Abstract
Background: The number of New Zealanders aged over 65 years is increasing, leading to increased demand for residential aged-care and health services. Supporting the aging population to maintain their health and not to lose further independence will help to reduce the burden on these services. Optimal nutrition is important for maintaining health, and malnutrition is associated with declines in physical and cognitive function, increased morbidity, and decreased autonomy and quality of life. While a high prevalence of inadequate nutrient intakes and malnutrition have been reported in studies of aged care residents in Australia and Europe, there is limited information regarding the nutritional status of aged care residents in New Zealand. This information is required in order to develop safe and effective strategies to improve the nutritional status of New Zealand rest home residents.
Objective: To describe the prevalence of inadequate intakes of selected nutrients, and determine the prevalence of malnutrition in older New Zealanders receiving rest home level care.
Design: Cross-sectional survey of 34 residents (20 women, 14 men) from two rest homes in Hawkes Bay. Data collected included demographics, dietary intakes, anthropometric measurements, medical history (including current medications), supplement use, and cognitive and physical function tests. In addition, a fasting blood sample was collected and haemoglobin measured. Dietary intakes were measured using non-consecutive 3-day weighed food records and were matched to nutrient lines in the New Zealand Food Composition tables using Kaiculator (Department of Human Nutrition, University of Otago). The percentage of participants at risk of inadequate intakes of selected nutrients was calculated using the Estimated Average Requirement cut-point method. Anthropometric measurements obtained included height (and surrogate height measures ulna length and demispan), weight, waist and calf circumferences. Body mass index (BMI) (kg/m2) was calculated. Malnutrition risk was assessed using the Malnutrition Universal Screening Tool (MUST) and Mini Nutritional Assessment-Short Form (MNA-SF) screening tool.
Results: The mean age of study participants was 85 years and the mean length of stay in the rest home was two years. Half the participants (55%) were overweight or obese (BMI > 25 kg/m2), and 14% had a BMI < 20 kg/m2. Intakes of protein, energy and fibre were below recommendations for many participants (51%, 35% and 95%, respectively). The majority (>70%) of participants were at risk of inadequate intakes of calcium, selenium, magnesium, and vitamins B6, E and D. Men in particular were at high risk of inadequate zinc intake (90%). Eighteen percent of participants were classified as being at risk of malnutrition using the MUST tool and 32% were classified as at risk when using the MNA-SF tool. Three percent of participants were classified as malnourished using the MNA-SF tool. Forty percent of participants were anaemic (Hb <120 or <130 g/L for women and men, respectively).
Conclusion: The results of this study show a high prevalence of inadequate intakes of several nutrients that are required for optimal health amongst rest home residents in Hawkes Bay. The prevalence of malnutrition was lower than reports from other countries; however, malnutrition was still an issue with up to one third of residents at risk of malnutrition. Therefore, strategies aimed at improving the nutrient intakes and reducing malnutrition risk would be beneficial.