Undernutrition in geriatric institutions in South-West France: policies and risk factors.
OBJECTIVE
This study aimed to describe the nutritional status of geriatric home residents according to their place of dwelling and to identify institutional factors associated with higher rates of undernutrition.


METHODS
All institutions (514) in the Aquitaine region were interviewed for staff ratio, nutritional procedures, staff training, and other procedures in the area of nutrition. A stratified random sample of 601 residents in a subsample of 42 institutions underwent Mini-Nutritional Assessment.


RESULTS
The estimated prevalence of undernutrition was 19.1 (95% confidence interval [CI] 14.0-24.2), with a higher rate in long-term care (48.0%, 95% CI 15.9-80.2) than in nursing homes (14.5%, 95% CI 10.6-18.4, P < 0.0001). In univariate analyses the risk of undernutrition was higher in long-term care (P < 0.0001), in settings with better weighing equipment (P < 0.0001), with a higher staff ratio (P = 0.0001), and a higher rate of subjects needing help for eating (P < 0.0001) and was lower in settings with a higher rate of training in nutritional screening (P = 0.0001) and management (P < 0.0001). In nursing homes, each item of the Mini-Nutritional Assessment Short Form was independently predictive of undernutrition. In multivariate analyses in nursing homes only, better weighing equipment (adjusted odds ratio 2.34, 95% CI 1.39-4.12, P = 0.0017) and higher staff ratio (adjusted odds ratio 1.03, 95% CI 1.00-1.05, P = 0.0230) were associated with higher rates of undernutrition.


CONCLUSIONS
Undernutrition in institutions was linked to the resident health problems, with little evidence in favor of the influence of institutional policies.
CHU of Bordeaux, Department of Gerontology; UMR 5536 CNRS/University V Segalen Bordeaux 2, Bordeaux, France. isabelle.bourdel-marchasson@chu-bordeaux.fr
Isabelle
I
Bourdel-Marchasson
Charlotte
C
Rolland
Marthe-Aline
MA
Jutand
Christian
C
Egea
Béatrice
B
Baratchart
Pascale
P
Barberger-Gateau
D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D005260:Female; D005602:France / Q000453:epidemiology; D015577:Geriatric Assessment; D006306:Health Surveys; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008134:Long-Term Care; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D015999:Multivariate Analysis; D009726:Nurses / Q000600:supply & distribution; D009735:Nursing Homes / Q000706:statistics & numerical data*; D015596:Nutrition Assessment; D018673:Nutrition Policy; D009749:Nutrition Surveys; D009752:Nutritional Status; D016017:Odds Ratio; D012307:Risk Factors