Abstract
Background: In the context of New Zealand’s growing ageing population, the maintenance of health and function is a critical issue for decreasing the demand on health and long-term care facilities. Good nutrition contributes to the maintenance of good health and independence in old age, whereas malnutrition increases morbidity, disability and mortality. Therefore, assessment of nutritional status is an important component of health care for the elderly. Internationally, research has shown a high prevalence of both nutrient inadequacies and malnutrition in long-term care settings. Currently, limited data are available on these measures in the New Zealand low level aged care population.
Objective: To describe the prevalence of inadequate nutrient intakes and malnutrition risk in Christchurch rest home residents.
Design: The present study was a cross-sectional study involving 40 residents (n 11 men, n 29 women) aged 65 years and older, from two aged care facilities in Christchurch. Information was collected on participant demographics, dietary intakes, health status (including current prescribed medications), supplement use and dental status. Anthropometric measurements were taken (standing height, weight, ulna length, demispan and calf circumference), and body mass index (kg/m2) calculated. Fasting blood samples were collected and a complete blood count conducted. Dietary intake was assessed using 3-day weighed food records, and the dietary assessment software Kai-culator was used to calculate intake data based on the New Zealand Food Composition Tables. Malnutrition risk was assessed using the Malnutrition Universal Screening Tool and Mini Nutritional Assessment Short Form screening tools. Cognitive function was assessed using the Clock Drawing Test, and mood was assessed using the Geriatric Depression Scale. Handgrip strength, a 5-meter timed walk test, and Activities of Daily Living questionnaire were used to evaluate physical function.
Results: The majority of the sample suffered physical dysfunction and cognitive impairment. Long-term health conditions, including hypertension and coronary heart disease, were highly prevalent. Energy deficits were seen in 26% of participants, while 64% of males and 24% of females had protein intakes below estimated average requirements. When compared with current recommendations, over 75% of participants had inadequate intakes of calcium, magnesium, vitamin B6 and vitamin E. Almost all participants had inadequate intakes of vitamin D, selenium and zinc (men only). Depending on the criterion used, between 6-23% of participants were classified as anaemic. The Malnutrition Universal Screening Tool classified 13% of participants as at high risk of malnutrition, while 86% were determined to be at low risk. The Mini Nutritional Assessment Short Form classified 30% to be at risk of malnutrition, with 68% classified as not malnourished.
Conclusion: These findings suggest a high prevalence of macro- and micro-nutrient inadequacies in New Zealanders residing in low level care rest homes. Despite the large number of nutrient inadequacies observed, the risk of malnutrition was low when assessed using two different screening tools. Participants also suffered a number of characteristics which can be considered both causes and consequences of a poor nutritional status, such as poor physical and cognitive functioning. As nutrient inadequacies are implicated in both health and functional decline, these results warrant further investigation into the biochemical indicators of nutritional status.