American Journal of Clinical Nutrition, Vol 66, 819-828, Copyright © 1997 by The American Society for Clinical Nutrition, Inc

ORIGINAL RESEARCH COMMUNICATIONS

Nutrition risk screening characteristics of rural older persons: relation to functional limitations and health care charges

GL Jensen, K Kita, J Fish, D Heydt and C Frey
Department of Gastroenterology, Geisinger Medical Center, Danville, PA 17822, USA. GJensen@SMTP.Geisinger.Edu

This study was intended to characterize a rural population of older persons through nutrition screening and relate screening items to functional limitations and health care charges. There were 5373 participants (2522 males and 2851 females, mean age 71 y) screened over a 22-mo period by using a self-administered questionnaire adapted from the Nutrition Screening Initiative. Height and weight and cholesterol and albumin concentrations were measured, and health care claims data were obtained. The most frequent screening items reported were use of > or = 3 medications (41%) and food group intakes below recommended frequencies (> 50%). There were significant (P < 0.05) sex differences in affirmative responses to screening items and in likelihood of exceeding proposed threshold values for risk status assigned for body mass index (BMI; in kg/m2), albumin, or cholesterol. Overweight status was notable, with one-half of all subjects having BMIs > 27. Stepwise modeling procedures were used to identify screening items with the ability to predict self-reported functional limitation (logistic regression) and monthly average recorded health care charges (linear regression on logged charges). Age > or = 75 y, use of > or = 3 medications, and an albumin concentration < 35.0 g/L were significant predictors of both functional limitation and health care charges. Poor appetite, eating problems, income < $6000/y, eating alone, and depression were significant predictors of functional limitation but not health care charges. Being male, loss of 10 lb (4.5 kg), BMI > 27, cholesterol concentration < 4.14 or > 6.21 mmol/L, and functional limitation were significant predictors of health care charges only. These findings suggest that selected screening items may have be useful in the identification of subjects at potential risk for these outcomes.

This article has been cited by other articles:

				G. L. Jensen Inflammation as the Key Interface of the Medical and Nutrition Universes: A Provocative Examination of the Future of Clinical Nutrition and Medicine JPEN J Parenter Enteral Nutr, September 1, 2006; 30(5): 453 - 463. [Abstract] [Full Text] [PDF]

				C. Thompson Martin, J. Kayser-Jones, N. Stotts, C. Porter, and E. S. Froelicher Nutritional risk and low weight in community-living older adults: a review of the literature (1995-2005). J. Gerontol. A Biol. Sci. Med. Sci., September 1, 2006; 61(9): 927 - 934. [Abstract] [Full Text] [PDF]

				P. A. Higgins, B. J. Daly, A. R. Lipson, and S.-E. Guo Assessing Nutritional Status in Chronically Critically Ill Adult Patients Am. J. Crit. Care., March 1, 2006; 15(2): 166 - 176. [Abstract] [Full Text] [PDF]

				M. Visser, S. B Kritchevsky, A. B Newman, B. H Goodpaster, F. A Tylavsky, M. C Nevitt, T. B Harris, and for the Health, Aging and Body Composition Study Lower serum albumin concentration and change in muscle mass: the Health, Aging and Body Composition Study Am. J. Clinical Nutrition, September 1, 2005; 82(3): 531 - 537. [Abstract] [Full Text] [PDF]

				D. K Houston, J. Stevens, J. Cai, and P. S Haines Dairy, fruit, and vegetable intakes and functional limitations and disability in a biracial cohort: the Atherosclerosis Risk in Communities Study Am. J. Clinical Nutrition, February 1, 2005; 81(2): 515 - 522. [Abstract] [Full Text] [PDF]

				H. H. Keller, T. Ostbye, and R. Goy Nutritional Risk Predicts Quality of Life in Elderly Community-Living Canadians J. Gerontol. A Biol. Sci. Med. Sci., January 1, 2004; 59(1): M68 - 74. [Abstract] [Full Text] [PDF]

				J. H Ledikwe, H. Smiciklas-Wright, D. C Mitchell, G. L Jensen, J. M Friedmann, and C. D Still Nutritional risk assessment and obesity in rural older adults: a sex difference Am. J. Clinical Nutrition, March 1, 2003; 77(3): 551 - 558. [Abstract] [Full Text] [PDF]

				T. A. MARSHALL, J. J. WARREN, J. S. HAND, X.-J. XIE, and P. J. STUMBO Oral health, nutrient intake and dietary quality in the very old J Am Dent Assoc, October 1, 2002; 133(10): 1369 - 1379. [Abstract] [Full Text] [PDF]

				J. R. Sharkey and P. S. Haines Use of Telephone-Administered Survey for Identifying Nutritional Risk Indicators Among Community-Living Older Adults in Rural Areas Journal of Applied Gerontology, September 1, 2002; 21(3): 385 - 403. [Abstract] [PDF]

				J. R. Sharkey The Interrelationship of Nutritional Risk Factors, Indicators of Nutritional Risk, and Severity of Disability Among Home-Delivered Meal Participants Gerontologist, June 1, 2002; 42(3): 373 - 380. [Abstract] [Full Text] [PDF]

				E. Amarantos, A. Martinez, and J. Dwyer Nutrition and Quality of Life in Older Adults J. Gerontol. A Biol. Sci. Med. Sci., October 1, 2001; 56(90002): 54 - 64. [Abstract] [Full Text] [PDF]

				N. Zohoori Nutrition and Healthy Functioning in the Developing World J. Nutr., September 1, 2001; 131(9): 2429S - 2432. [Abstract] [Full Text] [PDF]

				G. L Jensen, J. M Friedmann, C. D Coleman, and H. Smiciklas-Wright Screening for hospitalization and nutritional risks among community-dwelling older persons Am. J. Clinical Nutrition, August 1, 2001; 74(2): 201 - 205. [Abstract] [Full Text] [PDF]

				J. R. Sharkey and P. S. Haines The Feasibility of Using a Telephone-Administered Survey for Determining Nutritional Service Needs of Noninstitutionalized Older Adults in Rural Areas: Time and Costs Gerontologist, August 1, 2001; 41(4): 546 - 552. [Abstract] [Full Text] [PDF]

				T. A. Marshall, P. J. Stumbo, J. J. Warren, and X.-J. Xie Inadequate Nutrient Intakes Are Common and Are Associated with Low Diet Variety in Rural, Community-Dwelling Elderly J. Nutr., August 1, 2001; 131(8): 2192 - 2196. [Abstract] [Full Text] [PDF]