Malnutrition and feeding difficulty in Taiwanese older with dementia

Aims and objectives. To determine differences in the physical and psychological factors and feeding difficulty between people who are well-nourished and malnourished and to determine the predictors of risk of malnutrition and malnutrition in Taiwanese residents with dementia. Background. Malnutrition is a common problem among nursing home residents but frequently is unrecognised. Nutritional status of older people is associated with cognitive impairment and patients with dementia have high risk for malnutrition because of difficulties in eating. Design. A cross-sectional design was used to determine predictors of risk of malnutrition and malnutrition. Methods. Subjects were recruited from five Taiwanese long-term care facilities. Data were collected using Mini Nutritional Assessment Screening Form, body mass index, Short Portable Mental Status Questionnaire, Barthel index, Edinburgh Feeding Evaluation in Dementia scale and eating time. Results. Eighty-three subjects participated. According to the Mini Nutritional Assessment Screening Form cut-point scores, 75 (90.4%) residents with dementia had risk of malnutrition. However, using the World Health Organization (WHO) body mass index cut-point of < 18.5, the prevalence rate of malnutrition was 19%. Using logistic regression, gender (odds ratio: 38.627, 95% CI: 1.927-774.407) and eating time (odds ratio: 0.814, 95% CI: 0.689-0.962) were significant predictors of risk of malnutrition. However, only gender (odds ratio: 6.12, 95% CI: 10.5-35.662) was a significant predictor of malnutrition using the WHO body mass index cut-point. Conclusions. The prevalence of the risk for malnutrition was high in residents with dementia in Taiwanese nursing homes. Feeding difficulty, activities of daily living dependence, cognitive impairment, number of medications and age increased with malnutrition while shorter eating times were associated with poorer nutrition. However, when the factors were considered together, only being female and eating time were significant risk factors for malnutrition. Being female was the only significant factor of malnutrition. Relevance to clinical practice. Monthly monitoring of weight and assessment with Mini Nutritional Assessment Screening Form are essential to early identification of emerging malnutrition and implementation of interventions. Providing nutritional supplements and energy and protein-dense food may be needed for good nutrition and more time for eating or feeding assistance may delay malnutrition or even improve nutritional status.