Nutritional parameters, body composition, and progression of disability inolder disabled residents living in nursing homes

Background. The evaluation of nutritional status is one of the primary comp onents of multidimensional geriatric assessment. We investigated the relati onship between some markers of malnutrition and the modification,ns in func tional status in a sample of older disabled residents living in nursing hom es. Methods. Ninety-eight subjects who were independent in at least two activit ies of daily living (ADLs) were enrolled in a 2-year longitudinal study. An thropometric. nutritional, and metabolic parameters. as well us body compos ition. were measured at baseline and after 2 years. Results. Deteriorating functional status (greater than or equal to2 additio nal lost ADLs) was associated with baseline albumin levels (Tertile 3 vs Te rtile 1: odds ratio [OR] 0.16, 95% confidence interval [CI] 0.01-0.67) and subscapular skinfold thick,less (Tertile 3 vs Tertile 1:OR 0.06, 95% CI 0.0 06-0.50). After multivariate adjustment. the OR for increasing disability w as >4 in subjects with decreasing body cell mass (BCM), compared with subje cts with a stable BCM. The degree of BCM reduction was strongly related to the number of additional ADLs lost at follow-up (test for trend. p = .003). Conclusions. In a sample of older disabled nursing home residents, signs of malnutrition seem to predict further worsening in functional status. Furth ermore. BCM declines proportionally to the loss in ADLs. suggesting the exi stence of a strong relationship between BCM loss and the progressive deteri oration of functional status.