Temporal trends in nutrition intake among older long-term care residents

Abstract

Background & aims: The temporal trends in protein and other nutrient intakes among older long-term care residents have not been studied. The aim of this study was to explore the changes in energy, protein, and other nutrient intakes between 2007 and 2017-8 in two cross-sectional samples of older long-term care residents in the Helsinki metropolitan area. We also studied how the residents' disability and stage of cognition modified the association between observation year and protein intake (g/body weight kg).

Methods: Two cross-sectional samples were collected in 2007 (n = 350) and 2017-8 (n = 476) in long-term care settings. Residents' nutrient intake was determined by a one- or two-day food record. Residents' disability was determined by the Clinical Dementia Rating (CDR) "personal care" question and stage of cognition was determined by the CDR "memory" item.

Results: There was no significant difference in energy intake between the observation years. Carbohydrates, total protein, and protein (g/body weight kg) intakes were significantly lower in 2017-8 than in 2007. Fat intake was higher in 2017-8 than in 2007. In 2017-8, the intake of some vitamins and minerals was lower (thiamine, calcium) but some higher (vitamins A, D, C, E) compared to 2007. Residents' disability (p = 0.049) and observation year (p = 0.037) were significantly associated with protein intake (g/body weight kg), but the interaction was not significant (p = 0.35). Furthermore, residents' stage of cognition was not associated with protein intake (p = 0.22) but observation year was (p < 0.001). The interaction was not significant (p = 0.30).

Conclusions: Whereas the energy intake remained at the same level in the observation years, the ratio of macronutrient intake changed in an unfavorable way. The intake of protein and some vitamins were lower whereas the relative proportion of fat was higher in 2017-8 compared to 2007. As long-term care residents become more disabled in the future, more attention should be paid to diet quality.

Keywords: Long-term care resident; Nursing home; Nutrient intake; Protein intake; Temporal trends.