Chapter 6 Nutrition Assessment of Older Adults

Figure 6.3 Level II Screen Level II Screen

Complete the following screen by interviewing the patient directly and/ or by referring to the patient chart. If you do not routinely perform all of the described tests or ask all of the listed questions, please consider including them but do not be concerned if the entire screen is not completed. Please try to conduct a minimal screen on as many older patients as possible, and please try to collect serial measurements, which are extremely valuable in monitoring nutritional status. Please refer to the manual for additional information.

Anthropometrics

Measure height to the nearest inch and weight to the nearest pound. Record the values below and mark them on the Body Mass Index (BMI) scale to the right. Then use a straight edge (paper, ruler) to connect the two points and circle the spot where this straight line crosses the center line (body mass index). Record the number below; healthy older adults should have a BMI between 24 and 27; check the

abnormally high or low value.

WEIGHT KG LB

130 140 150

100 110 120

90 95

75 80 85

65 70

45 50 55 60

35 40

30 25

100 110 120 130 140 150 160 170 180 190 200 220 240 260 280 300 320 340

50 55 60 65 70 75 80 85 90 95

BODY MASS INDEX

[WT/(HT)2]

60 70

WOMEN OBESE OVERWEIGHT ACCEPTABLE

40 50

30

93

NOMOGRAM FOR BODY MASS INDEX

HEIGHT CM IN

MEN OBESE OVERWEIGHT 20 ACCEPTABLE 10

125 130 135 140 145 150 155 160 165 170 175 180 185 190 195 200 205 210

50

55

60

65

70

75

80

85

Height (in): Weight (lbs): Body Mass Index (weight/height2

):

Please place a check by any statement regarding BMI and recent weight loss that is true for the patient.

Body mass index <24 Body mass index >27 Has lost or gained 10 pounds (or more) of body weight in the past 6 months

Record the measurement of mid-arm circumference to the nearest 0.1 centimeter and of triceps skinfold to the nearest 2 millimeters.

Mid-arm circumference (cm): Triceps skinfold (mm): Mid-arm muscle circumference (cm):

Refer to the table and check any abnormal values:

Mid-arm muscle circumference <10th percentile Triceps skinfold <10th percentile Triceps skinfold >95th percentile

Note: Mid-arm circumference (cm) – {0.314 × triceps skinfold (mm)} = mid-arm muscle circumference (cm)

For the remaining sections, please place a check by any statements that are true for the patient.

Laboratory Data Serum albumin below 3.5 g/dl Serum cholesterol below 160 mg/dl Serum cholesterol above 240 mg/dl

Drug Use Three or more prescription drugs, OTC medications, and/or vitamin/mineral supplements daily

Source: Reprinted with permission by the Nutrition Screening Initiative, a project of the American Academy of Family Physicians and the American Dietetic Association, funded in part by a grant from Ross Products Division, Abbott Laboratories Inc.