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GLIM in nursing homes; practical implications.

Marian A E de van der Schueren1, Jos W Borkent1, Gijs W Spaans1

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Clinical Nutrition (Edinburgh, Scotland)
|October 10, 2022
PubMed
Summary

Malnutrition affects 21% of nursing home residents by Global Leadership Initiative on Malnutrition (GLIM) criteria. Using the MNA-SF questionnaire underestimates malnutrition prevalence, missing many residents with low food intake.

Keywords:
Dietary intakeGLIMLong-term care facilityMNA-SFNursing homeSNAQ(RC)

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Area of Science:

  • Gerontology
  • Nutritional Science
  • Clinical Nutrition

Background:

  • Prevalence of malnutrition using Global Leadership Initiative on Malnutrition (GLIM) criteria in nursing homes is sparsely documented.
  • Practical challenges like missing body composition, dietary intake, or inflammation data limit GLIM assessments in these settings.

Purpose of the Study:

  • To determine malnutrition prevalence in nursing home residents using GLIM criteria.
  • To compare the accuracy of GLIM diagnosis with measured food intake versus the Mini Nutritional Assessment Short Form (MNA-SF) questionnaire for assessing food intake.

Main Methods:

  • Data collected from 5 nursing homes, including 3-day food intake observations.
  • GLIM diagnosis combined body weight loss and/or low BMI with insufficient food intake (below 90% of requirements).
  • Compared GLIM with measured intake (GLIM) against GLIM using MNA-SF food intake question (GLIM MNA).

Main Results:

  • 21.0% of 176 residents were malnourished per GLIM criteria.
  • Measured insufficient food intake was 81.3%, but only 39% identified by MNA-SF.
  • GLIM MNA identified 17.0% as malnourished, with 62.2% sensitivity and 95.0% specificity compared to GLIM.

Conclusions:

  • A significant portion (21%) of nursing home residents exhibit malnutrition based on limited GLIM criteria.
  • The MNA-SF food intake question significantly underestimates low food intake, leading to lower prevalence rates (17%) with GLIM MNA.
  • Accurate food intake measurement is recommended for studies to avoid underestimating malnutrition prevalence in nursing home populations.