Modalités de dépistage de la dénutrition chez les patients âgés : étude auprès de 100 médecins généralistes de l'Eurométropole de Strasbourg

Malnutrition among the elderly is a syndrome characterized by high prevalence and significant morbidity and mortality. The French National Health Authority (HAS) therefore issued guidelines regarding screening and management strategies in 2007. We believe that general practitioners occupy a key role in this mission. The objective of this study was to determine the modes of screening for malnutrition in the elderly used by general practitioners in the Euro-metropolitan area of Strasbourg in France. The study was conducted using postal mail questionnaires accompanied by a telephone follow-up. In all 100 general practitioners practicing in the Strasbourg Eurometropolis were included in the study, of whom 54% were found to perform systematic screening for malnutrition among their elderly patients. The main barrier to screening reported by general practitioners was the lack of time (59% of respondents). The warning signs for the risk of malnutrition were loss of weight objectified in consultation (99% of respondents) or patient-reported (90%), and/or a decrease in BMI (71%). Malnutrition risk factors were however less well known. Screening methods were generally in accordance with recommendations: use of anthropometric measurements (BMI was calculated by 85% of the practitioners interviewed), and nutritional markers (albumin is tested in 94% of cases). The use of nutritional indexes such as the Mini Nutritional Assessment (MNA) is not currently in common practice (MNA administered by 23% of the practitioners interviewed). To conclude, the systematic screening for malnutrition in the elderly is not optimal and warrants annual medical consultations.