Self-Perceived Health and Nutritional Status among Home-Living Older People A Prospective Study

Sammanfattning: The overall aim was to follow the development of nutritional status and its significance for general health status using an epiemiologic method in a representative population?based selection of older individuals in two cohorts. The main focus was to prospectively examine the significance of demographic, social and medical factors and to establish a basis to investigate the possibilities of preventive measures.Methods: Five hundred and eighty?three individuals (278 women and 305 men), 75 and 80 years old, when included, living in a municipality in Östergötland in Sweden, participated in this study. Data collection took place 2001?2006 with one examination yearly. The examination included a single question regarding self?perceived health demographical questions, different questionnaires in the areas of nutritional status, symptoms of depression, cognitive function, health?related quality of life and well being and objective assessments such as anthropometrical, physical and biochemical measurements.Results: Fifty percent of the women (I) and 58% of the men (II) perceived themselves as healthy. Important factors for women’s health (I) at baseline were no or few symptoms of depression, better physical mobility and better physical health. Among men who perceived themselves as healthy (II) at baseline, important factors were better physical health, maintaining a social network and the ability to walk outdoors. After one year 69% of the women and 75% of the men still perceived themselves as healthy. Among those women (I) who perceived themselves as healthy after one year, better physical mobility and better physical health were still important, with the addition of less or no pain. Important predictors for preserving health among men (II) were no symptoms of depression and the ability to walk up and down stairs. The prevalence of risk for malnutrition (III) was 14.5% (n=84), among women 18.8% and men 10.6%. Risk factors for malnutrition at baseline were a lower TSF, lower handgrip strength and worse physical health according to the PGC MAI. The incidence was 7.6%?16.2%, and was distributed equally among women and men over time. Predictors for developing malnutrition were lower self?perceived health, increased number of symptoms of depression.  Especially men with symptoms of depression ran a higher risk. Reported energy intake (IV) was low in relation to the estimated requirement, on average 74% among women and 67% among men. Intake of vitamins A, D, E and folate was below the recommended intake and the same pattern was found over time. A smaller weight loss was found among women and men from baseline to Follow?up 2.Conclusions: The experience of a good physical health was the only common factor for a good self?perceived health among women and men. The highest risk for developing malnutrition was a combination of impaired self?perceived health and increased number of symptoms of depression.Clinical implications: A combination of nutritional status, self?perceived health and symptoms of depression can be a base for clinical judgement and can be used by different professionals in ealth and medical care and in home care service.