Predictors of incident malnutrition-a nutritionDay analysis in 11,923 nursing home residents

Eur J Clin Nutr. 2022 Mar;76(3):382-388. doi: 10.1038/s41430-021-00964-9. Epub 2021 Jul 8.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Humans
  • Malnutrition* / complications
  • Malnutrition* / epidemiology
  • Nursing Homes*
  • Nutritional Status
  • Weight Loss