Malnutrition on the menu: nutritional status of institutionalised elderly Australians in low-level care.
BACKGROUND
Most studies reporting malnutrition in the elderly relate to high-level care. However, one third of Australians in aged care reside in low-level care facilities. Data is limited on their nutritional status.


OBJECTIVE
To investigate the nutritional status of elderly in low-level care facilities.


METHODS
A cross sectional study design.


METHODS
14 low-level aged care facilities in metropolitan Melbourne.


METHODS
Convenience sample of 103 ambulatory elderly (86 +/- 6.6 years (mean +/- SD), 76% female, comprising 15% of the hostel population) able to perform daily functions of living.


METHODS
Nutritional intake assessed by three-day weighed food records, and nutritional status by haematological and biochemical markers and body composition (dual energy X-ray absorptiometry).


RESULTS
FOOD served did not supply the estimated average requirements (EAR) for 5 of the 14 nutrients analysed. Compared with EAR, 34% of participants were protein malnourished and 62% had energy intake deficits. Micronutrient intake was low for calcium, magnesium, folate, zinc (for men) and dietary fibre. Vitamin D deficiency (serum 25OH Vitamin D < 50 nmol/L) was present in 58% of residents. More men than women had low haemoglobin (P < 0.000), low red blood cells (P < 0.000), and a raised white blood cell count (P = 0.004). Forty three percent of men and 21% women had sarcopenia, 28% of men and 44% women had excess body fat (> 28% and >40%, respectively) and 14% of men and 12 % of women were sarcopenic-obese. Only 12% showed no sign of undernutrition using seven different nutritional indicators. Around 65% had two or more indicators of undernutrition.


CONCLUSIONS
These findings highlight the need for the supply of more, better quality, nutrient dense food to residents and better detection of undernutrition in aged care facilities. Maintenance of nutritional status has the potential to reduce morbidity and delay the transition to high-level care.
Woods
J L
JL
Nutrition and Dietetics Department, Monash University, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia. julie.woods@med.monash.edu.au
Walker
K Z
KZ
Iuliano Burns
S
S
Strauss
B J
BJ
D000203:Activities of Daily Living; D000369:Aged, 80 and over; D000740:Anemia / Q000453:epidemiology*; D001315:Australia / Q000453:epidemiology; D001772:Blood Cell Count; D003430:Cross-Sectional Studies; D003677:Deficiency Diseases / Q000453:epidemiology*; D004032:Diet / Q000592:standards; D002149:Energy Intake; D005260:Female; D006801:Humans; D007326:Institutionalization; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage; D009751:Nutritional Requirements; D009752:Nutritional Status; D009765:Obesity / Q000453:epidemiology*; D011502:Protein-Energy Malnutrition / Q000453:epidemiology*; D055948:Sarcopenia / Q000453:epidemiology*; D012737:Sex Factors; D014808:Vitamin D Deficiency / Q000453:epidemiology
D018977:Micronutrients