Nutritional assessment of residents in Long-Term Care Facilities (LTCFS): Recommendations of the task force on nutrition and ageing of the IAGG European Region and the IANA

Abstract

Unintentional weight loss and Undernutrition are major problems among older people living in Long-Term Care Facilities (LTCF). Undernutrition manifests in LTCF particularly as weight loss and low Body Mass Index (BMI) and is associated with increased morbidity and mortality as well as with functional decline. There are many factors associated with poor nutritional status and affecting protein-energy intake and/or energy expenditure. These include age of 85 years or older, low nutrient intake, loss of ability to eat independently, swallowing and chewing difficulties, becoming bed-ridden, pressure ulcers, history of hip fracture, dementia, depressive symptoms and suffering from two or more chronic illnesses. Nutritional evaluation is an essential part of the Comprehensive Geriatric Assessment (CGA). This evaluation ranges from methods such as BMI to several validated tools such as Mini-Nutritional Assessment (MNA). After diagnosis, the management of undernutrition in LTCF requires a multidisciplinary approach which may involve dietary and environmental improvements and managing multiple co-morbidities, while avoiding polypharmacy as far as possible. Finally, the need for supplementation or artificial (tube) feeding may be considered taking into account the CGA and individual needs. This document presents a succinct review and recommendations of evaluation and treatment of undernutrition.

This is a preview of subscription content, access via your institution.

References

  1. 1.

    Constans T, Alix E, Dardaine V. [Protein-energy malnutrition. Diagnostic methods and epidemiology]. Presse Med 2000;29(39):2171–2176.

    PubMed  CAS  Google Scholar 

  2. 2.

    Woo J, Leung J, Kwok T. BMI, Body Composition, and Physical Functioning in Older Adults. Obesity (Silver Spring) 2007;15(7):1886–1894.

    Article  Google Scholar 

  3. 3.

    Zuliani G, Romagnoni F, Volpato S, Soattin L, Leoci V, Bollini MC et al. Nutritional parameters, body composition, and progression of disability in older disabled residents living in nursing homes. J Gerontol A Biol Sci Med Sci 2001;56(4):M212–M216.

    PubMed  CAS  Google Scholar 

  4. 4.

    Willcox BJ, Yano K, Chen R, Willcox DC, Rodriguez BL, Masaki KH et al. How much should we eat? The association between energy intake and mortality in a 36-year follow-up study of Japanese-American men. J Gerontol A Biol Sci Med Sci 2004;59(8):789–795.

    PubMed  Google Scholar 

  5. 5.

    Crogan NL, Pasvogel A. The influence of protein-calorie malnutrition on quality of life in nursing homes. J Gerontol A Biol Sci Med Sci 2003;58(2):159–164.

    PubMed  Google Scholar 

  6. 6.

    Wendland BE, Greenwood CE, Weinberg I, Young KW. Malnutrition in institutionalized seniors: the iatrogenic component. J Am Geriatr Soc 2003;51(1):85–90.

    PubMed  Article  Google Scholar 

  7. 7.

    Challa S, Sharkey JR, Chen M, Phillips CD. Association of resident, facility, and geographic characteristics with chronic undernutrition in a nationally represented sample of older residents in U.S. nursing homes. J Nutr Health Aging 2007;11(2):179–184.

    PubMed  CAS  Google Scholar 

  8. 8.

    Woo J, Chi I, Hui E, Chan F, Sham A. Low staffing level is associated with malnutrition in long-term residential care homes. Eur J Clin Nutr 2005;59(4):474–479.

    PubMed  Article  CAS  Google Scholar 

  9. 9.

    Garcia-Arias MT, Villarino RA, Garcia-Linares MC, Rocandio AM, Garcia-Fernandez MC. Iron, folate and vitamins B12 & C dietary intake of an elderly institutionalized population in Leon, Spain. Nutr Hosp 2003;18(4):222–225

    PubMed  CAS  Google Scholar 

  10. 10.

    Garcia-Arias MT, Villarino RA, Garcia-Linares MC, Rocandio AM, Garcia-Fernandez MC. Daily intake of macronutrients in a group of institutionalized elderly people in Leon. Spain. Nutr Hosp 2003;18(2):87–90.

    PubMed  CAS  Google Scholar 

  11. 11.

    Villarino RA, Garcia-Linares MC, Garcia-Fernandez MC, Garcia-Arias MT. [Evaluation of diet and biochemical parameters for minerals in a group of elderly subjects in the province of Leon (Spain)]. Nutr Hosp 2003;18(1):39–45.

    Google Scholar 

  12. 12.

    Thane CW, Bates CJ, Shearer MJ, Unadkat N, Harrington DJ, Paul AA et al. Plasma phylloquinone (vitamin K1) concentration and its relationship to intake in a national sample of British elderly people. Br J Nutr 2002;87(6):615–622.

    PubMed  Article  CAS  Google Scholar 

  13. 13.

    Bates CJ, Thane CW, Prentice A, Delves HT. Selenium status and its correlates in a British national diet and nutrition survey: people aged 65 years and over. J Trace Elem Med Biol 2002;16(1):1–8.

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    Blaum CS, Fries BE, Fiatarone MA. Factors associated with low body mass index and weight loss in nursing home residents. J Gerontol A Biol Sci Med Sci 1995;50(3):M162–M168.

    PubMed  CAS  Google Scholar 

  15. 15.

    Corbett CF, Crogan NL, Short RA. Using the minimum data set to predict weight loss in nursing home residents. Appl Nurs Res 2002;15(4):249–253.

    PubMed  Article  Google Scholar 

  16. 16.

    Mojon P, Budtz-Jorgensen E, Rapin CH. Relationship between oral health and nutrition in very old people. Age Ageing 1999;28(5):463–468.

    PubMed  Article  CAS  Google Scholar 

  17. 17.

    Sala R, Munto MJ, de la CJ, Preciado I, Miralles T, Cortes A et al. [Swallowing changes in cerebrovascular accidents: incidence, natural history, and repercussions on the nutritional status, morbidity, and mortality]. Rev Neurol 1998;27(159):759–766.

    PubMed  CAS  Google Scholar 

  18. 18.

    Roe DA. Medications and nutrition in the elderly. Prim Care 1994;21(1):135–147.

    PubMed  CAS  Google Scholar 

  19. 19.

    Akamine D, Filho MK, Peres CM. Drug-nutrient interactions in elderly people. Curr Opin Clin Nutr Metab Care 2007;10(3):304–310.

    PubMed  Google Scholar 

  20. 20.

    White HK, McConnell ES, Bales CW, Kuchibhatla M. A 6-month observational study of the relationship between weight loss and behavioral symptoms in institutionalized Alzheimer’s disease subjects. J Am Med Dir Assoc 2004;5(2):89–97.

    PubMed  Google Scholar 

  21. 21.

    Young KW, Greenwood CE. Shift in diurnal feeding patterns in nursing home residents with Alzheimer’s disease. J Gerontol A Biol Sci Med Sci 2001;56(11):M700–M706.

    PubMed  CAS  Google Scholar 

  22. 22.

    Pick N, McDonald A, Bennett N, Litsche M, Dietsche L, Legerwood R et al. Pulmonary aspiration in a long-term care setting: clinical and laboratory observations and an analysis of risk factors. J Am Geriatr Soc 1996;44(7):763–768.

    PubMed  CAS  Google Scholar 

  23. 23.

    Buckler DA, Kelber ST, Goodwin JS. The use of dietary restrictions in malnourished nursing home patients. J Am Geriatr Soc 1994;42(10):1100–1102.

    PubMed  CAS  Google Scholar 

  24. 24.

    Roberts SB, Hajduk CL, Howarth NC, Russell R, McCrory MA. Dietary variety predicts low body mass index and inadequate macronutrient and micronutrient intakes in community-dwelling older adults. J Gerontol A Biol Sci Med Sci 2005;60(5):613–621.

    PubMed  Google Scholar 

  25. 25.

    Desai J, Winter A, Young KW, Greenwood CE. Changes in type of foodservice and dining room environment preferentially benefit institutionalized seniors with low body mass indexes. J Am Diet Assoc 2007;107(5):808–814.

    PubMed  Article  Google Scholar 

  26. 26.

    Thomas DR, Ashmen W, Morley JE, Evans WJ. Nutritional management in long-term care: development of a clinical guideline. Council for Nutritional Strategies in Long-Term Care. J Gerontol A Biol Sci Med Sci 2000;55(12):M725–M734.

    PubMed  CAS  Google Scholar 

  27. 27.

    Galanos AN, Pieper CF, Kussin PS, Winchell MT, Fulkerson WJ, Harrell FE, Jr. et al. Relationship of body mass index to subsequent mortality among seriously ill hospitalized patients. SUPPORT Investigators. The Study to Understand Prognoses and Preferences for Outcome and Risks of Treatments. Crit Care Med 1997;25(12):1962–1968.

    PubMed  Article  CAS  Google Scholar 

  28. 28.

    Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW, Jr. Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med 1999;341(15):1097–1105.

    PubMed  Article  CAS  Google Scholar 

  29. 29.

    Flegal KM, Graubard BI, Williamson DF, Gail MH. Cause-specific excess deaths associated with underweight, overweight, and obesity. JAMA 2007;298(17):2028–2037.

    PubMed  Article  CAS  Google Scholar 

  30. 30.

    Crogan NL, Corbett CF. Predicting malnutrition in nursing home residents using the minimum data set. Geriatr Nurs 2002;23(4):224–226.

    PubMed  Article  Google Scholar 

  31. 31.

    Fries BE, Hawes C, Morris JN, Phillips CD, Mor V, Park PS. Effect of the National Resident Assessment Instrument on selected health conditions and problems. J Am Geriatr Soc 1997; 45(8):994–1001.

    Google Scholar 

  32. (32)

    Simmons SF, Lim B, Schnelle JF. Accuracy of minimum data set in identifying residents at risk for undernutrition: oral intake and food complaints. J Am Med Dir Assoc 2002;3(3):140–145.

    PubMed  Google Scholar 

  33. 33.

    Bowman JJ, Keller HH. Assessing nutritional risk of long-term care residents. Can J Diet Pract Res 2005;66(3):155–161.

    PubMed  Article  Google Scholar 

  34. 34.

    Blaum CS, O’Neill EF, Clements KM, Fries BE, Fiatarone MA. Validity of the minimum data set for assessing nutritional status in nursing home residents. Am J Clin Nutr 1997;66(4):787–794.

    PubMed  CAS  Google Scholar 

  35. 35.

    Morley JE, Silver AJ. Nutritional issues in nursing home care. Ann Intern Med 1995;123(11):850–859.

    PubMed  CAS  Google Scholar 

  36. 36.

    Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D, Lauque S et al. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition 1999;15(2):116–122.

    PubMed  Article  CAS  Google Scholar 

  37. 37.

    Guigoz Y, Lauque S, Vellas BJ. Identifying the elderly at risk for malnutrition. The Mini Nutritional Assessment. Clin Geriatr Med 2002;18(4):737–757.

    PubMed  Article  Google Scholar 

  38. 38.

    Bleda MJ, Bolibar I, Pares R, Salva A. Reliability of the mini nutritional assessment (MNA) in institutionalized elderly people. J Nutr Health Aging 2002;6(2):134–137.

    PubMed  CAS  Google Scholar 

  39. 39.

    Ruiz-Lopez MD, Artacho R, Oliva P, Moreno-Torres R, Bolanos J, de TC et al. Nutritional risk in institutionalized older women determined by the Mini Nutritional Assessment test: what are the main factors? Nutrition 2003;19(9):767–771.

    PubMed  Article  Google Scholar 

  40. 40.

    Saletti A, Lindgren EY, Johansson L, Cederholm T. Nutritional status according to mini nutritional assessment in an institutionalized elderly population in Sweden. Gerontology 2000;46(3):139–145.

    PubMed  Article  CAS  Google Scholar 

  41. 41.

    Vellas B, Guigoz Y, Baumgartner M, Garry PJ, Lauque S, Albarede JL. Relationships between nutritional markers and the mini-nutritional assessment in 155 older persons. J Am Geriatr Soc 2000;48(10):1300–1309.

    PubMed  CAS  Google Scholar 

  42. 42.

    Kagansky N, Berner Y, Koren-Morag N, Perelman L, Knobler H, Levy S. Poor nutritional habits are predictors of poor outcome in very old hospitalized patients. Am J Clin Nutr 2005;82(4):784–791.

    PubMed  CAS  Google Scholar 

  43. 43.

    Guerin O, Soto ME, Brocker P, Robert PH, Benoit M, Vellas B. Nutritional status assessment during Alzheimer’s disease: results after one year (the REAL French Study Group). J Nutr Health Aging 2005;9(2):81–84.

    PubMed  CAS  Google Scholar 

  44. 44.

    Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci 2001;56(6):M366–M372.

    PubMed  CAS  Google Scholar 

  45. 45.

    Formiga F, Chivite D, Mascaro J, Ramon JM, Pujol R. No correlation between mini-nutritional assessment (short form) scale and clinical outcomes in 73 elderly patients admitted for hip fracture. Aging Clin Exp Res 2005;17(4):343–346.

    PubMed  Google Scholar 

  46. 46.

    Vellas B, Villars H, Abellan G, Soto ME, Rolland Y, Guigoz Y et al. Overview of the MNA—Its history and challenges. J Nutr Health Aging 2006;10(6):456–463.

    PubMed  CAS  Google Scholar 

  47. 47.

    Sieber CC. Nutritional screening tools—How does the MNA compare? Proceedings of the session held in Chicago May 2–3, 2006 (15 Years of Mini Nutritional Assessment). J Nutr Health Aging 2006;10(6):488–492.

    PubMed  CAS  Google Scholar 

  48. 48.

    Chumlea WC. Is the MNA valid in different populations and across practice settings? J Nutr Health Aging 2006;10(6):524–527.

    PubMed  CAS  Google Scholar 

  49. 49.

    Rudman D, Feller AG, Nagraj HS, Jackson DL, Rudman IW, Mattson DE. Relation of serum albumin concentration to death rate in nursing home men. JPEN J Parenter Enteral Nutr 1987;11(4):360–363.

    PubMed  Article  CAS  Google Scholar 

  50. 50.

    Grant MD, Piotrowski ZH, Miles TP. Declining cholesterol and mortality in a sample of older nursing home residents. J Am Geriatr Soc 1996;44(1):31–36.

    PubMed  CAS  Google Scholar 

  51. 51.

    Mears E. Outcomes of continuous process improvement of a nutritional care program incorporating serum prealbumin measurements. Nutrition 1996;12(7–8):479–484.

    PubMed  Article  CAS  Google Scholar 

  52. 52.

    Pepersack T. Outcomes of continuous process improvement of nutritional care program among geriatric units. J Gerontol A Biol Sci Med Sci 2005;60(6):787–792.

    PubMed  Google Scholar 

  53. 53.

    Kuzuya M, Kanda S, Koike T, Suzuki Y, Iguchi A. Lack of correlation between total lymphocyte count and nutritional status in the elderly. Clin Nutr 2005;24(3):427–432.

    PubMed  Article  Google Scholar 

  54. 54.

    Ek AC, Larsson J, von SH, Thorslund S, Unosson M, Bjurulf P. The correlation between anergy, malnutrition and clinical outcome in an elderly hospital population. Clin Nutr 1990;9(4):185–189.

    PubMed  Article  CAS  Google Scholar 

  55. 55.

    Simmons SF, Reuben D. Nutritional intake monitoring for nursing home residents: a comparison of staff documentation, direct observation, and photography methods. J Am Geriatr Soc 2000;48(2):209–213.

    PubMed  CAS  Google Scholar 

  56. 56.

    Persson M, Elmstahl S, Blabolil V. The reproducibility of a new dietary record routine in geriatric patients. Clin Nutr 2002;21(1):15–25.

    PubMed  Article  CAS  Google Scholar 

  57. 57.

    Deijen JB, Slump E, Wouters-Wesseling W, De Groot CP, Galle E, Pas H. Nutritional intake and daily functioning of psychogeriatric nursing home residents. J Nutr Health Aging 2003;7(4):242–246.

    PubMed  CAS  Google Scholar 

  58. 58.

    Niedert KC. Position of the American Dietetic Association: Liberalization of the diet prescription improves quality of life for older adults in long-term care. J Am Diet Assoc 2005;105(12):1955–1965.

    PubMed  Article  Google Scholar 

  59. 59.

    Christensson L, Ek AC, Unosson M. Individually adjusted meals for older people with protein-energy malnutrition: a single-case study. J Clin Nurs 2001;10(4):491–502.

    PubMed  Article  CAS  Google Scholar 

  60. 60.

    Paquet C, St-Arnaud-McKenzie D, Kergoat MJ, Ferland G, Dube L. Direct and indirect effects of everyday emotions on food intake of elderly patients in institutions. J Gerontol A Biol Sci Med Sci 2003;58(2):153–158.

    PubMed  Google Scholar 

  61. 61.

    Christensson L, Unosson M, Bachrach-Lindstrom M, Ek AC. Attitudes of nursing staff towards nutritional nursing care. Scand J Caring Sci 2003;17(3):223–231.

    PubMed  Article  Google Scholar 

  62. 62.

    Kumlien S, Axelsson K. Stroke patients in nursing homes: eating, feeding, nutrition and related care. J Clin Nurs 2002;11(4):498–509.

    PubMed  Article  Google Scholar 

  63. 63.

    Nijs KA, de GC, Siebelink E, Blauw YH, Vanneste V, Kok FJ et al. Effect of family-style meals on energy intake and risk of malnutrition in dutch nursing home residents: a randomized controlled trial. J Gerontol A Biol Sci Med Sci 2006;61(9):935–942.

    PubMed  Google Scholar 

  64. 64.

    Nijs KA, de GC, Kok FJ, van Staveren WA. Effect of family style mealtimes on quality of life, physical performance, and body weight of nursing home residents: cluster randomised controlled trial. BMJ 2006;332(7551):1180–1184.

    PubMed  Article  Google Scholar 

  65. 65.

    Mathey MF, Vanneste VG, de GC, de Groot LC, van Staveren WA. Health effect of improved meal ambiance in a Dutch nursing home: a 1-year intervention study. Prev Med 2001;32(5):416–423.

    PubMed  Article  CAS  Google Scholar 

  66. 66.

    Kayser-Jones J, Schell ES, Porter C, Barbaccia JC, Steinbach C, Bird WF et al. A prospective study of the use of liquid oral dietary supplements in nursing homes. J Am Geriatr Soc 1998;46(11):1378–1386.

    PubMed  CAS  Google Scholar 

  67. 67.

    Baldwin C, Parsons T, Logan S. Dietary advice for illness-related malnutrition in adults. Cochrane Database Syst Rev 2007;(1):CD002008.

  68. 68.

    Braga JM, Hunt A, Pope J, Molaison E. Implementation of dietitian recommendations for enteral nutrition results in improved outcomes. J Am Diet Assoc 2006;106(2):281–284.

    PubMed  Article  Google Scholar 

  69. 69.

    Keller HH, Gibbs-Ward A, Randall-Simpson J, Bocock MA, Dimou E. Meal rounds: an essential aspect of quality nutrition services in long-term care. J Am Med Dir Assoc 2006;7(1):40–45.

    PubMed  Article  Google Scholar 

  70. 70.

    Munir J, Wright RJ, Carr DB. A quality improvement study on calcium and vitamin D supplementation in long-term care. J Am Med Dir Assoc 2006;7(5):305–309.

    PubMed  Article  Google Scholar 

  71. 71.

    Morley JE. Decreased food intake with aging. J Gerontol A Biol Sci Med Sci 2001;56Spec No 2:81–88.

    PubMed  Google Scholar 

  72. 72.

    Fiatarone MA, O’Neill EF, Ryan ND, Clements KM, Solares GR, Nelson ME et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 1994;330(25):1769–1775.

    PubMed  Article  CAS  Google Scholar 

  73. 73.

    Volicer L, Simard J, Pupa JH, Medrek R, Riordan ME. Effects of continuous activity programming on behavioral symptoms of dementia. J Am Med Dir Assoc 2006;7(7):426–431.

    PubMed  Article  Google Scholar 

  74. 74.

    Gersovitz M, Motil K, Munro HN, Scrimshaw NS, Young VR. Human protein requirements: assessment of the adequacy of the current Recommended Dietary Allowance for dietary protein in elderly men and women. Am J Clin Nutr 1982;35(1):6–14.

    PubMed  CAS  Google Scholar 

  75. 75.

    Vreeman RC, Carroll AE. Medical myths. BMJ 2007;335(7633):1288–1289.

    PubMed  Article  Google Scholar 

  76. 76.

    Mathey MF, Siebelink E, de GC, van Staveren WA. Flavor enhancement of food improves dietary intake and nutritional status of elderly nursing home residents. J Gerontol A Biol Sci Med Sci 2001;56(4):M200–M205.

    PubMed  CAS  Google Scholar 

  77. 77.

    Evans BC, Crogan NL. Building a scientific base for nutrition care of Hispanic

  78. 78.

    Shanley C, O’Loughlin G. Dysphagia among nursing home residents: an assessment and management protocol. J Gerontol Nurs 2000;26(8):35–48.

    PubMed  CAS  Google Scholar 

  79. 79.

    Odlund OA, Armyr I, Soop M, Jerstrom S, Classon I, Cederholm T et al. Energydense meals improve energy intake in elderly residents in a nursing home. Clin Nutr 2003;22(2):125–131.

    Article  Google Scholar 

  80. 80.

    Milne AC, Potter J, Avenell A. Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Syst Rev 2005;(2):CD003288.

  81. 81.

    Milne AC, Avenell A, Potter J. Meta-analysis: protein and energy supplementation in older people. Ann Intern Med 2006;144(1):37–48.

    PubMed  CAS  Google Scholar 

  82. 82.

    Kwok T, Woo J, Kwan M. Does low lactose milk powder improve the nutritional intake and nutritional status of frail older Chinese people living in nursing homes? J Nutr Health Aging 2001;5(1):17–21.

    PubMed  CAS  Google Scholar 

  83. 83.

    Hedstrom M, Ljungqvist O, Cederholm T. Metabolism and catabolism in hip fracture patients: nutritional and anabolic intervention—a review. Acta Orthop 2006;77(5):741–747.

    PubMed  Article  Google Scholar 

  84. 84.

    Woo J, Ho SC, Mak YT, Law LK, Cheung A. Nutritional status of elderly patients during recovery from chest infection and the role of nutritional supplementation assessed by a prospective randomized single-blind trial. Age Ageing 1994;23(1):40–48.

    PubMed  Article  CAS  Google Scholar 

  85. 85.

    Lee SK, Posthauer ME, Dorner B, Redovian V, Maloney MJ. Pressure ulcer healing with a concentrated, fortified, collagen protein hydrolysate supplement: a randomized controlled trial. Adv Skin Wound Care 2006;19(2):92–96.

    PubMed  Article  Google Scholar 

  86. 86.

    Ferreira IM, Brooks D, Lacasse Y, Goldstein RS, White J. Nutritional supplementation for stable chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2005;(2):CD000998.

  87. 87.

    Avenell A, Handoll HH. Nutritional supplementation for hip fracture aftercare in older people. Cochrane Database Syst Rev 2006;(4):CD001880.

  88. 88.

    Koretz RL, Avenell A, Lipman TO, Braunschweig CL, Milne AC. Does enteral nutrition affect clinical outcome? A systematic review of the randomized trials. Am J Gastroenterol 2007;102(2):412–429.

    PubMed  Article  Google Scholar 

  89. 89.

    Wouters-Wesseling W, Wouters AE, Kleijer CN, Bindels JG, De Groot CP, van Staveren WA. Study of the effect of a liquid nutrition supplement on the nutritional status of psycho-geriatric nursing home patients. Eur J Clin Nutr 2002;56(3):245–251.

    PubMed  Article  CAS  Google Scholar 

  90. 90.

    Gil GP, Ramirez Diaz SP, Ribera Casado JM. Dementia and Nutrition. Intervention study in institutionalized patients with Alzheimer disease. J Nutr Health Aging 2003;7(5):304–308.

    Google Scholar 

  91. 91.

    Keller HH, Gibbs AJ, Boudreau LD, Goy RE, Pattillo MS, Brown HM. Prevention of weight loss in dementia with comprehensive nutritional treatment. J Am Geriatr Soc 2003;51(7):945–952.

    PubMed  Article  Google Scholar 

  92. 92.

    Manders M, de Groot LC, van Staveren WA, Wouters-Wesseling W, Mulders AJ, Schols JM et al. Effectiveness of nutritional supplements on cognitive functioning in elderly persons: a systematic review. J Gerontol A Biol Sci Med Sci 2004;59(10):1041–1049.

    PubMed  Google Scholar 

  93. 93.

    Wouters-Wesseling W, Wagenaar LW, Rozendaal M, Deijen JB, de Groot LC, Bindels JG et al. Effect of an enriched drink on cognitive function in frail elderly persons. J Gerontol A Biol Sci Med Sci 2005;60(2):265–270.

    PubMed  Google Scholar 

  94. 94.

    van der Wielen RP, van Heereveld HA, De Groot CP, van Staveren WA. Nutritional status of elderly female nursing home residents; the effect of supplementation with a physiological dose of water-soluble vitamins. Eur J Clin Nutr 1995;49(9):665–674.

    PubMed  Google Scholar 

  95. 95.

    van Staveren WA, De Groot CP. [Nutrition and health—vitamin supplementation and the vitality of the elderly]. Ned Tijdschr Geneeskd 2003;147(16):748–752.

    PubMed  Google Scholar 

  96. 96.

    Wicherts IS, van Schoor NM, Boeke AJ, Visser M, Deeg DJ, Smit J et al. Vitamin D status predicts physical performance and its decline in older persons. J Clin Endocrinol Metab 2007;92(6):2058–2065.

    PubMed  Article  CAS  Google Scholar 

  97. 97.

    Chel VG, Ooms ME, Popp-Snijders C, Pavel S, Schothorst AA, Meulemans CC et al. Ultraviolet irradiation corrects vitamin D deficiency and suppresses secondary hyperparathyroidism in the elderly. J Bone Miner Res 1998;13(8):1238–1242.

    PubMed  Article  CAS  Google Scholar 

  98. 98.

    Lips P, Wiersinga A, van Ginkel FC, Jongen MJ, Netelenbos JC, Hackeng WH et al. The effect of vitamin D supplementation on vitamin D status and parathyroid function in elderly subjects. J Clin Endocrinol Metab 1988;67(4):644–650.

    PubMed  CAS  Article  Google Scholar 

  99. 99.

    Gloth FM, III, Smith CE, Hollis BW, Tobin JD. Functional improvement with vitamin D replenishment in a cohort of frail, vitamin D-deficient older people. J Am Geriatr Soc 1995;43(11):1269–1271.

    PubMed  CAS  Google Scholar 

  100. 100.

    Grados F, Brazier M, Kamel S, Duver S, Heurtebize N, Maamer M et al. Effects on bone mineral density of calcium and vitamin D supplementation in elderly women with vitamin D deficiency. Joint Bone Spine 2003;70(3):203–208.

    PubMed  Article  Google Scholar 

  101. 101.

    Broe KE, Chen TC, Weinberg J, Bischoff-Ferrari HA, Holick MF, Kiel DP. A higher dose of vitamin d reduces the risk of falls in nursing home residents: a randomized, multiple-dose study. J Am Geriatr Soc 2007;55(2):234–239.

    PubMed  Article  Google Scholar 

  102. 102.

    Gass M, wson-Hughes B. Preventing osteoporosis-related fractures: an overview. Am J Med 2006;119(4 Suppl 1):S3–S11.

    PubMed  Article  Google Scholar 

  103. 103.

    Murphy S, West KP, Jr., Greenough WB, III, Cherot E, Katz J, Clement L. Impact of vitamin A supplementation on the incidence of infection in elderly nursing-home residents: a randomized controlled trial. Age Ageing 1992;21(6):435–439.

    PubMed  Article  CAS  Google Scholar 

  104. 104.

    Keane EM, O’Broin S, Kelleher B, Coakley D, Walsh JB. Use of folic acid-fortified milk in the elderly population. Gerontology 1998;44(6):336–339.

    PubMed  Article  CAS  Google Scholar 

  105. 105.

    Smith AD. Folic acid fortification: the good, the bad, and the puzzle of vitamin B-12. Am J Clin Nutr 2007;85(1):3–5.

    PubMed  CAS  Google Scholar 

  106. 106.

    Provinciali M, Montenovo A, Di SG, Colombo M, Daghetta L, Cairati M et al. Effect of zinc or zinc plus arginine supplementation on antibody titre and lymphocyte subsets after influenza vaccination in elderly subjects: a randomized controlled trial. Age Ageing 1998;27(6):715–722.

    PubMed  Article  CAS  Google Scholar 

  107. 107.

    Wilkinson EA, Hawke CI. Oral zinc for arterial and venous leg ulcers. Cochrane Database Syst Rev 2000;(2):CD001273.

  108. 108.

    Langkamp-Henken B, Herrlinger-Garcia KA, Stechmiller JK, Nickerson-Troy JA, Lewis B, Moffatt L. Arginine supplementation is well tolerated but does not enhance mitogen-induced lymphocyte proliferation in elderly nursing home residents with pressure ulcers. JPEN J Parenter Enteral Nutr 2000;24(5):280–287.

    PubMed  Article  CAS  Google Scholar 

  109. 109.

    Desneves KJ, Todorovic BE, Cassar A, Crowe TC. Treatment with supplementary arginine, vitamin C and zinc in patients with pressure ulcers: a randomised controlled trial. Clin Nutr 2005;24(6):979–987.

    PubMed  Article  CAS  Google Scholar 

  110. 110.

    Wouters-Wesseling W, Vos AP, Van HM, de Groot LC, van Staveren WA, Bindels JG. The effect of supplementation with an enriched drink on indices of immune function in frail elderly. J Nutr Health Aging 2005;9(4):281–286.

    PubMed  CAS  Google Scholar 

  111. 111.

    Kvicala J, Zamrazil V. Effect of iodine and selenium upon thyroid function. Cent Eur J Public Health 2003;11(2):107–113.

    PubMed  CAS  Google Scholar 

  112. 112.

    Girodon F, Galan P, Monget AL, Boutron-Ruault MC, Brunet-Lecomte P, Preziosi P et al. Impact of trace elements and vitamin supplementation on immunity and infections in institutionalized elderly patients: a randomized controlled trial. MIN. VIT. AOX. geriatric network. Arch Intern Med 1999;159(7):748–754.

    PubMed  Article  CAS  Google Scholar 

  113. 113.

    Galan P, Preziosi P, Monget AL, Richard MJ, Arnaud J, Lesourd B et al. Effects of trace element and/or vitamin supplementation on vitamin and mineral status, free radical metabolism and immunological markers in elderly long term-hospitalized subjects. Geriatric Network MIN. VIT. AOX. Int J Vitam Nutr Res 1997;67(6):450–460.

    PubMed  CAS  Google Scholar 

  114. 114.

    Cui Y, Shikany JM, Liu S, Shagufta Y, Rohan TE. Selected antioxidants and risk of hormone receptor-defined invasive breast cancers among postmenopausal women in the Women’s Health Initiative Observational Study. Am J Clin Nutr 2008;87(4):1009–1018.

    PubMed  CAS  Google Scholar 

  115. 115.

    Akbaraly TN, Favier A, Berr C. Total plasma carotenoids and mortality in the elderly: results of the Epidemiology of Vascular Ageing (EVA) study. Br J Nutr 2008;1–7.

  116. 116.

    Morley JE. Orexigenic and anabolic agents. Clin Geriatr Med 2002;18(4):853–866.

    PubMed  Article  Google Scholar 

  117. 117.

    Wilson MM, Philpot C, Morley JE. Anorexia of aging in long term care: is dronabinol an effective appetite stimulant?—a pilot study. J Nutr Health Aging 2007;11(2):195–198.

    PubMed  CAS  Google Scholar 

  118. 118.

    Yeh SS, Wu SY, Lee TP, Olson JS, Stevens MR, Dixon T et al. Improvement in quality-of-life measures and stimulation of weight gain after treatment with megestrol acetate oral suspension in geriatric cachexia: results of a double-blind, placebo-controlled study. J Am Geriatr Soc 2000;48(5):485–492.

    PubMed  CAS  Google Scholar 

  119. 119.

    Simmons SF, Walker KA, Osterweil D. The effect of megestrol acetate on oral food and fluid intake in nursing home residents: a pilot study. J Am Med Dir Assoc 2004;5(1):24–30.

    PubMed  Article  Google Scholar 

  120. 120.

    Bodenner DL, Medhi M, Evans WJ, Sullivan DH, Liu H, Lambert CP. Effects of megestrol acetate on pituitary function and end-organ hormone secretion: a post hoc analysis of serum samples from a 12-week study in healthy older men. Am J Geriatr Pharmacother 2005;3(3):160–167.

    PubMed  Article  CAS  Google Scholar 

  121. 121.

    Perkins HS. Controlling death: the false promise of advance directives. Ann Intern Med 2007;147(1):51–57.

    PubMed  Google Scholar 

  122. 122.

    Chumlea WC, Roche AF, Steinbaugh ML. Estimating stature from knee height for persons 60 to 90 years of age. J Am Geriatr Soc 1985; 33(2):116–120.

    PubMed  CAS  Google Scholar 

Download references

Author information

Affiliations

Authors

Consortia

Corresponding author

Correspondence to A. Salva.

Additional information

TASK FORCE MEMBERS: Sandrine Andrieu (France), Luisa Bartorelli (Italy), Ytshal N. Berner (Israel), Stuart Bruce (United Kingdom), Bruno Corman (France), Alex Domingo (Spain), Thomas P. Egger (Austrian), Lisette de Groot (The Netherlands), Yves Guigoz (Switzerland), Ana Imedio (Spain), Mercè Planas (Spain), Concha Porras (Spain), Joan Carles Rovira (Spain), Antoni Salvà (Spain), José Antonio Serra (Spain), Bruno Vellas (France).

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Salva, A., Coll-Planas, L., Bruce, S. et al. Nutritional assessment of residents in Long-Term Care Facilities (LTCFS): Recommendations of the task force on nutrition and ageing of the IAGG European Region and the IANA. J Nutr Health Aging 13, 475–483 (2009). https://doi.org/10.1007/s12603-009-0097-7

Download citation

Keywords

  • Nursing Home Resident
  • Pressure Ulcer
  • Mini Nutritional Assessment
  • Nutr Health Aging
  • Comprehensive Geriatric Assessment