The Risk and The Prevalence of Malnutrition in Elderly Home-care Patients

Yıl 2022, Cilt: 13 Sayı: 45, 62 - 67, 07.04.2022

Mehmet Cenk Belibağlı

https://doi.org/10.17944/mkutfd.986356

Öz

Objective: The elderly are more susceptible to undernourishment, and those receiving home-care services have a higher prevalence of malnutrition. The study aimed to determine the prevalence of the community-dwelling elderly with malnutrition and those at risk of malnutrition enrolled in the home healthcare system.
Method: A cross-sectional, descriptive study was conducted using the Mini-Nutritional Assessment short-form among community-dwelling elderly home-care patients living in Adana, Turkey. Individuals the age of 65 and over and receiving home-care services were included. Patients were interviewed once at his or her residence individually, and on-site MNA questionnaires were completed.
Results: Among the 321 patients included in the analysis, 126 were malnourished (39.25%), and 132 were at risk of malnutrition (41.12%). The mean MNA-SF was 8.28±3.36. There was a strong association between malnutrition and literacy, with a third of the study group found to be illiterate (n=108, 33.64%, p=0.001).
Conclusion: The study showed that the majority of the patients were malnourished or at risk of malnutrition. Implementation of nutritional screening and interventions focusing on malnutrition might be required in home-care services.

Anahtar Kelimeler

Malnutrition, nutrition screening, Elderly, home-care

Yaşlı Evde Sağlık Hastalarında Malnütrisyon Prevalansı ve Malnütrisyon Riski

Öz

Amaç: Yaşlılar yetersiz beslenmeye daha duyarlıdır ve evde bakım hizmeti alanların malnütrisyon prevalansı daha yüksektir. Çalışma, evde sağlık sistemine kayıtlı, toplumda yaşayan yetersiz beslenen yaşlılar ve yetersiz beslenme riski taşıyanların prevalans istatistiklerini belirlemeyi amaçlamıştır.
Yöntem: Adana ili Numune Eğitim ve Araştırma Hastanesi Evde Sağlık Birimine kayıtlı evde bakım birimine kayıtlı yaşlı hastalarla yürütülen kesitsel tanımlayıcı çalışmada, Araştırmacılar tarafından düzenlenen anket formu ev ziyareti sırasında yüz yüze görüşme tekniğiyle uygulandı. Anketin ilk kısmında sosyodemografik değişkenler, 2. Kısmında MNA-SF yer almaktaydı. .
Bulgular: Analize dahil edilen 321 hastadan 126'sı yetersiz beslenmekteydi (% 39.25) ve 132'si malnütrisyon riski taşıyordu (% 41.12). Ortalama MNA-SF 8.28 ± 3.36 idi. Hastaların üçte birinin okuma yazma bilmediği tespit edilen çalışmada (n = 108,% 33.64, p = 0.001) yetersiz beslenme ve okuryazarlık arasında güçlü bir ilişki tespit edildi.
Sonuç: Çalışma, hastaların çoğunun malnütre veya malnütrisyon riski altında olduğunu gösterdi. Evde bakım hizmetlerinin yürütülmesinde beslenme taramalarına ve yetersiz beslenmeye yönelik müdahalelere daha fazla yer verilmesi gerektiği görülmektedir.

Anahtar Kelimeler

Malnutrisyon, yaşlı, evde bakım hizmetleri, beslenme anketleri

Kaynakça

• Jagger C, Gillies C, Moscone F, Cambois E, Oyen H, Nusselder W, et al. Inequalities in healthy life years in the 25 countries of the European Union in 2005: a cross-national meta-regression analysis. The Lancet 2008;372(9656):2124–31. https://doi.org/10.1016/S0140-6736(08)61594-9
• Stenholm S, Head J, Aalto V, Kivimaki M, Kawachi I, Zins M, et al. Body mass index as a predictor of healthy and disease-free life expectancy between ages 50 and 75: a multicohort study. Int J Obes 2017;41(5):769–75. https://doi.org/10.1038/ijo.2017.29.
• Hamilton DB. No place like home. [Review of Buhler-Wilkerson, K. No place like home: a history of nursing and home care in the United States. Baltimore: Johns Hopkins University Press, 2001]. Rev Am Hist 2002;30(2):310–5. https://pubmed.ncbi.nlm.nih.gov/12166481/
• Turkish Republic Ministry of Health. [The Delivery of Home Health Care] (in Turkish). 2005. https://www.resmigazete.gov.tr/eskiler/2005/03/20050310-5.htm (Access date:05.04.2021)
• Turkish Republic Ministry of Health. [The directive on the delivery and principles of home health care services offered by the Ministry of Health] (in Turkish). 2011. https://www.saglik.gov.tr/TR,11271/saglik-bakanliginca-sunulan-evde-saglik-hizmetlerinin-uygulama-usul-ve-esaslari-hakkinda-yonerge.html (Access date:05.04.2021)
• Morais C, Oliveira B, Afonso C, Lumbers M, Raats M, Almeida MDV. Nutritional risk of European elderly. Eur J Clin Nutr 2013;67(11):1215–9. https://doi.org/10.1038/ejcn.2013.175
• Crichton M, Craven D, Mackay H, Marx W, Schueren M, Marshall S. A systematic review, meta-analysis and meta-regression of the prevalence of protein-energy malnutrition: associations with geographical region and sex. Age Ageing 2019;48(1):38–48. https://doi.org/10.1093/ageing/afy144
• Ghimire S, Baral BK, Callahan K. Nutritional assessment of community-dwelling older adults in rural Nepal. PloS One 2017;12(2):e0172052. https://doi.org/10.1371/journal.pone.0172052
• Gunduz E, Eskin F, Gunduz M, Bentli R, Zengin Y, Dursun R, et al. Malnutrition in community-dwelling elderly in Turkey: A multicenter, cross-sectional study. Med Sci Monit. 2015;21:2750–6. https://doi.org/10.12659/MSM.893894
• Tori N, Shojaeizadeh D, Sum S, Hajian K. Effect of BASNEF-based nutrition education on nutritional behaviors among elderly people and mini nutritional assessment on nutritional status in elderly with diabetes with type 2 diabetes (A clinical trial intervention). J Educ Health Promot 2019;8(1):94. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6532392/
• Fernandez-Barres S, Garcia-Barco M, Basora J, Martinez T, Pedret R, Arija V. The efficacy of a nutrition education intervention to prevent risk of malnutrition for dependent elderly patients receiving home care: A randomized controlled trial. Int J Nurs Stud 2017;70(1):131–41. https://doi.org/10.1016/j.ijnurstu.2017.02.020
• Eichler T, Hoffmann W, Hertel J, Richter S, Wucherer D, Michalowsky B, et al. Living alone with dementia: prevalence, correlates and the utilization of health and nursing care services. J Alzheimers Dis. 2016;52(2):619–29. https://doi.org/10.3233/JAD-151058
• Meijers JMM, Schols JMGA, Halfens RJG. Malnutrition in care home residents with dementia. J Nutr Health Aging 2014;18(6):595–600. https://doi.org/10.1007/s12603-014-0006-6
• Mole L, Kent B, Abbott R, Wood C, Hickson M. The nutritional care of people living with dementia at home: A scoping review. Health Soc Care Community 2018;26(4):e485–96. https://doi.org/10.1111/hsc.12540
• Buell JS, Dawson-Hughes B, Scott TM, Weiner DE, Dallal GE, Qui WQ, et al. 25-Hydroxyvitamin D, dementia, and cerebrovascular pathology in elders receiving home services. Neurology 2010;74(1):18–26. https://doi.org/10.1212/WNL.0b013e3181beecb7
• Berggren E, Strang P, Orrevall Y, Odlund Olin A, Tornkvist L. Symptom burden in patients with home care who are at risk for malnutrition: a cross-sectional study. J Palliat Care 2019: 35(2):103-9. https://doi.org/10.1177/0825859719887240
• Geurden B, Franck E, Hartmann M, Weyler J, Ysebaert D. Prevalence of “being at risk of malnutrition” and associated factors in adult patients receiving nursing care at home in Belgium. Int J Nurs Pract 2015;21(5):635–644. https://doi.org/10.1111/ijn.12341
• Lembeck MA, Thygesen LC, Sorensen BD, Rasmussen LL, Holm EA. Effect of single follow-up home visit on readmission in a group of frail elderly patients – a Danish randomized clinical trial. BMC Health Serv Res. 2019;19:751. https://doi.org/10.1186/s12913-019-4528-9
• Adiguzel E, Acar Tek N. Nutrition-related parameters predict the health-related quality of life in home care patients. Exp Gerontol 2019;120:15–20. https://doi.org/10.1016/j.exger.2019.02.018
• Emiroglu C, Gorpelioglu S, Aypak C. The relationship between nutritional status, anemia and other vitamin deficiencies in the elderly receiving home care. J Nutr Health Aging 2019;23(7):677–82. https://doi.org/10.1007/s12603-019-1215-9
• Gil-Montoya JA, Ponce G, Lara I, Barrios R, Llodra JC, Bravo M. Association of the oral health impact profile with malnutrition risk in Spanish elders. Arch Gerontol Geriatr 2013;57(3):398–402. https://doi.org/10.1016/j.archger.2013.05.002
• Sonmez M, Nazik F, Andi S. Home medical care waste collection by caregivers in Turkey. Med Sci Int Med J 2018;7(4):733–5. https://doi.org/10.5455/medscience.2018.07.8872
• Tsuji T, Yamamoto K, Yamasaki K, Hayashi F, Momoki C, Yasui Y, et al. Lower dietary variety is a relevant factor for malnutrition in older Japanese home-care recipients: a cross-sectional study. BMC Geriatr 2019;19:197. https://doi.org/10.1186/s12877-019-1206-z