Comprehensive comparison of malnutrition and its associated factors between nursing home and community dwelling elderly: A case-control study from Northwestern Iran

Abstract

Background & aims: Only a limited number of studies have compared nursing home and community residing elderly in terms of health-related issues. The present study aimed to compare nutritional status and its associated factors between nursing home residents and community-dwelling seniors.

Methods: In this case-control, age- and gender-matched study in Tabriz (East Azarbaijan, Iran), elderly subjects aged 65 years and older were recruited from nursing homes (n = 76) and community (n = 88). Anthropometric, blood pressure and dietary intake measurements, as well as biochemical assays were performed. Nutritional status (Mini Nutritional Assessment: MNA), cognitive function (Mini Mental State Examination: MMSE) and physical performance (Barthel Index) were assessed and compared between the two settings.

Results: Nursing home residents had significantly lower body mass index (BMI), limbs, waist and hip circumferences, and diastolic blood pressure. Caloric and protein intake of the groups were similar, while nursing home residents received lower amounts of many micronutrients and saturated fats and higher polyunsaturated fats. MNA, MMSE and Barthel index scores were significantly different between the groups, all of them in favor of the free living elderly (p < 0.001, p < 0.001 and p = 0.014, respectively). Laboratory tests revealed significantly lower levels of hemoglobin, folate, fasting blood sugar, insulin, albumin, prealbumin, creatinine and uric acid in the nursing home group; however, mean cell volume (MCV) and HDL-cholesterol were higher in this group.

Conclusion: Elderly people living in nursing homes have lower BMI, suffer from many nutritional deficiencies and are predisposed to malnutrition, impaired cognition and deteriorating physical performance, compared to community dwelling seniors.

Keywords: Barthel index; Community; Elderly; Malnutrition; Mini Mental State Examination (MMSE); Mini Nutritional Assessment (MNA); Nursing home.