2022 Volume 26 Issue 3 Pages 180-189
Purpose: We conducted a survey to investigate the percentage of people with undernourishment, degree of undernourishment, and factors related to undernourishment such as oral and swallowing functions and the frequency of dietary intake in older adults receiving support and nursing care in daycare rehabilitation centers. Additionally, we examined the factors related to undernourishment and explored appropriate nutritional management methods. Participants and Methods: We included 118 elderly (aged ＞ 65 years) community-dwelling individuals, who used daycare rehabilitation centers, required assistance at levels 1 and 2, and nursing care from levels 1 to 3. Participants were recruited from November 2017 to June 2018. The participants were explained the research methods used and provided informed consent. This was a cross-sectional study, and the factors investigated were: nutritional status (Mini Nutritional Assessment Short-Form and body mass index), oral function (maximum tongue pressure, food intake level scale, oral diadochokinesis measurement, and chewing ability assessment), swallowing function (modified water swallowing test, Eating Assessment Tool [EAT-10], and volume of water per swallow), and food intake frequency (food diversity score and eating habits). Based on the nutritional status, participants were divided into undernourished, risk of undernourishment, and well-nourished groups for statistical analyses.
Results and Discussion: In total, 23 participants were defined as undernourished (19.4%), 63 as at risk of undernourishment (53.4%), and 32 as well-nourished (27.2%). Factors involved in oral and swallowing function, namely tongue pressure, volume of water swallowed per swallow, and EAT-10, were associated with nutritional status (p＜0.05). Food diversity scores were lower in the undernourished group than in the well-nourished group (p＝0.059). The undernourished group also had a lower food intake diversity score and an especially low protein-rich food intake. When examining the frequency of food intake, a significant association was observed between nutritional status and a diet including chicken and noodles (p＜0.05). Both items were consumed at a lower frequency in the undernourished group than in the wellnourished group. The examination of the association between undernourishment and oral and swallowing functions, items, and food intake diversity scores indicated that impaired oral and swallowing function affects eating.
Conclusions: Undernourishment was associated with decreased oral and swallowing function and food intake frequency. It is important to take measures against undernutrition, including preventing the deterioration of oral and swallowing function, before patients require support and nursing care for these deficiencies.
