FACTORS ASSOCIATED WITH LOW BODY-MASS INDEX AND WEIGHT-LOSS IN NURSING-HOME RESIDENTS

Background. Undernutrition in nursing home residents is a significant and possibly modifiable public health problem. We evaluated the hypoth esis that some potentially modifiable factors are associated with resi dent undernutrition. Methods. This study is a cross-sectional, seconda ry data analysis of 6,832 community nursing home residents sampled fro m 202 nursing homes in 7 states. Data were from the Minimum Data Set ( MDS), an HCFA-mandated resident assessment instrument used in U.S. com munity nursing homes. Two dependent variables represented undernutriti on: (a) low body mass index (BMI), defined as the lowest quartile BMI of the sample (19.42 kg/m(2) and below); and (b) weight loss, an MDS m easure defined as 5% decrease in weight in 30 days, or a 10% decrease in 180 days (9.9% of the sample). independent variables included resid ent demographics, eating-related variables, variables measuring functi onal, cognitive, and affective statuses, and medical conditions. Separ ate logistic regression models were estimated for low BMI and weight l oss to test multivariate associations. Results. Poor oral intake, eati ng dependency, decubiti, and chewing problems increase the likelihood of both low BMI and weight loss. Female gender, age 85 or older, bedfa st, and hip fracture increase the odds of low BMI only; depressed beha viors and two or more chronic diseases increase the odds of weight los s only. Conclusion. Undernutrition in nursing home residents is a mult ifactorial syndrome. Improved oral feeding methods and treatment of de pression are potentially important ways to counteract undernutrition i n nursing home residents by targeting reversible features.