NEARLY one-third of elderly hospital patients are malnourished, and a further 61 per cent are at risk of malnutrition.

A study of 100 Australian hospital patients aged 70 or more also suggests doctors and nurses do a poor job of spotting the problem. Even when they do, few of the patients affected are referred to a dietitian for help.

The study, carried out at Melbourne's St Vincent's Hospital, found doctors and nurses recorded a patient's recent weight loss in only 19 per cent of cases. Poor appetite, another risk factor for malnutrition, was recorded in medical notes barely half the time, or in 53 per cent of cases.

Just 7 per cent who had recently lost weight, and 9 per cent of patients with poor appetites, were referred to a dietitian.

The authors of the paper, published in the journal Nutrition & Dietetics, wrote that malnutrition in elderly hospitalised patients "remains a significant problem with low rates of recognition and referral by medical and nursing staff".

They called for better education for doctors and nurses to encourage better identification of the problem. "No one's really taking any notice of the fact that people are coming into hospital undernourished," said study co-author Alison Bowie.

The palatability of hospital meals was another issue. Ms Bowie said the tendency to make hospital food healthy, with low-fat and low-salt meals, did not help to make them more appealing. "We are working on making hospital meals more energy-dense," she said. "Being on a low-fat diet isn't the No1 priority when you are sick in hospital."

Nutrition status of the study's participants was assessed using a "mini nutritional assessment" tool, which consisted of 18 questions resulting in a score. Patients who scored less than 17 were classified as malnourished, while scores between 17 and 23.5 indicated risk of malnutrition.

The study's authors wrote that the understanding of malnutrition risk factors among doctors and nurses was poor, and "considerable scope" existed to improve training programs. Last month, a public inquiry into NSW hospitals was told that hospital food was "atrocious" and malnutrition was "rife".

Dietitians' Association of Australia executive director Claire Hewat said the latest study showed that malnutrition was a problem "even in a wealthy, Western country like Australia".

"There's been research saying this for as long as I can remember as a professional, but it keeps being swept under the carpet.

"People who are malnourished heal more slowly, their wounds break down, they are at greater risk from pressure sores, they are weak so they can't get up and do their physio so easily, and they are more prone to falling.

"All elderly people should be screened (for malnutrition) so we can pick people up more quickly.

"If they (governments) don't do something about it, it's going to blow their costs out of the water," Ms Hewat said.

Source: The Australian - Adam Cresswell, Health Editor