Nutritional assessment of older New Zealand adults in rest homes in Mid Canterbury
Background: New Zealand has an ageing population. This is accompanied by an increased demand for rest home residency. Malnutrition is a concern in the ageing population as it increases the risk of morbidity and mortality. While overseas studies report high rates of malnutrition in rest homes the prevalence of older adults at risk of malnutrition and nutritional inadequacies within rest homes in New Zealand has not been studied.Objective: The aims were describe the prevalence of inadequate nutrient intakes of selected nutrients and determine the prevalence of malnutrition among rest home residents in the Mid Canterbury region.Design: We conducted a cross-sectional study of 40 participants aged 65 years and over, residing in two rest homes in the Mid Canterbury Region. Demographic, dietary, anthropometric, and biochemical data were obtained, and cognitive and physical function tests were performed. Dietary data were collected with non-consecutive weighed three-day food records. Intake data were matched to nutrient lines in New Zealand Food Composition Tables. Dietary intakes were compared with Australian/New Zealand Nutrient Reference Values to determine the prevalence of participants at risk of nutrient inadequacies. Anthropometric measurements including weight, ulna length and waist circumference were obtained and Body Mass Index (BMI) (kg/m2) was calculated. Cognitive function was assessed using the Clock-Drawing Test and physical function was measured by handgrip strength and a timed walk test. Two malnutrition-screening tools, the Mini Nutritional Assessment-Short Form (MNA-SF) and Malnutrition Universal Screening Tool (MUST), were used to assess prevalence of malnutrition among participants.Results: Participants ranged in age from 65 to 97 years, and 72% were women. Average duration of residency was 31 months. The majority (68%) of participants were classified as overweight or obese (BMI>25) and 27% were underweight (BMI <20). Analysed energy intakes were below estimated requirements for 48% participants. More men (91%) than women (66%) were at risk of inadequate protein intake when compared with current recommendations (P=0.016). Total fat intake contributed >30% of participant’s overall energy intake (p<0.001). Saturated fat for men and women contributed 15.4% and 17.5% total energy intake, respectively. Seventy-six percent of men and 98% of women were at risk of inadequate fibre intakes. Intakes of calcium, zinc, selenium, magnesium and vitamin E intakes were suboptimal in >50% of participants. All participants had suboptimal selenium and vitamin D and 88% were prescribed vitamin D supplements. The risk of malnutrition across rest homes was 70% for men and 52% for women. Lastly, 22% of participants were anaemic.Conclusion: These findings indicate our sample of rest home residents are at risk of inadequate intakes of energy, protein and fibre and a number of micronutrients known to play a role in the health and well being of ageing adults. Furthermore, the risk of malnutrition in this population is high. While a larger, more representative study is warranted and additional biochemical analyses are needed to confirm nutritional status, these data highlight the need for future research to assess the possible causes of poor dietary intake and identify strategies to improve diet quality in this population.
Advisor: Houghton, Lisa
Degree Name: Master of Dietetics
Degree Discipline: Human Nutrition
Publisher: University of Otago
Keywords: Nutritional assessment, malnutrition, nutritional inadequacies, elderly, New Zealand, rest homes.
Research Type: Thesis