1
|
Galicia Ernst I, Worf I, Tarantino S, Hiesmayr M, Volkert D. Obesity in European nursing homes participating in nutritionDay 2016-2021-Prevalence and resident characteristics. Clin Obes 2024:e12697. [PMID: 39098644 DOI: 10.1111/cob.12697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 06/27/2024] [Accepted: 07/20/2024] [Indexed: 08/06/2024]
Abstract
The objective of this study is to assess obesity prevalence and characterize European nursing home (NH) residents with obesity comprehensively. Cross-sectional nutritionDay data from 2016 to 2021. Descriptive characterization of European NH residents ≥65 years with and without obesity. Binomial logistic regression to identify factors associated with obesity. A total of 11 327 residents (73.8% female, 86.4 ± 7.9 years, mean body mass index 25.3 ± 5.4 kg/m2) from 12 countries were analysed. Obesity prevalence was 17.7%, mostly class I (13.0%). Taking ≥5 drugs/day (OR 1.633; 95% confidence intervals 1.358-1.972), female sex (1.591; 1.385-1.832), being bed/chair-bound (1.357; 1.146-1.606), and having heart/circulation/lung disease (1.276; 1.124-1.448) was associated with increased obesity risk, older age (0.951; 0.944-0.958), mild (0.696; 0.601-0.805) and severe (0.591; 0.488-0.715) dementia, eating less than ¾ of lunch on nutritionDay (0.669; 0.563-0.793), needing assistance for eating (0.686; 0.569-0.825), and being identified by NH staff at risk for (0.312; 0.255-0.380) or with malnutrition (0.392; 0.236-0.619) decreased obesity risk. Almost one in five residents in European NH participating in nutritionDay is affected by obesity. Through a wide exploratory analysis, including data from 12 European countries, we confirmed previous findings and identified additional factors associated with obesity that should be considered in the daily care of affected residents.
Collapse
Affiliation(s)
- Isabel Galicia Ernst
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Isabella Worf
- CeMSIIS - Center for Medical Statistics, Informatics and Intelligent Systems, Medical University Vienna, Vienna, Austria
| | - Silvia Tarantino
- CeMSIIS - Center for Medical Statistics, Informatics and Intelligent Systems, Medical University Vienna, Vienna, Austria
| | - Michael Hiesmayr
- CeMSIIS - Center for Medical Statistics, Informatics and Intelligent Systems, Medical University Vienna, Vienna, Austria
| | - Dorothee Volkert
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| |
Collapse
|
2
|
Felix HC, Brown CC, Narcisse MR, Vincenzo JL, Weech-Maldonado R, Bradway CK. Characteristics of nursing homes with high percentages of falls and falls with injuries among residents with obesity. Geriatr Nurs 2023; 53:191-197. [PMID: 37540915 PMCID: PMC10976471 DOI: 10.1016/j.gerinurse.2023.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND Obesity among United States nursing home (NH) residents is increasing. These residents have special care needs, which increases their risk for falls and falls with injuries. NH are responsible for ensuring the health of their residents, including minimizing falls. However, given the special care needs of residents with obesity, different factors may be important for developing programs to minimize falls among this group. AIM We aimed to identify NH characteristics associated with falls and falls with injuries among residents with obesity. METHOD We used resident assessment data and logistic regression analysis. RESULTS We found that rates of falls and falls with injuries among residents with obesity varied significantly based on for-profit status, size, acuity index, obesity rate among residents, and registered nurse hours per patient day. CONCLUSION Recommendations are made as to how NH may be able to lower risk for falls and falls with injuries among their residents with obesity.
Collapse
Affiliation(s)
- Holly C Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 820, Little Rock, Arkansas 72205, USA.
| | - Clare C Brown
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 820, Little Rock, Arkansas 72205, USA
| | - Marie-Rachelle Narcisse
- College of Medicine, University of Arkansas for Medical Sciences, 2708 South 48th Street, Springdale, Arkansas 72762, USA
| | - Jennifer L Vincenzo
- College of Health Professions, University of Arkansas for Medical Sciences, 1125 North College Avenue, Fayetteville, Arkansas 72703, USA
| | - Robert Weech-Maldonado
- School of Health Professions, University of Alabama at Birmingham, 1720 2nd Avenue South, SHPB 558, Birmingham, AL 35294, USA
| | - Christine K Bradway
- School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Fagin Hall, Room 312, Philadelphia, PA 19104-4217, USA
| |
Collapse
|
3
|
Harris JA, Engberg J, Castle NG. Organizational and Geographic Nursing Home Characteristics Associated With Increasing Prevalence of Resident Obesity in the United States. J Appl Gerontol 2020; 39:991-999. [PMID: 31018750 PMCID: PMC7192234 DOI: 10.1177/0733464819843045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Nursing home resident obesity increases the complexity of nursing care, and nursing homes report avoiding residents with obesity when choosing which prospective residents to accept. The objective of this study was to examine the associations between nursing home obesity prevalence rate and nursing home organizational, staffing, resident, and geographic factors within a profit maximization framework. The study cohort included U.S. Centers for Medicare and Medicaid Services data from U.S. nursing homes in 2013. Study findings supported hypothesized associations between obesity prevalence rate and higher occupancy, higher bed capacity, and multi-facility affiliation, but findings did not support a relationship between obesity prevalence rate and for-profit status.
Collapse
|
4
|
Harris JA, Castle NG. Obesity and Nursing Home Care in the United States: A Systematic Review. THE GERONTOLOGIST 2020; 59:e196-e206. [PMID: 29253135 DOI: 10.1093/geront/gnx128] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Obesity is increasing among people residing in nursing homes, and resident obesity substantially affects services needed, equipment and facilities provided, and morbidity in this setting. The purpose of this article is to describe the scope and depth of evidence regarding the impact of obesity among nursing home residents in the United States. RESEARCH DESIGN AND METHODS A systematic literature review was performed in PubMed, EMBASE, CINAHL, and Web of Science databases as well as additional hand-searched documents. Included articles were published from 1997 to March 2017. The characteristics and content of the included articles were systematically reviewed and reported. RESULTS Twenty-eight studies met inclusion criteria for review. The median study size was 636 residents (interquartile range 40-11,248); 18 (64%) studies were retrospective and 10 (36%) were prospective in nature. Ten (36%) studies examined medical and functional morbidity, 10 (36%) examined health system effects, and 5 (18%) examined the risk of admission to nursing homes. Most studies found that obesity poses serious issues to resident health and the provision of health care, as well as broad health system and nursing challenges in the provision of high-quality nursing home care and services. DISCUSSION AND IMPLICATIONS Although obesity affects about one in four nursing home residents in the United States, relatively limited evidence exists on the complex challenges of obesity for their residents and their care. A continued focus on resident quality of life, health system improvement, and nursing best practices for properly caring for individuals with obesity is needed.
Collapse
Affiliation(s)
| | - Nicholas George Castle
- Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| |
Collapse
|
5
|
Zhang N, Field T, Mazor KM, Zhou Y, Lapane KL, Gurwitz JH. The Increasing Prevalence of Obesity in Residents of U.S. Nursing Homes: 2005–2015. J Gerontol A Biol Sci Med Sci 2019; 74:1929-1936. [DOI: 10.1093/gerona/gly265] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Indexed: 01/06/2023] Open
Abstract
Abstract
Background
Obesity prevalence has been increasing over decades among the U.S. population. This study analyzed trends in obesity prevalence among long-stay nursing home residents from 2005 to 2015.
Methods
Data came from the Minimum Data Sets (2005–2015). The study population was limited to long-stay residents (ie, those residing in a nursing home ≥100 days in a year). Residents were stratified into body mass index (BMI)-based groups: underweight (BMI < 18.5), normal weight (18.5 ≤ BMI < 25), overweight (25 ≤ BMI < 30), and obese (BMI ≥ 30); residents with obesity were further categorized as having Class I (30 ≤ BMI < 35), Class II (35 ≤ BMI < 40), or Class III (BMI ≥ 40) obesity. Minimum Data Sets assessments for 2015 were used to compare clinical and functional characteristics across these groups.
Results
Obesity prevalence increased from 22.4% in 2005 to 28.0% in 2015. The prevalence of Class III obesity increased from 4.0% to 6.2%. The prevalence of underweight, normal weight, and overweight decreased from 8.5% to 7.2%, from 40.3% to 37.1%, and from 28.9% to 27.8%, respectively. In 2015, compared with residents with normal weight, residents with obesity were younger, were less likely to be cognitively impaired, had high levels of mobility impairment, and were more likely to have important medical morbidities.
Conclusions and Relevance
There was a steady upward trend in obesity prevalence among nursing home residents for 2005–2015. Medical and functional characteristics of these residents may affect the type and level of care required, putting financial and staffing pressure on nursing homes.
Collapse
Affiliation(s)
- Ning Zhang
- Department of Health Policy and Promotion, School of Public Health and Health Sciences, University of Massachusetts Amherst, Worcester
- Meyers Primary Care Institute, University of Massachusetts Medical School, Reliant Medical Group, and Fallon Health, Worcester
- Division of Geriatric Medicine, University of Massachusetts Medical School, Worcester
| | - Terry Field
- Meyers Primary Care Institute, University of Massachusetts Medical School, Reliant Medical Group, and Fallon Health, Worcester
- Division of Geriatric Medicine, University of Massachusetts Medical School, Worcester
| | - Kathleen M Mazor
- Meyers Primary Care Institute, University of Massachusetts Medical School, Reliant Medical Group, and Fallon Health, Worcester
- Division of Geriatric Medicine, University of Massachusetts Medical School, Worcester
| | - Yanhua Zhou
- Meyers Primary Care Institute, University of Massachusetts Medical School, Reliant Medical Group, and Fallon Health, Worcester
- Division of Geriatric Medicine, University of Massachusetts Medical School, Worcester
| | - Kate L Lapane
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester
| | - Jerry H Gurwitz
- Meyers Primary Care Institute, University of Massachusetts Medical School, Reliant Medical Group, and Fallon Health, Worcester
- Division of Geriatric Medicine, University of Massachusetts Medical School, Worcester
| |
Collapse
|
6
|
Felix HC, Bradway C, Bird TM, Pradhan R, Weech-Maldonado R. Safety of Obese Persons in Nursing Homes. Med Care 2018; 56:1032-1034. [PMID: 30418962 PMCID: PMC6234852 DOI: 10.1097/mlr.0000000000000997] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Holly C. Felix
- Associate Professor of Health Policy, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 820, Little Rock, Arkansas 72205, / 501-526-6633 / 501-562-6620 fax
| | - Christine Bradway
- Associate Professor of Gerontological Nursing, University of Pennsylvania School of Nursing, 418 Curie Boulevard, Fagin Hall, Room 312, Philadelphia, Pennsylvania 19104-4217, / 215-573-3051
| | - T. Mac Bird
- Assistant Professor of Health Policy, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 820, Little Rock, Arkansas 72205, / 501-526-6633 / 501-562-6620 fax
| | - Rohit Pradhan
- Assistant Professor of Health Policy, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 820, Little Rock, Arkansas 72205, / 501-526-6633 / 501-562-6620 fax
| | - Robert Weech-Maldonado
- Professor & LR Jordan Endowed Chair of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, 1720 2nd Ave. S., SHPB 558, Birmingham, AL 35294, / 205-996-5838 / 205 975-6608 fax
| |
Collapse
|
7
|
Harris JA, Engberg J, Castle NG. Obesity and intensive staffing needs of nursing home residents. Geriatr Nurs 2018; 39:696-701. [PMID: 29884559 DOI: 10.1016/j.gerinurse.2018.05.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 05/18/2018] [Indexed: 01/20/2023]
Abstract
The objective of this study is to examine how increasing body mass index (BMI) among nursing home residents affects the amount of staffing assistance needed for activities of daily living (ADL). We analyzed 1,627,141 US nursing home residents reported in the 2013 Minimum Data Set in seven BMI categories, from underweight (BMI < 18.5 kg/m2) to obesity Class IIIB (≥50 kg/m2). Logistic regression models estimated the odds of nursing home-reported need for extensive (≥2 staff member) assistance needed for ADLs. The adjusted odds increased from 1.07 (95% Confidence Interval (95%CI) 1.06-1.08) for Class I, 1.16 (95%CI 1.14-1.17) for Class II, 1.33 (95%CI 1.31-1.35) for Class IIIA, and 1.90 (95%CI 1.86-1.95) for Class IIIB obesity residents compared to residents of normal weight. As a nursing home resident's BMI increases, especially for BMI ≥40 kg/m2, the need for extensive staffing assistance with ADLs also increases substantially.
Collapse
Affiliation(s)
- John Alexander Harris
- Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA.
| | | | - Nicholas George Castle
- Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| |
Collapse
|