Objective: To investigate nutritional status and its relationship to cognition, well-being, functional ability and energy intake in frail elderly service flat residents. Design: Cross-sectional and prospective study. Setting: Two municipal service flat complexes. Subjects: A total of 80 residents (median age 85.5 (79-90) y) with regular home care assistance participated. A subgroup of 35 residents took part in a re-examination 1 y later. Methods: Mini Nutritional Assessment (MNA), Short Portable Mental Status Questionnaire, Barthel Index and Health Index were used for the evaluation of nutritional, cognitive and ADL function and well-being, respectively. Results: In all, 30% of the frail and chronically ill service flat residents were assessed as malnourished and 59% were at risk of malnutrition. The malnourished residents had worse cognitive conditions (Po0.001) and well-being (Po0.05), lower functional ability (Po0.01) and they had a greater need for daily assistance (Po0.05) than the other residents. The median night fast period was 14.0 (12.5-15.0) h. Five subjects classified as malnourished at baseline had lost a median of À9.6 kg (range À11.0 to þ 7.3 kg) (Po0.05) in body weight at the 1-y follow-up, which contrasted significantly from the weight stability in residents classified as at risk for malnutrition or well-nourished. Conclusion: Out of 10 residents, nine were assessed to have impending nutritional problems that related to impaired wellbeing, cognition, and functional ability. Malnourished residents had a significant weight loss over one year. Studies are needed to determine whether weight loss and nutrition-related dysfunction in service flat residents are preventable or treatable.

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A significant increase in energy intake can be achieved by higher energy density in regular hospital food and that HE does not cause a decrease in the volume of the food consumed. These findings suggest that it is the volume of food rather than the energy that limits voluntary energy intake of hospital food in elderly hospitalized patients.