Interprofessional nutrition and dysphagia management for care-dependent older adults in day-care services: a...

Malnutrition and dysphagia in older adults complicate the maintenance of independent living. This study aimed to evaluate a dietary observation and assessment model by non-specialized staff and a consultation and support model by specialized staff in adult day services (ADS).

This non-randomized controlled trial was conducted across 31 ADS facilities in Japan. Participants were care-dependent older adults (n = 590; median age, 85 years; 69% female) for whom a 6-month follow-up assessment was completed, including body weight measurement, diet texture documentation, and Functional Oral Intake Scale (FOIS) scoring. The intervention group (n = 317) received 3 months of monthly mealtime observation by non-specialized staff, with targeted consultation from specialists (dental hygienists, dietitians) for individuals at risk, whereas the control group (n = 273) received usual care. The primary outcome was weight loss of ≥ 5% at 6 months, analyzed using a mixed-effects model. Sensitivity analyses were performed to assess the impact of attrition.

The incidence of ≥ 5% weight loss was significantly lower in the intervention group than in the control group (10.1% vs 17.3%; adjusted odds ratio 0.52, 95% confidence interval 0.31-0.89). This finding was upheld in a realistic sensitivity scenario. The intervention group showed a significantly greater increase in the use of texture-modified diets (p = 0.039) without a change in oral intake ability.

An interprofessional model combining observation by non-specialized staff with targeted specialist support offers a promising, efficient, and scalable strategy to mitigate the risk of weight loss in older adults who attend day-care settings.

UMIN000056668, 2025/01/08, retrospectively registered.