Recognizing malnutrition in adults: definitions and characteristics, screening, assessment, and team approach

Appropriate recognition of malnutrition in adults requires knowledge of screening and assessment methodologies. An appreciation for the contributions of inflammation has resulted in a new etiology-based approach to defining malnutrition syndromes. The Academy of Nutrition and Dietetics and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) have published a consensus document that extends this approach to describe characteristics for the identification and documentation of malnutrition in adults. Nutrition screening tools are used to identify patients at nutrition risk and those who are likely to benefit from further assessment and intervention. Nutrition assessment serves to guide appropriate intervention. A systematic approach to nutrition assessment that supports the new diagnostic scheme and criteria from the Academy and A.S.P.E.N. has recently been presented. Since screening delays and failures in the diagnosis and management of malnutrition are all too common, a multidisciplinary team approach is recommended to promote improved communication and quality of care.