BACKGROUND: Most studies reporting malnutrition in the elderly relate to high-level care. However, one third of Australians in aged care reside in low-level care facilities. Data is limited on their nutritional status. OBJECTIVE: To investigate the nutritional status of elderly in low-level care facilities. DESIGN: A cross sectional study design. SETTING: 14 low-level aged care facilities in metropolitan Melbourne. PARTICIPANTS: Convenience sample of 103 ambulatory elderly (86 +/- 6.6 years (mean +/- SD), 76 female, comprising 15 of the hostel population) able to perform daily functions of living. MEASUREMENTS: Nutritional intake assessed by three-day weighed food records, and nutritional status by haematological and biochemical markers and body composition (dual energy X-ray absorptiometry). RESULTS: FOOD served did not supply the estimated average requirements (EAR) for 5 of the 14 nutrients analysed. Compared with EAR, 34 of participants were protein malnourished and 62 had energy intake deficits. Micronutrient intake was low for calcium, magnesium, folate, zinc (for men) and dietary fibre. Vitamin D deficiency (serum 25OH Vitamin D 28 and >40, respectively) and 14 of men and 12 of women were sarcopenic-obese. Only 12 showed no sign of undernutrition using seven different nutritional indicators. Around 65 had two or more indicators of undernutrition. CONCLUSION: These findings highlight the need for the supply of more, better quality, nutrient dense food to residents and better detection of undernutrition in aged care facilities. Maintenance of nutritional status has the potential to reduce morbidity and delay the transition to high-level care.
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