Nutritional risk among rural older adults: Influences on quality of life and health care contacts.

摘要

The identification of modifiable factors associated with life quality and healthcare contacts in later life is important. Nutritional factors are an ideal target as indicators of nutritional status have been associated with adverse health outcomes. This study explored relationships between measures of nutritional risk and determined if nutritional status was predicative of future life quality and healthcare contacts. This was a longitudinal study based on a random sample of community-dwelling rural older adults (n = 181). Each participant received a baseline home visit for the collection of demographic, health, and anthropometric data and a blood sample. A nutrition risk screen and five 24-hour diet recalls were administered by telephone. Five years after baseline, the SF-36 quality of life survey was administered by telephone to follow-up participants (n = 123). Chart reviews were used to assess healthcare contacts made over the timeframe of three to five years past baseline for follow-up participants still receiving healthcare from Geisinger (n = 114). The first analytic phase found that elevated weight status was common and associated with other indicators of nutritional risk. This indicates obesity can be associated with unfavorable nutrient intakes, low diet quality scores, and compromised plasma biomarker values, especially among women. Further exploring the relationships between obesity and nutritional risk, the second analytic phase established that specific dietary patterns were related to weight status and nutritional status. Participants with a ‘low nutrient dense’ dietary pattern were twice as likely to be obese, twice as likely to have low plasma vitamin B12 levels and three to 17 times more likely to have low nutrient intakes. This suggests the relationships between obesity and nutritional risk found in the first analytic phase were linked to higher consumption of specific low nutrient dense foods including sweet breads, dairy desserts, processed meats, and fat and oils as well as lower consumption of high nutrient dense foods including cereals, fruits, and vegetables. The final analytic phase provided evidence for the long-term impacts of nutritional status, indicating that diet quality, weight status and several risk screening constructs have an independent, long-term impact on the life quality and healthcare contacts of rural older individuals.