Malnutrition among older adults living in Portuguese nursing homes: the PEN-3S study

Abstract

ObjectiveTo characterise the nutritional status and to identify malnutrition-associated variables of older adults living in Portuguese nursing homes.DesignCross-sectional study. Data on demographic and socio-economic characteristics, self-reported morbidity, eating-related problems, nutritional status, cognitive function, depression symptoms, loneliness feelings and functional status were collected by trained nutritionists through a computer-assisted face-to-face structured interview followed by standardised anthropometric measurements. Logistic regression was used to identify factors associated with being at risk of malnutrition/malnourished.SettingPortuguese nursing homes.SubjectsNationally representative sample of the Portuguese population aged 65 years or over living in nursing homes.ResultsA total of 1186 individuals (mean age 83·4 years; 72·8 % women) accepted to participate. According to the Mini Nutritional Assessment, 4·8 (95 % CI 3·2, 7·3) % were identified as malnourished and 38·7 (95 % CI 33·5, 44·2) % were at risk of malnutrition. These percentages increased with age and were significantly higher for women. Logistic regression showed (OR; 95 % CI) that older adults reporting no or little appetite (6·5; 2·7, 15·3), those revealing symptoms of depression (2·6; 1·6, 4·2) and those who were more dependent in their daily living activities (4·7; 2·0, 11·1) were also at higher odds of being malnourished or at risk of malnutrition.ConclusionsMalnutrition and risk of malnutrition are prevalent among nursing home residents in Portugal. It is crucial to routinely screen for nutritional disorders, as well as risk factors such as symptoms of depression and lower functional status, to prevent and treat malnutrition.

Social and Economic Factors and Malnutrition or the Risk of Malnutrition in the Elderly: A Systematic Review and Meta-Analysis of Observational Studies

“…Of the total 40 included studies, 36 were cross-sectional [13,14,17,18,[20][21][22][23][24][25][26][27][28][29][30][31][32][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][51][52][53] and four were cohort studies [16,19,33,50]. The study population was 60 years old and above, except for two studies that focused only on people aged over either 85 years [26] or 90 years [37].…”

“…All of the studies included people of both genders, except two studies [50,51]-one of them was only focused on men [50] and the other only on women [51]. Of the 40 studies included in the systematic review, according to the Development Human Index from the United Nations Development Program (UNDP) [54], 33 were conducted in regions with a high development human index (Poland [39], Sweden [38,40], China [30,37,53], Turkey [52], Canada [49,50], Italy [14,35], Taiwan [16], Lebanon [17,20,25], Brazil [18], Ireland [19,31], Finland [21], Spain [13,22,26], Norway [23,34], Portugal [24], Korea [27], Iran [28], Sri Lanka [29], New Zealand [48], Mexico [32], Amsterdam [33], Malaysia [36], and Shanghai [51]), five were conducted in regions with a medium development human index (Bangladesh [41,44], India [42], South Africa [43], and Egypt [45]), and two were conducted in regions with a low development human index (Central Africa…”

“…Of the 40 observational studies included in the systematic review, regarding the tools used to assess the nutritional status, 29 studies used the MNA [13,14,[16][17][18]20,21,[23][24][25][26][28][29][30][31][32][34][35][36][37][39][40][41][42][43]45,[51][52][53], one of which also used the Norwegian version of the Nutritional Form For the Elderly (NUFFE-NO) [34]. Of the other studies, five used only the Body Mass Index (BMI) [19,22,33,44,46] and one also used self-reported weight loss [19], four used the Senior in the community: risk evaluation for eating and nutrition (SCREEN II) [38,[48][49][50] and two used the Nutritional Screening Initiative (NSI) [27,47].…”

“…Of the total of 40 observational studies included in the systematic review, eight different socioeconomic variables were evaluated: 31 studies evaluated the educational level [13,14,16,18-20, 22,24-30,33,35-37,39,41-49,51-53], 27 the fact of living alone or cohabiting [13,14,19,21,22,[25][26][27][28][29]31,32,[36][37][38][39][40][42][43][44][45][48][49][50][51][52][53], 24 the marital status [13,14,16,19,23,24,26,27,29,30,[33][34][35][36]39,41,42,[44][45][46]48,…”

“…Of the 31 studies that evaluated educational level, 15 established significant relationships with regard to malnutrition or malnutrition risk [14,22,25,27,28,35,39,41,42,[45][46][47]49,52,53], two suggested a significant trend [30,44], and 14 did not present significant differences [13,16,[18][19][20]24,26,29,33,36,37,43,48,51] (Table S2). Of those 15 with signification, 11 studies showed a negative association, that is, the lower the educational level, the higher the malnutrition risk [14,25,28,35,39,41,42,45,46,49,53].…”