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

Abstract

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.