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Malnutrition in a home-living older population: prevalence, incidence and risk factors. A prospective study
Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
2009 (English)In: JOURNAL OF CLINICAL NURSING, ISSN 0962-1067, Vol. 18, no 9, 1354-1364 p.Article in journal (Refereed) Published
Abstract [en]

To prospectively investigate and describe the prevalence and incidence of malnutrition among home-living older people, related to demographic and medical factors, self-perceived health and health-related quality of life. Another aim was to find predictors for developing risk of malnutrition.

Risk factors for malnutrition have previously been identified as diseases, several medications, low functional status, symptoms of depression and inadequate nutrient intake. Most studies are cross-sectionally performed at hospitals or in nursing care settings.

A prospective study with a sample of 579 home-living older people, randomly selected from a local national register. Examinations were performed at baseline and yearly follow-ups two to four times.

Questionnaires validated and tested for reliability, to detect risk of malnutrition (Mini Nutritional Assessment), symptoms of depression (Geriatric Depression Scale-20), cognitive function (Mini Mental State Examination), health-related quality of life (Nottingham Health Profile), well-being (Philadelphia Geriatric Center Multilevel Assessment Instrument) self-perceived health, demographic factors, anthropometry and biochemical examinations. Predictors were searched for through multiple logistic regression analysis with the MNA as dependent factor.

The prevalence of risk for malnutrition was 14.5%, according to the MNA. Two risk factors for malnutrition were lower handgrip strength and lower self-perceived health. The incidence of risk for malnutrition at follow-ups was between 7.6% and 16.2%. Predictors for developing malnutrition were higher age, lower self-perceived health and more symptoms of depression. Men with symptoms of depression had a higher risk of developing malnutrition.

Lower self-perceived health had the highest power to predict risk for malnutrition, with increased number of depression symptoms and higher age as second and third predictors.

A regular and combined assessment using the Mini Nutrition Assessment, Geriatric Depression Scale-20 and self-perceived health as a base for identifying people in need, is one way to prevent the development of malnutrition.

Place, publisher, year, edition, pages
2009. Vol. 18, no 9, 1354-1364 p.
Keyword [en]
Assessment, daily activities of living, depressive symptomatology, elderly, nutrition, quality of life
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-18028DOI: 10.1111/j.1365-2702.2008.02552.xOAI: oai:DiVA.org:liu-18028DiVA: diva2:214275
Available from: 2009-05-04 Created: 2009-05-04 Last updated: 2009-11-06Bibliographically approved
In thesis
1. Self-Perceived Health and Nutritional Status among Home-Living Older People: A Prospective Study
Open this publication in new window or tab >>Self-Perceived Health and Nutritional Status among Home-Living Older People: A Prospective Study
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim was to follow the development of nutritional status and its significance for general health status using an epiemiologic method in a representative population‐based selection of older individuals in two cohorts. The main focus was to prospectively examine the significance of demographic, social and medical factors and to establish a basis to investigate the possibilities of preventive measures.

Methods: Five hundred and eighty‐three individuals (278 women and 305 men), 75 and 80 years old, when included, living in a municipality in Östergötland in Sweden, participated in this study. Data collection took place 2001‐2006 with one examination yearly. The examination included a single question regarding self‐perceived health demographical questions, different questionnaires in the areas of nutritional status, symptoms of depression, cognitive function, health‐related quality of life and well being and objective assessments such as anthropometrical, physical and biochemical measurements.

Results: Fifty percent of the women (I) and 58% of the men (II) perceived themselves as healthy. Important factors for women’s health (I) at baseline were no or few symptoms of depression, better physical mobility and better physical health. Among men who perceived themselves as healthy (II) at baseline, important factors were better physical health, maintaining a social network and the ability to walk outdoors. After one year 69% of the women and 75% of the men still perceived themselves as healthy. Among those women (I) who perceived themselves as healthy after one year, better physical mobility and better physical health were still important, with the addition of less or no pain. Important predictors for preserving health among men (II) were no symptoms of depression and the ability to walk up and down stairs. The prevalence of risk for malnutrition (III) was 14.5% (n=84), among women 18.8% and men 10.6%. Risk factors for malnutrition at baseline were a lower TSF, lower handgrip strength and worse physical health according to the PGC MAI. The incidence was 7.6%‐16.2%, and was distributed equally among women and men over time. Predictors for developing malnutrition were lower self‐perceived health, increased number of symptoms of depression.  Especially men with symptoms of depression ran a higher risk. Reported energy intake (IV) was low in relation to the estimated requirement, on average 74% among women and 67% among men. Intake of vitamins A, D, E and folate was below the recommended intake and the same pattern was found over time. A smaller weight loss was found among women and men from baseline to Follow‐up 2.

Conclusions: The experience of a good physical health was the only common factor for a good self‐perceived health among women and men. The highest risk for developing malnutrition was a combination of impaired self‐perceived health and increased number of symptoms of depression.

Clinical implications: A combination of nutritional status, self‐perceived health and symptoms of depression can be a base for clinical judgement and can be used by different professionals in ealth and medical care and in home care service.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2009. 63 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1154
Keyword
Energy intake, Gender, Health Physical activity, Risk for malnutrition, Symptoms of depression
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-51276 (URN)978-91-7393-511-1 (ISBN)
Public defence
2009-11-06, Berzeliussalen, Hälsouniversitetet, ingång 65, Campus US, Linköpings universitet, Linköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2009-11-06 Created: 2009-10-26 Last updated: 2010-05-03Bibliographically approved

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Johansson, YvonneBachrach-Lindström, MargaretaCarstensen, JohnEk, Anna-Christina

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