Undernutrition in geriatric institutions in South-West France: Policies and risk factors

Abstract 

Objective

This study aimed to describe the nutritional status of geriatric home residents according to their place of dwelling and to identify institutional factors associated with higher rates of undernutrition.

Methods

All institutions (514) in the Aquitaine region were interviewed for staff ratio, nutritional procedures, staff training, and other procedures in the area of nutrition. A stratified random sample of 601 residents in a subsample of 42 institutions underwent Mini-Nutritional Assessment.

Results

The estimated prevalence of undernutrition was 19.1 (95% confidence interval [CI] 14.0–24.2), with a higher rate in long-term care (48.0%, 95% CI 15.9–80.2) than in nursing homes (14.5%, 95% CI 10.6–18.4, P < 0.0001). In univariate analyses the risk of undernutrition was higher in long-term care (P < 0.0001), in settings with better weighing equipment (P < 0.0001), with a higher staff ratio (P = 0.0001), and a higher rate of subjects needing help for eating (P < 0.0001) and was lower in settings with a higher rate of training in nutritional screening (P = 0.0001) and management (P < 0.0001). In nursing homes, each item of the Mini-Nutritional Assessment Short Form was independently predictive of undernutrition. In multivariate analyses in nursing homes only, better weighing equipment (adjusted odds ratio 2.34, 95% CI 1.39–4.12, P = 0.0017) and higher staff ratio (adjusted odds ratio 1.03, 95% CI 1.00–1.05, P = 0.0230) were associated with higher rates of undernutrition.

Conclusion

Undernutrition in institutions was linked to the resident health problems, with little evidence in favor of the influence of institutional policies.

Keywords: Mini-Nutritional Assessment, Staff training, Functional dependency, Nutritional supplementation