[Nutritional risk in community-dwelling elderly long-term care insurance recipients]

To define degree of nutritional risk in community-dwelling older disabled adults using translated Nutrition Screening Initiative (NSI) checklist and to identify important underlying factors associated with high nutritional risk.

Community-based studies were conducted in Katsushika, Tokyo and Odate and Tashiro, Akita. A total of 695 and 381 older adults, respectively, designated for long-term care insurance were interviewed. Nutritional risk was measured using the Japanese-translated NSI checklist. Demographic information, ADL, IADL, MMSE, CES-D, PGC morale scale, self-perceived health, loneliness, perceived caregiver's care burden, relationship with caregiver, perceived inadequacy of income, perceived burden of care cost were assessed using standardized instruments.

Self-perceived health strongly related to high NSI score in both areas. Nutritional risk was considered 'high' when simply added NSI score was 3 points and over (NSI-10) and weighed NSI score was 6 points and over (NSI-21). Logistic regression analysis demonstrated that high levels of depression symptoms, poor self-perceived health, female and area (Odate/ Tashiro) were associated with NSI-10-based high risk and high levels of depression symptoms, smaller family member, perceived inadequacy of income and area (Odate/Tashiro) were associated with NSI-21-based high risk. These results were completely same when CES-D scores were replaced with PGC morale scale scores.

It is concluded that emotional well-being is the important factor for maintaining nutritional environment in community-dwelling disabled older adults.