title: [Routes of nutrition and types of diet among dependent community-dwelling older care recipients and the relevance to mortality and hospitalization].
abstract: OBJECTIVE
  To clarify the routes of nutrition and types of diet and their relevance to the risk of mortality and hospitalization among community-dwelling dependent elderly provided various home care services under the long-term care insurance program.
  
  
  METHODS
  The present study consisted of the collection of baseline data of participants in the Nagoya Longitudinal Study of the Frail Elderly (NLS-FE) and data regarding mortality and hospitalization during a three-year follow-up period. The study population consisted of 1,872 subjects, and the baseline data included demographic characteristics, basic activities of daily living (ADLs), comorbidities, nutritional routes and types of diet, which were evaluated by trained visiting nurses.
  
  
  RESULTS
  Among the participants, 1,786 were on oral nutrition (solid regular-texture diet: 1,487 (79.5%); modified-texture diet (minced/pureed texture): 299 (16.0%), 82 (4.4%) were on enteral nutrition and four (0.2%) were on parenteral nutrition. During the three-year follow-up period, 453 participants died and 798 participants experienced admission to the hospital (pneumonia-related death and hospitalization: n=103 and 155, respectively). Cox regression models revealed that a modified-texture diet and tube feeding are associated with all-cause mortality and hospitalization. In particular, feeding tube use showed a high risk of pneumonia-related mortality and hospitalization, even after adjusting for potential confounders, including comorbidities and the ADL status.
authors.affiliation: Department of Community healthcare & Geriatrics, Nagoya University Graduate School of Medicine, 2) Inistution for Future Society, NAGOYA COISTREAM, Nagoya University.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kuzuya
authors.forename: Jun
authors.initials: J
authors.lastname: Hasegawa
authors.forename: Hiromi
authors.initials: H
authors.lastname: Enoki
authors.forename: Sachiko
authors.initials: S
authors.lastname: Izawa
mesh_terms: D000203:Activities of Daily Living; D000369:Aged, 80 and over; D004032:Diet; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D057187:Independent Living; D008297:Male; D009752:Nutritional Status