Food intake and prevalence of malnutrition in nursing homes. A multicenter observational study

Objective. The aim of this study was to investigate malnutrition prevalence and its associated factors in NHs including resident food and liquid intake. Methods. We conducted a multicenter observational study in Italian NHs. NHs were recruited using a convenience sample from regional register. To detect malnourished residents, we used Body Mass Index (BMI) < 18.5 kg/m(2) and another criterion based on unintentional weight loss combined with reduced BMI. We performed logistic regression to identify associated factors with malnutrition. Results. We recruited 1795 residents that lived in 29 NHs. 76% were female, with mean age 85.4 +/- 8.5 years. 275 out of 1787 residents (15.4, 95% CI 13.8-17.2%) were malnourished. Moreover, when we combined BMI measures (< 20 kg/m2 if residents < 70 years or < 22 kg/m2 if residents >= 70 years) with unintentional weight loss data in the previous 6 months (5-10% or greater than 10%) we found that 18.1% residents were malnourished. Malnourished residents drank less (median 702 ml per day) than well nourished ones (median 800 ml per day) and ate less, especially at dinner. Malnutrition was significantly associated to age, psychiatric disorders, disability in activity of daily life, feeding assistance, swallowing and chewing problems and poor fluid intake. Moreover, we found a higher number of malnourished residents amongst those who needed more feeding care during dinner, when there was a lower number of staff. This result confirms the strong relationship between the care feeding and malnutrition. Conclusions. In this study we found that malnourished residents were older with poor functional ability, chewing problems, dependence in feeding and poor fluid intake. Interventions to prevent malnutrition in nursing homes are a priority for the practice and for further studies.