title: Managing Malnutrition in Older Persons Residing in Care Homes: Nutritional and Clinical Outcomes Following a Screening and Intervention Program.
abstract: This study aimed to establish prevalence of malnutrition in older adult care home residents and investigate whether a nutritional screening and intervention program could improve nutritional and clinical outcomes. A community-based cohort study was conducted in five Newcastle care homes. 205 participants entered; 175 were followed up. Residents already taking oral nutritional supplements (ONS) were excluded from interventions. Those with Malnutrition Universal Screening Tool (MUST) score of 1 received dietetic advice and ≥2 received dietetic advice and were prescribed ONS (220 ml, 1.5 kcal/ml) twice daily for 12 weeks. Body mass index (BMI), MUST, mini nutritional assessment score (MNA)®, mid upper arm muscle circumference (MAMC), and Geriatric Depression Scale (GDS) were recorded at baseline and 12 weeks. Malnutrition prevalence was 36.6% ± 6.6 (95% CI). A higher MUST was associated with greater mortality (p = 0.004). Type of intervention received was significantly associated with change in MUST score (p < 0.001); dietetic advice resulting in the greatest improvement. There were no significant changes in BMI (p = 0.445), MAMC (p = 0.256), or GDS (p = 0.385) following the interventions. Dietitian advice may slow the progression of nutritional decline. In this study oral nutritional supplements over a 3-month period did not significantly improve nutritional status in malnourished care home residents.
authors.affiliation: a Department of Gastroenterology , Newcastle Upon Tyne Hospitals, NHS Foundation Trust , Newcastle Upon Tyne , United Kingdom.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Mountford
authors.affiliation: b Medical School , Newcastle University , Newcastle Upon Tyne , United Kingdom.
authors.forename: Arthur C O
authors.initials: AC
authors.lastname: Okonkwo
authors.affiliation: c Department of Nutritional Sciences, Faculty of Health and Medical Sciences , University of Surrey , Guildford , United Kingdom.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Hart
authors.affiliation: a Department of Gastroenterology , Newcastle Upon Tyne Hospitals, NHS Foundation Trust , Newcastle Upon Tyne , United Kingdom.
authors.forename: Nick P
authors.initials: NP
authors.lastname: Thompson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology; D019587:Dietary Supplements; D005260:Female; D015577:Geriatric Assessment; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000178:diet therapy* / Q000453:epidemiology; D015596:Nutrition Assessment; D009752:Nutritional Status; D016896:Treatment Outcome
keywords: Malnutrition; older adult; oral nutritional supplementation; screening