Abstract
Disease Related Malnutrition is a common condition in many patients seen in the ambulatory or hospital setting. It is associated with increased fatigue or reduced muscle strength, risk of pressure ulcers and poor wound healing, infectious complications, depression, leading to augmented morbidity and mortality, higher lengths of stay and health care costs. Malnutrition is a very common problem in patients with neurological disorders, such as stroke, Parkinson’s disease, motor neuron disease, Alzheimer’s disease and other dementias. Patients may present different factors causing insufficient dietary intake, such as dysphagia, anorexia, or need of help for eating. Health care providers have to be aware of the nutritional consequences of neurological diseases and incorporate into their clinical practice the required steps to identify those patients with malnutrition or at risk of developing it. The main steps are screening, assessment, nutritional planning, monitoring, and registration along with diagnostic coding and, finally, audit of the whole process. In this chapter, we will review how to carry out nutritional screening, assessment and diagnostic coding. The results of this diagnostic process have to be registered into the medical record of each patient, along with the therapeutic interventions delivered in response to these findings.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Bistrian BR, Blackburn GL, Vitale J, Cochran D, Naylor J (1976) Prevalence of malnutrition in general medical patients. JAMA 235:1567–1570
Braun MM, Osecheck M, Joyce NC (2012) Nutrition assessment and management in amyotrophic lateral sclerosis. Phys Med Rehabil Clin N Am 23:751–771
Jensen GL, Bistrian B, Roubenoff R, Heimburger DC (2009) Malnutrition syndromes: a conundrum vs continuum. JPEN J Parenter Enteral Nutr 33:710–716
Meijers JM, van Bokhorst-de van der Schueren MA, Schols JM, Soeters PB, Halfens RJ (2010) Defining malnutrition: mission or mission impossible? Nutrition 26:432–440
Jensen GL, Mirtallo J, Compher C, Dhaliwal R, Forbes A, Grijalba RF et al (2010) International consensus guideline committee. Adult starvation and disease related malnutrition: a proposal for etiology-based diagnosis in the clinical practice setting from the International consensus guideline Committee. Clin Nutr 29:151–153
Jensen GL, Compher C, Sullivan DH, Mullin GE (2013) Recognizing malnutrition in adults: definitions and characteristics, screening, assessment, and team approach. JPEN J Parenter Enteral Nutr 37:802–807
Baxter JP (1999) Problems of nutritional assessment in the acute setting. Proc Nutr Soc 58:39–46
Kondrup J, Allison SP, Elia M, Vellas B, Plauth M (2003) ESPEN guidelines for nutrition screening 2002. Clin Nutr 22:415–421
Jones JM (2002) The methodology of nutritional screening and assessment tools. J Hum Nutr Diet 15:59–71
Buzby GP, Williford WO, Peterson OL, Crosby LO, Page CP, Reinhardt GF, Mullen JL (1988) A randomized clinical trial of total parenteral nutrition in malnourished surgical patients: the rationale and impact of previous clinical trials and pilot study on protocol design. Am J Clin Nutr 47(2 Suppl):357–365
Detsky AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson RA et al (1987) What is subjective global assessment of nutritional status? JPEN J Parenter Enter Nutr 11:8–13
Guigoz Y, Vellas BJ, Garry PJ (1996) Assessing the nurtritional status of the elderly. The MNA as part of the geriatric evaluation. Nutr Rev 54:59–65
Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T et al (2009) Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging 13:782–788
Ferguson M, Capra S, Bauer J, Banks M (1999) Development of a valid and reliable malnutrition screening tool for adult acute hospital patients. Nutrition 15:458–464
Kondrup J, Rasmussen H, Hamberg O, Stanga Z, ESPEN Working Group (2003) Nutritional Risk screening (NRS 2002): a new method based on analysis of controlled clinical trials. Clin Nutr 22:321–336
Johansen N, Kondrup J, Plum LM et al (2004) Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 23:539–550
Stratton RJ, Hackston A, Longmore D et al (2004) Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the “malnutrition universal screening tool” (‘MUST’) for adults. Br J Nutr 92:799–808
Kruizenga HM, Seidell JC, de Vet HC, Wierdsma NJ, van Bokhorst-de van der Schueren MA (2005) Development and validation of a hospital screening tool for malnutrition: the short nutritional assessment questionnaire (SNAQ). Clin Nutr 24:75–82
Kruizenga HM, de Jonge P, Seidell JC et al (2006) Are malnourished patients complex patients? Health status and care complexity of malnourished patients detected by the Short Nutritional Assessment Questionnaire (SNAQ©). Eur J Intern Med 17:189–194
Neelemaat F, Kruizenga HM, De Vet HCW, Seidell JC, Butterman M, van Bokhorst-de van der Schueren MAE (2008) Screening malnutrition in hospital outpatients. Can the SNAQ malnutrition screening tool also be applied to this population? Clin Nutr 27:439–446
Van Bokhorst-de van der Schueren MAE, Guaitoli PR, Jansma EP, de Vet HC (2014) Nutrition screening tools: does one size fit all? A systematic review of screening tools for the hospital setting. Clin Nutr 33:39–58
Tappenden KA, Quatrara B, Parkhurst ML, Malone AM, Fanjiang G, Ziegler TR (2013) Critical role of nutrition in improving quality of care: an interdisciplinary call to action to address adult hospital malnutrition. JPEN J Parenter Enteral Nutr 37:482–497
Neelemaat F, Meijers J, Kruizenga H, van Ballegooijen H, van Bokhorst-de van der Schueren M (2011) Comparison of five malnutrition screening tools in one hospital inpatient sample. J Clin Nurs 20(15-16):2144–2152
Ellis AC, Rosenfeld J (2011) Which equation best predicts energy expenditure in amyotrophic lateral sclerosis? J Am Diet Assoc 111:1680–1687
Chumlea WC, Roche AF, Steinbaugh ML (1985) Estimating stature from knee height for persons 60 to 90 years of age. J Am Geriatr Soc 33:116–120
Paganoni S, Deng J, Jaffa M, Cudkowicz ME, Wills AM (2011) Body mass index, not dyslipidemia, is an independent predictor of survival in amyotrophic lateral sclerosis. Muscle Nerve 44:20–24
White JV, Guenter P, Jensen G, Malone A, Schofield M, Academy of Nutrition and Dietetics Malnutrition Work Group, A.S.P.E.N. Malnutrition Task Force, A.S.P.E.N. Board of Directors (2012) Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). J Acad Nutr Diet 112:730–738
Malone A, Hamilton C (2013) The Academy of Nutrition and Dietetics/The American Society for Parenteral and Enteral Nutrition Consensus Malnutrition Characteristics: application in practice. Nutr Clin Pract. 28:639–650
Cederholm T, Bosaeus I, Barazzoni R, Bauer J, Van Gossum A, Klek S et al (2015) Diagnostic criteria for malnutrition—an ESPEN consensus statement. Clin Nutr 34:335–340
Rojer AGM, Kruizenga HM, Trappenburg MC, Reijnierse EM, Sipilä S, Narici MV et al (2016) The prevalence of malnutrition according to the new ESPEN definition in four diverse populations. Clin Nutr 35:758–762
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this chapter
Cite this chapter
León-Sanz, M., Valero, M.A. (2017). Screening and Assessment of Malnutrition. In: Arsava, E. (eds) Nutrition in Neurologic Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-53171-7_2
Download citation
DOI: https://doi.org/10.1007/978-3-319-53171-7_2
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-53170-0
Online ISBN: 978-3-319-53171-7
eBook Packages: MedicineMedicine (R0)