Nutritional assessment of the elderly in the ambulatory care setting

Malnutrition is a major risk for morbidity and mortality among elderly hospital and nursing home patients. Moreover, prevalence of malnutrition or inadequate nutrition among the elderly is quite high with 10% to 51% of community-residing elderly, 20% to 60% of hospitalized elderly patients, and up to 85% of nursing home patients showing significant nutritional deficits. Malnutrition in the elderly is a multifactorial problem involving physical, physiological, psychosocial, and economic factors. Because of the many factors that can contribute to inadequate nutrition in the elderly, the clinician needs to assess the elderly individual's physical function, cognition, mood, and alcohol use, socialization and living arrangements, finances, and medications as part of the routine nutrition assessment. Accurate identification of the underlying problems is essential. Interventions are aimed at reducing or alleviating risk factors for inadequate nutrition or at maintaining or promoting nutritional status. Thus, nutrition interventions cover a wide range of activities and can be provided by various social and health professionals. This article provides an overview of the common factors affecting the elderly's nutritional status, recommended assessment techniques, and intervention strategies.