Abstract

Background: Persons with dementia commonly suffers from malnutrition. It can be a challenge to improve an already poor nutritional status, and consequently preventive care is of importance.

Objective:The aim of the study was to investigate if body weight could increase by using a structured preventive care model among persons with dementia at risk of malnutrition or malnourished.

Method: Older persons (>65 years) registered in both the national quality registry Senior Alert and the Swedish dementia registry during July 2012- June 2014 was included. In total 1912 persons had been registered regarding their nutritional status according to the Mini Nutritional Assessment-Short Form and had a dementia diagnosis. Among these 572 was assessed as malnourished or at risk of malnutrition, received individualized nutritional interventions by care staff and had a registered follow-up weight. A pre-post design was used with body weight measured at baseline and follow-up (7-180 days later) among those at risk of malnutrition or malnourished living in their ordinary home (n=407) and those in nursing homes (n=165). Statistical significant was accepted at p<0.05. Results: Among the persons (n=1912) 20.2% was assessed as malnourished, 54.1 % as at risk of malnutrition and 25.7% as well-nourished. After receiving interventions based on needs an improvement in body weight was found among those living in ordinary home (baseline Md 62.0, follow-up 63.0 p=0.044). No improvement was detected among those living in a nursing home (baseline Md p=0.07. Comparing the groups [ordinary home vs nursing home] revealed that body mass index (BMI) (23.3 vs 23.8, p=0.26) and age (83.2 vs 84.4 p=0.068) was similar in the groups. According to Mini-Mental State Examination those in nursing home had lower cognitive function (18.9 vs 16.6 p<0.001). Conclusion: According to the results it seems important to work with preventive care and try to stop a downward health trend in time that is when persons with dementia still live independently and have less cognitive impairment. Further, trying to improve the nutritional status in the ordinary home might help to reduce the high rate of undernutrition in nursing homes.