UWL: Assess Anthropometric Measurements 2009
Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.
UWL: Assess Anthropometric Measurements
The Registered Dietitian (RD) should ensure that older adults are weighed upon initial visit, admission or readmission to obtain a baseline weight, and then weekly thereafter, using standard procedures. Studies support an association between unintended weight loss and increased mortality.
Risks/Harms of Implementing This Recommendation
- Standard weighing procedures must be followed or weights may be inaccurate
Conditions of Application
Potential Costs Associated with Application
- Appropriate equipment (bed scales, chair scales, etc.) may be costly
- Cost of staff time should be considered
- Five studies support an association between underweight and/or unintended weight loss and increased mortality but the definition is inconsistent.
- One study reported that mortality was 50% for subjects with a BMI < 20 kg/m2 (Saletti et al, 2005), but additional research suggests that the current BMI thresholds may not apply to the elderly (Sanchez-Garcia et al, 2007).
- Two studies report that weight loss was associated with a 2 to 10-fold increased risk for death (Sullivan et al, 2002; Sullivan et al, 2004), and one study reported that those who were severely underweight were four times more likely to have unintentional weight loss of 10 pounds in 6 months (Martin et al, 2007).
Recommendation Strength Rationale
- Conclusion Statement in support of this recommendation received Grade II
- Risks/Harms of Implementing This Recommendation
The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).
Martin CT, Kayser-Jones J, Stotts NA, Porter C, Froelicher ES. Risk for low weight in community-dwelling, older adults. Clinical Nurse Specialist. 2007; 21: 203-211.
Saletti A, Johansson L, Yifter-Lindgren E, Wissing U, Osterberg K, Cederholm T. Nutritional status and a 3-year follow-up in elderly receiving support at home. Gerontology, 2005; 51 (3): 192-198.
Sanchez-Garcia S, Garcia-Pena C, Duque-Lopez MX, Juarez-Cedillo T, Cortes-Nunez AR, Reyes-Beaman S. Anthropometric measures and nutritional status in a healthy elderly population. BMC Public Health. 2007; 7: 2-11.
Sullivan DH, Morley JE, Johnson LE, Barber A, Olson JS, Stevens MR, Yamashita BD, Reinhart SP, Trotter JP, Olave XE. The GAIN (Geriatric Anorexia Nutrition) Registry: The impact of appetite and weight on mortality in a long-term care population. J Nutrition Health and Aging. 2002; 6 (4): 275-281.
Sullivan DH, Johnson LE, Bopp MM, Roberson PK. Prognostic significance of monthly weight fluctuations among older nursing home residents. J Gerontol A Biol Sci Med Sci. 2004; 59(6): M633-M639.