An observational study of screening for malnutrition in elderly people living in sheltered accommodation


Dr Dylan Harris, Department of Adult Medicine, Nevill Hall Hospital, Abergavenny, NP7 7EG UK.
Tel.: 01872 732732
Fax: 01873 732518


Background  Elderly people are particularly at risk of malnutrition. There is no consensus regarding the optimal malnutrition screening test for elderly people and little is known about the prevalence of malnutrition in elderly people living in sheltered housing.

Method  An observational study comparing sensitivity, specificity and positive and negative predictive values of the following screening measures in elderly people living in sheltered accommodation: body mass index, mid-arm circumference, albumin, haemoglobin, lymphocyte count, cholesterol and the Malnutrition Universal Screening Tool (MUST) and Mini Nutritional Assessment (MNA). A dietitian assessment was used as the gold standard to establish whether there was a risk of malnutrition.

Results  Of 100 people recruited (31 male and 69 female with average age 79.3 years) ten were categorized at risk by the dietitian assessment. The MUST score was the most sensitive and specific screening measure (100% and 98% respectively) with a negative predictive value of 1. The sensitivity and specificity of the other measures were: MNA 80% and 90%, mid-arm circumference 70% and 99%, BMI 60% and 90%, albumin 30% and 77%, haemoglobin 50% and 61%, lymphocyte count 20% and 86%, low cholesterol 30% and 90%.

Conclusions  Ten per cent of elderly people in sheltered housing are at risk of malnutrition. The MUST screening tool is a sensitive and specific method of identifying those requiring further nutritional assessment.