Unintended weight loss in the elderly living at home: The aged in home care project (ADHOC)

Abstract

Abstract:Objective: To describe associations between unintended weight loss (UWL) and characteristics of nutritional status. Design: A comparative cross-sectional assessment study at 11 sites in Europe. The target population was a stratified random sample of 4,455 recipients of home care (405 in each random sample from 11 urban areas) aged 65 years and older. Measurements: the Resident Assessment Instrument for Home Care, version 2.0. Epidemiological and medical characteristics of clients and service utilisation were recorded in a standardized, comparative manner. UWL was defined as information of 5% or more weight loss in the last 30 days (or 10% or more in the last 180 days). Results: The final sample consisted of 4,010 persons; 74% were female. The mean ages were 80.9 ± 7.5 years (males) and 82.8 ± 7.3 years (females). No associations were found between single diagnoses and UWL, except for cancer. Cancer patients were excluded from further analyses. Persons with a Cognitive Performance Scale value (CPS) > 3 (impaired) had increased risk of UWL (OR = 2.0) compared with those scoring < 3 (less impaired). Only in the oldest group did we find a significant association between UWL and reduction in ADL and IADL functions, comparing those who scored 3 or less with those who scored more than 3 (disabled). A binary logistic regression model explained 26% of UWL: less than one meal/day, reduced appetite, malnutrition, reduced social activity, experiencing a flare-up of a recurrent or chronic problem, and hospitalisation were important indicators. Conclusion: We recommend a regular comprehensive assessment in home care to identify clients with potential risk factors for weight loss and malnutrition, in particular those discharged from hospital, and those with physical dependency or cognitive problems. This study may provide incentives to create tailored preventive strategies.

Unintentional weight loss in older adults

“…Social factors A large cohort study (n = 4010) found that reduced social activity is an independent contributor to unexplained weight loss in the older person (OR 2.0, 95% CI 1.6-2.5). 7 Additionally, a retrospective chart review of 96 residents in six intermediate care facilities in the United States showed that unexplained weight loss was most prevalent among the lowest income group. 8 In summary, determination of potential contributing factors to weight loss should not focus solely on disease-related processes.…”

Content Validation of a Standardized Language Diagnosis by Certified Specialists in Gerontological Nutrition

“…Eleven percent and 10% of the CSGs, respectively, reported dementia/cognitive decline and poor oral health (difficulty chewing or poor dentition) as recommended language for the etiology component of the term. Older adults with cognitive impairment have increased risk of unintended weight loss (54) and adverse outcomes (19,(54)(55)(56). Poor oral health is a contributing factor in the development of involuntary weight loss in the frail elderly population wearing ill-fitting dentures or edentulous (53) and leads to use of texture-modified diets, a validated etiology for involuntary weight loss by the CSGs.…”

The prevalence time trend and risk factors of weight loss among the Chinese elder people over the period from 2011-2013

“…Weight loss could accelerate sarcopenia in elder adults [19]. The significant association between unintentional weight loss and reduction in ADL and IADL functions could also be found [20]. For older women experienced weight loss, they had higher rates of hip-bone loss and a two-fold greater risk of subsequent hip fracture [21] and the risk of frailty fracture had also been increased substantially [22].…”