A vital sign: progress and prospects in nutrition screening of older Americans

The population of older Americans over 65, and particularly over 75 and 85 years of age, when daily activities affecting eating and food-getting are often compromised, is growing rapidly. Screening to identify risk factors to nutritional and general health, and further assessment and intervention for those who are found to be at risk is essential. The Nutrition Screening Initiative is a voluntary effort of several major health professional organizations focused on promoting better nutrition screening and nutritional care for our nation's elderly. This article describes some of the nutrition-related problems faced by older Americans. The progress of the Nutrition Screening Initiative is reviewed, and some simple steps to implement the Initiative's recommendations in physician offices and other health care settings serving older Americans are provided. By adopting and using the simple screening and assessment tools that are provided, or by developing individualized tools, the practicing physician can incorporate these essential components of comprehensive geriatric assessment into office practice. This will do much to alleviate remediable problems early, and to control or ameliorate those that cannot be prevented. Some useful supportive continuing medical education efforts, resources available, and measures that are being taken at the community level are summarized. A case study of some potential problems and how they might be alleviated is provided. Finally, some potential avenues in both the health and social services system for more effective interventions to deal with problems are identified.