TY - JOUR
T1 - Behavioral and Cognitive Problems as Determinants of Malnutrition in Long-Term Care Facilities, a Cross-Sectional and Prospective Study
AU - Borkent, Jos W.
AU - van Hout, H. P. J.
AU - Feskens, E. J. M.
AU - Naumann, E.
AU - de van der Schueren, M. A. E.
N1 - Funding Information: Funding: This project was funded by the Taskforce for Applied Research, part of the Netherlands Organization for Scientific Research (NWO), financed by the Dutch Ministry of Education, Culture and Science, project number RAAK.PUB06.O1O. The sponsor had no role in the design, methods, subject recruitment, data collections, analysis and preparation of paper. Publisher Copyright: © 2022, The Author(s).
PY - 2022/8/1
Y1 - 2022/8/1
N2 - Objectives: To investigate the cross-sectional and prospective associations between behavior and cognitive problems and malnutrition in long-term care facilities (LTCF). Design: Cross-sectional and prospective routine care cohort study. Setting: 6874 Residents in Dutch LTCFs (period 2005–2020). Participants: Data were obtained from the InterRAI-LTCF instrument. Cross-sectional analyses on prevalence of malnutrition at admission included 3722 residents. Prospective analyses studied incident malnutrition during stay (total follow-up time 7104 years) and included data of 1826 residents with first measurement on admission (‘newly-admitted’) and n=3152 with first measurement on average ∼1 year after admission (‘existing’). Measurements: InterRAI scales for communication problems (CS), aggressive behavior (ABS), social engagement (RISE), depressive symptoms (DRS), cognitive performance (CPS) and the total number of behavior and cognitive problems were investigated as independent variables and malnutrition (ESPEN 2015 definition) as dependent variable in regression analyses. Results were stratified for gender and group ‘newly-admitted’ vs. ‘existing’. Results: On admission, 9.5% of residents was malnourished. In men, low social engagement was associated with prevalence of malnutrition. In women, all behavior and cognitive problems except depression were associated with malnutrition in the unadjusted analyses, but this attenuated in the full model taking all problems into account. The incidence of malnutrition during stay amounted to 8.9%. No significant associations of behavior and cognitive problems with malnutrition incidence were seen in ‘newly-admitted’ male residents while in ‘existing’ male residents all determinants were significantly associated. In ‘newly-admitted’ female residents CS, ABS and CPS, and in ‘existing’ female residents CS, RISE, ABS and CPS were significantly associated with incident malnutrition. All associations slightly attenuated after adjustment. Malnutrition incidence increased with increasing number of combined behavior and cognitive problems. Conclusion: Residents with behavior and cognitive problems are at an increased risk of being malnourished at admission, or becoming malnourished during stay in a LTCF, especially residents with multiple behavior and cognitive problems.
AB - Objectives: To investigate the cross-sectional and prospective associations between behavior and cognitive problems and malnutrition in long-term care facilities (LTCF). Design: Cross-sectional and prospective routine care cohort study. Setting: 6874 Residents in Dutch LTCFs (period 2005–2020). Participants: Data were obtained from the InterRAI-LTCF instrument. Cross-sectional analyses on prevalence of malnutrition at admission included 3722 residents. Prospective analyses studied incident malnutrition during stay (total follow-up time 7104 years) and included data of 1826 residents with first measurement on admission (‘newly-admitted’) and n=3152 with first measurement on average ∼1 year after admission (‘existing’). Measurements: InterRAI scales for communication problems (CS), aggressive behavior (ABS), social engagement (RISE), depressive symptoms (DRS), cognitive performance (CPS) and the total number of behavior and cognitive problems were investigated as independent variables and malnutrition (ESPEN 2015 definition) as dependent variable in regression analyses. Results were stratified for gender and group ‘newly-admitted’ vs. ‘existing’. Results: On admission, 9.5% of residents was malnourished. In men, low social engagement was associated with prevalence of malnutrition. In women, all behavior and cognitive problems except depression were associated with malnutrition in the unadjusted analyses, but this attenuated in the full model taking all problems into account. The incidence of malnutrition during stay amounted to 8.9%. No significant associations of behavior and cognitive problems with malnutrition incidence were seen in ‘newly-admitted’ male residents while in ‘existing’ male residents all determinants were significantly associated. In ‘newly-admitted’ female residents CS, ABS and CPS, and in ‘existing’ female residents CS, RISE, ABS and CPS were significantly associated with incident malnutrition. All associations slightly attenuated after adjustment. Malnutrition incidence increased with increasing number of combined behavior and cognitive problems. Conclusion: Residents with behavior and cognitive problems are at an increased risk of being malnourished at admission, or becoming malnourished during stay in a LTCF, especially residents with multiple behavior and cognitive problems.
KW - Undernutrition
KW - cognition
KW - longitudinal research
KW - nursing homes
KW - residentialcare
UR - http://www.scopus.com/inward/record.url?scp=85135551576&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s12603-022-1827-3
DO - https://doi.org/10.1007/s12603-022-1827-3
M3 - Article
C2 - 35934819
SN - 1279-7707
VL - 26
SP - 749
EP - 759
JO - Journal of Nutrition, Health and Aging
JF - Journal of Nutrition, Health and Aging
IS - 8
ER -