Association between Weight Loss and Food Form in Older Individuals Residing in Long-Term Care Facilities: 1-Year Multicenter Longitudinal Study

Abstract

Changing the food form for older adults requiring nursing care from a regular to dysphagia diet is thought to impact their nutritional status. We assessed the association between changes in food form and weight loss over 1 year in older adults. Older adults residing in long-term care facilities in Japan (n = 455) who participated in the baseline (2018) and follow-up (2019) surveys were divided into two groups (regular diet, n = 284; dysphagia diet, n = 171). The regular diet group was further divided into the weight loss (n = 80; weight loss ≥5% over 1 year) and weight maintenance (n = 204; weight loss <5%) groups. After 1 year, the Barthel Index significantly decreased, and the proportion of participants who switched from a regular diet to a dysphagia diet significantly increased in the weight loss group than in the weight maintenance group. Multivariate logistic regression analysis found that Barthel index variation (odds ratio (OR): 0.97, 95% confidence interval (CI): 0.94‒0.99), change from a regular diet to a dysphagia diet (OR: 4.41, 95% CI: 1.87‒10.41), and body weight at baseline (OR = 1.06, 95% CI: 1.01‒1.11) were significantly associated with weight loss. Our results suggest that maintaining the food form inhibits weight loss and improves health outcomes in older adults.

Observational Variables for Considering a Switch from a Normal to a Dysphagia Diet among Older Adults Requiring Long-Term Care: A One-Year Multicenter Longitudinal Study

“…In an LTCF, the prevention of incidents such as asphyxiation and aspiration is prioritized over trying to maintain food forms, and many cases of switching to a dysphagia diet have been reported [ 10 , 31 ]. However, Endo et al reported that switching from a normal to a dysphagia diet is associated with weight loss in LTCF residents [ 10 ], which suggests that the food form should not be changed hastily without any evaluation.…”

“…In an LTCF, the prevention of incidents such as asphyxiation and aspiration is prioritized over trying to maintain food forms, and many cases of switching to a dysphagia diet have been reported [ 10 , 31 ]. However, Endo et al reported that switching from a normal to a dysphagia diet is associated with weight loss in LTCF residents [ 10 ], which suggests that the food form should not be changed hastily without any evaluation. The findings that predict switching from a normal to a dysphagia diet as revealed by the present study could be an effective tool to maintain dietary safety and appetite in older adults with cognitive decline who require a high level of nursing care and may help prevent undernutrition, suffocation, aspiration, and other conditions in LTCF that do not have in-house specialists.…”

“…4). Written informed consent was obtained from the 455 residents who had participated in the first year’s survey [ 10 ]. The survey was conducted in the same manner as the baseline survey ( Figure 1 ).…”

Association between Death or Hospitalization and Observable Variables of Eating and Swallowing Function among Elderly Residents in Long-Term Care Facilities: A Multicenter Prospective Cohort Study

“…Our findings suggested that tongue movement, perioral muscle function, and mouth rinsing predict a change from ND to DD [ 8 ]. It has been shown that a change in food form is associated with weight loss [ 9 ]. Since simple observables associated with a change in food form can also be used to screen eating and swallowing function, we hypothesized that poor eating and swallowing functions are associated with hospitalization, survival, and death outcomes.…”