Association of resident, facility, and geographic characteristics with chronic undernutrition in a nationally represented sample of older residents in U.S. nursing homes.
BACKGROUND
Undernutrition (also known as protein-calorie malnutrition or energy-deficiency) is associated with exacerbation of health conditions, increased frailty, and decline in physical, cognitive, and affective function. This is a critical problem for older adults who reside in nursing homes and have many limitations that contribute to reduced food intake.


OBJECTIVE
To determine the relationship of chronic undernutrition [body mass index (BMI) < 18.5 kg/m2] to resident, facility, and geographical characteristics in a national sample of nursing home residents aged 60 y or older in the U.S.


METHODS
A cross-sectional, secondary analysis of a 10% nationally representative random sample of annual assessments of nursing home residents in the U.S. (n = 128,514), using the Minimum Data Set (MDS). Data included measured weight and height, resident characteristics, facility characteristics, and geographic location.


RESULTS
More than 12% (n = 15,566) were chronically undernourished (energy-deficient), with more than 27% of those being severely undernourished (BMI < 16). Independent correlates of chronic undernutrition (multivariate analysis) included resident characteristics (ADL, having chewing or swallowing problems, or leaving at least 25% of the meal uneaten), facility characteristics (% Medicare and for-profit status), and geographic characteristics (living in nursing home in urban or large towns).


CONCLUSIONS
This study found a high percentage of chronic undernutrition in this nationally representative sample of U.S. nursing home residents. Furthermore, resident, facility, and geographic characteristics were associated with chronic undernutrition. Strategies need to be developed and documented that ensure nutritional health to residents with a variety of health problems.
Challa
S
S
Dept. of Community Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA. challas@uthscsa.edu
Sharkey
J R
JR
Chen
M
M
Phillips
C D
CD
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D015992:Body Mass Index; D005260:Female; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006742:Hospital Bed Capacity; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D015999:Multivariate Analysis; D009735:Nursing Homes / Q000706:statistics & numerical data*; D011502:Protein-Energy Malnutrition / Q000453:epidemiology; D012424:Rural Population; D014481:United States / Q000453:epidemiology; D014505:Urban Population