Food Anxiety Is Associated with Poor Health Status Among Recently Hospital-Discharged Older Adults

Abstract

Older adults returning home from the hospital may encounter health issues that cause anxiety about their ability to obtain enough food. Home-delivered meal (HDM) programs support nutritional needs and improve food security of those who cannot provide for themselves. A study conducted in six states examined feelings of anxiety about getting enough food in older adults (aged 60 years and older), comparing three time points: prior to hospitalization, at hospitalization (n = 566) and after receiving HDMs for two months posthospitalization (n = 377). Food anxiety during hospitalization was significantly higher among Hispanic ethnicity, current and former smokers, diabetics, and those who eat alone or have difficulty shopping. Food anxiety was significantly lower from baseline to two months follow-up (P < 0.0001), and participants showed improvements in certain coping strategies they used to get their meals. Indicators of food anxiety can help the health care system and community nutrition programs target those at highest risk of negative health outcomes.

Does Participation in Home-Delivered Meals Programs Improve Outcomes for Older Adults? Results of a Systematic Review

“…Nine studies involved a pre- post-assessment of home-delivered meals on some outcome (57, 58,59, 60, 61, 62, 63, 64, 65). These studies attempted to determine: 1) whether receipt of home-delivered meals improved participants’ status along some dimension (e.g., nutritional status, nutrition risk) (57, 58,59, 60, 61, 62); 2) whether changes were observed in participants’ use of formal or informal care (64); or 3) what accounted for withdrawal or continuance in home-delivered meals programs (63, 65).…”

“…These studies attempted to determine: 1) whether receipt of home-delivered meals improved participants’ status along some dimension (e.g., nutritional status, nutrition risk) (57, 58,59, 60, 61, 62); 2) whether changes were observed in participants’ use of formal or informal care (64); or 3) what accounted for withdrawal or continuance in home-delivered meals programs (63, 65). More recent studies included outcome measures of anxiety, well-being, and loneliness in addition to the standard nutritional status outcomes (57, 58). All studies examining changes in participants’ status identified improvements.…”

“…Studies by Sharkey are notable for their focus on disease and disability/functional status (27, 31, 61). An increased focus on quality of life, satisfaction, and health service utilization are also important and increasingly being used by investigators to evaluate program impact (e.g., 57, 58). …”

Meals Enhancing Nutrition After Discharge: Findings from a Pilot Randomized Controlled Trial

“…10 Vaudin and Sahyoun found that food anxiety was high among recently hospitalized older adults and was associated with poor health status. 11 Concerns about post-discharge nutrition-related care persist in international contexts as well as the US, including in Australia, where one study found “few patients at nutrition risk received nutrition-focused care in the post-hospital period.” 12 Other studies suggest that collaboration between different health services providers is an important step to addressing these concerns. 13,14 …”

What Does the Evidence Reveal Regarding Home- and Community-Based Nutrition Services for Older Adults?

“…Next, Sattler, Lee and Young [14] found that low-income older adults in need of nutrition-related HCBS, as well as those who had multiple chronic conditions, were at high risk of being admitted or readmitted to an inpatient hospital. Sayoun and colleagues [15] evaluated food anxiety among older adults being discharged from the hospital and showed that food anxiety was greatest among Hispanics, persons unable to cook, being a current/former smoker, having diabetes, and eating alone; they also found that receiving home delivered meals may serve as an intervention on these feelings of anxiety.…”