The Coexistence of Dual Form of Malnutrition among Portuguese Institutionalized Elderly People

In the present study we evaluated the nutritional status of 214 institutionalized elderly residents of both genders, aged 65 years and older of 11 care homes located in the district of Viseu (center of Portugal). The evaluation was based on anthropometric measurements and the Mini Nutritional Assessment (MNA) score.

The mean age of the subjects was 82.3 ± 6.1 years-old. Most of the elderly residents were female (72.0%). The majority had 4 years of formal education (51.9%) and was widowed (74.3%) or married (14.0%).

Men presented a mean age of 81.2±8.5 years-old, weight 69.3±14.5 kg and BMI 25.33±6.5 kg/m². In women, the mean age was 84.5±8.2 years-old, weight 61.2±14.7 kg and BMI 27.43±5.6 kg/m².

The evaluation of the nutritional status using the MNA score showed that 24.0% of the residents show a risk of undernutrition and 76.0% of them were well nourished.

There was a high prevalence of obese (24.8%) and overweight residents (33.2%) according to the BMI. 7.5% were considered underweight.

We also found that according to their waist circumference measurements 88.3% of the residents were at risk for cardiovascular disease (CVD) and 64.0% of them presented very high risk for CVD (WC≥88 cm for women and WC ≥102 cm for men).

The present study revealed the coexistence of a dual form of malnutrition (undernourished and overweight) among the institutionalized Portuguese concomitantly with an excess of abdominal adiposity. The high prevalence of residents at high risk for CVD should not be overlooked.

Given the vulnerability of the group of institutionalized elderly, our study highlights the importance of the classification of nutritional status based on both instruments: the BMI and the MNA.

• C. Caçador
• M. J. Reis Lima
• J. Oliveira
• M. J. Veiga
• M. Teixeira Veríssimo
• F. Ramos
• M. C. Castilho and E. Teixeira-Lemos

• Nutritional status
• MNA
• BMI
• elderly.

[1] Haub.C. Global aging and the demographic divide. Public Policy and Aging Report, 2007; 17,1, 3-6.
[2] Parker MG, Thorslund M. Health trends in the elderly population: getting better and getting worse. Gerontologist. 2007;47:150.
[3] Carneiro R.,Chau F., Soares C., Sousa Fialho J., Sacadura MJ. O Envelhecimento da População: Dependência, Ativação e Qualidade, Centro de Estudos dos Povos e Culturas de Expressão Portuguesa, Faculdade de Ciências Humanas, Universidade Católica Portuguesa, 2012
[4] Bourdel-Marchasson, I, Rollandb, C, Jutand, MA, Egeab, C,Baratchart, B, Barberger-Gateau, P. Undernutrition in geriatric institutions in South-West France: policies and risk factors.Nutrition 2009; 25: 155-64.
[5] Gariballa SE. Nutritional support in elderly patients. J Nutr Health Aging. 2000;4:25–7.
[6] Mihalynuk TV, Knopp RH, Scott CS, et al. Physician informational needs in providing nutritional guidance to patients. Fam Med. 2004;36:722–6
[7] Bonnefoy M, Jauffret M, Kostka T, Jusot JF. Usefulness of calf circumference measurement in assessing the nutritional state of hospitalized elderly people. Gerontology2002; 48: 162-9.
[8] Pérez-Llamas F. Risk of desnutrition in the Spanish population. Evaluation of the current situation and need for a nutritional intervention. Med Clin(Barc) 2012; 139: 163-4
[9] Esteban M, Fdez. Ballart J, Salas J. Estado nutricional de la población anciana en función del régimen de institucionalización. NutrHosp 2000; 15: 105-13
[10] Stratton RJ, Green CJ, Elia M (2003) Disease-related malnutrition. An evidence based approach to treatment. Wallingford: CABI Publishing (CAB International)..
[11] Serra J, Salva A. Cribado de la desnutrición en personas mayores. Med Clinic.2001; 116: 35-9
[12] Fontanive R, De Paula TP, Peres WAF. Avaliação da Composição Corporal de Adultos. In: Duarte ACG. Avaliação Nutricional: aspectos clínicos e laboratoriais. São Paulo: Atheneu. 2007, p. 41-63.
[13] Rubenstein LZ, Harker JO, Salvà A, et al. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF) J Gerontol A Bio Sci Med Sci. 2001;56A:M366–72.
[14] Vellas B, Guigoz Y, Garry P, et al. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition. 1999;15:116–22.
[15] Guigoz Y, Vellas B, Garry PJ. Mini Nutritional Assessment: a practical tool for grading the nutritional state of the elderly patients. Facts Res Gerontol1994 ; (suppl 2): 15-60.
[16] W. C. Chumlea, S. S. Guo, K. Wholihan, D. Cockram, R. J. Kuczmarski, and C. L. Johnson,"Stature prediction equations for elderly non-Hispanic white, non-Hispanic black, and Mexican-American persons developed from NHANES III data,” Journal of the American Dietetic Association,1998; 98, 2:137–142.
[17] WHO. Physical status: the use and interpretation of anthropometry WHO Technical Report, Series No. 854, 1995. World Health Organization. Geneve. pp. 439.
[18] Lean ME, Han TS, Morrison CE:Waist circumference as a measure for indicating need for weight management. BMJ 1995,311:158-161
[19] Rolland Y, Lauwers-Cances V, Cournot M, NourhashémiF,Reynish W, Rivière D, Vellas B, Grandjean H. Sarcopenia, calf circumference, and physical function of elderly woman: a cross-sectional study. J Am GeriatrSoc 2003; 51: 1120-4.