Lower dietary variety is a relevant factor for malnutrition in older Japanese home-care recipients: a cross-sectional study

Abstract

Background Nutritional status of the older people is affected by various life-style factors. Although dietary habit is one of the life-style factors, it is unknown which of older home-care recipients’ dietary habits are associated with malnutrition. The purpose of this study was to examine the association of dietary variety, as an evaluation index for dietary habits, with malnutrition in Japanese older home-care recipients. Methods This cross-sectional study was conducted in a single city, Hyogo Prefecture, Japan between July and October 2016. Three hundred thirty-three community-dwelling older care recipients (aged 65 years or older who were receiving home-visit nursing care services) were enrolled. Their nutritional status (Mini Nutritional Assessment®-short form: MNA®-SF), dietary variety (Food frequency score [FFS]), socio-demographic characteristics (age, sex, marital status, etc.), health indicators (comorbidity [Charlson Comorbidity Index] and dysphagia status [Dysphagia Severity Scale]) were assessed. The participants were classified into two groups: malnourished (0–7 points) and non-malnourished (8–14 points), according to their MNA®-SF scores. Multivariate logistic regression analysis was used to examine the factors associated with malnutrition. Results A total of 317 participants were analyzed (118 men, 199 women, median age: 84 years). Compared to the fourth (highest) quartile of FFS, odds ratios (OR) (95% confidence intervals [CI]) of the third, second, and first (lowest) quartiles of FFS were 1.08 (0.42–2.80), 1.29 (0.56–2.98), and 2.30 (1.02–5.19), respectively (p for trend = 0.049). Higher Charlson Comorbidity Index score and the presence of dysphagia were also significantly associated with malnutrition (OR: 2.08, 95% CI: 1.08–4.00 and OR: 3.86, 95% CI: 2.08–7.17, respectively). Conclusion Lower dietary variety was significantly associated with malnutrition in Japanese older home-care recipients.

Malnutrition Is Associated With Impaired Functional Status in Older People Receiving Home Care Nursing Service

“…Our study also showed an indirect effect of the CCI on the MNA score. The correlation between malnutrition and comorbidities is well-known, and previous studies reported that malnourished older people have higher CCI scores (37,38). The most prevalent comorbidity found in the participants of the current study was dementia (29.5%).…”

The nutritional status and dietary intake of free-living seniors: A cross-sectional study

“…The average folate intake was also notably lower in this study compared to NANS [16], particularly for males (427 vs. 333 mcg), which could have significant implications due to the role of folate in cognitive health [37]. A number of factors contribute to low micronutrient intakes in the elderly; some of them modifiable, such as lack of variety in the diet [38] and a poor level of nutritional knowledge, recently identified in this age group [39].…”

The Nutritional Issue of Older People Receiving Home-Delivered Meals: A Systematic Review

“…After title and abstract screening, 334 records were kept for full-text retrieval and 52 articles were included at full-text review−48 original studies ( Figure 1) and four Systematic Literature Reviews (13)(14)(15)(16). It should be noted that seven papers including older people with HDM in a broad sample were not included in the synthesis as separated data analyses were not conducted for HDM participants-analyses were done on a broader sample including participants without and with HDM (17)(18)(19)(20)(21)(22)(23). Unfortunately, we were not able to find the full text for 12 records despite that we tried to purchase them through the network of university libraries or to contact the authors.…”

“…Nine studies assessed the impact of an "improved" HDM service on nutritional outcomes compared to a regular service ( Table 5). Improvement consisted in providing energy and/or protein enriched meals and/or snacks [six studies: 21,44,45,49,56,64], in providing additional meals and/or snack (e.g., breakfast) to the regular offer (31,71), or in providing dietetic counseling (49).…”