Assessment of nutritional status and functional ability in the elderly
More details
Hide details
Chair and Department of Health Prevention, University of Medical Sciences, Poznan, Poland
Chair and Clinic of Palliative Medicine, University of Medical Sciences, Poznan, Poland
Corresponding author
Magdalena Strugała   

Chair and Department of Health Prevention, Poznan University of Medical Sciences
Med Og Nauk Zdr. 2019;25(4):274-281
Introduction and objective:
The incidence of problems related with nutrition disorders and decrease of functional activity among the elderly are often an important element of their disability. The aim of the study was to analyse the relationship between the nutritional status and functional fitness of aselected population of elderly people.

Material and methods:
The cross-sectional study comprised 412 elderly persons, including 318 females (77%). The mean age of the study group was 75.8 years±7.6. Within the entire group an analysis of correlation between nutritional status and functional ability was performed, assessed according to the Mini Nutritional Assessment (MNA) scale, as well as social and demographic parameters, health condition (number of chronic diseases, drugs taken) and the functional independence exponents. To identify factors significantly affecting the risk of malnutrition, the logistic regression model was used. Results obtained were presented as odds ratios with 95% confidence intervals. A stepwise multiple logistic regression with backward elimination was also performed.

Results The normal nutritional status (MNA 23–30 point), good mental status (MMSE 24–30), no risk of depression (GDS – 0–5 points), risk of falls (TUG – less than 14 seconds) and correct functional capability (Barthel index 86–100; IADL – 27), were determined in 253 (61.4%) respondents. Multi-parameter analysis proved that the independent determinants of nutrition status were: risk of depression (p<0.001), risk of falling (p<0.01), cognitive ability (p<0.05) and education (p<0.05).

Conclusions Incorrect nutritional status can be both a consequence and cause of disability. Due to the determined correlation between nutritional status and the components of functional fitness, the existence of irregularities in the area of any element should necessitate the conduction of screening tests to determine nutritional status.

MNA – Mini Nutritional Assessment scale; MMSE – Mini Mental State Examination; Barthel Index – Barthel Index of Activities of Daily Living; IADL – Instrumental Activities of Daily Living Scale; GDS – Geriatric Depression Scale; TUG – Time Up and Go.
Kondrup J, Rasmussen HH, Hamberg O, Stanga Z. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr. 2003; 22: 321–336.
Ribeiro DKMN, Lenardt MH, Lourenco TM, et al. The use of the functional independence measure in elderly. Rev Gaucha Enferm. 2018; 38(4). doi: 10.1590/1983-1447.2017.04.66496.
Forster S, Gariballa S. Age as a determinant of nutritional status: A cross sectional study. Nutr J. 2005; 27: 4–28.
Volkert D, Saeglitz C, Gueldenzoph H, et al. Undiagnosed malnutrition and nutrition – related problems in geriatric patients. Nutr Health Aging. 2010; 14: 387–392.
Holle R, Gräßel E, Ruckdäschel S, et al. Dementia care initiative in primary practice – study protocol of a cluster randomized trial on dementia management in a general practice setting. Health Serv Res. 2009; 6: 9–91.
Feldblum I, German L, Castel H, et al. Characteristics of undernourished older medical patients and the identification of predictors for undernutrition status. Nutr J. 2007; 2: 6–37.
Izawa S, Kuzuya M, Okada K, et al. The nutritional status of frail edery with care needs according to the mini-nutritional assessment. Clin Nutr. 2006; 25: 962–967.
Risonar MGD, Rayco-Solon P, Ribaya-Mercado JD, et al. Physical activity, energy requirements, and adequacy of dietary intakes of older persons in a rural Filipino community. Nutr J. 2009; 4: 8–19.
Marrone A, Donini LM, Scardella P, et al. Malnutrition in eldery: clinical features, psychological and social determinants. Preliminary results. Ann Iq. 2011; 23: 161–172.
Dessi M, Noce A, Agnoli A, et al. The usefulness of the prognostic inflammatory and nutritional index (PINI) in a haemodialysis population. Nutr Metab Cardiovasc Dis. 2009; 19, 11: 811–5.
Cuervo M, Ansorena D, García A, et al. Assessment of calf circumference as an indicator of the risk for hyponutrition in the elderly. Nutr Hosp. 2009; 24: 63–67.
Nakagawa HB, Ferraresi JR, Prata MG, et al. Postural balance and Functional independence of elderly people according to gender and age: cross-sectional study. Sao Paulo Med. 2017; 135(3): 260–265.
Lei Z, Qingyi D, Feng G, et al. Clinical study of Mini Nutritional assessment for older Chinese inpatients. J Nutr Health Aging, 2009; 13(10): 871–875.
Phillips MB, Foley AL, Barnard R, et al. Nutritional screening in community-dwelling older adults: a systematic literature review. Asia Pac J Clin Nutr. 2010; 19: 440–449.
Bauer JM, Sieber CC. Significance and diagnosis of malnutrition in the elderly. Z Arztl Fortbild Qualitatssich. 2007; 101: 605–609.
Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965; 14: 61–65.
Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969; 9(3): 179–186.
Folstein M, Folstein S, McHugh P. Mini-Mental state. a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12(3): 189–198.
Podsiadlo D, Richardson S. The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons. J Am Geriatr Soc. 1991; 39: 142–148. doi:10.1111/j.1532-5415.1991.tb01616.x.
Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey MB, Leirer VO. Development and validation of a geriatric depression screening cale: A preliminary report. J Psychiatr Res. 1983; 17: 37–49.
Guigoz Y, Vellas B. The Mini Nutritional Assessment (MNA) for Grading the Nutritional State of Elderly Patients: Presentation of the MNA, History and Validation. In: Editor(s): B. Nestle Nutr Workshop Ser Clin Perform Programme. 1999; 1: 3–11.
Kondrup J, Allison SP, Elia M. ESPEN guidelines for nutrition screening 2002. Clin Nutr. 2003; 22: 415–421.
Sacks GS, Dearman K, Reploge WH. Use of subjective global assessment to identify nutrition-associated complications and death in geriatric long-term care facility residents. J Am Coll Nutr. 2000; 19: 570–577.
Phillips MB, Foley AL, Barnard R, et al. Nutritional screening in community-dewelling older adults: a systematic literature review. Asia Pac J Clin Nutr. 2010; 19: 440–449.
Timpini A, Facchi E, Cossi S, et al. Self-reported socio-economic status, social, physical and leisure activities and risk for malnutrition in late life: a cross-sectional population-based study. J Nutr Health Aging 2011; 15: 233–238.
Jyrkkä J, Enlund H, Lavikainen P, et al. Association of polypharmacy with nutritional status, functional ability and cognitive capacity over a three-year period in an elderly population. Pharmacoepidemiol Drug Saf. 2011; 20: 514–522.
Visvanathan R, Newbury JW, Chapman I. Malnutrition in older people. Screening and management strategies. Aust Fam Phys. 2004; 33: 799–805.
Smoliner C, Norman K, Wagner KH, et al. Malnutrition and depression in the institiutionalised elderly. Br J Nutr. 2009; 102: 1663–1667.
Grieger JA, Nowson CA, Ackland LM. Nutritional and fuctional status indicators in residents of a long-term care facility. J Nutr Elder. 2009; 28: 47–60.
Kaburagi T, Hirasawa R, Yoshino H, et al. Nutritional status in strongly correlated with grip strength and depression in community-living elderly Japanese. Public Health Nutr. 2011; 14: 1893–1899.
Isaia G, Mondino S, Germinara C, et al. Malnutrition in an elderly demented population living home. Arch Gerontol Geriatr. 2011; 53: 249–251.
Ferdous T, Cederholm T, Kabir ZN, et al. Nutritional status and cognitive function in community-living rural Bangladeshi older adults: data from the poverty and health in ageing project. J Am Geriatr Soc. 2010; 58: 919–924.
Johansson L, Sidenvall B, Malmberg B, et al. Who will become malnourished? A prospective study of factors associated with malnutrition in older persons living at home. J Nutr Health Aging. 2009; 13: 855–861.
De La Montana J, Miguez M. Suitability of the short-form Mini Nutritional Assessment in free-living elderly people in the northwest of Spain. J Nutr Health Aging. 2011; 15: 187–191.
Orsitto G, Fulvio F, Tria D, et al. Nutritional status in hospitalized elderly patients with mild cognitive impairment. Clin Nutr. 2009; 28: 100–102.
Oliveira MR, Fogaca KCP, Leandro-Merhi VA. Nutritional status and functional capacity of hospitalized eldery. Nutr J. 2009; 8: 54–62.
Ülger Z. Halil M., Kalan I, et al. Comprehensive assessment of malnutrition risk and related factors in a large group of communitydwelling older adults. Clin Nutr. 2010; 29: 507–511.
Ghisla MK, Cossi S, Timpini A, et al. Predictors of successful rehabilitation in geriatric patients: subgroup analysis of patients with cognitive impairment. Aging Clin Exp Res. 2007; 19: 417–423.
Journals System - logo
Scroll to top