Publication details

Title
Prevalence and measures of nutritional compromise among nursing home patients: Weight loss, low body mass index, malnutrition, and feeding dependency, a systematic review of the literature.
Authors
Bell,C. L.;Tamura,B. K.;Masaki,K. H.;Amella,E. J.
Publication Year
2013
Abstract
Weight loss and poor nutrition have been important considerations in measuring quality of nursing home care since 1987. Our purpose was to examine, synthesize, and provide a systematic review of the current literature on the prevalence and definitions of nutritional problems in nursing home residents. In the fall of 2011, we performed MEDLINE searches of English-language articles published after January 1, 1990. Articles were systematically selected for inclusion if they presented prevalence data for general nursing home populations on at least one of the following: weight loss, low body mass index, Mini-Nutritional Assessment or other measure of malnutrition, poor oral intake, or dependency for feeding. Data on each study, including study author, year, setting, population, type of study (study design), measures, and results, were systematically extracted onto standard matrix tables by consensus by a team of two fellowship-trained medical school faculty geriatrician clinician-researchers with significant experience in long term care. The MEDLINE search yielded 672 studies plus 229 studies identified through related citations and reference lists. Of the 77 studies included, 11 articles provided prevalence data from the baseline data of an intervention study, and 66 articles provided prevalence data in the context of an observational study of nutrition. There is a wide range of prevalence of low body mass index, poor appetite, malnutrition, and eating disability reported among nursing home residents. Studies demonstrate a lack of standardized definitions and great variability among countries. Of all the measures, the Minimum Data Set (MDS) weight loss definition of (greater-than or equal to)5% in 1 month or (greater-than or equal to)10% in 6 months had the narrowest range of prevalence rate: 6% to 15%. Weight loss, as measured by the MDS, may be the most easily replicated indicator of nutritional problems in nursing home residents for medical directors to follow for quality-improvement purposes. Additional studies are needed, reporting the prevalence of the MDS weight loss definition among international nursing home residents. (copyright) 2013 American Medical Directors Association, Inc.
Journals
J Am Med Dir Assoc.
Volume
14
Issue
2
Startpage
94-
Endpage
100
Booktitle
Editors
City
Publisher
Issnisbn
1525-8610
Reflist
0
Doi
doi:10.1016/j.jamda.2012.10.012
Pmid
PMID: 23246236
Keywords
appetite disorder;body mass;consensus;eating disorder;feeding disorder;human;leadership;long term care;malnutrition;medical education;meta analysis;nursing home patient;nutritional assessment;nutritional disorder;observational study;prevalence;review;samp????
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