A nutritional study of 45 elderly patients admitted to o general medical ward

Abstract

Introduction: This paper reviews the problems associated with the diagnosis of under-nutrition in the hospitalise bedridden, elderly patient. It aims to assess the nutritional status of patients aged 65 years or older, admitted to the general me­dical ward of a Central Hospital.

Methodology: The triceps skinfold thickness (TST) and mid­arm circumference were measured using the standard manner and the midarm muscle cir­cumference (MAMC) calculated using the re­ commended formula. The TST or the MAMC were considered diminished when below the 10^th percentile of the reference table, matched for age and sex. The albumin, transferrin, pre-al­bumin, retinol binding protein, haemoglobin, total number of lymphocytes and total cholesterol were also measured and compared to the hospital's laboratory reference values.

Results: The percentage of undernourished patients, in accordance with the previously defined parameters, revealed a wide range of values, varying from 11,1 to 35,6 %, with respect to each of the anthropometric values measure · andfrom 30,6 to 88,6 % with respect to each of the laboratoty values.

Discussion andconclusion: There is no single anthropometric measure­ ment or laboratory parameter, that is, in iso­lation, a good indicator of the nutritional status in an individual patient. There is a large disparity between the information given by each variable in relation to the nutritional status of an individual pattent. ln the elderly, bedri­dden pattent, who often has a serious inter­ current illness that leads to hospitalisation, there is an urgent needfor the development of a nutritional índex which could be used in daily clinical practice. Furthermore, there is a gre­at need for large-scale anthropometric studi­es in bealthy adults, in particular in the elderly population, in Portugal the correct iden­tification of under-nutrition in individual ca­ses and groups of patients needs to be made.