3.10 Nutrition, Unintended Weight Loss, and Hydration

Nutritional assessments are intended to ensure that residents' nutritional needs are met and to prevent unintended weight loss. Unintended weight loss can contribute to an overall medical condition called sarcopenia, which is the loss of muscle and strength, and is linked to poor balance, decline in gait speed, and increased falls and fractures (Castillo, 2003). Malnutrition and unintended weight loss are also associated with increased hospitalizations, risk of pressure ulcers, infection rates, heart failure, and mortality. The most common causes of unintended weight loss are cancer, gastrointestinal disorders, endocrine diseases, infections, medications, cardiovascular disease, and nervous system disorders, including depression (Hall, 2003).

Proportion with a Comprehensive Nutritional Assessment

The proportion of residents in 2008 who had a comprehensive nutritional assessment done on admission or annually did not change from 2007 (Figure 3.10):

2007 — 93%
2008 — 93%

The proportion of residents whose nutritional assessment included estimating nutritional needs increased by 8% in 2008 to 97% (Figure 3.10):

2007 — 89%
2008 — 97%

top of page

Risk Factors for Weight Loss and Dehydration

Risk factors for weight loss include confusion, dementia, poor oral hygiene or missing teeth, dysphagia (difficulty swallowing), and an inability to feed oneself. Risk factors for dehydration include difficulty holding a glass or swallowing, swallowing only thickened liquids, age greater than 85, use of diuretics, confusion, and dementia.

The proportion of residents who were assessed for risk factors for weight loss increased by 4% to 69% in 2008 compared to 2007:

2007 — 65%
2008 — 69%

Significantly more residents were assessed for risk factors for dehydration in 2008 than in 2007 (17).

2007 — 53%
2008 — 63%

Figure 3.10 – Nutrition, Unintended Weight Loss & Hydration

Did the resident have an initial or annual nutritional assessment? [Q10.1]

Yes — 93%
No — 7%

Unintended weight loss can directly affect overall endurance and resistance to disease.

For all residents [Q10.2]

Did the initial or annual assessment include estimating the resident's nutritional needs?

Yes — 97%
No — 3%

Assessing risk factors

For unintended weight loss [Q10.3]

Yes — 69%
No — 31%

For dehydration [Q10.4]

Yes — 63%
No — 37%

Survey conducted: February – July 2008 [Q#.#] = Survey question number (Appendix A) Survey sample: 2,129 from 128,971 residents (Medicare, Medicaid, or any other payer source) living in the 1,044 Medicaid certified nursing facilities in Texas. For further information, contact the NFQR Project Lead at 512-438-3472.

Footnotes

17. Statistically significant at p<.001

top of page

Updated: June 8, 2010