Apathy and Weight Loss in Nursing Home Residents: Longitudinal Study

Volicer, Ladislav; Frijters, Dinnus; Steen, Jenny T. van der

doi:10.1016/j.jamda.2012.12.004

Cited by 50 publications

(28 citation statements)

References 34 publications

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“…Food intake can be promoted by addressing the potential causes of low intake. Risk factors for poor food intake and weight loss in persons with dementia have been described in a variety of studies and include poor appetite, decreased smell and taste, apathy, depression, lack of concentration, decreased capacity to prepare meals, self‐feeding difficulties (which can lead to frustration and aggression), dependence on others for eating, dysphagia, and eventually, an inability to recognize when food is in the mouth . For those with mid‐ to late‐stage dementia living in residential care, the prevalence of these behaviors can be quite high: dysphagia (22%); inability to handle current diet texture (46%); difficulty with utensils (14%); taking more than 25 min to eat (32%); playing with food (8%); eating others’ food (5%); agitation (30%); requiring partial (16%) or full assistance (13%) for eating; and resisting assistance (22%), have all been described .…”

Section: Nutritional Status Following Diagnosis Of Dementiamentioning

confidence: 99%

Improving food intake in persons living with dementia

Keller

2016

Annals of the New York Academy of Sciences

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Persons living with dementia have many health concerns, including poor nutritional states. This narrative review provides an overview of the literature on nutritional status in persons diagnosed with a dementing illness or condition. Poor food intake is a primary mechanism for malnutrition, and there are many reasons why poor food intake occurs, especially in the middle and later stages of the dementing illness. Research suggests a variety of interventions to improve food intake, and thus nutritional status and quality of life, in persons with dementia. For family care partners, education programs have been the focus, while a range of intervention activities have been the focus in residential care, from tableware changes to retraining of self-feeding. It is likely that complex interventions are required to more fully address the issue of poor food intake, and future research needs to focus on diverse components. Specifically, modifying the psychosocial aspects of mealtimes is proposed as a means of improving food intake and quality of life and, to date, is a neglected area of intervention development and research.

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Section: Nutritional Status Following Diagnosis Of Dementiamentioning

confidence: 99%

Improving food intake in persons living with dementia

Keller

2016

Annals of the New York Academy of Sciences

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“…Mealtimes can be the highlight of the day for residents, providing opportunities for social interaction as well as development of relationships with care providers and tablemates [43]. Apathy and depression have been found to be independently associated with weight loss in LTC residents [44] and may be influenced by a negative mealtime experience [42]. Two theories specific to persons with dementia ( Mealtimes as Active Processes in LTC and the Life Nourishment Theory ), demonstrate the importance and potential influence of the psychosocial environment on food intake [28, 45].…”

Section: Introductionmentioning

confidence: 99%

Making the Most of Mealtimes (M3): protocol of a multi-centre cross-sectional study of food intake and its determinants in older adults living in long term care homes

et al. 2017

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BackgroundOlder adults living in long term care (LTC) homes are nutritionally vulnerable, often consuming insufficient energy, macro- and micronutrients to sustain their health and function. Multiple factors are proposed to influence food intake, yet our understanding of these diverse factors and their interactions are limited. The purpose of this paper is to fully describe the protocol used to examine determinants of food and fluid intake among older adults participating in the Making the Most of Mealtimes (M3) study.MethodsA conceptual framework that considers multi-level influences on mealtime experience, meal quality and meal access was used to design this multi-site cross-sectional study. Data were collected from 639 participants residing in 32 LTC homes in four Canadian provinces by trained researchers. Food intake was assessed with three-days of weighed food intake (main plate items), as well as estimations of side dishes, beverages and snacks and compared to the Dietary Reference Intake. Resident-level measures included: nutritional status, nutritional risk; disease conditions, medication, and diet prescriptions; oral health exam, signs of swallowing difficulty and olfactory ability; observed eating behaviours, type and number of staff assisting with eating; and food and foodservice satisfaction. Function, cognition, depression and pain were assessed using interRAI LTCF with selected items completed by researchers with care staff. Care staff completed a standardized person-directed care questionnaire. Researchers assessed dining rooms for physical and psychosocial aspects that could influence food intake. Management from each site completed a questionnaire that described the home, menu development, food production, out-sourcing of food, staffing levels, and staff training. Hierarchical regression models, accounting for clustering within province, home and dining room will be used to determine factors independently associated with energy and protein intake, as proxies for intake. Proportions of residents at risk of inadequate diets will also be determined.DiscussionThis rigorous and comprehensive data collection in a large and diverse sample will provide, for the first time, the opportunity to consider important modifiable factors associated with poor food intake of residents in LTC. Identification of factors that are independently associated with food intake will help to develop effective interventions that support food intake.Trial RegistrationClinicalTrials.gov ID: NCT02800291, retrospectively registered June 7, 2016.

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“…A common side-effect of poor psychological or emotional health is a dwindling appetite and a decline in nutritional status [8]. For instance, depression and apathy have been independently associated with weight loss in care home residents [9]. …”

Section: Introductionmentioning

confidence: 99%

Exploring residents’ experiences of mealtimes in care homes: A qualitative interview study

et al. 2017

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BackgroundMany interventions aim to alleviate well-documented problems of malnutrition in residential care homes and improve residents’ health and wellbeing. Despite some positive findings, little is known about how and why mealtime interventions might be effective, and in particular, what effects residents’ experiences of mealtimes have on health outcomes. The aim of this study was to gain an insight into these experiences and explore some of the issues that may impact on residents’ enjoyment of meals, and resulting health and wellbeing.MethodsSemi-structured interviews were conducted with eleven residents from four care homes in the South West UK. Thematic analysis was used to derive content and meaning from transcribed interviews. Interviews were supplemented by researcher observations of mealtimes.ResultsThe dining experience was a focal point for participants’ broader experiences of residing in a care home. Three themes pertaining to residents’ experiences were identified: (1) Emotional and psychological connections with other residents; (2) managing competing interests with limited resources; and (3) familiarity and routine.ConclusionMealtimes are a mainstay of life in a care home through which residents’ experiences are characterised, exemplified and magnified. Understanding how residents interact with one another, accommodating their preferences and encouraging autonomy may enhance their mealtime experiences. It may also help to ease the transition from independent-living to life in care, which can be particularly stressful for some residents, and improve health and wellbeing over the long-term.

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Apathy and Weight Loss in Nursing Home Residents: Longitudinal Study

Cited by 50 publications

References 34 publications

Improving food intake in persons living with dementia

Improving food intake in persons living with dementia

Making the Most of Mealtimes (M3): protocol of a multi-centre cross-sectional study of food intake and its determinants in older adults living in long term care homes

Exploring residents’ experiences of mealtimes in care homes: A qualitative interview study

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