Abstract

Our aim was to investigate how energy intake modifies the association of the stage of dementia with health related quality of life (HRQoL) among institutionalized older people. A cross-sectional sample of 538 older long-term care residents with dementia in Helsinki, Finland were assessed with HRQoL (15D), energy intake (from one to two days), and the stage of dementia by the clinical dementia rating (CDR) scale. The energy intakes were standardized by z-scores to include both men and women in the same analyses. Severity of dementia was associated with HRQoL (15D index in CDR 0.5–1: 0.65 (0.11), CDR 2: 0.60 (0.10), CDR 3: 0.52 (0.10)). When the three groups of dementia severity were divided according to their energy intake quartiles, there was an association between the HRQoL and the stage of dementia (p < 0.001) and energy intake (p = 0.013); however, no interaction was observed (p = 0.30). While partial correlation analysis showed that energy intake correlated with HRQoL among residents with very mild/mild or moderate dementia, this was not observed among those with severe dementia. In moderate dementia, the dimensions of mobility and usual activities correlated significantly with higher energy intake. Both energy intake and severity of dementia are associated with HRQoL.

Highlights

  • When measured by the Mini-Nutritional Assessment (MNA), the prevalence of malnutrition in nursing homes in Europe ranges from 14–21% and from 21–40% in long-term care [1]

  • When the three groups of dementia severity were divided according to their energy intake quartiles, there was an association between the health related quality of life (HRQoL) and the stage of dementia (p < 0.001) and energy intake (p = 0.013); no interaction was observed (p = 0.30)

  • We observed that the stage of dementia according to clinical dementia rating (CDR) and standardized energy intake were both associated with HRQoL

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Summary

Introduction

When measured by the Mini-Nutritional Assessment (MNA), the prevalence of malnutrition in nursing homes in Europe ranges from 14–21% and from 21–40% in long-term care [1]. In an earlier study on a heterogeneous sample of older people whose nutritional status was normal according to the MNA, only approximately 40% of participants reached the amount of energy and. Engelheart et al observed that there was no correlation between nutritional status and energy or protein intake among older people living at home or in a nursing home [4]. The energy and protein intake in institutionalized older people varies between studies depending on culture, dementia stage, age, and gender distribution. Age (years), mean (SD 2) Female (%).

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