The GAIN (Geriatric Anorexia Nutrition) registry: the impact of appetite and weight on mortality in a long-term care population.
OBJECTIVE
To investigate nursing home residents at high nutritional risk to determine: 1) which baseline nutrition or health status indicators correlated with subsequent weight gain or appetite improvement; and, 2) whether a continued weight loss correlated with higher mortality.


METHODS
At study entry, nutritional, health status, and demographic data were extracted from the nursing home chart or the MDS. Each subject was tracked for 6 months with survival, weight gain of   5%, and appetite improvement the primary outcome measures.


RESULTS
During the 6-month study, younger age was the strongest correlate of appetite improvement. The odds of gaining weight were negatively correlated with BMI, age, and feeding dependency. Subjects who were receiving appetite stimulants (orexigenics) at study entry had a 70% greater probability of gaining weight than those who were not. A weight loss during the 6-month period was associated with a nearly two-fold increase in the likelihood of dying (adjusted RR: 1.95, 95% CI 1.43 to 2.66).


CONCLUSIONS
The course of nutritional problems within nursing homes is highly variable. Continued weight loss, however, appears to have ominous implications for mortality. Younger residents who are not dependent on others for feeding assistance, and who receive orexigenics tend to experience weight gain.
Sullivan
D H
DH
GRECC, Central Arkansas Veterans Healthcare System, and Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Morley
J E
JE
Johnson
L E
LE
Barber
A
A
Olson
J S
JS
Stevens
M R
MR
Yamashita
B D
BD
Reinhart
S P
SP
Trotter
J P
JP
Olave
X E
XE
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001066:Appetite / Q000502:physiology*; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects / Q000502:physiology*; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006305:Health Status Indicators; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009026:Mortality; D009735:Nursing Homes; D009752:Nutritional Status; D012042:Registries; D012306:Risk; D015431:Weight Loss