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Introduction: Background & aims: the last large multicenter study on disease-related malnutrition (DRM) in Spain (the PREDyCES study) showed a 23.7 % prevalence of malnutrition, according to the Nutritional Risk Screening (NRS-2002) tool. The main objective of the SeDREno study was to assess the prevalence of hospital malnutrition upon admission, according to GLIM criteria, ten years later. Methods: a cross-sectional, observational, multicenter study in standard clinical practice, conducted in 17 hospitals during a period of five to seven days. Patients were initially screened using the Malnutrition Universal Screening Tool (MUST), and then assessed using the GLIM criteria for diagnosis and severity grading. Results: a total of 2,185 patients, 54.8 % males, mean age 67.1 (17.0) years (50.2 % aged ≥ 70 years), were evaluated. Malnutrition was observed in 29.7 % of patients according to GLIM criteria (12.5 % severe, 17.2 % moderate). In patients ≥ 70 years malnutrition was observed in 34.8 %. The clinical conditions significantly associated with a higher prevalence of malnutrition were dysphagia (47.6 %), cognitive impairment (43.4 %), cancer (39.1 %), gastrointestinal disease (37.7 %), diabetes (34.8 %), and cardiovascular disease (33.4 %). The multivariate analysis revealed that gender, BMI, diabetes, cancer, gastrointestinal disorders, and polypharmacy were the main independent factors associated with DRM. Malnutrition was associated with an increase in length of hospital stay and death (p < 0.001). Conclusions: DRM in admitted patients has increased in Spain in the last 10 years paralleling ageing of the population. In the SeDREno study almost one in three patients are malnourished. A systematic assessment of nutritional status allows early detection and implementation of nutritional interventions to achieve a better clinical outcome. [ABSTRACT FROM AUTHOR]

Introduction: Introduction: malnutrition in cancer patients can lead to a reduction in patient quality of life, increased morbidity and mortality, and associated healthcare costs. Objective: to analyze nutritional interventions in the different phases of the oncological process, integrating the needs of patients and those of healthcare professionals. Material and methods: "Design Thinking" techniques were used to address the analysis of the current situation and identify key aspects. Thirteen professionals from 8 public health centers (endocrinology and nutrition, medical and radiotherapy oncology, primary care (PC), nursing and dietetics) participated in the study. Results: nutritional screening is not carried out in a systematic way in the different phases of the oncological process, and there is no universal consensus on the protocols for action and nutritional intervention. A wide compliance with the pathways and referral times of the selected processes has been observed. In the therapeutic phase, there is the possibility of consulting the Clinical Nutrition and Dietetics Unit (UNCYD) and 75 % have specific referral protocols. The nurse case manager is present in all hospitals and in PC. Patient access to the center psychologist was possible in 87 % of the hospitals. Participation of the UNCYD in Tumor Committees was low (only in 25 % of the centers). In all centers there is some kind of collaboration and support by patient associations and the School of Patients, especially in the therapeutic and the control and follow-up phases. Conclusions: variations are observed between the different hospitals and areas in Andalusia, both in terms of means and structures and in activities and procedures. Key points have been selected and prioritized to improve nutritional care in oncology. [ABSTRACT FROM AUTHOR]

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Introduction: the preliminary nutritional screening tool CIPA (food intake, proteins, anthropometry) is positive when it fulfills one of the following: control food intake (CI) 48-72 h < 50%, albumin < 3 g/dl, total protein < 5 g/dl, body mass index (BMI) < 18,5 kg/m2 or mid-upper arm circumference (MUAC) ≤ 22,5 cm. The use of two protein parameters increases costs and difficulty; one of them can be suppressed without affecting validity.Objectives: to evaluate the effectiveness of screening CIPA after exclusion of total protein.Method: prospective study of hospitalized patients; prevalence or risk of malnutrition was evaluated through CIPA and Subjective Global Assessment (SGA). Hospital malnutrition according to complete CIPA screening (with total proteins and albumin, [CIPAc] and without total proteins [CIPAw/p]) and concordance between both methods were analyzed, as well as the association of the positive screening result with clinical outcomes.Results: three hundred and forty-three patients were analyzed. The prevalence or risk of malnutrition identified by complete CIPA (c) was 38.19% (33.02-43.36); by CIPA without protein (w/p), 37.32% (32.17-42.46); and SGA was 29.15% (24.32-33.99). Kappa index: 0.981 between both CIPAs, p < 0.001. Both CIPA and SGA detect patients with higher mortality in hospital and one month after discharge. Early readmission was higher in positive CIPA, statistical significantly in CIPAw/p (screening with positive results 21.88% vs screening with negative results 13.49%, p = 0.044), SGA 20.01% vs 15.23%, p = 0.28. Length of stay was higher in patients with positive screening in CIPAc, CIPAw/p and SGA.Conclusions: CIPAw/p is equally or more effective than the previously validated full CIPA; therefore, it could replace the latter saving costs. The prevalence of malnutrition is high in both variants and they are able to predict which patient has worse clinical prognosis. [ABSTRACT FROM AUTHOR]

Background: Enteral nutrition (EN) is an effective nutritional intervention for patients at risk of malnutrition or malnourished. However, complications such as gastrointestinal intolerance, hyperglycemia or refeeding syndrome can be triggered by EN.Aim: To investigate the effects of a tube feeding formula (TFF) on patients' nutritional status, biochemical status, bowel habits and safety.Methodology: Observational, prospective and multicenter study. Patients ≥ 18 years, undernourished or at nutritional risk, who were prescribed a high-calorie, high-protein, fiber-fortified TFF were included. Patients were evaluated over a period of eight weeks (baseline [V1], four weeks [V2] and eight weeks [V3]).Results: A statistically significant increase in weight (1.5 kg), body mass index (0.6 kg/m2) and nutritional intake (59.7 kcal/day) was observed between V1 and V2. Between V1 and V3, there was a statistically significant decrease in the percentage of individuals with abnormal biochemical markers for glucose, potassium, total protein and albumin. The number of patients' bowel movements remained stable throughout the study with a mean of 1.1 daily bowel movements.Conclusion: The TFF was safe and well tolerated, improving patients' nutritional status without altering patients' bowel habits. [ABSTRACT FROM AUTHOR]

Disease-related malnutrition is highly prevalent in pathologies commonly integrating care complexity. Healthcare models for complexity must include malnutrition detection and approaches, since it is a key factor which has great impact on the patient’s evolution and the consumption of healthcare resources. Malnourished patients present higher hospitalization, complication and mortality rates, higher demand of post-discharge social resources and higher hospital readmission frequency. Detecting malnutrition is necessary to implement a nutritional care program which might be used in any assistance level. The integration of health and social care and the development of information tools which are shared by the different assistance agents has allowed the development of a program for the management of disease-related malnutrition in patients with clinical complexity in Catalonia. [ABSTRACT FROM AUTHOR]

Objetive: to determine the prevalence of malnutrition in patients aged 65 years or more at admission and factors associated with its presence. Analyze excess hospital stay (EHS), economic impact and premature readmission rate associated with hospital malnutrition in elderly patient.Material and Method: retrospective study conducted at the University Hospital Reina Sofía. All patients aged 65 years or older admitted to internal medicine in 2011. The sample size was calculated taking into account the income of the previous year, and considering a prevalence of malnutrition of 50% with a 95% and included error of 5%. To define the degree of malnutrition nutritional control tool (CONUT), which establishes a score based on albumin, total cholesterol and lymphocyte determination was used. To determine the factors associated with the presence of moderate to severe malnutrition analysis of multivariate logistic regression was performed. For each patient the EHS, premature readmissions and the associated cost to EHS was calculated. A threshold of statistical significance of 0.05 was used for all analyzes and were performed with SPSS v15.0.Results: 310 patients, of whom 54.2% were women were included, the mean age was 80.1 years (SD: 6.8), ranging between 65 and 95 years. Regarding diagnosis at admission 27.4% were respiratory diseases, 22.6% of the circulatory and digestive 11.6%. The median Charlson index was 2.0, found that 36.8% of patients had high comorbidity. The most prevalent chronic diseases were diabetes mellitus (44.2%), chronic kidney disease (25.2%) and dementia (10.6). Regarding the CONUT, 75.8% of patients met the criteria of malnutrition: 42.6% mild, 28.7% moderate and severe 4.5%, of which only 46.6% had some nutritional support during admission. Factors associated with the presence of moderate to severe malnutrition were female gender (OR: 1.7; 95%: 1.1 - 2.8), age over 80 years (OR: 2.0, IC 95%: 1.2 - 3.5), and dementia (OR: 2.4; IC 95%:1.2 - 5.2). No association with comorbidity or with other chronic diseases was found. Regarding the EHS (days) differences between patients with moderate to severe malnutrition (4.7; IC 95%: 2.3 - 7.1) and normally nourished (-0.1; IC 95%: -1.4 - 1.2) (p = 0.001) were found, but were not for cases of mild malnutrition (1.6, 95%: 0.5-2.8) (p = 0.07).Regarding the rate of premature readmission in malnourished patients was 28/235 (11.9%). The cost associated with EHS / 100 patients was € 195 479.4 for moderate malnutrition, mild malnutrition € 73 484.8, and normally nourished patients represented a saving of € 12 353.Conclusions: hospital malnutrition in elderly patients remains an unsolved problem, given the high prevalence found, associated to an excess of hospital stay and increased hospital costs, especially in patients with moderate to severe malnutrition. The CONUT is a nutritional screening tool very useful for the speed and validity of their results, and allows detecting patients at risk or nutritional alert without lead to increased costs. [ABSTRACT FROM AUTHOR]

Introduction: dysphagia and malnutrition are conditions that frequently appear together in hospitalized patients.Objectives: the main purpose of this study was to analyze the prevalence of malnutrition in patients with dysphagia included in the PREDyCES study as well as to determine its clinical and economic consequences.Methods: this is a substudy of an observational, cross-sectional study conducted in 31 sites all over Spain.Results: 352 dysphagic patients were included. 45.7% of patients presented with malnutrition (NRS-2002 ≥ 3) at admission and 42.2% at discharge. In elderly patients (≥ 70 years old) prevalence of malnutrition was even higher: 54.6% at admission and 57.5% at discharge. Also, prevalence of malnutrition was higher in urgent admissions versus those scheduled (45.7% vs 33.3%; p < 0.05) and when admitted to small hospitals vs. large hospitals (62.8% vs 43.9%; p < 0.001). In-hospital length of stay was higher in malnourished patients compared to those well-nourished (11.5 ± 7.1 days vs. 8.8 ± 6.05 days; p < 0.001), and in malnourished patients a tendency towards increase related-costs was also observed, even though it was not statistically significant (8 004 ± 5 854 € vs. 6 967 ± 5 630 €; p = 0.11). Length of stay was also higher in elderly patients (≥ 70 y/o) vs adults (< 70 y/o). 25% of dysphagic patients and 34.6% of malnourished patients with dysphagia received nutritional support during hospitalization.Discussion: these results confirm that in patients with dysphagia, malnutrition is a prevalent and under recognized condition, that also relates to prolonged hospitalizations. [ABSTRACT FROM AUTHOR]

Copyright of Historia Contemporanea is the property of Historia Contemporania and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Deficient nutritional status has important implications on vulnerable people's health status, such as those with chronic diseases or older people in situation of dependency. Objective: To examine SARquavitae centers users' nutritional status at admission. Material and Methods: Health, cognitive and functional status of people admitted to any company centers during 2012 was studied. Nutritional status was assessed using the short version of the Mini Nutritional Assessment. Finally, an analysis was performed to identify the most influential variables on the sample's nutritional status. Results: Clinical records of 4,297 admissions were analyzed. The average age was 82.08 years and 66.1% were women with high comorbidity. At admission, 30.4% of the sample was in malnutrition and 49.4% at risk of malnutrition. A higher prevalence of malnutrition is found in women, in those coming from an acute care hospital or its outpatient clinics, with worse functional and cognitive status and those with chronic conditions such as dementia, cerebrovascular disease or dysphagia. Conclusions: As demonstrated by the study results, people admitted to SARquavitae nursing homes present a high clinical complexity. Comprehensive assessments are needed that allow establishing specific care plans for people with complex care needs in nursing homes. [ABSTRACT FROM AUTHOR]

Introduction: Parents are most responsible for nutritional education of children, and pediatritians must advise and help them with their doubts. The purpose of this study was to know the relevance of nutritional topics in daily practice and the main nutritional problems perceived by pediatritians in children under 3 years of age. Methods: Descriptive, cross-sectional study performed in 2 stages. First stage consisted on discussion meetings with 30 random-selected pediatritians from Madrid and Barcelona. Results were used to design the on-line questionnaire of the second stage (76 questions related to nutrition in children under 3 years). A random and representative sample of Spanish pediatritians was selected for this stage. Results: One hundred and fifty one pediatritians, among 258 sampled, completed the questionnaire. They referred to see a mean of 588 patients/month. The main perceived nutritional problems in the first year of life were iron and vitamin deficiencies and poor weight gain. In the next months, excess in carbohydrates and lipid intake and overweight were the main problems perceived. Parents were considered the main actors regarding their children's nutritional health, but their concern in these questions significantly reduced with children's age (p < 0,0001). Factors considered to have the greatest relevance in the acquisition of good nutritional habits were to provide a diet adjusted for children's requirements and to observe the appropriate sleeping hours. The proportion of children who receive nutritional counseling varied from 88% (0-6 months) to 61% (24-36 months). Conclusions: Despite of the relevance given by pediatritians, educational intervention regarding nutritional health is not ideal. Nutritional problems perceived by pediatritians varied with children's age. [ABSTRACT FROM AUTHOR]

Hyponutrition is a common problem at all health care levels, from primary to specialized care, as well as in geriatric care. Its incidence in a hospital setting is 40% and 60% in nursing homes. This is very important, it is highly related with progressive aging of the European population, and is the biggest and most frequent cause of disability among the elderly population living at home or institutions. Countries such as Holland, Denmark, or the United Kingdom have developed Comprehensive Strategic Plans to fight against hyponutrition by developing and implementing guidelines, establishing mandatory screenings at the moment of hospital admission and discharge, at nursing homes, etc. In our country, a combined action of SENPE and Abbott Foundation is developing a Comprehensive Strategic Plan (+ nutridos Project) in which clear, precise, and validated recommendations are established to perform nutritional screening both in hospitalized patients and institutionalized and ambulatory elderly people. This issue has to take into account the social and financial aspects. Hyponutrition is many times insufficiently recognized and treated. This has a negative impact on the individual patient in terms of morbidity, mortality, independence, and quality of life, as well as on the health care systems in terms of use of health care resources and costs. [ABSTRACT FROM AUTHOR]

Background: Malnutrition among inpatients is highly prevalent, and has a negative impact on their clinical outcome. The Working Group for the Study of Malnutrition in Hospitals in Catalonia was created to generate consensus guidelines for the prevention and/or treatment of malnutrition in hospitals in Catalonia, Spain. Aims: The objectives of the study were to determine the prevalence of malnutrition on admission to hospital in Catalonia and to assess relationships between malnutrition, social and demographic data, overall costs, and mortality. Methods: Prospective and multicenter study conducted with 796 patients from 11 hospitals representative of the hospitalized population in Catalonia. Nutritional status was evaluated using the Nutritional Risk Screening 2002 method. Results: Overall, 28.9% of the patients are malnourished or at nutritional risk. Elderly patients, non-manual workers, those admitted to hospital as emergencies and with higher co-morbidities had higher risk of malnutrition. The type of hospital (second level vs. tertiary or University referral) to which they were admitted was also a factor predisposing to malnutrition. Length of hospital stay was longer in malnourished patients (10.5 vs. 7.7 days, p < 0.0001). The need for a convalescent home on leaving hospital was higher as well as the risk of mortality (8.6% malnourished vs. 1.3% non-malnourished, p < 0.0001). Conclusions: The prevalence of malnutrition is high in patients on admission to hospital in our community, resulting in elevated overall costs and higher risk of mortality. Age, social class and characteristics of the Unit and the Hospital are the main factors involved in hospital malnutrition. [ABSTRACT FROM AUTHOR]

Background: Nutritional supplementation might be an effective strategy for improving the nutritional status and the quality of life of institutionalized fragile elderly. Objectives: The prevalence of malnutrition and its relation with disease, and the influence of dietary supplementation by means of oral formulas on the nutritional status of elderly nursing home residents were assessed. Methods: Two studies were carried out, one a crosssectional survey in 31 subjects and the other a longitudinal-sectional survey in 19 subjects, both groups living in a public nursing home in the city of Murcia (SE Spain). Body mass index (BMI), serum albumin concentration (ALB) and geriatric nutritional risk index (GNRI) were assessed as markers of potential malnutrition. Illnesses were ascertained from medical records. Results and discussion: The prevalence of malnutrition of the total collective was high (39%), and especially in the fragile subjects (50%). The administration of oral nutritional supplements in the usual diet for 12 months significantly increased ALB and GNRI, and had no effect on body weight and BMI. Jointly, these effects decreased the in the number of subjects at high nutritional risk and increased the number of subjects with a low or zero risk of malnutrition. Conclusion: The administration of oral nutritional supplements in the usual diet of this elderly collective is an effective clinical strategy in nutritional therapy. [ABSTRACT FROM AUTHOR]

Introduction: Population ageing is a main concern from the biosanitary point of view. Aim: To assess the nutritional status of people 65 years old and older in Cantabria (Spain). Method: A total of 1,605 persons were studied by means of the MNA (Mini Nutritional Assessment); a) by primary care (59.9% in the unit, and 4.7% at home) and, b) in nursing homes (35.4%). Results: Nutritional score (NS) was 23.4 ± 4.1 for women and 24.4 ± 4 in males (p < 0.001). We emphasize the fact that 22.3% of people studied in the nursing homes were malnourished or at risk of malnutrition, compared with 14.2% of those studied at the unit, and only 3.3% of the home visited elders. The correlation between the value of the NS and the subjective estimation of nutrition status showed a high value (0.65). We emphasize the negative correlation (-0.53) between BNI value and the incidence of skin lesions. Conclusion: Our results highlight the importance of identifying malnutrition or its risk in elders in order to prevent the negative consequences of this deficiency. [ABSTRACT FROM AUTHOR]

It is well known that hospital malnutrition is a highly prevalent condition associated with an increase in morbidity and mortality as well as related healthcare costs. Although previous studies have already measured the prevalence and/or costs of hospital nutrition in our country, their local focus (at the regional or even hospital level) causes the true prevalence and economic impact of hospital malnutrition for the National Health System to remain unknown in Spain. The PREDyCES® (Prevalence of hospital malnutrition and associated costs in Spain) study aimed to assess the prevalence of hospital malnutrition in Spain and to estimate related costs. Some aspects made this study unique: a) It was the first study in a representative sample of hospitals of Spain; b) different measures to assess hospital malnutrition (NRS2002, MNA as well as anthropometric and biochemical markers) where used both at admission and discharge and, c) the economic consequences of malnutrition where estimated using the perspective of the Spanish National Health System. [ABSTRACT FROM AUTHOR]

Malnutrition related to illness and inadequate nutrition remains a matter of relevant interest in the member countries of the European Union because of its elevated prevalence and high costs. It is estimated to affect 30 million patients and cost 170 billion euros annually. The 2008-2013 strategy "Together for Health" put forward in the European Parliament urges Member States to develop, together with local and regional authorities, initiatives in the field of education of the population, training, investigation and good clinical practices. SENPE (Spanish Society of Parenteral and Enteral Nutrition) collaborates in different areas in the development of this strategy which aim to put malnutrition related to illness in the focus of the health system. One of its contributions has been the preparation of the Document of Consensus on the Coding of Malnutrition SENPE-SEDOM (Spanish Society of Medical Documentation). The agreements adopted have helped normalize the process of coding this pathology with the assignment of specific codes for specifically defined terms. This document has allowed the optimization of information regarding the types and degrees of malnutrition and the procedures employed for its prevention or treatment in the hospital centres of the National Health System. [ABSTRACT FROM AUTHOR]

Background: Undernutrition is a very common situation among elderly, that is associated with increased morbidity and mortality rates. On the other hand, calf circumference (CC) is a direct anthropometric measurement, related to fat free mass. An early detection of an elderly undernutrition situation, based on CC assessment, could contribute to prevent its development and consequences. Objective: To analyse the relationship between CC and a possible undernutrition situation, based on the application of the Mini Nutritional Assessment (MNA) test, among Spanish subjects of 65 or more years old, including the gender and age influences. Subjects and methods: A cross-sectional study was carried out to assess the nutritional situation of an ambulatory population, from every area of Spanish geography (n = 22007), using the questionnaire MNA. Every subject surveyed was 65 or more years old when the test was done. Results: There were statistically significant differences between subjects with a CC < 31 cm and those with CC ≥ 31 cm, both men and women, in weight, height, body mass index (BMI), MNA total score and undernutrition classification. On the other hand, it was found that those elders with lower CC showed a higher undernutrition risk, both men and women, in every age range studied. Conclusions: It does exit an association between CC of Spanish subjects of 65 or more years old and the risk of developing undernutrition. That association is similar among men and women, and in all age ranges. [ABSTRACT FROM AUTHOR]

Given the increasing number of adoptions from China in countries such as Spain, a study was designed to know and assess the nutritional profile at arrival and its likely implication in global health status, growth, and development of adopted Chinese girls. Patients and methods: Eighty-five Chinese girls adopted in Spain during the 2002-2003 period and ages ranging 7-33 months of life were studied at the Social Pediatrics Unit of the "Niño Jesús" Hospital, MData. Data regarding institution of origin, nutritional parameters (anthropometrical and biochemical), presence of associated diseases, and developmental retardations (psychomotor/bone age) were gathered. Results: Waterlow's nutritional index showed a malnourishment rate of 11% based on Chinese reference tables, as compared to 58% based on Spanish tables, of which 82% was acute malnourishment. When comparing the efficacy of both nutritional assessment methods proposed by Waterlow and Gomez, there were no differences in detection of malnourishment in spite of the fact that the latter author gives priority to the weight/age index as a nutritional indicator at ages lower than 2 years. Eighteen percent of the girls were considered at (height/age < p10) of suffering chronic malnourishment, but this was only confirmed in 67% of the group according to Waterlow's criteria. Among assessed plasma parameters, decreased prealbumin, lymphocytes, iron, and transferrin stand out. The predominant pathological findings were thalassemia, dermatitis, psychomotor retardation, and ferropenic anemia. Conclusions: These results make us believe in a possible in the conditions at Chinese orphanages. The low age at the time of adoption may justify the low incidence of chronic nutritional deficiencies. As a whole, anthropometrical / nutritional impairments found may be related with the consequences of carelessness and vulnerability of the adoption process. In any case, early diagnosis and implementation of appropriate therapy as soon as possible, as it is being done, is essential to provide appropriate growth and development of these girls. [ABSTRACT FROM AUTHOR]

It has been well documented in medical literature that hyponutrition is a common issue at all healthcare levels, from primary to specialized health care, as well as geriatric healthcare facilities. This problem is not limited to countries with scarce economic resources or limited social development; it is also a universal issue in Europe. Hyponutrition increases the rates of morbidity, mortality, hospital admissions, and hospital stay. These higher figures also represent a higher use of healthcare resources. In spite of this, hyponutrition may often go undetected and the patient may not receive the necessary treatment. This problem requires the cooperation of multiple agents such as the Governments, the healthcare professionals, and the citizens themselves. The VIII Discussion Forum concludes on the need to establish a clear-cut plan for action (similar to the European Alliance for Health Nutrition) and the creation of a platform (coalition) encompassing the voices of healthcare professionals associations, institutions, professional colleges, patients associations, the pharmaceutical companies, and insurance companies. The goals of this platform will be to inform about the extent of this issue, to identity and promote leaders that will convey the aims of this initiative to regional and national healthcare authorities, to present solutions and to collaborate in their implementation, and finally to assess/control the actions taken. [ABSTRACT FROM AUTHOR]

Objective: To analyze the nutritional status (NS) of patients older than 65 years and establish their relationship with sociodemographic and health variables., Design: Cross-sectional observational study in patients older than 65 years., Location: 3 health centers., Participants: 255 patients: ambulatory (AP), in domiciliary care (DP) or institutionalized (IP). They completed the study 243 (response rate 95.3%)., Main Measurements: The Chang method was applied to determine the NS. Sociodemographic, anthropometric variables, dependence, mood, cognitive and analytical parameters were collected. Associations were analyzed applying chi-square and analysis of variance. The prevalence ratio (PR) for malnutrition was calculated. A multivariate model was applied (binary logistic regression). Significance was considered for p<0.05., Results: The average age was 81.3 years (SD=7.4) and 72.0% were women. 48.9% were AP, 26.8% DP and 24.2% IP. 29.6% (95% CI: 23.9-35.8) presented malnutrition. Greater malnutrition was established in relation to living in a residence or requiring home help (PR=5.3), age over 85 (PR=4.9), presenting a moderate or higher dependency for basic activities of daily living (PR=3.9) and instrumental (PR=3.3), need help for mobility (PR=2.9) and present moderate/severe cognitive impairment (PR=2.1). The determinants of malnutrition in the multivariate model were older than 85 years old and being IP or DP., Conclusions: Emphasis should be placed on evaluating NS in patients older than 85 years of age who live in a residence or require home care, since they are the groups at greatest risk of malnutrition., (Copyright © 2018. Publicado por Elsevier España, S.L.U.)

Introduction: Disease-related malnutrition (DRM) is highly prevalent. Various European resolutions urge to screen and treat DRM. No policy in this regard has yet been developed in Extremadura (Spain)., Objectives: To assess the prevalence of DRM (defined as NRS 2002≥3) using an analytical method (FILNUT), and to compare it with the official rate., Results: FILNUT scores≥3 showed values of sensitivity (S) and positive predictive value (PPV) of 82.3% and 72.3% respectively. No statistically significant differences were found between men and women using this tool. FILNUT showed a significantly higher sensitivity for detecting malnutrition in medical - as compared to surgical - diseases when low scores were used. The estimated prevalence of DRM was 21.4%. Prevalence of DRM is much greater than officially reported., Conclusions: FILNUT scores≥3 show high sensitivity and PPV for detecting DRM, and is a good alternative as a nutritional screening tool to detect malnutrition at our center., (Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To analyse the nutritional status of patients older than 65 years included in the home care program (PAD)., Design: Croos-sectional study., Emplacement: 3 urban health centers., Participants: 218 patients in the PAD., Method: Mini Nutritional Assessment questionnaire (MNA) was applied. Sociodemographic, anthropometric, dependency, emotional and cognitive status and analytical parameters: 57 variables were collected. Possible associations were analysed by applying the chi square and variance analysis. The level of significance was considered to be P<.05 was considered., Results: The mean age was 83.9 years (SD=7.4); 34.9% were institutionalized and 80.7% were women; 21.2% of patients were malnourished and 40.1% were at risk of it. A significant association was established between poorer nutritional status and older age, lower BMI, greater dependence on basic and instrumental activities of daily living and greater cognitive impairment. The lowest mean hemoglobin, albumin, and iron levels were also associated with malnutrition and risk of malnutrition., Conclusions: More than half of PAD patients are malnourished or at risk for it, and a high proportion of them some laboratory abnormality susceptible to be corrected. Most cognitive impairment and functional dependence are closely related to malnutrition; so patients with these characteristics should receive more attention from the nutritional point of view., (Copyright © 2017 Elsevier España, S.L.U. All rights reserved.)