The calf circumference as a quick-reliable marker of malnutrition in hospitalized elderly. Its relation with age and gender

Abstract

Introduction: Malnutrition in the hospitalized elderly is very common, and it frequently predicts, not only the lengthened hospital stay, but also the prognosis and other adverse pathologies. Nutritional assessment can be based on anthropometric measurements, biochemical parameters and nutritional tests.Objectives: To evaluate if the calf circumference is a valid indicator of malnutrition in the elderly patient recently hospitalized, analysing the possible influence of sex and age.Material and methods: A descriptive study in 907 pluripathological elderly patients has been performed upon arrival to the Hospital. The average age was 82,13 +/- 7,08 years. Number of lymphocytes, total cholesterol, plasma transferrin and plasma albumin were evaluated. In addition the nutritional status was evaluated using the Mini Nutritional Assessment, Nutritional Risk Screening and subjective Global assessment tests. Finally it was determined the calf circumference.Results: Nutritional tests show a malnutrition average near to 75%. Biochemical parameters show a percentage of malnutrition ranging from 63.4% to 76.7% and the results for the calf circumference were 74.2%. The prevalence of malnutrition is higher in women, regardless of the parameter used. Age, particularly from 85 years, increases the malnutrition risk under all parameters. All parameters are correlated with the calf circumference, settling the concept "be malnourished" in the cut-off point of 29 cm, for both sexes and in all different age groups (sensitivity 99.31%).Conclusions: 75% of the elderly population presents malnutrition upon arrival at the hospital. Calf circumference is an easy marker of malnutrition in the elderly, with high sensitivity and reliability, independently of sex and age.