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Associated factors of different nutrition indicators in German nursing home residents

Comparative results of a multicenter cross-sectional study

Verschiedene Indikatoren für Mangelernährung und assoziierte Faktoren

Vergleichende Ergebnisse einer multizentrischen Querschnittsstudie in deutschen Altenheimen

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Abstract

Background

Malnutrition is one of the most important care problems in the nursing home care sector. The subject of this analysis is the investigation of associative factors for different indicators of malnutrition of residents in nursing homes in Germany.

Methods

A secondary data analysis was conducted using data from 4,478 nursing home residents. Unintended weight loss or reduced intake and BMI ≤ 20 were analysed as indicators for malnutrition. The influence of age, sex, co-morbidities and care dependency were investigated in logistic regression models.

Results

Residents with a high care dependency had a higher risk of suffering weight loss/reduced intake. With regard to BMI ≤ 20, residents aged > 85 years, female gender, cancer, musculoskeletal disease as well as high care dependency had a higher risk.

Conclusion

In both models, care dependency plays a major role in explaining malnutrition. Associative factors for malnutrition must be interpreted according to the indicators used to define malnutrition.

Zusammenfassung

Hintergrund

Mangelernährung stellt eines der bedeutsamsten Probleme in der Versorgung von Menschen in Altenpflegeeinrichtungen dar. Ziel des Beitrags ist die Darstellung einer vergleichenden Analyse von assoziierten Faktoren mit verschiedenen Indikatoren von Mangelernährung.

Material und Methoden

Bei 4478 Bewohnern von Altenhilfeeinrichtungen in Deutschland wurde eine Sekundärdatenanalyse einer Prävalenzerhebung von Mängelernährung durchgeführt. Untersucht wurden vergleichend die Indikatoren unbeabsichtigter Gewichtsverlust oder reduzierte Nahrungsaufnahme sowie ein BMI ≤ 20. Mittels logistischer Regressionsanalyse wurde analysiert, ob sich der Zusammenhang der Variablen Alter, Geschlecht, Pflegeabhängigkeit sowie verschiedener Erkrankungen mit den beiden Indikatoren unterscheidet.

Ergebnisse

Unbeabsichtigter Gewichtsverlust oder reduzierte Nahrungsaufnahme war ausschließlich mit einer hohen Pflegeabhängigkeit assoziiert. Für einen BMI ≤ 20 konnten Zusammenhänge mit einem Alter > 85 Jahre, dem weiblichen Geschlecht, dem Vorliegen einer Krebserkrankung, Erkrankungen des Bewegungsapparats und einer hohen Pflegeabhängigkeit gefunden werden.

Schlussfolgerung

Beide Indikatoren ließen sich mit einer hohen Pflegeabhängigkeit in Verbindung bringen. Andere assoziative Faktoren sollten immer gemeinsam mit der Operationalisierung der Ernährungssituation interpretiert werden.

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References

  1. Bartholomeyczik S, Reuther S, Luft L et al (2010) Prävalenz von Mangelernährung, Maßnahmen und Qualitätsindikatoren in deutschen Altenpflegeheimen- erste Ergebnisse einer landesweiten Pilotstudie. Gesundheitswesen 72:1–7

    Article  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  3. Christensson L, Unosson M, Ek AC (1999) Malnutrition in elderly people newly admitted to a community resident home. J Nutr Health Aging 3:133–139

    PubMed  CAS  Google Scholar 

  4. Compan B, Di Castri A, Plaze JM et al (1999) Epidemiological study of malnutrition in elderly patients in acute, sub-acute and long-term care using the MNA. J Nutr Health Aging 3:146–151

    PubMed  CAS  Google Scholar 

  5. Cook Z, Kirk S, Lawrenson S et al (2005) Use of BMI in the assessment of undernutrition in older subjects: reflecting on practice. Proc Nutr Soc 64:313–317

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  7. Crogan NL, Corbett CF, Short RA (2002) The minimum data set: predicting malnutrition in newly admitted nursing home residents. Clin Nurs Res 11:341–353

    PubMed  Google Scholar 

  8. Deutsche Gesellschaft Für Ernährungsmedizin (DGEM) (2003) Leitlinie Enterale Ernährung. Aktuel Ernaehr Med 28:1–120

    Google Scholar 

  9. Deutsches Netzwerk Für Qualitätsentwicklung in Der Pflege (2009) Expertenstandard Ernährungsmanagement zur Sicherstellung und Förderung der oralen Ernährung in der Pflege. Fachhochschule Osnabrück, Osnabrück

  10. Dijkstra A, Brown L, Havens B et al (2000) An international psychometric testing of the care dependency scale. J Adv Nurs 31:944–952

    Article  PubMed  CAS  Google Scholar 

  11. Dijkstra A, Buist GaH, Dassen TWN et al (1999) Het meten van zorgafhankelijkheid met de ZorgAfhankelijkheidsSchaal: Care Dependency Scale (CDS). In: Noordelijk Centrum voor Gezondheidsvraagstukken. Rijksuniversiteit Groningen, Groningen, p 40

  12. Dijkstra A, Tiesinga LJ, Plantinga L et al (2005) Diagnostic accuracy of the care dependency scale. J Adv Nurs 50:410–416

    Article  PubMed  Google Scholar 

  13. Dyck MJ (2007) Nursing staffing and resident outcomes in nursing homes: weight loss and dehydration. J Nurs Care Qual 22:59–65

    Article  PubMed  Google Scholar 

  14. Eichhorn-Kissel J, Lohrmann C (2009) Die Pflegeabhängigkeitsskala. In: Bartholomeyczik S, Halek M (eds) Assessmentinstrumente in der Pflege. Schütersche Verlagsgesellschaft, Hannover, pp 46–49

  15. Engels D, Pfeuffer F, Heusinger J et al (2007) Möglichkeiten und Grenzen selbständiger Lebensführung in stationären Einrichtungen (MuG IV) – Demenz, Angehörige und Freiwillige, Versorgungssituation sowie Beispielen für “Good Practice”. Bundesministerium für Familie, Senioren, Frauen und Jugend, Berlin, p 350

  16. Field A (2009) Discovering statistics using SPSS. Sage Publications, London

  17. Gillette Guyonnet S, Abellan Van Kan G, Alix E et al (2007) IANA (International Academy on Nutrition and Aging) Expert Group: weight loss and Alzheimer’s disease. J Nutr Health Aging 11:38–48

    Google Scholar 

  18. Griep MI, Mets TF, Collys K et al (2000) Risk of malnutrition in retirement homes elderly persons measured by the “Mini-Nutritional Assessment”. J Gerontol A Biol Sci Med Sci 55:M57–M63

    Article  PubMed  CAS  Google Scholar 

  19. Hosmer DW, Lemeshow S (2000) Applied logistic regression. Wiley, New York

  20. Kayser-Jones J, Schell E (1997) The effect of staffing on the quality of care at mealtime. Nurs Outlook 45:64–72

    Article  PubMed  CAS  Google Scholar 

  21. Kayser-Jones J, Schell ES, Porter C et al (1999) Factors contributing to dehydration in nursing homes: inadequate staffing and lack of professional supervision. J Am Geriatr Soc 47:1187–1194

    PubMed  CAS  Google Scholar 

  22. Keller HH (1993) Malnutrition in institutionalized elderly: how and why? J Am Geriatr Soc 41:1212–1218

    PubMed  CAS  Google Scholar 

  23. Lin LC, Watson R, Wu SC (2010) What is associated with low food intake in older people with dementia? J Clin Nurs 19:53–59

    Article  PubMed  Google Scholar 

  24. Lohrmann C, Balzer K, Dijkstra A et al (2003) Pflegeabhängigkeit im Pflegeheim–eine psychometrische Studie. Z Gerontol Geriatr 36:255–259

    Article  PubMed  CAS  Google Scholar 

  25. Lohrmann C, Dijkstra A, Dassen T (2003) Care dependency: testing the German version of the Care Dependency Scale in nursing homes and on geriatric wards. Scand J Caring Sci 17:51–56

    Article  PubMed  Google Scholar 

  26. Meijers J (2009) Awareness of malnutrition in healthcare: the Dutch perspective. Dissertation, Maastricht University

  27. Meijers JM, Halfens RJ, Van Bokhorst-De Van Der Schueren MA et al (2009) Malnutrition in Dutch health care: prevalence, prevention, treatment, and quality indicators. Nutrition 25:512–519

    Article  PubMed  Google Scholar 

  28. Meijers JM, Schols JM, Van Bokhorst-De Van Der Schueren MA et al (2009) Malnutrition prevalence in The Netherlands: results of the annual Dutch national prevalence measurement of care problems. Br J Nutr 101:417–423

    Article  PubMed  CAS  Google Scholar 

  29. Nordenram G, Ljunggren G, Cederholm T (2001) Nutritional status and chewing capacity in nursing home residents. Aging (Milano) 13:370–377

    Google Scholar 

  30. Pauly L, Stehle P, Volkert D (2007) Nutritional situation of elderly nursing home residents. Z Gerontol Geriatr 40:3–12

    Article  PubMed  CAS  Google Scholar 

  31. Salva A, Coll-Planas L, Bruce S et al (2009) 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

    Article  PubMed  CAS  Google Scholar 

  32. Smith KL, Greenwood CE (2008) Weight loss and nutritional considerations in Alzheimer disease. J Nutr Elder 27:381–403

    Article  PubMed  Google Scholar 

  33. Spss Inc (2009) SPSS 17.0 Version for Windows. IBM, Chicago, IL, USA

  34. Stratton RJ, Green CJ, Elia M (2003) Disease-related malnutrition: an evidence-based approach to treatment. CABI Publishing, Wallingford, Oxon, UK

  35. Suominen M, Muurinen S, Routasalo P et al (2005) Malnutrition and associated factors among aged residents in all nursing homes in Helsinki. Eur J Clin Nutr 59:578–583

    Article  PubMed  CAS  Google Scholar 

  36. Valentini L, Schindler K, Schlaffer R et al (2009) The first nutrition day in nursing homes: participation may improve malnutrition awareness. Clin Nutr 28:109–116

    Article  PubMed  Google Scholar 

  37. Van Nie-Visser NC, Meijers JM, Schols JM et al (2011) Comparing quality of nutritional care in Dutch and German nursing homes. J Clin Nurs 20:2501–2508

    Article  Google Scholar 

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Conflict of interest

The corresponding author states the following: the study was financed by Nutricia Pfrimmer.

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Authors and Affiliations

  1. German Center for Neurodegenerative Diseases (DZNE), Stockumer Str. 12, 58453, Witten, Germany

    R. Palm MSc., S. Reuther MScN &  S. Bartholomeyczik

  2. Department of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany

    S. Bartholomeyczik

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  1. R. Palm MSc.
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  2. S. Reuther MScN
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  3. S. Bartholomeyczik
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Correspondence to R. Palm MSc..

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Palm, R., Reuther, S. & Bartholomeyczik, S. Associated factors of different nutrition indicators in German nursing home residents. Z Gerontol Geriat 45, 658–664 (2012). https://doi.org/10.1007/s00391-012-0300-z

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