evaluate the risk of malnutrition. Odor perception was measured bythe detection threshold for isoamylacetate. The number of drugs taken byeach person was counted. General health status was determined by theMedical Outcome Study (MOS) scores. Oral examinations were carried out tocount the number of natural teeth and type of dentures. RESULTS: Onaverage, women had slightly, but significantly, lower MNA scores than men(respectively, 23.4, SD = 2.8; and 24.6, SD = 2.6; p = .048). Thecorrelations between age and MNA score and between odor perception and MNAscore were not significant. Significant correlations were found between ageand number of natural teeth (r = -.26, p = .001) and between MNA score andnumber of natural teeth (r = .27, p = .001). The mean MNA score of completedenture wearers (22.8, SD = 2.9) was significantly lower than that ofpartial denture wearers (25.8, SD = 2.9; p = .0005). The total MOS and MNAscores were not correlated, but a significant correlation was found withthe subscales mental functioning (r = .29, p = .003), social functioning (r= . 19, p = .045), and perceived health (r = .19, p = .047). No relationwas found between the activities of daily living (ADL) and MNA scores. Asignificant negative correlation was observed between number of drugs takenand the MNA score (r = -.34, p = .001). When participants without risk ofmalnutrition (MNA > or = 24) were compared with those at risk (MNA =17-23.5), again, the number of drugs taken was significantly different (onaverage, respectively, 4.5, SD = 2.9; and 7.0, SD = 2.6; p < .0005).Using multiple regression to test the separate effects of the differentindependent variables, the number of drugs taken showed a significantnegative regression coefficient (beta = -.31, p = .008), as did the mentalhealth score (beta = .27, p =.02), giving a total R2 = .32. The otherparameters did not contribute significantly. CONCLUSION: Among the elderlyin retirement homes, the health state (as measured by the MOS subscalemental health and by the medication use) appears to be the most clinicallyrelevant parameter to explain the risk for malnutrition. Loss of naturalteeth and perceived health are less independently contributing, whereas nocontribution derives from decline of odor perception, degree of dependency,and age itself.

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