THE SIGNS AND SYMPTOMS OF POOR NUTRITIONAL-STATUS

It is vital for all members of the health care team to be astute and skilled in detecting the signs and symptoms of poor nutritional status. Although these signs and symptoms can be the, result of various disease processes other than poor nutrition, improving nutrition in the elderly relies on all of us considering a nutritional cause for these clinical features and laboratory results. By the time these signs and symptoms are present, the patient's status is already compromised: poor nutritional status is already present and causing some effect. This article details the signs and symptoms that should be sought in interviewing patients and their caregivers, from observation of the patients in their environment, and by physical examination including specific anthropometric measurements, and laboratory tests. The Nutrition Screening Initiative classification of these signs and symptoms into ''major indicators'' (which, if present, mandate a search for nutritional problems) and ''n-minor indicators'' are reproduced. The importance of recognizing that the sensitivity to change of some of these indicators over time can be used to establish the need for and the response to interventions is clarified.