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Country of origin predicts nutrition risk among community living older people

  • JNHA: Nutrition
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

To assess the nutrition risk status of community living older people and to identify associated risk factors.

Design

A cross-sectional study using convenience sampling.

Setting

North Shore City, Auckland, New Zealand. Data collection was carried out by a research nutritionist using computer assisted personal interviewing in the participant’s own home.

Participants

Fifty-one independently living people aged between 80 and 85 years.

Measurement

A survey using three validated questionnaires: Practitioner Assessment of Network Type (PANT) to evaluate social networks; Elderly Assessment System (EASY-Care) to evaluate physical and mental wellbeing and Seniors in the Community: Risk Evaluation for Eating and Nutrition Version II (SCREEN II) to assess nutrition risk.

Results

A third of the participants (31%) were at high risk of malnutrition (SCREEN II score <50; range 29–58 out of maximum score of 64). The majority of participants (82%) lived alone and nearly half (47%) had supportive social networks including close relationships with local family, friends and neighbours. Low self-rated health, disability and social factors (being born outside of New Zealand, losing a spouse and loneliness) were key underlying factors associated with being at nutrition risk.

Conclusion

Nutrition risk is common among aged individuals living in the community. Health and social factors that shape eating behaviours place older people at increased nutrition risk. Strategies are needed for the early identification of risk factors to prevent nutrition problems. Engaging older people at risk to share meal preparation and dining experiences may foster better outcomes.

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References

  1. Ministry of Health. Health of older people strategy: health sector action to 2010 to support positive ageing. Wellington: Ministry of Health, 2002.

    Google Scholar 

  2. Wilkinson T, Sainsbury R. The association between mortality, morbidity and age in New Zealand’s oldest old. International Journal of Aging & Human Development. 1998; 46:333–343.

    Article  CAS  Google Scholar 

  3. Ministry of Social Policy, The New Zealand Positive Ageing Strategy. 2001. Wellington. http://www.osc.govt.nz/documents/nzpositiveageingstrategy.pdf

  4. American Dietetic Association. Position paper of the American Dietetic Association: nutrition across the spectrum of aging. Journal of the American Dietetic Association. 2005; 105(4):616–633.

    Article  Google Scholar 

  5. Wylie C, Copeman J, Kirk S. Health and social factors affecting the food choice and nutritional intake of elderly people with restricted mobility. Journal of Human Nutrition and Dietetics. 1999; 12:375–380.

    Article  Google Scholar 

  6. Donini LM, Savina C, Cannella C. Eating Habits and Appetite Control in the Elderly: The Anorexia of Aging. International Psychogeriatrics. 2003; 15(01):73–87.

    Article  PubMed  Google Scholar 

  7. Posthauer M, Dorse B, Foiles R. ADA’s definitions for nutrition screening and nutrition assessment. Journal of the American Dietetic Association 1994; 94(8):838–839.

    Article  Google Scholar 

  8. Elia M, Zellipour L, Stratton R. To screen or not to screen for adult malnutrition? Clinical Nutrition. 2005; 24:867–884.

    Article  PubMed  CAS  Google Scholar 

  9. Keller H, Hedley M, Wong Brownlee S. Development of SCREEN-Seniors in the Community: Risk Evaluation for Eating and Nutrition. Can J Diet Prac Res. 2000; 61:62–72.

    Google Scholar 

  10. Keller H, Goy R, Kane S-L. Validity and reliability of SCREEN II (Seniors in the Community; Risk evaluation for eating and nutrition, Version II). Eur J Clin Nutr. 2005; 59:1149–1157.

    Article  PubMed  CAS  Google Scholar 

  11. Barrett P, Twitchin S, Kletchko S, Ryan F. The Living Environments Of Community-Dwelling Older People Who Become Frail: Another Look At The Living Standards Of Older New Zealanders Survey. Social Policy Journal of New Zealand. 2006; 28:133–157.

    Google Scholar 

  12. Locher J, Ritchie C, Roth D, Sawyer Baker P, Bodner E, Allman R. Social isolation, support, and capital and nutritional risk in an older sample: ethnic and gender differences. Social Science & Medicine. 2005; 60:747–761.

    Article  Google Scholar 

  13. de Castro J. Age-related changes in the social, psychological, and temporal influences on food intake in free-living, healthy, adult humans. Journal of Gerontology: Medical Sciences 2002; 57A:M368–M377.

    Google Scholar 

  14. Walker D, Beauchene RE. The relationship of loneliness, social isolation, and physical health to dietary adequacy of independently living elderly. Journal of the American Dietetic Association. 1991; 91(3):300–305.

    PubMed  CAS  Google Scholar 

  15. Davis MA, Murphy SP, Neuhaus JM, Lein D. Living arrangements and dietary quality of older U.S. adults. Journal of Gerontology. 1985; 40(4):434–442.

    PubMed  CAS  Google Scholar 

  16. McIntosh W, Shifflett P, Picou J. Social support, stressful events, strain, dietary intake, and the elderly. Medical Care. 1989; 27(2):140–153.

    Article  PubMed  CAS  Google Scholar 

  17. Mezuk B, Rebok GW. Social Integration and Social Support Among Older Adults Following Driving Cessation. Journal of Gerontology. 2008; 63B(5):S298–S303.

    Google Scholar 

  18. Davey, J., Coping without a car. 2004, New Zealand Institute for Research on Ageing: Wellington.

    Google Scholar 

  19. Wenger GC. Review of findings on support networks of older Europeans. Journal of Cross-Cultural Gerontology. 1997 (12):1–21.

  20. Wenger, G.C., Support networks of older people: A guide for practitioners. 1994, Bangor: Centre for Social Policy Research and Development, University College of Wales.

    Google Scholar 

  21. Sidenvall B, Nydahl M, Fjellstrom C. Managing food shopping and cooking: the experiences of older Swedish women. Ageing and Society. 2001; 21:151–168.

    Article  Google Scholar 

  22. Sharkey JR, Branch LG, Zohoori N, Giuliani C, Busby-Whitehead J, Haines PS. Inadequate nutrient intakes among homebound elderly and their correlation with individual characteristics and health-related factors. Am J Clin Nutr 2002; 76(6):1435–1445.

    PubMed  CAS  Google Scholar 

  23. Benyamini Y, Leventhal EA, Leventhatl H. Elderly people’s ratings of the importance of health-related factors to their self-assessments of health. Social Science and Medicine. 2003; 56:1661–1667.

    Article  PubMed  Google Scholar 

  24. Osler M, Heitmann BL, Høidrup S, Jørgensen LM, Schroll M. Food intake patterns, self rated health and mortality in Danish men and women. A prospective observational study. Journal of Epidemiol and Community Health. 2004; 555:399–403.

    Google Scholar 

  25. Goldman N, Glei D, Chang M-C. The role of clinical risk factors in understanding self-rated health. Annals of Epidemiology. 2003; 14:49–57.

    Article  Google Scholar 

  26. Salmond, C., P. Crampton, and J. Atkinson, NZDep2006 Index of Deprivation. 2007, Department of Public Health, University of Otago. Wellington.

    Google Scholar 

  27. Keller HH. The SCREEN I (Seniors in the Community: Risk Evaluation for Eating and Nutrition) index adequately represents nutritional risk. Journal of Clinical Epidemiology. 2006; 59(8):836–841.

    Article  PubMed  Google Scholar 

  28. Philp I. EASY-Care. A systematic approach to the assessment of older people. Geriatric Medicine. 2000; 30(5):15–19.

    Google Scholar 

  29. Keller H, Hedley M, Wong S-L, Vanderkooy P, Tindale J, Norris J. Community organised food and nutrition education: participation, attitudes and nutritional risk in seniors. J Nutr Health Aging. 2006; 10(1):15–20.

    PubMed  CAS  Google Scholar 

  30. Keller HH, McKenzie JD. Nutritional risk in vulnerable community-living seniors. Canadian Journal of Dietetic Practice and Research. 2003; 64(4):195–201.

    Article  PubMed  Google Scholar 

  31. American Dietetic Association. Position of the American Dietetic Association: nutrition, ageing, and the continuum of care. Journal of American Dietetic Association. 2000; 100(5):580–595.

    Article  Google Scholar 

  32. de Castro J, Stroebele N. Food intake in the real world: implications for nutrition and aging. Clinics in Geriatric Medicine. 2002; 18(4):685–697.

    Article  PubMed  Google Scholar 

  33. Locher J, Robinson C, Roth D, Ritchie C, Burgio K. The Effect of the Presence of Others on Caloric Intake in Homebound Older Adults, Journal of Gerontology: Medical Sciences. 2005; 60A(11):1475–1478.

    Google Scholar 

  34. Chipperfield JG. Everyday Physical Activity as a Predictor of Late-Life Mortality (vol 48, pg 349, 2008). Gerontologist. 2008; 48(5):708–708.

    Google Scholar 

  35. Donini LM, Savina C, Cannella C. Eating habits and appetite control in the elderly: the anorexia of aging. International Psychogeriatrics. 2003;15:73–87.

    Article  PubMed  Google Scholar 

  36. Bernstein MA, Tucker KL, Ryan ND, et al. Higher dietary variety is associated with better nutritional status in frail elderly people. Journal of the American Dietetic Association. 2002; 102(8):1096–1104.

    PubMed  Google Scholar 

  37. Gama EV, Damina J, del Molino JP, Lopez MR, PErez ML, Iglesias FJ. Association of individual activites of daily living with self-rated health in older people. Age and Ageing. 2000; 29:267–270.

    Article  PubMed  CAS  Google Scholar 

  38. Burge K, Gazibarich B. Nutritional risk among a sample of community-living elderly attending senior citizens’ centres. Australian Journal of Nutrition and Dietetics. 1999;56(3):137–143.

    Google Scholar 

  39. Keller HH, Goy R, Kane S-L. Validity and reliability of SCREEN II (Seniors in the Community: Risk evaluation for eating and nutrition, Version II). European Journal of Clinical Nutrition. 2005;59(10):1149–1157.

    Article  PubMed  CAS  Google Scholar 

  40. Campbell AJ, Busby WJ, Robertson C, Horwarth C. Control over future health in old age: Characteristics of believers and sceptics. Age and Ageing. 1995; 24:204–209.

    Article  PubMed  CAS  Google Scholar 

  41. Whichelow MJ, Prevost AT. Dietary patterns and their associations with demographic, lifestyle and health variables in a random sample of British adults. British Journal of Nutrition. 1996;76:17–30.

    Article  PubMed  CAS  Google Scholar 

  42. Idler EL, Angel RJ. Self-rated health and mortality in the NHANES-I epidemiologic follow-up study. American Journal of Public Health. 1990;80(4):446–452.

    Article  PubMed  CAS  Google Scholar 

  43. Ministry for Culture and Heritage. Life in New Zealand -assisted immigration. 2008. http://www.nzhistory.net.nz/culture/assisted-immigration/life-in-new-zealand

  44. Kerse N, Butler M, Robinson E, Todd M. Wearing slippers, falls and injury in residential care. Australian & New Zealand Journal of Public Health. 2004; 28:180–187.

    Article  Google Scholar 

  45. Statistics New Zealand. New Zealand’s 65+ population. A Statistical Volume: 2 2007.

  46. Baker A, Wardle J. Sex differences in fruit and vegetable intake in older adults. Appetite 2003; 40:269–275.

    Article  PubMed  Google Scholar 

Download references

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Authors and Affiliations

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Corresponding author

Correspondence to Carol Wham.

Additional information

Correspondence to: Carol A Wham PhD. Senior Lecturer, Institute of Food, Nutrition and Human Health, Massey University, Albany Campus, Private Bag 102904, North Shore Mail Centre, Auckland, New Zealand.

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Wham, C., Carr, R. & Heller, F. Country of origin predicts nutrition risk among community living older people. J Nutr Health Aging 15, 253–258 (2011). https://doi.org/10.1007/s12603-010-0305-5

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  • DOI: https://doi.org/10.1007/s12603-010-0305-5

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