D.H. Sullivan*, J.E. Morley**, L.E. Johnson***, A. Barber****, J.S. Olson*****, M.R. Stevens*****, B.D. Yamashita******, S.P. Reinhart******, J.P. Trotter******, X.E. Olave******

* GRECC, Central Arkansas Veterans Healthcare System, and Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR. **Division of Geriatric Medicine, Saint Louis University and GRECC, St. Louis VA Medical Center, St. Louis, MO. ***Central Arkansas Veterans Healthcare System, and Department of Geriatrics and Family and Community Medicine, University of Arkansas for Medical Sciences, Little Rock, AR. ****NCS Healthcare, Inc., Long-term Care Consultant Pharmacist, Akron, OH. *****Bristol-Myers Squibb, Plainsboro, NJ. ******Ovation Research Group, Highland Park, IL. Correspondence: Beverly D. Yamashita, Ovation Research Group, 600 Central Avenue, Highland Park, IL 60035 USA. Phone: 847-266-4105. Fax: 847-266-9121. E-mail: byamasita@ovation.org

PURPOSE: To investigate nursing home residents at high nutritional risk to determine: 1) which baseline nutrition or health status indicators correlated with subsequent weight gain or appetite improvement; and, 2) whether a continued weight loss correlated with higher mortality. METHODS: At study entry, nutritional, health status, and demographic data were extracted from the nursing home chart or the MDS. Each subject was tracked for 6 months with survival, weight gain of = 5%, and appetite improvement the primary outcome measures. RESULTS: During the 6-month study, younger age was the strongest correlate of appetite improvement. The odds of gaining weight were negatively correlated with BMI, age, and feeding dependency. Subjects who were receiving appetite stimulants (orexigenics) at study entry had a 70% greater probability of gaining weight than those who were not. A weight loss during the 6-month period was associated with a nearly two-fold increase in the likelihood of dying (adjusted RR: 1.95, 95% CI 1.43 to 2.66). CONCLUSION: The course of nutritional problems within nursing homes is highly variable. Continued weight loss, however, appears to have ominous implications for mortality. Younger residents who are not dependent on others for feeding assistance, and who receive orexigenics tend to experience weight gain.

Keywords: Nutrition, outcomes, long-term care, weight loss.