For the first time, the nation's top perts in nutrition and medicine reached a consensus about signs for detecting malnutrition in elderly, and they are urging physicians, social workers, and others who treat elderly to become more aware of patients' eating habits.
The checklist of early warning signs malnutrition is based on a report, "Screening Older Americans' tional Health/' written by Johanna Dwyer, a nutritionist at Tufts schools of Medicine and Dental cine, Boston. Some things that may nal malnutrition include tooth loss mouth pain, an annual income of than $6,000, spending less than $35 a week on food, and being more than lbs overweight or 20 lbs underweight.
Elderly people who see family friends less than once a week are also risk because people who live alone out much social contact may not be tivated to prepare or eat nutritious meals.
"With respect to nutrition-related medical expenditures in older cans, like much of medical care, the system is end-loaded, with the most time and expense being spent at the very end of life," said Dwyer, also Director of the Frances Stern Nutrition Center at the New England Medical Center, Boston. In her study, Dwyer wrote that the American medical community spends far more time and money trying to "control the adverse health consequences of poor nutrition" than it does trying to find ways to promote healthy eating habits that would serve as a source of pleasure among the elderly.
Although people over age 65 represent ? 1% of America's population, they also account for 30% of all medications used in this country. Four fifths of all Americans over age 65 have one or more chronic diseases caused by poor diet.
With these statistics in mind, Dwyer and her colleagues, under the auspices of the American Academy of Physicians, the American Dietetic Association, and the National Council on Aging, set out to define the risk factors of poor nutritional status in older Americans, ways for physicians and nurse practitioners to recognize poor nutritional status in the elderly, and a set of basic nutrition screening tools, such as the prevention checklist, for use by anyone who takes care of the elderly.
The group concluded that health-care professionals should be aware of the following risk factors of poor nutritional status for people over age 50: disabling conditions and immobility, acute and chronic diseases, chronic medication use, and poverty.
Reaching a consensus means physicians and health-care providers nationally will have a common ground to work from by knowing what to look for in detecting and preventing malnutrition, Dwyer said. Previously, health-care professionals have been undecided about what should be looked for in a nutritional screening.
"Limited understanding of the importance of screening, skepticism about its effectiveness, and lack of reimbursement for screening and preventive services have been barriers to implementation," Dwyer said. "This is a beginning. Each segment of the health-care community will work within its own constraints to make these screenings happen. The important part is that the standards are agreed upon," she said.
For more information, contact Mary Ross, Tufts University Office of Communications, 203 Harrison Avenue, Boston, MA 021 11; 61 7-956-5705.