Abstract
Objectives
Malnutrition is frequent in older adults, associated with increased morbidity, mortality,
and higher costs. Nursing home residents are especially affected, and evidence on
institutional factors associated with malnutrition is limited. We calculated the prevalence
of malnutrition in Swiss nursing home residents and investigated which structure and
process indicators of nursing homes are associated with residents’ malnutrition.
Design
Subanalysis of the Swiss Nursing Homes Human Resources Project 2018, a multicenter,
cross-sectional study conducted from 2018 to 2019 in Switzerland.
Setting and Participants
This study included 76 nursing homes with a total of 5047 residents.
Methods
Malnutrition was defined as a loss of bodyweight of ≥5% in the last 30 days or ≥10%
in the last 180 days. Binomial generalized estimating equations (GEE) were applied
to examine the association between malnutrition and structural (staffing ratio, grade
mix, presence of a dietician, malnutrition guideline, support during mealtimes) and
process indicators (awareness of malnutrition, food administration process). GEE models
were adjusted for institutional (profit status, facility size) and specific resident
characteristics.
Results
The prevalence of residents with malnutrition was 5%. A higher percentage of units
per nursing home having a guideline on prevention and treatment of malnutrition was
significantly associated with more residents with weight loss (OR 2.47, 95% CI 1.31-4.66,
P = .005). Not having a dietician in a nursing home was significantly associated with
a higher rate of residents with weight loss (OR 1.60, 95% CI 1.09-2.35, P = .016).
Conclusions and Implications
Having a dietician as part of a multidisciplinary team in a nursing home is an important
step to address the problem of residents’ malnutrition. Further research is needed
to clarify the role of a guideline on prevention and treatment of malnutrition to
improve the quality of care in nursing homes.
Keywords
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Article info
Publication history
Published online: March 16, 2023
Publication stage
In Press Corrected ProofFootnotes
Funding: SHURP 2018 was funded via participation fees paid by the included nursing homes.
The authors declare no conflicts of interest.
Identification
Copyright
© 2023 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
