Nutrition and quality of life in the aged: the Jerusalem 70-year olds longitudinal study.

Abstract

Inadequate nutrition is a major problem of elderly people today. Yet, despite the prevalence and significance of the problem, there is little information on the nutritional status of elderly persons in the community, and its impact on their quality of life. During 1990-1991, as part of a first cross-section in a longitudinal medical and social study of 70-year olds in Jerusalem, we surveyed the nutritional status of this population. During the first phase, 605 people were examined in their homes; data were collected regarding socioeconomic status, education, self-perceived health state, use of medications and health services, and ADL. During the second stage, a sub-group of 463 people was examined in a geriatric outpatient clinic; all subjects underwent medical history, physical examination, cognitive assessment, psychiatric questionnaire, blood and urine tests, electrocardiogram, and pulmonary function tests. In addition, general hospital admissions and morbidity and mortality in the two years following the study were studied. The nutritional status of the participants was determined according to nutritional assessment (NA) scale, based on the Mini Nutritional Assessment (MNA). The majority of the study population lived at home, was without cognitive disturbance (86%), and was independent in ADL (83%). Based on NA > 24, 91% of the study population were in good nutritional state, 8.3% were at risk of undernutrition, and 0.7% were malnourished. There was a significant positive relationship between NA score and ADL as well as cognitive state. In addition, a strong negative relation was found between NA score and visits to the family physician in the previous fortnight, visits to the emergency room in the previous year, and hospital admissions in the following two years. An inverse relation, although not significant, was found between NA score and two-year post-study mortality. These results suggest that the nutritional status of the studied population is inadequate, and that the nutritional state is one of the major determinants of the quality of life in the elderly and therefore, should be part of any geriatric assessment. Elder population surveys are needed to identify and treat at risk elders.