title: Meal programs improve nutritional risk: a longitudinal analysis of community-living seniors.
abstract: OBJECTIVE
  To determine the independent association of meal programs (eg, Meals On Wheels and other meal programs with a social component) and shopping help on seniors' nutritional risk.
  
  
  METHODS
  Cohort design. Baseline data were collected with an in-person interview and subjects were followed up for 18 months via telephone interview.
  
  
  METHODS
  Cognitively well, vulnerable (ie, required informal or formal supports for activities of daily living) seniors were recruited through community service agencies in southwestern Ontario, Canada. Three hundred sixty-seven seniors participated in baseline interviews and 263 completed data collection at 18-month follow-up; 70% participated in meal programs at baseline.
  
  
  METHODS
  The 15-item Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN) questionnaire identified nutritional risk at 18 months.
  
  
  METHODS
  Descriptive and bivariate analyses were performed and significant associations (P<0.05) used to build the full multiple linear regression model. Meal and shopping variables were forced into the model as predictors of follow-up SCREEN questionnaire scores.
  
  
  RESULTS
  Meals On Wheels use was independently associated with higher SCREEN questionnaire scores (ie, less risk), as was higher income. Baseline SCREEN questionnaire scores also strongly and positively predicted follow-up scores. Self-reported depression at baseline was associated with lower scores at follow-up. Although use of programs at baseline was associated with decreased risk, if participants experienced increased use of the program (eg, more meals) during the follow-up period this was associated with lower scores, or increased risk.
  
  
  CONCLUSIONS
  Meal programs can improve or maintain nutritional risk for vulnerable seniors. Increased use of these programs over time may indicate a senior's declining status. Seniors who are in need of informal or formal supports for food shopping or preparation should be encouraged to participate in meal programs as a means of maintaining or improving their nutrition.
authors.affiliation: Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada N1G 2W1. hkeller@uoguelph.ca
authors.forename: Heather H
authors.initials: HH
authors.lastname: Keller
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005522:Food Services / Q000706:statistics & numerical data*; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D009752:Nutritional Status; D009864:Ontario; D018570:Risk Assessment; D012944:Social Support; D011795:Surveys and Questionnaires