Assessment of nutrition risk using the Mini-Nutritional Assessment Short-Form and biomarkers (prealbumin) in community-living older adults within Auckland : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Albany, New Zealand

Abstract

Background: The global population is ageing with New Zealand currently experiencing a large growth in those aged 65 years and older. Increasing age is associated with increasing use of health and disability support services. Vulnerable older adults are at high risk of malnutrition and may be high users of these services. With global ageing creating more economic and social pressures on countries, it is important that nutritional well-being, a key determinant of good health and healthy ageing, is maintained throughout life to sustain functional health and quality-of-life in older adults. Assessing nutrition status will help determine those at nutrition risk. Aim: To determine the prevalence of nutrition risk in community-living older adults enrolled with The Henderson Medical Centre, a general practice in West Auckland; to determine the prevalence of dysphagia risk; and to assess the potential of prealbumin (PAB) in conjunction with C-reactive protein (CRP) as biomarkers of nutrition risk. Method: Patients enrolled with Henderson Medical Centre were recruited into this crosssectional study over a three-month period. Nutrition risk was determined by the Mini Nutritional Assessment Short-Form (MNA-SF), dysphagia risk by the 10-Item Eating Assessment Tool (EAT-10), and cognitive function by the Montreal Cognitive Assessment tool (MoCA). Demographic, living situation, co-morbidities, number of medications, and support services information was collected through a face-to-face interview. Serum PAB and CRP were measured and their relationship with the MNA-SF analysed. Results: Two hundred participants, mean age 80.9±4.5 years, were recruited. Women comprised 55.5%. Two participants were categorised by the MNA-SF as malnourished and 12% categorised as at risk of malnutrition. Dysphagia risk was observed in 7.5%. 131 participants received a blood test, with a mean PAB value of 0.27±0.06g/L and mean CRP value 4.66 ±11.81mg/L. 85% of participants had a normal PAB and CRP value. No significant association was found between serum PAB values and nutrition risk status when compared. Conclusion: One in seven community-living older adults were categorised as at risk of malnutrition. Our study found a low prevalence of nutrition and dysphagia risk indicating a generally ‘well’ study population. PAB and CRP did not significantly correlate with the MNA SF scores in this population. The results highlight the need for further studies investigating the use of PAB and CRP as nutrition biomarkers in community-living older adults. Key words: older adults, community-living, nutrition risk, dysphagia, prealbumin, C-reactive protein