PREVALENCE OF RISK OF MALNUTRITION AND ASSOCIATED FACTORS IN HOME CARE CLIENTS

Abstract

Abstract\r\rObjectives: To describe nutritional status and to detect factors associated with it in home care clients aged 75 years or older. Design: A cross-sectional study with a population-based sample. Setting: Home care.Participants: The study included 267 home care clients in three cities in Finland. Measurements: The outcomes were nutritional status (Mini Nutritional Assessment, MNA), body mass index (BMI), functional ability (Barthel Index, Instrumental Activities of Daily Living, IADL), cognitive function (Mini Mental State Examination, MMSE), depression (Geriatric Depression Scale, GDS-15), comorbidity (Functional Comorbidity Index, FCI), Vitamin D and drug use and levels of blood albumin and haemoglobin. Chewing problems and dry mouth were assessed by using a structured interview. Results: According to the MNA, a majority (86%, n = 229) of all home care clients were at risk of malnutrition or were malnourished. Persons at risk of malnutrition or who were malnourished used more drugs and had a higher depressive score and lower Barthel Index, IADL and MMSE scores than well-nourished participants. Multivariate analysis showed that excessive polypharmacy (OR 3.63, 95% CI:1.51–8.74), a lower MMSE score (OR 1.29, 95% CI:1.12–1.48) and a higher GDS-15 score (OR 1.32, 95% CI:1.07–1.63) appeared to be independently connected to malnutrition or a risk of malnutrition. Conclusions: Malnutrition or a risk of malnutrition is a common problem among home care clients. Excessive polypharmacy, cognitive impairment and depressive symptoms increase malnutrition or the risk of malnutrition. To prevent a further decline in their health status, home care clients should be screened for malnutrition and the risk of malnutrition. \r\r \r\rKey words: Malnutrition, home care, MNA, aged.