Skin condition and nutritional status of long-term care hospital residents: possibility of quantitative skin evaluation as a nutritional screening tool

Abstract

　Although nutritional screening is important for the early detection of older residents at risk of undernutrition, the availability of nutritional screening tools is limited, depending on their physical characteristics or the setting. We focused on skin conditions evaluated by engineering measures, and investigated their associations with nutritional status. A cross-sectional study was conducted in a long-term care hospital in Japan. Ninety elderly residents without dermatologic disorders were included. Mean age was 82.5 years（standard deviation, 8.0）and 70（77.8%）were female. The nutritional status of the residents was assessed by body mass index（BMI）and serum albumin levels. Leg skin condition at lateral and medial sites of the tibia was evaluated by: 1）functional factors including pH, hydration and transepidermal water loss; 2）skin color including L*, a*, b* and individual typology angle（ITA°）using a tristimulus colorimetric instrument; and 3）skin morphology. Among the skin conditions, b* was significantly correlated with BMI at both sites（medial siteρ=－0.28, p=0.008; lateral siteρ=－0.30, p=0.004）. When residents were categorized by the risk of malnutrition, b* was significantly higher in residents with BMI<18.5 than those with BMI < 18.5（medial site p=0.006; lateral site p=0.004）. Also, b* was significantly higher in residents with serum albumin level < 3.5g/dl than those with > 3.6g/dl（medial site p=0.016; lateral site p=0.006）. Residents at risk of malnutrition demonstrated a more yellow skin color. In the future, skin color could be used as a simple screening tool to evaluate the chronic nutritional status of older people.