In his work entitled Nutrition Clinique Pratique, Stéphane Schneider examines malnutrition. The book gives us the opportunity to issue a reminder of the key issues relating to the condition.
Overview
■ Malnutrition is defined as a deficiency in energy, protein or any other macro or micronutrient that affects bodily functions and/or body composition and worsens conditions. Muscles are the part of the body most affected by malnutrition.
■ Increase in morbidity and mortality rates of chronic and acute diseases
■ Increase in the likelihood of:
- infection, particularly hospital-acquired and pulmonary
- osteopenia/osteoporosis
- dependence, falling and handicap
- bedsores and thromboembolic disorders
- fractures
- hypothermia
■ Delays cure
■ Reduces efficiency of treatments
■ Increases length of convalescence, number of prescriptions and hospital costs
■ Affects quality of life, well-being and social relations
According to Stratton et al
■ The condition can be caused by a lack of appropriate intake and/or an increase in loss and/or and increase in requirements. It is associated with certain chronic diseases.
Three types of malnutrition :
- Malnutrition in conjunction with an inflammatory disease is defined as cachexia
- Malnutrition in conjunction with a non-inflammatory disease (e.g. increase in loss or increased requirements)
- Non disease-related malnutrition (insufficient intake)
Disease/Age | Consequences of |
Cancers | 39% |
AIDS | 5 à 10% |
Kidney disease | 25% (kidney disease) à 70% (dialysis) |
Respiratory disease | 20 à 70% |
Chronic pancreatitis | 67% |
Chronic liver conditions | 30% |
IBD | 15% |
Neuromuscular disorders | 15-55% |
Neurological disorders with difficulty swallowing | 100% Swallowing difficulties as a result of a stroke |
Patients aged 70-80, at home | 3-5% |
Patients aged over 80 | 10% |
Patients in care, aged over 60 | 20-30% |
According to Stratton et al
■ A combination of symptoms indicate malnutrition
■ Memory loss and lack of concentration
■ Mid-day asthenia
■ Loss of physical ability
■ Apathy
■ Digestive symptoms: anorexia, dysphagia and odynophagia, slow digestion, dyspepsia, diarrhoea and/or constipation
■ A number of concording clinical, biological and MNA or NRI elements lead to a diagnosis of malnutrition.
Malnutrition | Severe Malnutrition |
<70 years BMI: 16-18.5 | <70 years BMI <16 |
>70 years BMI: 18-21 | >70 years BMI <18 |
Criteria issued by HAS, the French health authority