Nutrition risk factors for institutionalization in a free-living functionally dependent elderly population

Risk factors for institutionalization of frail elderly have been studied bu t the role of nutritional status has not been addressed. A prospective coho rt of 288 frail elderly (81 male; 207 female; mean age: 78.2 +/- 7.6 years) were recruited from the current list of those receiving home help services and followed for 3-5 years. At baseline, height, weight, and arm muscle ci rcumference were measured. Self-reported weight loss prior to baseline, ene rgy, and protein intake were recorded. Covariates included sociodemographic factors, social network variables, functional and health status. Cox's mul tivariate survival analysis was used to identify independent predictors of institutionalization. Over the period of observation, 46% of subjects were institutionalized. Univariate predictors included weight loss greater than or equal to 5 kg, functional status, and not living alone. In multivariate analysis, weight loss significantly increased the likelihood of institution alization [Hazard Ratio (HR) = 1.71 (95% CI: 1.08-2.73)] as did limited fun ctional capacities [HR = 1.26 (95% CI:-1.02-1.55)]. Among the free-living f rail elderly, weight loss greater than or equal to 5 kg is an important pre dictor of early institutionalization after controlling for social network, health, and functional status. (C) 2000 Elsevier Science Inc. All rights re served.