Low Self-Perception of Malnutrition in Older Hospitalized Patients

Figures & data

Table 1 Characteristics of Study Population on Admission

	All (n=197)
Gender (number, %)
Females	121 (61)
Males	76 (39)
Age (y)	82.2 ± 6.8
BMI (kg/m^2)	25.3 ± 6.3
Geriatric assessments, Median (IQR)
MNA-SF	9 (7–11)
Barthel-Index on admission	55 (35–70)
Barthel-Index at discharge	75 (65–85)
MMSE	28 (25–29)
MoCA	21 (17–24)
Charlson Comorbidity Index	2 (1–4)
Reason for admission
Cardiovascular disease	39 (20)
Falls and fractures	72 (37)
Osteoarthritis	16 (8)
Neurodegenerative diseases	6 (3)
General diseases	64 (32)

Notes: For MMSE and MoCA, scores <26 considered as cognitively impaired. MMSE and MoCA were performed in 93 and 93 patients, respectively. Values are given as number (%), mean ± SD or median (IQR, interquartile range).

Abbreviations: MNA-SF, Mini Nutritional Assessment Short Form (normal nutritional status 12–14 points, at risk of malnutrition 8–11 points and malnourished 0–7 points); MMSE, Mini Mental Status Examination; MOCA, Montreal Cognitive Assessment.

Table 2 Patient Perception of Body Weight, Nutritional Status and Appetite (n=197)

	Number (%)
Body weight status
Underweight	49 (25)
Normal weight	104 (53)
Overweight	42 (22)
Nutritional status
Good	150 (77)
Undernourished	34 (17)
Overnourished	12 (6)
Satisfaction with nutritional status
Satisfied	143 (73)
Unsatisfied	51 (27)
Appetite according to SNAQ
Very poor	9 (5)
Poor	26 (13)
Average	76 (39)
Good	73 (38)
Very good	9 (5)
Body weight change in last 3 months
No	67 (35)
Decreased	101 (52)
Increased	14 (7)
Unknown	11 (6)
Willing to change body weight in the next 3 months
No	91 (46)
Willing to decrease	`48 (24)
Willing to increase	52 (27)
Unknown	5 (3)

Abbreviation: SNAQ, Simplified Nutritional Appetite Questionnaire.

Table 3 Results of Medical Assessment of Nutritional Status (n=197)

	Total Population
Current body weight (kg)	70.1 ± 18.8
Height (m)	1.66 ± 0.1
BMI (kg/m^2)	25.3 ± 6.4
Objective body weight status
Underweight (BMI <18.5 kg/m^2)	16 (9)
Normal weight (BMI 18.5–24.9 kg/m^2)	91 (47)
Overweight (BMI 25.0–29.9 kg/m^2)	45 (23)
Obesity (BMI ≥30.0 kg/m^2)	41 (21)
Weight loss in last 3 months
No (n, %)	83 (46)
Yes (n, %)	97 (54)
Nutritional status according to MNA-SF
Normal nutritional status (n, %)	31 (16)
At risk of malnutrition (n, %)	95 (49)
Malnourished (n, %)	69 (35)
SNAQ score, Median (IQR)	14 (11–15)
<14 (n, %)	86 (48)
≥14 (n, %)	92 (52)
Nutritional therapy of weight loss
No (n, %)	42 (40)
Yes (n, %)	62 (60)

Notes: Body weight was measured using a calibrated chair scale. Values are given as number (%), mean ± SD or median (IQR, interquartile range).

Abbreviations: MNA-SF, Mini Nutritional Assessment Short Form (normal nutritional status 12–14 points, at risk of malnutrition 8–11 points and malnourished 0–7 points); SNAQ score, Simplified Nutritional Appetite Questionnaire (maximum score 20, score <14 indicates risk of at least 5% weight loss within six months).

Table 4 Concordance Between Patient Perception and Medical Assessment of Nutritional Status

Self-Reported by Patients	MNA-SF Classification (n, %)				P value
	Malnourished (n=69, 35%)	At Risk (n=95, 49%)	Normal (n=31, 16%)	Total
Body weight status
Normal weight	31 (45)	54 (58)	19 (61)	104	P<0.001
Underweight	31 (45)	16 (16)	2 (6)	49
Overweight	7 (10)	25 (26)	10 (33)	42
Nutritional status
Good	44 (64)	82 (87)	24 (77)	150	P<0.001
Undernourished	23 (33)	8 (8)	3 (10)	34
Overnourished	2 (3)	5 (5)	4 (13)	11
Satisfaction with nutritional status
Satisfied	39 (58)	78 (82)	26 (87)	143	P=0.002
Unsatisfied	30 (42)	17 (18)	4 (13)	51

Abbreviation: MNA-SF, Mini Nutritional Assessment Short Form (normal nutritional status 12–14 points, at risk of malnutrition 8–11 points and malnourished 0–7 points).