Optimising Malnutrition Screening Protocols in Geriatric Patients at Federal Medical Centres in South West Nigeria: A Biochemical Perspective

Geriatric malnutrition is significantly underdiagnosed in Nigerian tertiary health facilities despite its association with adverse clinical outcomes including prolonged hospitalisation, increased infection risk, and excess mortality. This study optimises malnutrition screening protocols for geriatric inpatients from a biochemical perspective, evaluating the diagnostic concordance and clinical utility of biochemical markers in the context of existing screening tools at three Federal Medical Centres in Ogun, Ondo, and Ekiti states. A sample of two hundred and forty patients aged sixty years and above admitted to medical wards across the three facilities was enrolled. Nutritional status was assessed using the Mini Nutritional Assessment tool as the reference standard. Biochemical markers including serum albumin, prealbumin, transferrin, serum zinc, serum cholesterol, and haematological indices were measured. The sensitivity, specificity, positive and negative predictive values of each biochemical marker at defined cut-off thresholds were calculated against the MNA reference diagnosis. Serum prealbumin showed the highest diagnostic sensitivity (81%) and acceptable specificity (74%) for malnutrition detection among biochemical markers, outperforming serum albumin in responsiveness to acute nutritional change. Serum albumin, while less sensitive, remained an important predictor of malnutrition severity and clinical outcome. A combined biochemical screening index incorporating prealbumin and serum zinc performed better than any single marker. The study recommends incorporating serum prealbumin and zinc into standardized malnutrition screening pathways for geriatric inpatients in South West federal facilities. Keywords: geriatric malnutrition, biochemical screening, serum prealbumin, Federal Medical Centre, South West Nigeria.