The purpose of this study was to describe the prevalence of protein-calorie malnutrition (PCM) among newly admitted elderly nursing home residents and identify the most significant predictors of PCM using Minimum Data Set (MDS) variables. Using a cross-sectional design, the authors studied 306 nursing home residents. Malnutrition risk factors found on the MDS were measured for each resident. Overall, 118 (38.6%) residents met the Nutrition Screening Initiative Guidelines for PCM.MDS variables found to be significant predictors were weight loss, leaves 25% or more of food uneaten at most meals, psychiatric/mood diagnoses, deteriorated ability to participate in activities of daily living, and older age. Three additional variables (antidepressant use, diuretic use, ther apeutic diet) were found to be protective—residents with these variables were more likely to have a normal body mass index. MDS data provide an opportunity for early identification of residents who are at risk for PCM and accompanying morbidity.
Get full access to this article
View all access options for this article.
References
1.
American Dietetic Association
. (1998). Liberalized diets for older adults in long-term care. Journal of the American Dietetic Association, 98, 201-204.
2.
American Health Care Association
. (1998). Facts and trends, the nursing facility sourcebook. Washington, DC: Author.
3.
Andres, R.
, Muller, D. C., & Sorkin, J. D. (1993). Long-term effects of change in body weight on all-cause mortality. A review. Annals of Internal Medicine, 119(7-Part 2), 737-743.
4.
Blaum, C.
, Fries, B., & Fiatarone, M. (1995). Factors associated with low body mass index and weight loss in nursing home residents. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 50A, M162-M168.
5.
Blaum, C.
, O’Neill, E., Clements, K., Fries, B., & Fiatarone, M. (1997). Validity of the Minimum Data Set for assessing nutritional status in nursing home residents. American Journal of Clinical Nutrition, 66, 787-794.
6.
Callahan, C. M.
, Stump, T. E., Stroupe, K. T., & Tierney, W. M. (1998). Cost of health care for a community of older adults in an urban academic health care system. Journal of the American Geriatric Society, 46, 1371-1377.
7.
Corbett, J.
, & Edington, J. (1996). How much malnutrition is there in the community?Community Nursing, 2, 22-22, 24-24.
8.
Fischer, J.
, & Johnson, M. A. (1990). Low body weight and weight loss in the aged. Journal of the American Dieticians Association, 90, 1697-1706.
9.
Fries, B. E.
, Hawes, C., Morris, J. N., Phillips, C. D., Mor, V., & Park, P. S. (1997). Effect of the national resident assessment instrument on selected conditions and problems. Journal of the American Geriatric Society, 45, 994-1001.
10.
Frisoni, G.
, Franzoni, S., Rozzini, R., Ferrucci, L., Buffelli, S., & Trabucchi, M. (1994). A nutritional index predicting mortality in the nursing home. Journal of the American Geriatric Society, 42, 1167-1172.
11.
Galanos, A. N.
, Pieper, C. F., Cornoni-Huntley, J. C., Bales, C. W., & Fillenbaum, G. G. (1994). Nutrition and function: Is there a relationship between body mass index and functional capabilities of communitydwelling elderly?Journal of the American Geriatrics Society, 42, 368-373.
12.
Grants, R.
(1997). Detection and correction of underweight problems in nursing home residents. Journal of Gerontological Nursing, 23(12), 26-31.
13.
Hawes, C.
, Morris, J. N., Phillips, C. D., Mor, V., Fries, B. E., & Nonemaker, S. (1995). Reliability estimates for the Minimum Data Set for nursing home resident assessment and screening (MDS). Gerontology, 35, 172-178.
14.
Heimburger, D. C.
, & Weinsier, R. L. (1997). Handbook of clinical nutrition. Philadelphia: Mosby.
15.
James, W. P.
, Ferro-Luzzi, A., & Waterlow, J. C. (1988). Definition of chronic energy deficiency in adults. European Journal of Clinical Nutrition, 42, 969-981.
16.
Kahn, R.
(1995). Weight loss and depression in a community nursing home. Journal of the American Geriatric Society, 43, 83-83.
17.
Kayser-Jones, J.
(2000). Improving the nutritional care of nursing home residents. Nursing Homes, 49(10), 56-59.
18.
Keller, H.
(1995). Malnutrition in institutionalized elderly: How and why?Journal of the American Geriatrics Society, 46, 1371-1377.
19.
Kozma, C. M.
, Reeder, C. E., & Schultz, R. M. (1993). Economic, clinical, and humanistic outcomes: A planning model for pharmacoeconomic research. Clinical Therapeutics, 15, 1121-1132.
20.
Matarese, L. E.
, & Gottschlich, M. M. (1997). Contemporary nutrition support practice. Philadelphia: W. B. Saunders Company.
21.
Money, J. E.
, & Silver, A. (1995). Nutritional issues in nursing home care. Annals of Internal Medicine, 12(2), 850-859.
22.
Morley, J.
, & Kraenzle, D. (1994). Causes of weight loss in a community nursing home. Journal of the American Geriatric Society, 42, 583-585.
23.
Morley, J.
, & Silver, A. (1995). Nutritional issues in nursing home care. American College Physicians, 123, 850-859.
24.
Morris, J. N.
, Murphy, K., & Nonemaker, S. (1995). Long term care facility resident assessment instrument (RAI) user’s manual. Health Care Financing Administration: Briggs Health Care Products.
25.
Rowe, J.
, & Kahn, R. (1998). Successful aging. New York: Pantheon Books.
26.
Ryan, C.
, Bryant, E., Eleazer, P., Rhodes, A., & Guest, K. (1995). Unintentional weight loss in long-term care: Predictor of mortality in the elderly. Southern Medical Journal, 88, 721-724.
27.
Schlenker, E.
(1998). Nutrition in aging (3rd ed.). New York: McGraw-Hill.
28.
Silver, A.
, Morley, J., Strome, L., Jones, D., & Vickers, L. (1988). Nutritional status in an academic nursing home. Journal of the American Geriatric Society, 36(6), 487-491.
29.
Thomas, D. R.
, Ashmen, W., Morley, J. E., Evans, W. J., & The Council for Nutritional Strategies in Long-Term Care. (2000). Nutritional management in long-term care: Development of a clinical guideline. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 55, M725-M734.
30.
Tully, C. L.
, & Snowden, D. A. (1995). Weight change and physical function in older women: Findings from the nun study. Journal of the American Geriatrics Society, 43, 1394-1397.
