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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #57202
Title: FACTORS ASSOCIATED WITH LOW BODY MASS AND WEIGHT LOSS IN NURSING HOME RESIDENTS

Author
item BLAUM CAROLINE S - UNIV OF MICHIGAN
item FRIES BRANT E - UNIV OF MICHIGAN
item FIATARONE MARIA - TUFTS-HNRCA

Submitted to: Journal of Gerontology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/1/1994
Publication Date: N/A
Citation: N/A

Interpretive Summary: Malnutrition in nursing home residents is a significant and possibly modifiable public health problem. Nutritional deficiencies in nursing home residents have been shown to be associated with undesirable outcomes such as increased infection rates and complications and increased hospital- izations. It remains unclear whether improving undernutrition in long-term care residents will improve health outcomes, or how often resident under- nutrition may be improved by correcting associated underlying problems. The research presented here is the first study of nursing home resident charac- acteristics associated with undernutrition that uses a large sample size of residents from multiple nursing homes in several states with information derived from a large, consistent clinical data set, the Minimum Data Set (MDS). By using the multidimensional clinical information available in the MDS, we were able to evaluate multiple domains of resident functional and medical status for their relationship to undernutrition and nutritional risk. Our research goal was to test the hypothesis that undernutrition in nursing home residents is related to conditions affecting eating ability, some of which are potentially correctable.

Technical Abstract: The Minimum Data Set (MDS), a HCFA-mandated resident assessment system used in community nursing homes, is potentially useful to assess nutritional status. The purpose of our study was to evaluate eating, feeding and dependency characteristics as assessed by MDS questions for associations with low (25th percentile of sample and below) anthropomorphic and bioelectrical impedance (BIA) measures of nutritional status. Data were from a sample of residents of an academic nursing home (n=203, mean age 89.8+/- 5.6 years, 75.7% female). MDS evaluations were done simultaneously with anthropomorphic and BIA measures of nutritional status. Findings were 1) Anthropomorphic/BIA measures could not be obtained on the most dependent residents. In residents with eating dependency, height was obtained on 9%, BIA on 35%, knee height on 68%, mid-arm circumference (MAC) and weight on 82%. 2) Despite missing data, bivariate analysis showed that MDS assessment tof poor oral intake (chi square of association p<.05), and advanced de- mentia (p<.05) were highly associated with low body weight, MAC, mean arm muscle area, body mass index using knee height, and %body fat. Presence of chewing problems, being bedfast, behavior problems, and pressure ulcers had borderline associations; oral-dental problems and depressed behaviors were not associated. Our results suggest that MDS nutritional and dependency variables are associated with clinical measures of low nutritional status, but routine height measures on the MDS may be biased. The MDS could be improved for nutritional assessment by adding arm anthropomorphics and knee height.