Malnutrition in a home-living older population: prevalence, incidence and risk factors. A prospective study.

AIMS AND OBJECTIVES To prospectively investigate and describe the prevalence and incidence of malnutrition among home-living older people, related to demographic and medical factors, self-perceived health and health-related quality of life. Another aim was to find predictors for developing risk of malnutrition. BACKGROUND Risk factors for malnutrition have previously been identified as diseases, several medications, low functional status, symptoms of depression and inadequate nutrient intake. Most studies are cross-sectionally performed at hospitals or in nursing care settings. DESIGN A prospective study with a sample of 579 home-living older people, randomly selected from a local national register. Examinations were performed at baseline and yearly follow-ups two to four times. METHOD Questionnaires validated and tested for reliability, to detect risk of malnutrition (Mini Nutritional Assessment), symptoms of depression (Geriatric Depression Scale-20), cognitive function (Mini Mental State Examination), health-related quality of life (Nottingham Health Profile), well-being (Philadelphia Geriatric Center Multilevel Assessment Instrument) self-perceived health, demographic factors, anthropometry and biochemical examinations. Predictors were searched for through multiple logistic regression analysis with the MNA as dependent factor. RESULTS The prevalence of risk for malnutrition was 14.5%, according to the MNA. Two risk factors for malnutrition were lower handgrip strength and lower self-perceived health. The incidence of risk for malnutrition at follow-ups was between 7.6% and 16.2%. Predictors for developing malnutrition were higher age, lower self-perceived health and more symptoms of depression. Men with symptoms of depression had a higher risk of developing malnutrition. CONCLUSION Lower self-perceived health had the highest power to predict risk for malnutrition, with increased number of depression symptoms and higher age as second and third predictors. RELEVANCE TO CLINICAL PRACTICE A regular and combined assessment using the Mini Nutrition Assessment, Geriatric Depression Scale-20 and self-perceived health as a base for identifying people in need, is one way to prevent the development of malnutrition.