Assessment of Food Intake Assisted by Photography in Older People Living in a Nursing Home: Maintenance over Time and Performance for Diagnosis of Malnutrition

Abstract

Malnutrition is related to poor outcomes. Food intake semi-quantitative assessment is helpful for malnutrition screening. Aims: to assess maintenance over one month of one-day semi-quantitative assessment of food intake (primary aim) and its performance in diagnosing malnutrition (secondary aim) in older people living in a nursing home. Food portions consumed at lunch and dinner were measured during 20 days by the Simple Evaluation of Food Intake (SEFI)® assisted by photography (SEFI®-AP) in 70 residents. Nutritional status was assessed in each patient during the first week of food intake monitoring according to Global Leadership Initiative on Malnutrition criteria. Food intake was decreased, i.e., SEFI®-AP ®-AP medians of lunch (p = 0.11) and means of lunch and dinner (p = 0.15) did not vary over time. Day 3 SEFI®-AP anticipated decreased food intake from days 4 to 20, with a sensitivity of 78% (95% confidence interval (CI), 62–94), a specificity of 30% [95%CI, 17–44] and positive and negative predictive values of 41% [95%CI, 28–55] and 68% [95%CI, 48–89]. The performance of SEFI®-AP for diagnosis of malnutrition using calf circumference ®-AP sensitivity was better if ≤9.5 than ®-AP correctly anticipates food intake during the following month and predicts diagnosis of malnutrition. Any decrease in food intake should lead to suspect malnutrition.

Keywords

• undernutrition
• food intake
• muscle
• sarcopenia
• body composition