Unplanned Weight Loss and Sarcopenia Across Body Mass Index Categories in Nursing Homes-A Cross-Sectional Study

Background: Nutritional risks in older adults, such as malnutrition and sarcopenia, are often underdiagnosed. Screening practices frequently rely on Unplanned Weight Loss (UPWL), potentially overlooking at-risk individuals. This study aims to assess the prevalence of nutritional risk, identified by UPWL and sarcopenia, across different body mass index categories in a nursing home (NH) population. Methods: Cross-sectional data were collected from an NH in a Danish municipality, including those of all self-reliant participants who consented and excluding those of terminally ill older adults. Data on age, sex, height, weight, and chronic diseases were extracted from medical records. Nutritional risk was assessed using two markers: a UPWL of ≥1 kg during the last six months and muscle strength via a modified 30 s chair stand test as a marker of sarcopenia. An ANOVA and Fisher's Exact Test were used to assess differences, followed by a post hoc Tukey test. Results: In our study of older adults (n = 93, mean age 83.2 ± 9.12 years, 63% female), 17 individuals (19%) had UPWL, and 27 (29%) had sarcopenia. Among those with obesity, twelve (48%) had sarcopenia, but only two (8%) had UPWL. In contrast, seven (21%) of those with normal weight had sarcopenia, while eleven (33%) experienced UPWL. Conclusions: Older adults in NHs are at nutritional risk, but the prevalence varies significantly depending on whether UPWL or sarcopenia markers are applied for categorization. Sarcopenia prevalence was the highest in the obesity group, suggesting a need for integrating muscle strength or quantity assessments into community care to identify older adults at nutritional risk better.