ASSOCIATIONS BETWEEN NUTRITION STATUS AND THE DEGREE OF INDEPENDENCE IN DEMENTIA ELDERLY'S ACTIVITY OF DAILY LIVING IN THE ELDERLY IN NURSING CARE FACILITIES IN JAPAN

Background and objectives: Most of elderly who requires nursing care has chronic disease, and due to a diminished food intake and physical activity, they tend to show decreased skeletal muscle mass. As a result, there is a great increase in the risk of fall and malnutrition in the elderly. Malnutrition is known to worsen the prognosis after infection and delay healing of disease in the elderly due to decreased immune function. Methods: We have examined the associations between nutrition status and blood biochemical parameters, the degree of independence in dementia elderly's activity of daily living, the nursing care levels, and the form of food in 1,823 elderly persons aged 61-106 y (average 86.7 y) who lives in nursing care facilities were analyzed using Spearman's rank correlation coefficient analysis and steel-dwass test. Results: The percentages of the elderly at risk of malnutrition according to GNRI (Geriatric Nutritional Risk Index) were 67.0% for men and 66.2% for women. The GNRI scores tended to be lower according to an increase in the nursing care level. In elderly men, the GNRI scores were remarkably lower in the groups categorized as nursing care levels 4 and higher than those in nursing care level 3 or lower. In elderly women, the GNRI scores were greatly decreased in the groups categorized as nursing care levels 2 and higher. The lower the degree of independence in dementia elderly's activity of daily living was, the lower the GNRI, and the GNRI scores of the groups categorized IIIa and over were significantly lower than those categorized as of IIb or under. The GNRI scores were associated with the provided form of food, according to the transition from regular to liquid form. Conclusions: The results of this study suggest that the nutrition status of elderly who requires nursing care in nursing homes was associated with the degree of independence in dementia elderly's activity of daily living, the nursing care level, and the form of food, and it may be attributable to a decrease in physical function required for activity of daily living.