Abstract
Nutrition assessment is a comprehensive evaluation of nutritional status that uses medical, nutritional, and medication histories, physical examination, anthropometric measurements, and laboratory data. Inflammatory metabolism both acute and chronic affects a number of physical, anthropometric, and laboratory measurements used in the assessment process. Chronic diseases associated with old age and perhaps aging itself produce chronic inflammatory alterations that affect immunity, hepatic protein metabolism, lean body mass homeostasis, and fluid compartment shifts that obfuscate the ability of clinicians to evaluate nutritional status and monitor the outcomes of nutritional interventions. Additional problems unique to the elderly include sarcopenia and frailty, perhaps related to inflammatory alterations, which also cause anthropometric abnormalities and likewise are difficult to integrate with nutrition assessment and monitoring. The most useful assessment methodologies in the elderly are those that focus on recent weight changes and the functional capacity of an individual to achieve or maintain nutritional adequacy. Activities, including instrumental activities, of daily living are an excellent tool to evaluate the functional capacity of an elderly individual. Minimum Data Set accomplishes this as part of a comprehensive assessment of clinical status in long-term care facilities in the United States. In Europe, the Mini Nutrition Assessment has been validated as the optimal tool to evaluate nutritional status in the elderly and has been suggested as a useful tool to use in settings in the United States where the Minimum Data Set is not used.