Nutritional Status Plays More Important Role in Determining Functional State in Older People Living in the Community than in Nursing Home Residents.

Małgorzata Pigłowska,Tomasz Kostka,Agnieszka Guligowska

doi:10.3390/nu12072042

Małgorzata Pigłowska, Tomasz Kostka + Show 1 more

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https://doi.org/10.3390/nu12072042

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Journal: Nutrients	Publication Date: Jul 9, 2020
Citations: 13	License type: CC BY 4.0

Affiliation: Medical University of Lodz

Abstract

The aim of this study was to verify whether the relationship between nutritional and functional status differs between seniors in the community and those in long-term care institutions. One hundred nursing home (NH) residents aged 60 years and above and 100 sex- and age-matched community-dwelling (CD) older adults were examined. Functional status was assessed using the Comprehensive Geriatric Assessment (CGA) and nutritional status using anthropometric measures, the Mini Nutritional Assessment questionnaire (MNA) and bioimpedance analysis (BIA). Significant environmental interactions were observed with resting metabolic rate (RMR), extracellular water (ECW) and intracellular water (ICW) ratio, skeletal muscle mass (SMM), skeletal muscle index (SMI) and impedance (Z) and resistance (R) to the results of the Timed Up and Go (TUG) test. The two groups demonstrated different relationships between Z and R and handgrip strength and between Geriatric Depression Scale (GDS) score and fat free mass (FFM), body density, total body water (TBW) and phase angle (PhA). Nutritional status seems to be more important for functional state in CD older people than in NH residents. Therefore, to ensure the functional independence of seniors living in the community, it is crucial to maintain the correct nutritional parameters. Further studies are necessary to account for the fact that this relationship is less significant among NH residents and to identify other factors that may contribute to these discrepancies between community and institutional environments.

Highlights

Due to a wide range of physiological, psychological, social or environmental factors, older people are vulnerable to the development of nutritional impairments
Community-dwelling sex- and age-matched outpatients of the Geriatrics Clinic were consecutively enrolled in the study, one for each nursing home (NH)
NH residents were characterized with worse functional status, both with regard to the basic and instrumental activities of daily living

Summary

Introduction

Due to a wide range of physiological, psychological, social or environmental factors, older people are vulnerable to the development of nutritional impairments. Various studies have associated malnutrition with poor functional status, impaired muscle strength, low bone mass and reduced cognitive function [3]. Whereas the prevalence ranges between 5 and 10% among older adults living in the community, it may reach as high as 60% in institutionalized subjects [1,5,6]. Institutionalization is described as a factor that may be connected with poorer nutritional and functional status in older people [7,8], while living in a nursing home (NH) increases their degree of dependence [7,8,9,10].

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