Methods for Assessing Malnutrition in Older People

A Summary of Initial Findings

In the first edition of Field Exchange we reported on an ongoing research project by Helpage and the LSHTM which was developing methods for assessing malnutrition in older people in developing countries. After five years of this study some of the results were presented at a symposium held at LSHTM at the end of September. The symposium advocated for greater attention to be paid by development and emergency organisations to the nutritional and related needs of older people.

The research concentrated on finding a simple but effective way of using anthropometric measurements to assess the nutritional status of older people. It examined the relationship between nutritional status and functional ability (the ability to perform basic activities of daily life without support). Vulnerability factors associated with risk of malnutrition in the elderly were also examined. The study took place in three sites, an urban slum in Bombay, a rural population in Malawi and a refugee population in Karagwe region of Tanzania. The elderly were defined as those over 50 years of age.

Nutritional status was measured using various indices like MUAC (mid upper arm circumference) and BMI (wt/ht2 )but substituting armspan (the distance between the tips of the middle fingers when both arms are held out) for height where there was curvature of the spine (kyphosis). One difficulty with using BMI to assess nutritional status of the elderly is that accurate height measurement is necessary, yet curvature of the spine confounds accurate measurement. In one of the study populations the percentage of the elderly with kyphosis was 17%.

The main findings of the study were as follows:

One of the main conclusions from the study is that prevention of malnutrition is critical in protecting functional ability of the elderly.

A handbook arising out of this study, to assist organisations or individuals wishing to measure nutritional status or assess vulnerability in the elderly is currently at draft stage. The first three chapters have largely been written. These explain methods of assessing nutritional status in the elderly, e.g. MUAC, BMI using armspan, height or demispan. BMI nutritional status charts using all these anthropometric measures are provided. Further chapters are to be written on ways of assessing vulnerability in the elderly and on appropriate interventions to deal with nutritional risk and problems in the elderly.

A report of the symposium can be obtained from Kate Gregory at Help Age International, 67-74 Saffron Hill, London EC1N 8QX. Tel No +44 171 404 7201, E-Mail helpage@dial.pipex.com

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Reference this page

Methods for Assessing Malnutrition in Older People. Field Exchange 3, January 1998. p7. www.ennonline.net/fex/3/methods