Screening for adult malnutrition

Screening for malnutrition should be carried out using a standardised malnutrition screening tool.

For all elderly people living at home, it is recommended to screen for malnutrition at least once a year. For those living in residential care, the frequency increases to once a month. If the elderly person is identified as being at high risk of malnutrition or has certain medical conditions, the screening may be completed even more frequently, for example weekly. It depends on the person’s clinical condition and the level of risk.

People could be identified as having no risk, being at risk or at high risk of becoming malnourished. The first step in screening is to identify a person’s risk factors, such as weight loss, medical conditions including cognitive impairment, and difficulties with chewing or swallowing.

It is important to consider any medication being taken and the potential impact on appetite and digestion. Finally, other difficulties such as social isolation, widowing, or loss of independence are all key factors that should not be neglected when identifying a person’s risk of becoming malnourished.

Beyond considering their nutritional intake, checking a person’s weight is the first step in screening. It is important to calculate their Body Mass Index or BMI using this formula:

BMI (in kg/m²) = weight (in kg) / height (in m²)

This information can then be used to complete a Mini Nutritional Assessment or any standardised tool in a given country¹. Concretely, a person would normally be considered malnourished if they have a BMI of less than 18.5 kg/m² or if they have unintentionally lost more than 10% of their body weight during the last 6 months².

Identifying a person’s level of risk can help the supervising health care professional develop an appropriate management plan.

In conclusion, quickly detecting malnutrition improves treatment and helps avoid complications.

For information about relevant international standards, see the ISDI brochure on Foods for Special Medical Purposes (FSMP).

Download the factsheet.

1. Irish Society for Clinical Nutrition & Metabolism

2. Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition, National Institute for Health and Care Excellence

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Understanding adult malnutrition

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Managing adult malnutrition