The nutritional status of 1081 elderly people residing in publicly funded shelter homes in Peninsular Malaysia

Objectives: The aim of this study was to determine the: ( 1) prevalence of undernutrition as determined by the 'DETERMINE Your Nutritional Health Checklist' (NHC) and ( 2) factors independently associated with undernutrition among the older residents of these publicly funded shelter homes in Peninsular Malaysia. Design: A total of 1081 elderly people (59% M) over the age of 60 y were surveyed using questionnaires determining baseline demographics, nutritional and cognitive status, physical function and psychological well-being. Setting: Shelter homes, Peninsular Malaysia. Results: In all, 41.4% ( n = 447) were nourished ( score <3), 32.1% ( n = 347) at moderate risk ( score between 3 and 5) and 26.6% ( n = 287) were at high risk of undernutrition ( score>5) according to the NHC. A large proportion of subjects were underweight with 14.3% of subjects recording a low body mass index (BMI) <18.5 kg/m(2) and a further 18.2% recording a BMI between 18.5 and 20 kg/m(2). The residential geriatric depression score (GDS-12R) ( relative risk (RR) = 1.03 (95% confidence interval (CI) 1.01 - 1.05); P = 0.002) and the number of illnesses ( RR = 1.14 ( 95% CI 1.07 - 1.21); P< 0.001) were found to be independently associated with nutritional risk ( NHC score greater than or equal to 3). Using a BMI <18.5 kg/m(2) as an objective marker for nutritional risk, the NHC was shown to have a sensitivity of 66.4% ( 95% CI 58.0 - 74.2%), specificity of 42.7% ( 95% CI 39.3 - 46.1%), positive predictive value of 16.2% ( 95% CI 13.3 - 19.5%) and a negative predictive value of 88.4% ( 95% CI 84.9 - 91.4%). Conclusions: Many elderly people residing in publicly funded shelter homes in Malaysia may be at-risk of undernutrition, and were underweight. The NHC is better used as an awareness tool rather than as a screening tool. Sponsorship: A grant from University Putra Malaysia to Dr Zaiton Ahmad.