Protein‐Calorie Undernutrition in the Nursing Home

Rudman, Daniel; Feller, Axel G.

doi:10.1111/j.1532-5415.1989.tb05880.x

Cited by 213 publications

(136 citation statements)

References 124 publications

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“…Malnutrition in the long term residential care setting has been extensively documented to be a prevalent problem, with adverse effects on morbidity and mortality (Munci & Carbonetto, 1982;Pinchcofsky-Devin & Kaminski Jr, 1986;Sandman et al, 1987;Rudman & Feller, 1989;Thomas et al, 1991;Abbasi & Rudman, 1993;Sullivan & Walls, 1994;Morley & Silver, 1995). The causes are largely reversible (Morley & Kraenzle, 1994;Morley & Silver, 1995;Sullivan, 1995), and nutritional assessment has been incorporated as one of several performance indicators linked to reimbursement in countries such as the US (Hawes et al, 1997), as part of the Resident Assessment Instrument (Brown, 1995).…”

Section: Introductionmentioning

confidence: 99%

Low staffing level is associated with malnutrition in long-term residential care homes

et al. 2005

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Objective: To determine if staffing level is associated with poor nutrition in the long-term residential care setting, adjusting for other confounding factors. Design: Cross-sectional survey. Setting: In total, 14 residential care facilities in Hong Kong, stratified by nature (government subvention or for-profit) to reflect the overall proportion in Hong Kong. Subjects: A total of 1914 subjects were assessed, using the Resident Assessment Instrument (RAI) 2.0. The response rate was 95% (1820 subjects), of which 1699 subjects had complete nutritional information. Intervention: Body mass index (BMI) was calculated by weighing and height measurement, and arm span was used if the subject could not stand. Subjects who were receiving parenteral or enteral nutrition via nasogastric of enterostomy tubes were excluded. A history of weight loss of 5% in the past month or 10% in the past 6 months, leaving 25% of food uneaten, and BMI o18.5 kg/m 2 were examined as nutritional indicators. Association with age, gender, functional disability, oral problems, taste problems, presence of physical diseases and psychological well-being was examined using w 2 -test, and multiple logistic regression. Results: In all, 26% of residents had a BMI o18.5 kg/m 2 , with a higher prevalence in the for-profit homes. History of weight loss and the record that 25% of food was left uneaten were poor indicators of low BMI. Multivariate analysis showed that having chronic obstructive airways disease, requiring help with feeding, being female, older age, were factors associated with an increased risk of poor nutrition, while being independent in activities of daily living and higher staff levels were associated with a reduced risk. Conclusion: Poor nutrition is a persistent problem in the long-term care setting, and inadequate staffing levels may be a reversible cause. However, resource limitations may render efforts at improvement difficult. Sponsorship: SK Yee Memorial Fund.

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Section: Introductionmentioning

confidence: 99%

Low staffing level is associated with malnutrition in long-term residential care homes

et al. 2005

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“…The prevalence of malnutrition in institutionalised elderly has been estimated at 30 -70% (Asplund et al, 1981;Morgan et al, 1986;Rudman & Feller, 1989). In general, the causes of these deficiencies are threefold: (1) inadequate intake which might be caused by reduced macronutrient need, poor dietary habits, isolation, depression, dental or chewing problems, medication or dementia; (2) increased nutritional requirements due to fever, infection or dementia; and (3) losses of nutrients or reduced absorption, for instance protein loss from wounds, glycosuria, diarrhoea or medication (Mobarhan & Trumbore, 1991;Chernoff, 1994).…”

Section: Introductionmentioning

confidence: 99%

Study of the effect of a liquid nutrition supplement on the nutritional status of psycho-geriatric nursing home patients

Wouters-Wesseling¹,

Wouters²,

Kleijer

et al. 2002

Eur J Clin Nutr

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Objectives: To evaluate the acceptance of a multinutrient liquid nutrition supplement in psycho-geriatric nursing home patients and the effect on weight, plasma nutrients and activities of daily life. Design: Double-blind, placebo-controlled 12-week intervention study. Setting: Two nursing homes in Boxtel, The Netherlands. Subjects: Forty-two (body mass index (BMI) < 23 kg=m 2 for men or < 25 kg=m 2 for women) psycho-geriatric nursing home patients aged 60 y or over. Interventions: Provision with a complete micronutrient-enriched liquid nutrition supplement of 125 ml and 0.6 MJ (135 kcal) or placebo twice daily during daytime between main meals. Study parameters were assessed at 0, 6 and 12 weeks. Main Outcome for Measures: Weight, Barthel index of daily activities, several plasma values (albumin, C-reactive protein (CRP), homocysteine, thiamine, thiamine diphosphate (TDF), vitamin B 6 , vitamin B 12 , folic acid, vitamin D), bowel function. Results: The supplement was well accepted. Thirty-five patients completed the intervention period (16 control group; 19 supplement group). Baseline daily nutrient intake was low. A statistically significant improvement was observed for body weight (difference between groups 2.2 kg, P ¼ 0.03), and homocysteine, vitamin B 1 , TDF, vitamin B 6 , vitamin B 12 , folate and vitamin D in the supplement group compared to the placebo group. No significant difference was observed in the Barthel index (mean difference 7 0.3 AE 1.1 for both groups). No difference in occurrence of diarrhoea was observed. Conclusions: The study shows that nutritional supplementation is well accepted and can improve the nutritional status of psycho-geriatric nursing home patients.

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“…Three categories defined by this instrument were used: normal nutritional status (score ≥ 24), at risk of malnutrition (score 17-23.5), and malnourished (score under 17 points) [16,17,22].…”

Section: Mini Nutritional Assessment (Mna)mentioning

confidence: 99%

Association between Nutritional Status Determined By Mini Nutritional Assessment and Serum Marker Levels in Older Adults at Eldercare Facilities

Lopez

2015

JNB

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Malnutrition in the older adult is an ongoing situation in Mexico and is most apparent in individuals that reside in hospitals, nursing homes, and retirement homes. For that reason, it is necessary to evaluate the nutritional status of these adults by means of the Mini Nutritional Assessment (MNA) and levels of three serum indicators that are commonly ordered when making malnutrition diagnosis. An analytical cross-sectional study was carried out on 100 older adults residing in eldercare facilities. Nutritional status was evaluated by means of the MNA and three serum indicators (albumin, ferritin, and hemoglobin). Descriptive statistics were used to analyze sociodemographic characteristics, and a Student's t test, based on sex and reference values, was used to compare mean values of the three serum indicators. A Chi-square test was used to compare proportions in individuals, based on sex, who had normal nutritional status or were malnourished, and who were at risk of malnutrition. A One-way ANOVA with Scheffé post hoc test was used to identify the association between serum indicators and the nutritional status of older adults. Of the 100 older adults studied, 53% were men and 47% were women. The mean age was 85 ± 0.7 years. According to the MNA, 20% had normal nutritional status, 55% were at risk of malnutrition, and 25% were malnourished. The mean indicator values were: albumin 4.7 ± 0.04 g/dL, ferritin 74.2 ± 8.7 ng/mL, and hemoglobin 13.0 ± 0.1 g/dL. No significant association was found between serum indicators and each MNA classification. However, when the same indicators were compared between the sexes, hemoglobin showed a significant difference (P=0.037). Women had lower values but those values did not extend beyond the established physiological range for this population. There was a 55% prevalence of risk of malnutrition in the nutritional status of older adults living in Mexican eldercare facilities in a Mexican province and it was even more frequent in women.

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Protein‐Calorie Undernutrition in the Nursing Home

Cited by 213 publications

References 124 publications

Low staffing level is associated with malnutrition in long-term residential care homes

Low staffing level is associated with malnutrition in long-term residential care homes

Study of the effect of a liquid nutrition supplement on the nutritional status of psycho-geriatric nursing home patients

Association between Nutritional Status Determined By Mini Nutritional Assessment and Serum Marker Levels in Older Adults at Eldercare Facilities

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