Displaying publications 1 - 20 of 23 in total

  1. Abd Aziz NAS, Teng NIMF, Abdul Hamid MR, Ismail NH
    Clin Interv Aging, 2017;12:1615-1625.
    PMID: 29042762 DOI: 10.2147/CIA.S140859
    PURPOSE: The increasing number of elderly people worldwide throughout the years is concerning due to the health problems often faced by this population. This review aims to summarize the nutritional status among hospitalized elderly and the role of the nutritional assessment tools in this issue.

    METHODS: A literature search was performed on six databases using the terms "malnutrition", "hospitalised elderly", "nutritional assessment", "Mini Nutritional Assessment (MNA)", "Geriatric Nutrition Risk Index (GNRI)", and "Subjective Global Assessment (SGA)".

    RESULTS: According to the previous studies, the prevalence of malnutrition among hospitalized elderly shows an increasing trend not only locally but also across the world. Under-recognition of malnutrition causes the number of malnourished hospitalized elderly to remain high throughout the years. Thus, the development of nutritional screening and assessment tools has been widely studied, and these tools are readily available nowadays. SGA, MNA, and GNRI are the nutritional assessment tools developed specifically for the elderly and are well validated in most countries. However, to date, there is no single tool that can be considered as the universal gold standard for the diagnosis of nutritional status in hospitalized patients.

    CONCLUSION: It is important to identify which nutritional assessment tool is suitable to be used in this group to ensure that a structured assessment and documentation of nutritional status can be established. An early and accurate identification of the appropriate treatment of malnutrition can be done as soon as possible, and thus, the malnutrition rate among this group can be minimized in the future.

    Matched MeSH terms: Geriatric Assessment/methods*
  2. Minhat HS, Mat Din H, Hamid TA, Hassan Nudin SS
    Geriatr Gerontol Int, 2019 Jun;19(6):492-496.
    PMID: 30920129 DOI: 10.1111/ggi.13648
    AIM: To identify the determinants of sexual intimacy among married older people in Malaysia.

    METHODS: A cross-sectional study was carried out among 1294 married Malaysian older couples who were randomly selected from all 14 states in Malaysia. The data were collected by trained enumerators using a set of validated questionnaires consisting of eight sections, namely sociodemographic characteristics, chronic diseases, perceived health status, life satisfaction, body mass index, disability status (World Health Organization Disability Assessment Schedule), social support (Lubben Social Network Scale) and sexual intimacy.

    RESULTS: Having good social support (AOR 0.57, 95% CI 0.45-0.74) from family and friends were protective determinants against poor sexual intimacy in later life. Meanwhile, those who were aged 70-79 years (AOR 1.81, 95% CI 1.35-2.42), aged >80 years (AOR 35.49, 95% CI 4.80-262.18), women (AOR 1.47, 95% CI 1.13-1.90), non-Malay (AOR 1.93, 95% CI 1.50-2.48), received only informal education (AOR 1.81, 95% CI 1.35-2.42), had gastritis (AOR 2.62, 95% CI 1.58-4.34), had a stroke (AOR 3.83, 95% CI 1.04-14.12), perceived their current health status was satisfactory (AOR 1.52, 95% CI 1.15-2.00) and disabled based on the World Health Organization Disability Assessment Schedule (AOR 3.14, 95% CI 1.34-7.36) were at risk of poor sexual intimacy.

    CONCLUSIONS: The majority of older Malaysian couples were having poor sexual intimacy despite being still married and sleeping with their partners, reflecting the presence of underlying barriers towards sexual intimacy in later life among older Malaysians. Geriatr Gerontol Int 2019; 19: 492-496.

    Matched MeSH terms: Geriatric Assessment/methods*
  3. Abolfathi Momtaz Y, Ibrahim R, Hamid TA
    Psychogeriatrics, 2014 Mar;14(1):31-7.
    PMID: 24299124 DOI: 10.1111/psyg.12036
    Social support that may contribute to the physical and mental health of older adults is widely studied. However, much of the existing research has focused on the impact of receiving support; the effects of giving support have largely been neglected. Using the biopsychosocial perspective, this study aimed to examine the independent impact of giving support to others on older adults' perceived health status.
    Matched MeSH terms: Geriatric Assessment/methods*
  4. Othman WN, Muttalib KA, Bakri R, Doss JG, Jaafar N, Salleh NC, et al.
    J Public Health Dent, 2006;66(3):199-204.
    PMID: 16913247
    To translate and validate the Geriatric Oral Health Assessment Index (GOHAI into the Malay language for use in Malaysia.
    Matched MeSH terms: Geriatric Assessment/methods*
  5. Singh DK, Pillai SG, Tan ST, Tai CC, Shahar S
    Clin Interv Aging, 2015;10:1319-26.
    PMID: 26316727 DOI: 10.2147/CIA.S79398
    Physical performance and balance declines with aging and may lead to increased risk of falls. Physical performance tests may be useful for initial fall-risk screening test among community-dwelling older adults. Physiological profile assessment (PPA), a composite falls risk assessment tool is reported to have 75% accuracy to screen for physiological falls risk. PPA correlates with Timed Up and Go (TUG) test. However, the association between many other commonly used physical performance tests and PPA is not known. The aim of the present study was to examine the association between physiological falls risk measured using PPA and a battery of physical performance tests.
    Matched MeSH terms: Geriatric Assessment/methods*
  6. Vanoh D, Shahar S, Din NC, Omar A, Vyrn CA, Razali R, et al.
    Aging Clin Exp Res, 2017 Apr;29(2):173-182.
    PMID: 26980453 DOI: 10.1007/s40520-016-0553-2
    BACKGROUND: Concepts of successful aging (SA), usual aging (UA), and mild cognitive impairment (MCI) have been developed to identify older adults at high risk of Alzheimer's diseases (AD), however, the predictors have rarely been investigated in a single study. Thus, this study aims to explore the risk factors of MCI as compared to UA and SA among older adults, in a large community based cohort study in Malaysia.
    METHOD: 1993 subjects from four states in Malaysia were recruited. A comprehensive interview-based questionnaire was administered to determine socio-demographic information, followed by assessments to evaluate cognitive function, functional status, dietary intake, lifestyle and psychosocial status. Risk factors of cognitive impairment were assessed using the ordinal logistic regression (OLR).
    RESULT: The prevalence of SA, UA and MCI in this study was 11, 73 and 16 % respectively. OLR indicated that higher fasting blood sugar, hyperlipidemia, disability, lower education level, not regularly involved in technical based activities, limited use of modern technologies, lower intake of fruits and fresh fruit juices and not practicing calorie restriction were among the risk factors of poor cognitive performance in this study.
    CONCLUSION: This study will be a stepping stone for future researchers to develop intervention strategies to prevent cognitive decline.
    Matched MeSH terms: Geriatric Assessment/methods
  7. Romli MH, Mackenzie L, Lovarini M, Tan MP, Clemson L
    J Eval Clin Pract, 2017 Jun;23(3):662-669.
    PMID: 28105771 DOI: 10.1111/jep.12697
    RATIONALE, AIMS AND OBJECTIVES: Falls can be a devastating issue for older people living in the community, including those living in Malaysia. Health professionals and community members have a responsibility to ensure that older people have a safe home environment to reduce the risk of falls. Using a standardised screening tool is beneficial to intervene early with this group. The Home Falls and Accidents Screening Tool (HOME FAST) should be considered for this purpose; however, its use in Malaysia has not been studied. Therefore, the aim of this study was to evaluate the interrater and test-retest reliability of the HOME FAST with multiple professionals in the Malaysian context.

    METHODS: A cross-sectional design was used to evaluate interrater reliability where the HOME FAST was used simultaneously in the homes of older people by 2 raters and a prospective design was used to evaluate test-retest reliability with a separate group of older people at different times in their homes. Both studies took place in an urban area of Kuala Lumpur.

    RESULTS: Professionals from 9 professional backgrounds participated as raters in this study, and a group of 51 community older people were recruited for the interrater reliability study and another group of 30 for the test-retest reliability study. The overall agreement was moderate for interrater reliability and good for test-retest reliability. The HOME FAST was consistently rated by different professionals, and no bias was found among the multiple raters.

    CONCLUSION: The HOME FAST can be used with confidence by a variety of professionals across different settings. The HOME FAST can become a universal tool to screen for home hazards related to falls.

    Matched MeSH terms: Geriatric Assessment/methods*
  8. Yunus RM, Hairi NN, Choo WY, Tan MP, Hairi F, Sooryanarayana R, et al.
    J Am Geriatr Soc, 2018 07;66(6):1165-1171.
    PMID: 29601084 DOI: 10.1111/jgs.15370
    OBJECTIVES: To examine the cross-sectional and longitudinal relationships between elder abuse and neglect (EAN) and chronic pain in rural older Malaysians.

    DESIGN: Two-year prospective cohort study.

    SETTING: Kuala Pilah, a district in Negeri Sembilan approximately 100 km from the capital city, Kuala Lumpur.

    PARTICIPANTS: Community-dwelling older adults aged 60 and older. Using a multistage cluster sampling strategy, 1,927 respondents were recruited and assessed at baseline, of whom 1,189 were re-assessed 2 years later.

    MEASURES: EAN was determined using the modified Conflict Tactic Scale, and chronic pain was assessed through self-report using validated questions.

    RESULTS: The prevalence of chronic pain was 20.4%. Cross-sectional results revealed 8 variables significantly associated with chronic pain-age, education, income, comorbidities, self-rated health, depression, gait speed, and EAN. Abused elderly adults were 1.52 times as likely to have chronic pain (odds ratio=1.52, 95% confidence interval (CI)=1.03-2.27), although longitudinal analyses showed no relationship between EAN and risk of chronic pain (risk ratio=1.14, 95% CI=0.81-1.60). This lack of causal link was consistent when comparing analysis with complete cases with that of imputed data.

    CONCLUSION: Our findings indicate no temporal relationship between EAN and chronic pain but indicated cross-sectional associations between the two. This might indicate that, although EAN does not lead to chronic pain, individuals with greater physical limitations are more vulnerable to abuse. Our study also shows the importance of cohort design in determining causal relationships between EAN and potentially linked health outcomes.

    Matched MeSH terms: Geriatric Assessment/methods
  9. Thiruchelvam K, Wong PS, Kairuz T, Babar ZU, Hasan SS
    J Am Med Dir Assoc, 2018 08;19(8):717-718.
    PMID: 29680204 DOI: 10.1016/j.jamda.2018.03.007
    Matched MeSH terms: Geriatric Assessment/methods
  10. Kadar M, Ibrahim S, Razaob NA, Chai SC, Harun D
    Aust Occup Ther J, 2018 02;65(1):63-68.
    PMID: 29315609 DOI: 10.1111/1440-1630.12441
    BACKGROUND/AIM: The Lawton Instrumental Activities of Daily Living Scale is a tool often used to assess independence among elderly at home. Its suitability to be used with the elderly population in Malaysia has not been validated. This current study aimed to assess the validity and reliability of the Lawton Instrumental Activities of Daily Living Scale - Malay Version to Malay speaking elderly in Malaysia.

    METHODS: This study was divided into three phases: (1) translation and linguistic validity involving both forward and backward translations; (2) establishment of face validity and content validity; and (3) establishment of reliability involving inter-rater, test-retest and internal consistency analyses. Data used for these analyses were obtained by interviewing 65 elderly respondents.

    RESULTS: Percentages of Content Validity Index for 4 criteria were from 88.89 to 100.0. The Cronbach α coefficient for internal consistency was 0.838. Intra-class Correlation Coefficient of inter-rater reliability and test-retest reliability was 0.957 and 0.950 respectively.

    CONCLUSIONS: The result shows that the Lawton Instrumental Activities of Daily Living Scale - Malay Version has excellent reliability and validity for use with the Malay speaking elderly people in Malaysia. This scale could be used by professionals to assess functional ability of elderly who live independently in community.

    Matched MeSH terms: Geriatric Assessment/methods*
  11. Ong S, Woo J, Parikh P, Chan R, Sun J, Mun CY, et al.
    Asia Pac J Clin Nutr, 2019;28(2):204-213.
    PMID: 31192548 DOI: 10.6133/apjcn.201906_28(2).0001
    The number of older persons in Asia is expected to triple by 2050. Ageing is associated with non-communicable chronic diseases, malnutrition, and geriatric syndromes, which influences the burden on the cost related to healthcare, health outcomes, and the quality of life. Experts in the field of older adult nutrition from Asia, Australia, and Europe were invited to participate in a two-day workshop to review the available data, current policies and programs for the ageing population in different countries of Asia to identify the gaps in knowledge and to develop recommendations for action. In Asia, most of the data pertaining to health status, nutritional status, and nutrient intake of the older persons were mainly obtained by conducting studies in nursing homes or hospitals and small cohort studies. There were limited country-specific data on this population. Moreover, the available data pertaining to different countries were difficult to compare due to differences in the reporting format and reference values used. Although nutrition initiatives and policies were realized and public education was conducted to support the older persons, most of these efforts targeted the general population rather than the older persons population segment. In healthcare management, a higher amount of education is required pertaining to the knowledge of nutritional requirements and appropriate feeding of the older persons to reduce underfeeding and its consequences. The expert group recommended the use of a systematic approach for reviewing data pertaining to different countries, initiatives, and programs to further evaluate the available data to underpin future research.
    Matched MeSH terms: Geriatric Assessment/methods*
  12. Razali R, Jean-Li L, Jaffar A, Ahmad M, Shah SA, Ibrahim N, et al.
    Compr Psychiatry, 2014 Jan;55 Suppl 1:S70-5.
    PMID: 24314103 DOI: 10.1016/j.comppsych.2013.04.010
    Mild Cognitive Impairment (MCI) is a known precursor to Alzheimer disease, yet there is a lack of validated screening instruments for its detection among the Malaysian elderly.
    Matched MeSH terms: Geriatric Assessment/methods
  13. Ng ST, Hamid TA
    Australas J Ageing, 2013 Dec;32(4):217-21.
    PMID: 24373040 DOI: 10.1111/j.1741-6612.2012.00619.x
    AIM: To examine the effects of work participation, intergenerational transfers and savings on the life satisfaction of older community-dwelling Malaysians.
    METHOD: Data from the 1999 Survey on Perceptions of Needs and Problems of the Elderly on people aged 60 and over were used. The life satisfaction score was constructed from 10 questions adopted from the Life Satisfaction Inventory-A by Neugarten, Havighurst and Tobin. Multiple regression analysis was used to estimate the expected level of life satisfaction.
    RESULTS: Controlling for other variables in the model, respondents who provided assistance to and received assistance from children with savings had significantly higher life satisfaction than their counterparts, while work participation did not have any significant effect on life satisfaction.
    CONCLUSION: Intergenerational transfers and savings are important predictors of life satisfaction. The interdependence between generations should remain and savings habits need to be cultivated to ensure a higher life satisfaction in old age.
    KEYWORDS: intergenerational transfers; life satisfaction; older people; savings; work participation
    Matched MeSH terms: Geriatric Assessment/methods*
  14. Shahar S, Ibrahim Z, Fatah AR, Rahman SA, Yusoff NA, Arshad F, et al.
    Asia Pac J Clin Nutr, 2007;16(2):346-53.
    PMID: 17468093
    A multidimensional assessment of nutritional and health status comprised of subjective global assessment (SGA), anthropometry function, biochemistry, dietary intake, social and health aspects was carried out on 820 older people (52.8% men and 47.2% women) from four rural areas of Peninsular Malaysia. A proportion of the subjects had been classified as either overweight (25.7%) or chronic energy deficient (20.3%). Although 49% of subjects had normal body weight, 68.4% have been classified as having mild to moderate malnutrition according to the SGA. Only 1.1% and 2.3% had low serum albumin and ferritin, respectively. Almost 80% of subjects, especially men, were at high risk of cardiovascular diseases on the basis of the assessment of total cholesterol and LDL-cholesterol. The majority of the subjects (87.2%) were fully independent in performing daily tasks, with men having a significantly higher score compared to women (p<0.001). However, men were less likely to be able to perform a flexibility test (50.7%) than were women (27.0%) (p<0.05). The mean energy intake for men (1412 +/- 461 kcal/d) and women (1201 +/- 392 kcal/d) were below the Recommended Nutrient Intake (RNI) for Malaysia, although this is a difficult assertion to make in an age-group which generally experiences declining energy expenditure. Moreover, 52.5% of men and 47.5% of women might have underreported their food intake. Dietary micronutrients most likely to be deficient were thiamin, riboflavin and calcium. It is concluded that a substantial proportion of rural elderly Malays had problems related to both undernutrition and overnutrition. An appropriate nutrition intervention program is needed to improve the nutritional status of rural elderly Malays.
    Matched MeSH terms: Geriatric Assessment/methods*
  15. Rosli R, Tan MP, Gray WK, Subramanian P, Chin AV
    Int Psychogeriatr, 2016 Feb;28(2):189-210.
    PMID: 26450414 DOI: 10.1017/S1041610215001635
    The prevalence of dementia is increasing in Asia than in any other continent. However, the applicability of the existing cognitive assessment tools is limited by differences in educational and cultural factors in this setting. We conducted a systematic review of published studies on cognitive assessments tools in Asia. We aimed to rationalize the results of available studies which evaluated the validity of cognitive tools for the detection of cognitive impairment and to identify the issues surrounding the available cognitive impairment screening tools in Asia.
    Matched MeSH terms: Geriatric Assessment/methods*
  16. Johari N, Manaf ZA, Ibrahim N, Shahar S, Mustafa N
    Clin Interv Aging, 2016;11:1455-1461.
    PMID: 27799751
    PURPOSE: Diabetes mellitus is prevalent among older adults, and affects their quality of life. Furthermore, the number is growing as the elderly population increases. Thus, this study aims to explore the predictors of quality of life among hospitalized geriatric patients with diabetes mellitus upon discharge in Malaysia.

    METHODS: A total of 110 hospitalized geriatric patients aged 60 years and older were selected using convenience sampling method in a cross-sectional study. Sociodemographic data and medical history were obtained from the medical records. Questionnaires were used during the in-person semistructured interviews, which were conducted in the wards. Linear regression analyses were used to determine the predictors of each domain of quality of life.

    RESULTS: Multiple regression analysis showed that activities of daily living, depression, and appetite were the determinants of physical health domain of quality of life (R(2)=0.633, F(3, 67)=38.462; P<0.001), whereas depression and instrumental activities of daily living contributed to 55.8% of the variability in psychological domain (R(2)=0.558, F(2, 68)=42.953; P<0.001). Social support and cognitive status were the determinants of social relationship (R(2)=0.539, F(2, 68)=39.763; P<0.001) and also for the environmental domain of the quality of life (R(2)=0.496, F(2, 68)=33.403; P<0.001).

    CONCLUSION: The findings indicated different predictors for each domain in the quality of life among hospitalized geriatric patients with diabetes mellitus. Nutritional, functional, and psychological aspects should be incorporated into rehabilitation support programs prior to discharge in order to improve patients' quality of life.

    Matched MeSH terms: Geriatric Assessment/methods
  17. Damayanthi HDWT, Moy FM, Abdullah KL, Dharmaratne SD
    Asian Nurs Res (Korean Soc Nurs Sci), 2018 Sep;12(3):231-236.
    PMID: 30193884 DOI: 10.1016/j.anr.2018.08.008
    PURPOSE: Low muscle strength is central to geriatric physical disabilities and mortality. The purpose of the present study was to examine handgrip strength (HGS) and its associated factors among community-dwelling older people in Sri Lanka.

    METHODS: A cross-sectional study was conducted in the Kandy district using multistage sampling. A total of 999 older people were recruited, with a female preponderance. Data were collected using interviewer-administered questionnaires on demographic characteristics, depression, and physical activity. Anthropometric measurements including weight, height, mid-upper arm circumference, calf circumference, and HGS were recorded. Complex sample general linear model was used to examine the association between HGS and its associated factors.

    RESULTS: The mean highest HGS of the study group was 12.56 kg (95% confidence interval: 11.94-13.19). Male older people had a higher HGS (17.02, 95% confidence interval: 15.55-18.49 kg) than females (10.59, 95% confidence interval: 10.12-11.06 kg). For both men and women, older age was associated with lower HGS, while mid-upper arm circumference was associated with better HGS. Diabetes mellitus, vegetarian diet, and alcohol consumption were associated with HGS for women only.

    CONCLUSION: Men had a higher HGS compared with women. Age, mid-upper arm circumference, diabetes mellitus, vegetarian diet, and alcohol consumption were factors associated with HGS among community-dwelling older people in Kandy district, Sri Lanka. HGS can be used as a feasible strategy to improve health status of older people by community health nurses.

    Matched MeSH terms: Geriatric Assessment/methods
  18. Petrovic M, Tangiisuran B, Rajkumar C, van der Cammen T, Onder G
    Drugs Aging, 2017 02;34(2):135-142.
    PMID: 28000156 DOI: 10.1007/s40266-016-0428-4
    BACKGROUND: Adverse drug reactions (ADRs) in older people are often preventable, indicating that screening and prevention programs aimed at reducing their rate are needed in this population.

    OBJECTIVE: The aim of this study was to externally validate the GerontoNet ADR risk score and to assess its validity in specific subpopulations of older inpatients.

    METHODS: Data from the prospective CRIteria to assess appropriate Medication use among Elderly complex patients (CRIME) cohort were used. Dose-dependent and predictable ADRs were classified as type A, probable or definite ADRs were defined according to the Naranjo algorithm, and diagnostic accuracy was tested using receiver operating characteristic (ROC) analyses. Sensitivity and specificity were calculated for a cut-off point of 4.

    RESULTS: The mean age of the 1075 patients was 81.4 years (standard deviation 7.4) and the median number of drugs was 10 (range 7-13). At least one ADR was observed in 70 patients (6.5%); ADRs were classified as type A in 50 patients (4.7%) and defined as probable or definite in 41 patients (3.8%). Fair diagnostic accuracy to predict both type A and probable or definite ADRs was found in subpopulations aged <70 or ≥80 years with heart failure, diabetes, or a previous ADR. Good accuracy to predict type A ADRs was found in patients with a low body mass index (BMI; >18.5 kg/m2) and a Mini-Mental State Examination (MMSE) score of >24/30 points, as well as in patients with osteoarthritis. The cut-off point of 4 points yielded very good sensitivity but poor specificity results in these subpopulations.

    CONCLUSION: This study suggests that the GerontoNet ADR risk score might represent a pragmatic approach to identifying specific subpopulations of older inpatients at increased risk of an ADR with a fair to good diagnostic accuracy.

    Matched MeSH terms: Geriatric Assessment/methods*
  19. Abd Aziz NAS, Mohd Fahmi Teng NI, Kamarul Zaman M
    Clin Nutr ESPEN, 2019 02;29:77-85.
    PMID: 30661705 DOI: 10.1016/j.clnesp.2018.12.002
    BACKGROUND & AIMS: Malnutrition is common among hospitalized elderly patients, and the prevalence is increasing not only in Malaysia but also in the rest of the world. The Geriatric Nutrition Risk Index (GNRI) and the Mini Nutritional Assessment (MNA) were developed to identify malnourished individuals among this group. The MNA was validated as a nutritional assessment tool for the elderly. The GNRI is simpler and more efficient than the MNA, but studies on the use of the GNRI and its validity among the Malaysian population are absent. This study aimed to determine the prevalence of malnourished hospitalized elderly patients and assess the criterion validity of the GNRI and MNA among the geriatric Malaysian population against the reference standard for malnutrition, the Subjective Global Assessment (SGA), and determine whether the optimal cutoff value of the GNRI is suitable for the Malaysian population and determine the optimal tool for use in this population.

    METHODS: A cross-sectional study was conducted among 134 geriatric patients with a mean age of 68.9 ± 8.4 who stayed at acute care wards in Hospital Tuanku Ampuan Rahimah, Klang from July 2017 to August 2017. The SGA, MNA, and GNRI were administered through face-to-face interviews with all the participants who gave their consent. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the GNRI and MNA were analyzed against the SGA. Receiver-operating characteristic (ROC) curve analysis was used to obtain the area under the curve (AUC) and suitable optimal cutoff values for both the GNRI and MNA.

    RESULTS: According to the SGA, MNA, and GNRI, 26.9%, 42.5%, and 44.0% of the participants were malnourished, respectively. The sensitivity, specificity, PPV, and NPV for the GNRI were 0.622, 0.977, 0.982, and 0.558, respectively, while those for the MNA were 0.611, 0.909, 0.932, and 0.533, respectively. The AUC of the GNRI was comparable to that of the MNA (0.831 and 0.898, respectively). Moreover, the optimal malnutrition cutoff value for the GNRI was 94.95.

    CONCLUSIONS: The prevalence of malnutrition remains high among hospitalized elderly patients. Validity of the GNRI is comparable to that of the MNA, and use of the GNRI to assess the nutritional status of this group is proposed with the new suggested cutoff value (GNRI ≤ 94.95), as it is simpler and more efficient. Underdiagnosis of malnutrition can be prevented, possibly reducing the prevalence of malnourished hospitalized elderly patients and improving the quality of the nutritional care process practiced in Malaysia.

    Matched MeSH terms: Geriatric Assessment/methods*
  20. Hanisah R, Suzana S, Lee FS
    J Nutr Health Aging, 2012 Jul;16(7):660-5.
    PMID: 22836710 DOI: 10.1007/s12603-012-0056-6
    Poor appetite is one of the main contributing factors of poor nutritional status among elderly individuals. Recognizing the importance of assessment of appetite, a cross sectional study was conducted to determine the validity of appetite screening tools namely, the Council on Nutrition Appetite questionnaire (CNAQ) and the simplified nutritional appetite questionnaire (SNAQ) against the appetite, hunger and sensory perception questionnaire (AHSPQ), measures of nutritional status and food intake among geriatric patients at the main general hospital in Malaysia. Nutritional status was assessed using the subjective global assessment (SGA) while food intake was measured using the dietary history questionnaire (DHQ). Anthropometric parameters included weight, height, body mass index (BMI), calf circumference (CC) and mid upper arm circumference (MUAC). A total of 145 subjects aged 60 to 86 years (68.3 ± 5.8 years) with 31.7% men and 68.3% women were recruited from outpatients (35 subjects) and inpatients (110 subjects) of Kuala Lumpur Hospital of Malaysia. As assessed by SGA, most subjects were classified as mild to moderately malnourished (50.4%), followed by normal (38.6%) and severely malnourished (11.0%). A total of 79.3% and 57.2% subjects were classified as having poor appetite according to CNAQ and SNAQ, respectively. CNAQ (80.9%) had a higher sensitivity than SNAQ (69.7%) when validated against nutritional status as assessed using SGA. However, the specificity of SNAQ (62.5%) was higher than CNAQ (23.2%). Positive predictive value for CNAQ and SNAQ were 62.6% and 74.7%, respectively. Cronbach's alpha for CNAQ and SNAQ were 0.546 and 0.578, respectively. History of weight loss over the past one year (Adjusted odds ratio 2.49) (p < 0.01) and thiamine intake less than the recommended nutrient intake (RNI) (Adjusted odds ratio 3.04) (p < 0.05) were risk factors for poor appetite among subjects. In conclusion, malnutrition and poor appetite were prevalent among the geriatric outpatients and inpatients. SNAQ was more reliable and valid as an appetite screening tool among this special group of population. There is a need to regularly include nutritional and appetite assessment for early intervention measures in order to prevent consequences of malnutrition.
    Study site: Medical Ward and Outpatient Medical Clinic, Kuala Lumpur Hospital, Malaysia
    Matched MeSH terms: Geriatric Assessment/methods*
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