title: Factors associated with eating performance for long-term care residents with moderate-to-severe cognitive impairment.
abstract: OBJECTIVE
  The aim of this study was to examine the association of specific personal and environmental factors with eating performance among long-term care residents with moderate-to-severe cognitive impairment.
  
  
  BACKGROUND
  Eating is the one of the most basic and easiest activities of daily living to perform. While multilevel factors can be associated with eating performance, the evidence among those with dementia was insufficient.
  
  
  METHODS
  A secondary analysis of baseline data collected between March and September in 2012 from 199 residents in eight long-term care facilities.
  
  
  METHODS
  Eating performance was conceptualized using the single self-care 'feeding' item in the Barthel Index and was scored based on four levels of dependence and assistance required. Binary logistic regression was used to examine the adjusted association of specific factors with eating performance.
  
  
  RESULTS
  Almost one-third of the residents needed help with eating. After adjusting the type of facility, number of comorbidities, chair-sitting balance, agitation and depression, compromised eating performance was associated with severe cognitive impairment and low physical capability.
  
  
  CONCLUSIONS
  This study supported the association of eating performance with cognitive impairment and physical capability among long-term care residents with moderate-to-severe cognitive impairment. Targeted interventions should be implemented to reduce the impact of cognitive decline on eating performance and promote physical capability to optimize eating performance. Future work need to use validated multiple-item measures for eating performance and test the association of personal and environmental factors with eating performance among a larger heterogeneous group of long-term care residents to enhance understanding of the factors.
authors.affiliation: The University of Iowa College of Nursing, Iowa, USA.
authors.forename: Wen
authors.initials: W
authors.lastname: Liu
authors.affiliation: University of Maryland School of Nursing, Baltimore, Maryland, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Galik
authors.affiliation: Boston College Connell School of Nursing, Chestnut Hill, Massachusetts, USA.
authors.forename: Marie
authors.initials: M
authors.lastname: Boltz
authors.affiliation: University of Maryland School of Nursing, Baltimore, Maryland, USA.
authors.forename: Eun-Shim
authors.initials: ES
authors.lastname: Nahm
authors.affiliation: University of Maryland School of Nursing, Baltimore, Maryland, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Lerner
authors.affiliation: University of Maryland School of Nursing, Baltimore, Maryland, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Resnick
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D040561:Assisted Living Facilities; D003072:Cognition Disorders / Q000150:complications*; D003704:Dementia / Q000150:complications*; D005247:Feeding Behavior / Q000523:psychology*; D001068:Feeding and Eating Disorders / Q000209:etiology*; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes
keywords: adults; cognitive impairment; eating performance; long-term care; nursing; physical capability