The prevalence of nutrition risk and associated risk factors among older adults recently admitted to age-related residential care within the Waitemata District Health Board region : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Auckland, New Zealand

Abstract

Background: New Zealand has a rapidly growing ageing population, aligned with the ageing population trend occurring globally. Older adults account for a significant proportion of the government health care expenditure, primarily due to higher needs for disability services and a higher level of care, such as residential care. Malnutrition is multi-factorial and may result in disability and poor health contributing to a significant decline in the independence in older adults. Internationally, previous research has found a high prevalence of malnutrition among older adults in the residential care setting. This study aims to investigate the prevalence of malnutrition and associated risk factors among older adults (aged 64 to 84 years) newly admitted to residential care facilities across the Waitemata District Health Board (WDHB) region. Methods: A cross-sectional study was undertaken among older adults newly admitted to WDHB residential care facilities. A questionnaire was used to assess participant sociodemographic and health characteristics. Anthropometric and body composition measurements were recorded. Grip strength was measured using a handgrip dynamometer and gait speed was measured by a 2.4m walk test. Nutrition risk was assessed using the Mini Nutritional Assessment- Short Form (MNASF), dysphagia risk was determined from the 10-item Eating Assessment Tool (EAT-10) and the Montreal Cognitive Assessment (MoCA) examined cognitive function. Results: The mean age of participants was 78.7 ± 5.0 years. Of 77 participants, just under half (45.5%) were malnourished with a further 49.4% were at high nutrition risk. Over a third (37.7%) of participants were at dysphagia risk. Malnourished participants were more likely to require daily help prior to admission (p=0.011) and have a slower gait speed (p=0.014). A higher nutrition risk (lower MNA-SF score) was strongly correlated with a lower BMI (r=0.274, p=0.024), grip strength (r=0.368, p=0.001), higher dysphagia risk (r=-0.248, p=0.029) and higher medication use (r=-0.213, p=0.043). Conclusion: Nearly half the participants were malnourished, and over a third were at risk of dysphagia. This study highlights that low BMI, grip strength and higher dysphagia risk and medication use are potential risk factors for malnutrition. Findings highlight the importance of malnutrition and dysphagia screening among older adults upon admission to residential care. This will ensure appropriate diagnosis and treatment for those identified at risk.