Meal programs improve nutritional risk: A longitudinal analysis of community-living seniors

Objective To determine the independent association of meal programs (eg, Meals On Wheels and other meal programs with a social component) and shopping help on seniors' nutritional risk. Design Cohort design. Baseline data were collected with an in-person interview and subjects were followed up for 18 months via telephone interview. Subjects/setting Cognitively well, vulnerable (ie, required informal or formal supports for activities of daily living) seniors were recruited through community service agencies in southwestern Ontario, Canada. Three hundred sixty-seven seniors participated in baseline interviews and 263 completed data collection at 18-month follow-up; 70% participated in meal programs at baseline. Main outcome measures The 15-item Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN) questionnaire identified nutritional risk at 18 months. Statistical analyses performed Descriptive and bivariate analyses were performed and significant associations (P<0.05) used to build the full multiple linear regression model. Meal and shopping variables were forced into the model as predictors of follow-up SCREEN questionnaire scores. Results Meals On Wheels use was independently associated with higher SCREEN questionnaire scores (ie, less risk), as was higher income. Baseline SCREEN questionnaire scores also strongly and positively predicted follow-up scores. Self-reported depression at baseline was associated with lower scores at follow-up. Although use of programs at baseline was associated with decreased risk, if participants experienced increased use of the program (eg, more meals) during the follow-up period this was associated with lower scores, or increased risk. Conclusions Meal programs can improve or maintain nutritional risk for vulnerable seniors. Increased use of these programs over time may indicate a senior's declining status. Seniors who are in need of informal or formal supports for food shopping or preparation should be encouraged to participate in meal programs as a means of maintaining or improving their nutrition.