Abstract
Background/Objectives: Malnutrition (MN) in nursing home (NH) residents is associated with poor outcome. In order to identify those with a high risk of incident MN, the knowledge of predictors is crucial. Therefore, we investigated predictors of incident MN in older NH-residents. Subjects/Methods: NH-residents participating in the nutritionDay-project (nD) between 2007 and 2018, aged ≥65 years, with complete data on nutritional status at nD and after 6 months and without MN at nD. The association of 17 variables (general characteristics (n = 3), function (n = 4), nutrition (n = 1), diseases (n = 5) and medication (n = 4)) with incident MN (weight loss ≥ 10% between nD and follow-up (FU) or BMI (kg/m2) < 20 at FU) was analyzed in univariate generalized estimated equation (GEE) models. Significant (p < 0.1) variables were selected for multivariate GEE-analyses. Effect estimates are presented as odds ratios and their respective 99.5%-confidence intervals. Results: Of 11,923 non-malnourished residents, 10.5% developed MN at FU. No intake at lunch (OR 2.79 [1.56–4.98]), a quarter (2.15 [1.56–2.97]) or half of the meal eaten (1.72 [1.40–2.11]) (vs. three-quarter to complete intake), the lowest BMI-quartile (20.0–23.0) (1.86 [1.44–2.40]) (vs. highest (≥29.1)), being between the ages of 85 and 94 years (1.46 [1.05; 2.03]) (vs. the youngest age-group 65–74 years)), severe cognitive impairment (1.38 [1.04; 1.84]) (vs. none) and being immobile (1.28 [1.00–1.62]) (vs. mobile) predicted incident MN in the final model. Conclusion: 10.5% of non-malnourished NH-residents develop MN within 6 months. Attention should be paid to high-risk groups, namely residents with poor meal intake, low BMI, severe cognitive impairment, immobility, and older age.
| Original language | English |
|---|---|
| Pages (from-to) | 382-388 |
| Number of pages | 7 |
| Journal | European Journal of Clinical Nutrition |
| Volume | 76 |
| Issue number | 3 |
| Early online date | 8 Jul 2021 |
| DOIs | |
| Publication status | Published - Mar 2022 |
Bibliographical note
Funding Information:We thank all participating nursing homes for their contribution to the nutritionDay project. We are also grateful to the European Society for Clinical Nutrition (ESPEN) and all national medical nutrition societies, the Medical University Vienna and the Friedrich-Alexander-University Erlangen-Nürnberg for their support of the nutrition-Day project. The present work was performed in partial fulfillment of the requirements for obtaining the degree Dr. rer. biol. hum (Doctoral Degree in Human Biology) for G.T. We acknowledge support by the MaNuEL knowledge hub and the Joint Programming Initiative Healthy Diet for a Healthy Life. The funding agencies supporting this work are (in alphabetical order of participating member state): Germany: German Federal Ministry of Food and Agriculture through the Federal Office for Agriculture and Food (Grants 2815ERA10E (FAU)); The Netherlands: The Netherlands Organisation for Health Research and Development (ZonMw 50‐52905‐ 98‐499). The sponsors had no role in the design and conduct of the study, in the collection, analysis, or interpretation of data, or in the preparation, review, or approval of the manuscript.
Funding Information:
This analysis is part of the Joint Action Malnutrition in the Elderly Knowledge Hub (MaNuEL) of the European Joint Programming Initiative A Healthy Diet for a Healthy Life (JPI‐HDHL) that investigated determinants and risk factors for (incident) malnutrition in older people in different settings [20–24] and is based on the nutritionDay-project (nD) (NCT04202939). The nD-project is a world-wide survey, performed annually in hospitals and NHs [25–27] with a follow-up (FU) after six months in the NH-setting [27]. The project is supported by the European Society for Clinical Nutrition and Metabolism (ESPEN) and national medical societies and is promoted via the internet, emails, newsletters, reports and at national and international congresses (e.g. of ESPEN and European Geriatric Medicine Society (EuGMS)). Resident and ward characteristics are assessed by standardized questionnaires which are available in more than 30 languages (https://www.nutritionday.org/). The nD-project was approved by the ethical committee of the Medical University of Vienna, Austria, by the ethical committee of the Friedrich-Alexander-Universitaẗ Erlangen-Nürnberg, Germany and by local ethical committees as required by national rules. All residents or their legal representatives gave written or oral consent prior to participation and all information was assessed completely anonymised.
Funding Information:
We thank all participating nursing homes for their contribution to the nutritionDay project. We are also grateful to the European Society for Clinical Nutrition (ESPEN) and all national medical nutrition societies, the Medical University Vienna and the Friedrich-Alexander-University Erlangen-N?rnberg for their support of the nutritionDay project. The present work was performed in partial fulfillment of the requirements for obtaining the degree Dr. rer. biol. hum (Doctoral Degree in Human Biology) for G.T. We acknowledge support by the MaNuEL knowledge hub and the Joint Programming Initiative Healthy Diet for a Healthy Life. The funding agencies supporting this work are (in alphabetical order of participating member state): Germany: German Federal Ministry of Food and Agriculture through the Federal Office for Agriculture and Food (Grants 2815ERA10E (FAU)); The Netherlands: The Netherlands Organisation for Health Research and Development (ZonMw 50?52905?98?499). The sponsors had no role in the design and conduct of the study, in the collection, analysis, or interpretation of data, or in the preparation, review, or approval of the manuscript.
Publisher Copyright:
© 2021, The Author(s).
