title: Nutrition risk screening characteristics of rural older persons: relation to functional limitations and health care charges.
abstract: This study was intended to characterize a rural population of older persons through nutrition screening and relate screening items to functional limitations and health care charges. There were 5373 participants (2522 males and 2851 females, mean age 71 y) screened over a 22-mo period by using a self-administered questionnaire adapted from the Nutrition Screening Initiative. Height and weight and cholesterol and albumin concentrations were measured, and health care claims data were obtained. The most frequent screening items reported were use of > or = 3 medications (41%) and food group intakes below recommended frequencies (> 50%). There were significant (P < 0.05) sex differences in affirmative responses to screening items and in likelihood of exceeding proposed threshold values for risk status assigned for body mass index (BMI; in kg/m2), albumin, or cholesterol. Overweight status was notable, with one-half of all subjects having BMIs > 27. Stepwise modeling procedures were used to identify screening items with the ability to predict self-reported functional limitation (logistic regression) and monthly average recorded health care charges (linear regression on logged charges). Age > or = 75 y, use of > or = 3 medications, and an albumin concentration < 35.0 g/L were significant predictors of both functional limitation and health care charges. Poor appetite, eating problems, income < $6000/y, eating alone, and depression were significant predictors of functional limitation but not health care charges. Being male, loss of 10 lb (4.5 kg), BMI > 27, cholesterol concentration < 4.14 or > 6.21 mmol/L, and functional limitation were significant predictors of health care charges only. These findings suggest that selected screening items may have be useful in the identification of subjects at potential risk for these outcomes.
authors.affiliation: Department of Gastroenterology, Geisinger Medical Center, Danville, PA 17822, USA. GJensen@SMTP.Geisinger.Edu
authors.forename: G L
authors.initials: GL
authors.lastname: Jensen
authors.forename: K
authors.initials: K
authors.lastname: Kita
authors.forename: J
authors.initials: J
authors.lastname: Fish
authors.forename: D
authors.initials: D
authors.lastname: Heydt
authors.forename: C
authors.initials: C
authors.lastname: Frey
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009748:Nutrition Disorders / Q000191:economics / Q000453:epidemiology*; D009749:Nutrition Surveys; D010414:Pennsylvania / Q000453:epidemiology; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D012709:Serum Albumin / Q000032:analysis; D017678:Sex Distribution; D011795:Surveys and Questionnaires
chemical_list: D012709:Serum Albumin; D002784:Cholesterol