This study determined the independent association of 24 risk factors with dietary intake in community-living seniors. The study sample was 5,073 seniors for whom complete data were available from the 1990 Ontario Health Survey. Risk factors were items completed on an interviewer-administered health questionnaire. Diet Score, Mean Adequacy Ratio and energy were the diet outcomes derived from a self-administered food frequency questionnaire. The independent association of risk factors with these diet outcomes was assessed with multiple linear regression analyses. Factors that were consistently and positively associated with diet outcomes included: education, income, social support, perceived health status, belief in the nutrition/health link, dependence in walking and vision. Factors that were consistently and negatively associated with diet outcomes included: chewing status, dentition, hearing, level of happiness and body mass index. These results provide a basis for the development of a screening tool for the identification of "at risk" subgroups of seniors.
Frail older adults are at risk for poor nutrition and frequently experience declining healthrelated quality of life (HR-QOL). The relationship between nutritional risk and HR-QOL although intuitive, has been rarely studied.
To determine the independent association of nutritional risk with HR-QOL in frail older adults.
Cross-sectional survey. Data were collected by interviewer-administered questionnaire. Nutritional risk was measured by SCREEN (Seniors in the Community: Risk Evaluation for Eating and Nutrition) and HR-QOL by perceived health status and report of number of days in the past month where physical or mental health was not good, or where activities were limited. Frail (n=367) seniors were recruited from 23 community service providers. A wide variety of covariates were also measured. Multivariate modeling based on a conceptual model was used to identify factors associated with HR-QOL.
Nutritional risk appears to be a significant and important factor associated with HR-QOL. Other significant covariates were: falls, social supports, social activity, health behaviours, pain and medication use.
Nutritional risk as measured by SCREEN appears to be a significant covariate in explaining differences in HRQOL among frail older adults. Further work should determine if nutritional risk predicts changes in HR-QOL over time.
To determine the prevalence of undernutrition and overnutrition in long-term care elderly patients and the functional, behavioral, environmental, nutritional, and medical variables associated with this prevalence.
Long-term care hospital in Canada.
Two hundred elderly patients (n = 166 male), average age 78.5 years.
Assessment of nutritional status and presence of specific behavioral, medical, environmental, and functional characteristics known to impact on nutritional status. Nutritional status was determined by weight, % weight loss, BMI, skinfolds, arm circumference, area measurements, and % body fat. Multiple regression analyses were performed to identify the factors associated specifically with undernutrition and overnutrition in this population.
Severe undernutrition was present in 18% (n = 36) and severe overnutrition in 10% (n = 20). Mild/moderate undernutrition was present in 27.5% (n = 55) and mild/moderate overnutrition in 18% (n = 36). Overnutrition was positively associated with primary diagnosis and number of medications and negatively associated with poor appetite, number of feeding impairments, protein intake, and mental state. Undernutrition was positively associated with dysphagia, slow eating, low protein intake, poor appetite, presence of a feeding tube, and age and negatively associated with primary diagnosis.
Undernutrition exists at a level that is high (45.5%) but not unusual for this type of institutional setting. Behavioral, environmental, and disease-related factors greatly influence nutritional status. Undernutrition appears to be affected by nutritional factors more than overnutrition. Efforts should be directed toward influencing some of these factors to decrease undernutrition in the institutionalized elderly.