Page 126 - Petelin, Ana, and Šarabon, Nejc. 2018. Eds. Zdravje starostnikov / Health of the Elderly. Znanstvena monografija / Proceedings. Koper: University of Primorska Press
P. 126
avje starostnikov | health of the elderly 126 reduced body mass, change in body composition and sarcopenia (Cruz-Jentoft
et al., 2010; Cereda et al., 2017). Despite the fact that the health profession and
science are constantly developing, nutrition and nutritional status in older
adults often still remain disregarded.
Malnutrition is often found associated with an increase in severity and
number of complications, longer recovery time, prolonged hospitalization and
cost of treatment. A substantial number of older adults are in poor nutrition-
al status or malnourished at the time of hospital admission (Kjerstin et al.,
2015; Gärtner et al., 2017). With nutritional assessment which consist of nu-
tritional screening and assessment of nutritional status it is possible to recog-
nize patients with nutritional risk (Kondrup et al., 2003; Van Bokhorst-de van
Schueren et al., 2014). Anthropometric measures, hand grip dynamometer and
bioelectrical impedance analysis (BIA) enable the determination of body com-
position and reliable nutritional status (Scalfi and Troiano, 2013).
The purpose of the study was to investigate the nutritional status of older
adults at the admission to the surgical ward as well as to determine the associ-
ation between age, body mass index (BMI), fat free mass index (FFMI), phase
angle (PA) and hand grip strength (HGS).
Methods
Data collection
The study was conducted at the Surgical Ward of the Izola General Hospital
between January and May 2016. All patients aged 65 years or older were invit-
ed to the study within 48 hours after being admitted to the ward (abdominal,
urological and vascular surgery) in the preoperative period. Data on demo-
graphic characteristics, clinical history, medical diagnoses and associated dis-
eases were obtained from patients’ medical records. Body weight and standing
height were measured with calibrated portable scale and stadiometer (KERN
MPS 220K100PM). BMI was calculated as [(kg)/ height2 (m)]. The patients’ nu-
tritional status was determined based on BMI cut-off points for malnutrition
(< 20 kg/m2 (65 y ≤ and < 70 y) or < 22 kg/m2 (≥ 70 y) (Cederholm et al., 2015).
Information about the participants’ nutrition risk was collected using the
NRS-2002 in accordance with the recommendations Kondrup et al. (2013). Pa-
tients who had a total final score ≥ 3 were classified nutritionally-at-risk. With
multi-frequency BIA (Bodystat 6000, Bodystat) FFM and PA were measured.
FFMI was calculated as [FFM (kg)/ height2 (m)]. For the interpretation of the
FFMI and PA the cut-off points were used. Patients were grouped as malnour-
ished if FFMI < 15 and 17 kg/m2 for women and men, respectively (Cederholm
et al., 2015) and if PA < 4,6° and < 5° for women and men, respectively (Guer-
ra et al., 2015). HGS measurement was carried out by hand held dynamome-
ter (Jamar Hydraulic hand dynamometer). For the interpretation of HGS cut-
off points for sarcopenia were used. Patients were grouped as malnourished
if HGS < 20 and < 30 kg for women and men, respectively (Cruz-Jentoft et
et al., 2010; Cereda et al., 2017). Despite the fact that the health profession and
science are constantly developing, nutrition and nutritional status in older
adults often still remain disregarded.
Malnutrition is often found associated with an increase in severity and
number of complications, longer recovery time, prolonged hospitalization and
cost of treatment. A substantial number of older adults are in poor nutrition-
al status or malnourished at the time of hospital admission (Kjerstin et al.,
2015; Gärtner et al., 2017). With nutritional assessment which consist of nu-
tritional screening and assessment of nutritional status it is possible to recog-
nize patients with nutritional risk (Kondrup et al., 2003; Van Bokhorst-de van
Schueren et al., 2014). Anthropometric measures, hand grip dynamometer and
bioelectrical impedance analysis (BIA) enable the determination of body com-
position and reliable nutritional status (Scalfi and Troiano, 2013).
The purpose of the study was to investigate the nutritional status of older
adults at the admission to the surgical ward as well as to determine the associ-
ation between age, body mass index (BMI), fat free mass index (FFMI), phase
angle (PA) and hand grip strength (HGS).
Methods
Data collection
The study was conducted at the Surgical Ward of the Izola General Hospital
between January and May 2016. All patients aged 65 years or older were invit-
ed to the study within 48 hours after being admitted to the ward (abdominal,
urological and vascular surgery) in the preoperative period. Data on demo-
graphic characteristics, clinical history, medical diagnoses and associated dis-
eases were obtained from patients’ medical records. Body weight and standing
height were measured with calibrated portable scale and stadiometer (KERN
MPS 220K100PM). BMI was calculated as [(kg)/ height2 (m)]. The patients’ nu-
tritional status was determined based on BMI cut-off points for malnutrition
(< 20 kg/m2 (65 y ≤ and < 70 y) or < 22 kg/m2 (≥ 70 y) (Cederholm et al., 2015).
Information about the participants’ nutrition risk was collected using the
NRS-2002 in accordance with the recommendations Kondrup et al. (2013). Pa-
tients who had a total final score ≥ 3 were classified nutritionally-at-risk. With
multi-frequency BIA (Bodystat 6000, Bodystat) FFM and PA were measured.
FFMI was calculated as [FFM (kg)/ height2 (m)]. For the interpretation of the
FFMI and PA the cut-off points were used. Patients were grouped as malnour-
ished if FFMI < 15 and 17 kg/m2 for women and men, respectively (Cederholm
et al., 2015) and if PA < 4,6° and < 5° for women and men, respectively (Guer-
ra et al., 2015). HGS measurement was carried out by hand held dynamome-
ter (Jamar Hydraulic hand dynamometer). For the interpretation of HGS cut-
off points for sarcopenia were used. Patients were grouped as malnourished
if HGS < 20 and < 30 kg for women and men, respectively (Cruz-Jentoft et
