The Prevalence of Undiagnosed Protein‐Calorie Undernutrition in a Population of Hospitalized Elderly Patients

TLDR

The study aimed to assess how often elderly hospitalized patients with objective signs of malnutrition were diagnosed and recorded by physicians. A cross‑sectional study of 121 non‑critically ill patients aged 70+ in an Oslo hospital compared medical record entries with anthropometric measurements taken on admission, with serum albumin measured in 66 patients. Among 66 patients, only 24 were identified as malnourished on admission, five received nutritional support, and none were diagnosed at discharge, indicating widespread underdiagnosis and undertreatment of malnutrition with potentially harmful health consequences.

Abstract

Objective : To determine the extent to which patients with objective signs of malnutrition had been diagnosed as such by physicians and the diagnosis documented in the medical record. Design : Cross‐sectional. Subjects : All non‐critically ill patients ( n = 121) aged 70 years or older admitted to an Oslo hospital during a 3‐week period. Methods : Compared problem list and other elements of the medical record with observations of height, weight, triceps skinfold, midarm circumference, and arm‐muscle circumference made on first weekday in hospital. Serum albumin available on 66 subjects. Main Results : Nine patients had weight/height ratios below 60% of normal, 16 patients between 60% and 75%, and 41 patients between 74% and 90% of normal. Of these 66 patients, only 24 were recognized as malnourished on admission, only five received nutritional support, and none was diagnosed as having malnutrition at the time of discharge. Conclusions : Malnutrition is underdiagnosed and under‐treated. The consequences of this are likely to be deleterious to health.