Nutritional screening of patients at a memory clinic - association between patients' and their relatives' self-reports

• Published in: Journal of clinical nursing 2016-03, Vol.25 (5-6), p.760-768
• Main Authors: Lyngroth, Anne Liv, Hernes, Susanne Miriam Sørensen, Madsen, Bengt-Ove, Söderhamn, Ulrika, Grov, Ellen Karine
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Alzheimer's disease; Ambulatory Care Facilities; Body Mass Index; Cognitive ability; cognitive impairment; Cross-Sectional Studies; Dementia; Dementia - complications; Dementia - nursing; Family; Female; Health Services for the Aged; Humans; Male; malnutrition; Malnutrition - complications; Malnutrition - diagnosis; Malnutrition - nursing; Memory; Middle Aged; Norway; Nursing; Nutrition; Nutritional Form For the Elderly; nutritional screening; Nutritional Status; older persons; proxy-rating; Self Report
• ISSN: 0962-1067; 1365-2702
• DOI: 10.1111/jocn.13093

Aims and objectives To compare individual reports by patients and relatives (proxy) of the Nutritional Form For the Elderly and relate the Nutritional Form For the Elderly scores to Mini Mental Status Examination scores, weight loss, Body Mass Index, five‐point Clock Drawing Test and background variables. Background Undernutrition or risk of undernutrition is a significant problem among people with dementia. A poor nutritional state increases the risk of infections, delayed convalescence after acute illness and reduced quality of life. Design A cross‐sectional study. Method Application of the Nutritional Form For the Elderly in addition to clinical nutrition parameters and cognitive tests in a memory clinic among 213 persons referred for assessment due to possible cognitive impairment or dementia. Results Patients’ and proxy Nutritional Form For the Elderly scores yielded comparative results. Nutritional Form For the Elderly scores ≥6 (medium to high risk of undernutrition) were found in 32% of the patients vs. 43% of proxy. Mean Mini Mental Status Examination score was 23·2 (SD 4·5) and 50% failed the Clock Drawing Test. Involuntary weight loss was reported by 42% of the patients, and in 26% of the patients, Body Mass Index values were below 22 kg/m2, indicating undernutrition. By regression analysis, Clock Drawing Test (p = 0·019) and Mini Mental Status Examination (p = 0·04) might predict the risk of reduced nutritional status. Conclusion The study demonstrates that a significant proportion of patients at our memory clinic were at nutritional risk. Corresponding results exist between patients’ and proxy Nutritional Form For the Elderly scores; however, the patients assessed themselves more well‐nourished as compared to proxy assessment. The discrepancies seem to increase with more severe cognitive impairment. Females and single‐dwelling individuals were at higher risk of undernutrition compared to males and cohabitants. Relevance to clinical practice Self‐reporting and proxy‐rating seem both applicable for nutritional screening among moderate cognitive impaired. Cognitive decline seems to affect the accuracy when patients rate themselves. A reduced Mini Mental Status Examination and/or failed Clock Drawing Test might predict the risk of undernutrition.