Does undernutrition still prevail among nursing home residents?

Abstract

Background & aims: During recent years public awareness about malnutrition has increased and collective initiatives have been undertaken. Simultaneously, the number of older adults is increasing, and the elderly care has been placed under pressure. The aim was to assess the nutritional situation and one-year mortality among nursing home (NH) residents, and compare with historical data. Methods: Mini Nutritional Assessment-Short Form (MNA-SF), ADL Barthel Index (BI), Short Portable Mental Status Questionnaire (SPMSQ), EQ-5D, Charlson Comorbidity Index (CCI), and blood samples were collected from 172 NH residents (86.3 ± 8 years, 70% women). Mortality data was taken from NH records. Nutritional data from 166 NH residents (83.8 ± 8 years, 61% women) examined in 1996 was retrieved for historical comparison. Results: The prevalence of malnutrition was 30%, as compared to 71% in the historical data set, corresponding to a present average body mass index of 23.7 ± 5.1 compared with 22.3 ± 4.2 kg/m2 (p < 0.01). Reduced nutritional status was associated with decline in function (p < 0.001) and cognition (p < 0.01). One-year mortality was 24%. Regression analyses indicated high age (OR = 1.09, 95% CI (1.03–1.16)), high scores in CCI (OR = 1.54, (1.19–1.99)), low BMI (OR = 2.47, (1.14–5.38)) and malnutrition (OR = 2.37, (1.07–5.26)) to be independently associated with one-year mortality. Conclusions: Malnutrition still prevails and is associated with deteriorated cognition, function and increased mortality. A possible improvement in nutritional status in NH residents over time was observed.