Nutrition risk in age-related residential care : prevalence and associated factors in adults of advanced age : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics, Massey University, Albany, New Zealand
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Date
2017
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Massey University
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Abstract
Background: The New Zealand population is rapidly ageing. Adults of
advanced age (≥85 years) are one of the fastest growing population groups with
numbers expected to double by 2036. Increasing longevity is associated with
reduced mobility, health loss, cognitive decline, and nutritional vulnerability. This
often results in increased care requirements and movement into age-related
residential care (ARRC). Overseas research indicates an increased prevalence
of malnutrition in ARRC residents. Malnutrition in older adults is associated with
increased morbidity and mortality, and consequently increased cost of health
care. This study aims to establish the prevalence of nutrition risk and associated
factors among adults of advanced age recently admitted to ARRC within the
Waitemata District Health Board (WDHB) region of Auckland, New Zealand.
Methods:
A total of 97 participants aged ≥85 years were recruited within five days of
admission to WDHB ARRC facilities. Sociodemographic and health
characteristics of participants were determined during a single 60-minute
interview. Standardised measures were used to measure body composition,
grip strength and gait speed. Nutrition risk was assessed using the Mini
Nutritional Assessment-Short Form (MNA-SF), dysphagia risk using the 10-Item
Eating Assessment Tool (EAT-10) and cognitive status using the Montreal
Cognitive Assessment (MoCA).
Results:
Of the 97 participants (mean age 90.9 ± 3.8 years), half (50.5%) were
malnourished, 40.2% at nutrition risk and a third (37.1%) were at dysphagia
risk. Malnourished participants were more likely to be ≥90 years (p = 0.019),
admitted to ARRC on a permanent basis (p = 0.016), at dysphagia risk (p =
0.015), have a BMI <23 (p = 0.022), lower fat mass (p = 0.005), and fewer
comorbidities (p = 0.030). The MNA-SF score was inversely correlated with age
(r = -0.225, p = 0.027) and positively correlated with BMI (r = 0.499, p = <0.001)
and fat mass (r = 0.765, p = <0.001).
Conclusion:
A high prevalence of malnutrition and dysphagia risk was discovered within this
study population. Residents aged ≥90 years with low BMI are at greatest
nutrition risk and are an easily identifiable group. Early screening and
intervention is recommended upon admission to ARRC.
Key words: Aged, anthropometric measures, deglutition disorders, malnutrition,
mini nutritional assessment, rest home
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Keywords
Older people, Nursing home patients, Nutrition, Institutional care, New Zealand, Research Subject Categories::INTERDISCIPLINARY RESEARCH AREAS::Domestic science and nutrition, Aged, Anthropometric measures, Deglutition disorders, Malnutrition, Mini nutritional assessment, Rest home