Prevalence and Risk Factors of Undernutrition among Older Adults Living in Nonsubsidized Residential Care Homes: A Cross-sectional Descriptive Study

Purpose: This study investigated the prevalence and risk factors of undernutrition among older adults living in nonsubsidized Residential Care Homes (RCHs). Methods: Face-to-face interviews and assessments were conducted in a convenience sample of 298 older adults (aged 65 years or older) residing in nonsubsidized RCHs in Hong Kong in January 2015. Subjects who ate by mouth (with or without assistance) and who had no communication barriers were included. We employed a descriptive cross-sectional study design according to the STROBE reporting guidelines. Data were collected on participants' demographics, history of chronic illness, physical function (assessed by the 10-item Simplified Barthel Index with the self-care ability and mobility subscales), cognitive function (assessed by the 10-item Abbreviated Mental Test), and nutritional status (assessed by the 18-item Mini Nutritional Assessment). After identifying the variables associated with undernutrition, hierarchical multivariate logistic regression was used to identify salient predictors. Results: In total, 40.9% of participants had undernutrition, which was associated with a longer length of stay in RCHs and poorer physical and cognitive functions compared to adequate nutrition or being at risk of undernutrition. Hierarchical multivariate logistic regression showed that residents with better cognitive function (adjusted Odds Ratio [OR]=0.88) and self-care ability (adjusted OR=0.75) were at a lower risk of undernutrition. Conclusion: Undernutrition is prevalent among residents in RCHs in Hong Kong and poses a significant risk of cognitive impairment and poor self-care skills. To lessen the likelihood and the consequences of undernutrition, RCHs must give special consideration to residents with these risk factors.