title: Nutritional status and a 3-year follow-up in elderly receiving support at home.
abstract: BACKGROUND
  Elderly receiving public services and care are often frail, suffer from chronic diseases, and sustain a high risk for malnutrition.
  
  
  OBJECTIVE
  To evaluate nutritional status and long-term outcome in elderly living at home.
  
  
  METHODS
  Of 507 eligible subjects receiving home care in five Swedish municipalities, we examined 353 (age 82+/-7 years, 64% females). The subjects were interviewed, and the nutritional status was assessed by means of the Mini Nutritional Assessment (0-30 points; the lower the score, the greater the risk). The Mini Nutritional Assessment consists of 18 questions concerning, e.g., anthropometry (body mass index or BMI; kg/m2) and global and dietary issues. The mortality was evaluated in 224 study participants after a 3-year period. In one municipality, 31 of 64 elderly were reexamined after 3 years.
  
  
  RESULTS
  8 and 41% of the elderly were assessed as malnourished or at risk of malnutrition, respectively. BMIs <20 and <23 were found in 12 and 31% of the subjects, respectively. Chewing and swallowing problems and reduced appetite were more often reported by those at risk of being malnourished compared with the well-nourished study participants (p<0.001). Meals-on-wheels services were given to one third, of whom 66% used one portion for several meals. The 3-year mortality was 50% for those who were malnourished, 40% for those at risk of malnutrition, and 28% for the well-nourished group (p<0.05). The corresponding mortality was 50% for subjects with a BMI<20, 35% for those with BMIs 20-28, and 27% for those with a BMI>28 (p=0.05). After 3 years, a weight loss of 4.0+/-5.8 kg was registered (p<0.001).
  
  
  CONCLUSIONS
  About half of the home-living elderly with public support were malnourished or were at risk of malnutrition. The malnourished subjects often had problems during mealtimes and seldom ate full meals. Elderly with a BMI>28 displayed the lowest risk of death within 3 years.
authors.affiliation: Neurotec Department, Karolinska Institutet, Stockholm, Sweden. Anjas@telia.com
authors.forename: Anja
authors.initials: A
authors.lastname: Saletti
authors.forename: Lennarth
authors.initials: L
authors.lastname: Johansson
authors.forename: Elinor
authors.initials: E
authors.lastname: Yifter-Lindgren
authors.forename: Ulla
authors.initials: U
authors.lastname: Wissing
authors.forename: Kerstin
authors.initials: K
authors.lastname: Osterberg
authors.forename: Tommy
authors.initials: T
authors.lastname: Cederholm
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006699:Home Care Services / Q000592:standards*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000209:etiology / Q000401:mortality; D015596:Nutrition Assessment; D009752:Nutritional Status; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D013548:Sweden; D013997:Time Factors