Association between being at‐risk of malnutrition and discontinued home medical care among older patients: a 1‐year follow‐up study

Abstract

AbstractBackgroundBoth malnutrition and at‐risk of malnutrition are prevalent among older patients receiving home medical care. Discontinuation of home medical care usually occurs when an older patient is admitted to a hospital or nursing home or dies. This study aimed to assess prospective associations between nutritional status and discontinuation of home medical care in older patients.MethodsThree hundred and thirty‐three Japanese older patients receiving home‐visit nursing care services were included in this study. Their nutritional status was assessed using the Mini Nutritional Assessment®‐Short Form, and patients were classified into three groups (well‐nourished, at‐risk of malnutrition and malnourished). Outcomes were confirmed at the 1‐year follow‐up survey. Hazard ratios (HRs) and 95% confidence intervals (CIs) for discontinuation of home medical care based on nutritional status were calculated using a Cox proportional hazard model. Covariates included age, sex, living status, economic status, activities of daily living, comorbidities and dysphagia status.ResultsIn total, 297 patients (median age: 84 years) were analysed. At baseline, 48.5% of the patients were at‐risk of malnutrition and 18.9% were malnourished. During the observation period of 1 year, 27.6% patients discontinued their home medical care. In the adjusted model, the HR for discontinuation of home medical care among those at‐risk of malnutrition was 2.44 (95% CI: 1.34–4.45) times than that of the well‐nourished group, although the malnourished group was not significantly associated with discontinuation of home medical care (HR: 1.69, 95% CI: 0.77–3.72; referent: well‐nourished).ConclusionsAt‐risk of malnutrition was associated with discontinuation of home medical care among older patients.