Detecting Risk of Malnutrition Among the Elderly Based on Their Neck Circumference
Thu, April 22, 2021

Detecting Risk of Malnutrition Among the Elderly Based on Their Neck Circumference

Mini Nutritional Assessment (MNA) is an assessment tool to determine the association between the parameters of the elderly and the results of the study. / Photo by Jozef Polc via 123rf


A new study conducted by researchers from the Miguel Servet University Hospital in Zaragoza, Spain determined the probability of malnutrition among elderly people basing it only on their neck circumference.



The research, which was published in the journal Science Direct, explained that anthropometry or the scientific study of the proportions and measurements of the human body is a noninvasive and easy method to evaluate the nutritional status in institutionalized elderly people who are usually bedridden. 

To determine the elderly’s risk of malnutrition, the cross-sectional study involved 352 senior people living in different public nursing homes. The mean age of the participants was 83 years old and 59 percent of them were females. The researchers said that neck circumference below 35.2 centimeters in females and 37.8 centimeters in males indicate the risk of malnutrition.

Authors Beatriz Lardiés-Sánchez from the Nutrition Department of University Hospital Miguel Servet and the team said that professionals working in elderly nursing homes usually detect malnutrition cases in their patients by measuring the calf or arm of the elderly. This gives the team an insight to use the anthropometry method by highlighting the neck’s circumference.


Professionals working in elderly nursing homes usually detect malnutrition cases in their patients by measuring the calf or arm of the elderly. / Photo by Elnur Amikishiyev via 123rf


Mini Nutritional Assessment tool

The team also used the assessment tool called Mini Nutritional Assessment or MNA to determine the association between the parameters of the elderly and the results of the study. The findings showed that the circumference of the neck or the calf provides the “best predictive value” to diagnose the risk of malnutrition among elderly people. The 35.2 centimeters (women) and 37.8 centimeters (men) cutoff can be taken into consideration by staff working in nursing homes.

Lardiés-Sánchez added that diagnosing malnutrition in the elderly cannot be relied upon using one anthropometric parameter only, such as the circumference of the arm or calf.  It can only help identify the risk. In their study, they found that 48.3 percent of the female subjects and 45.5 percent of men were at risk of malnutrition. The researchers based it on their MNA scores. Once the nursing staff already know who is at risk, they can take the measures needed to reverse the situation and such action should be done immediately.

The team also said that results could also be applied to larger populations that share the same characteristics although they cannot ensure that the cutoff points they determined would be valid in some population groups.

A 2018 study also appeared in the Indian Journal of Community and Family Medicine, wherein authors Chaitanya R. Patil from the Department of Palliative care and Psycho-Oncology in Tata Medical Center and team explained that neck circumference can also be used as a marker of malnutrition among children. They wrote that India has been facing a “dual burden” of obesity or overweight and undernutrition among kids less than 5 years old. The team correlated the children’s neck circumference with their body mass index to determine their status.



Malnutrition: a senior health issue

On the part of older adults or seniors, malnutrition is a serious health issue. This is because it can lead to various health concerns such as increased risk of hospitalization, decreased bone mass and muscle weakness that can lead to fractures and fall, poor wound healing, weak immune system leading to increased risk of infection, and increased risk of death. 

Scientific online publication Our World in Data shared the malnutrition death rate (per 100,000) in 2017 among certain countries. It included Bangladesh with 3.39 deaths, Columbia with 2.32 deaths, Indonesia 8.37 deaths, United States 0.69 deaths, Singapore 0.01 deaths, United Arab Emirates 0.13 deaths, China (0.62 deaths, Kenya 15.74 deaths, Central African Republic 33.24 deaths, Mali 23.16 deaths, New Zealand 0.08 deaths, and Switzerland 0.2 deaths.  The protein-energy malnutrition death rate was measured as a result of an insufficient protein or caloric intake. 

The American Society on Aging, a nonprofit organization composed of professionals concerned with the emotional, physical, economic, social, and spiritual aspects of aging, likewise shared that one out of every two seniors is at risk for malnutrition. Annually, disease-associated malnutrition among the elderly costs $51.3 billion. The organization believed that to prevent senior malnutrition and help improve the wellbeing and health of seniors, it is important to identify the elderly who are malnourished or at risk for malnutrition in the community and clinical settings. 



Senior malnutrition care

After identifying those at risk and are already malnourished, ASA said that the next step is to intervene, which involves improving the public’s interactions with the seniors to address the social and medical factors that contribute to malnutrition. Next is to conduct research, measure outcomes, promote best practices, and capture learning to advance senior malnutrition care. By malnutrition, it does not just mean that the body is not getting enough nutrients from the food that one eats. Malnutrition may also happen because older adults have health problems that cause their loss of appetite or make it difficult for them to eat or swallow food. In the same way, certain medicines may also affect their sense of smell and taste of food. This is why it is also important to address these areas.