Paker-Eichelkraut, H. Sündüs: Nutritional status and related factors in nursing home residents : Comparative study in elderly migrants and native Germans. - Bonn, 2011. - Dissertation, Rheinische Friedrich-Wilhelms-Universität Bonn.
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author = {{H. Sündüs Paker-Eichelkraut}},
title = {Nutritional status and related factors in nursing home residents : Comparative study in elderly migrants and native Germans},
school = {Rheinische Friedrich-Wilhelms-Universität Bonn},
year = 2011,
month = apr,

note = {Introduction: Elderly migrants represent an ever increasing portion of German nursing home residents. However, the nutritional status of elderly migrants and related problems are still largely unknown. The primary aim of this comparative study was to investigate the nutritional status and related health factors of elderly migrants living in German nursing homes in comparison to a matched group of native German residents living in the same nursing homes. The specific objectives were to find out the prevalence of undernourishment, identify nutritional issues and to assess the dependency in daily activities, in order to reveal if there are specific needs of elderly migrants living in nursing homes.
Methods: All migrants (>65 y) living in two German nursing homes were enrolled. A group of non migrants living in the same nursing homes, matched in age and gender, was selected for comparison. Nutritional status was assessed by using the body mass index (BMI, <22 kg/m2), calf circumference (CC, <31 cm) and mid-upper arm circumference (MUAC, <22 cm). As a summarising screening, the Mini Nutritional Assessment (MNA, <17 points) was used for not tube fed residents. Information about health and functional status, dietary habits, nursing care level and nutritional problems of the residents were gathered in a comprehensive questionnaire, completed by care staff. Daily energy and nutrients intake was evaluated with 3-consecutive day weighed/estimated food records.
Results: Twenty-three migrants took part in the study and the majority of them (87%) had a Turkish background. A group of 37 non migrants was matched (migrants; mean age 76 ±6 y, 52% female, non migrants; 78 ±7 y, 59% female). Almost half of the migrants were seriously in need of care (48% vs. 11%), one third of them were bedridden (30% vs. 8%) and five of them were tube fed (22% vs. 3%). The prevalence of undernourishment was significantly higher among migrants than non migrants by almost every method applied. The prevalence was the highest in both groups according to CC (migrants; 57%, non migrants; 22%), followed by BMI (39% vs. 11%) and MNA (22% vs. 3%). Only one of the non migrants had a low MUAC level. 83% of the migrants had 3 or more nutritional problems (non migrants; 27%). The main problems in migrants and non migrants were eating noticeably little (61% vs. 21%), refusal to eat (56% vs. 25%) and loss of appetite (56% vs. 19%). Nutritional problems were highly correlative with a low BMI as well as with the activities of daily living (ADL-score). The majority of the migrants were more dependent than non migrants in ADL (61% vs. 24%). Dementia was the most common diagnosed disease (48%) in migrants whereas in non migrants was hypertension (49%). Consumption of pureed diet was higher in migrants (17%) compared to non migrants. Participants from both groups did not reach the recommended energy intake of 6.9 MJ (women) and 8.3 MJ (men) for individuals of 65 y and older. Proportion of carbohydrate intake was lower (44 E% and 42 E%) and of fat intake was higher (40 E% and 43 E%) than the recommended in both groups. More than 50% participants fall below D-A-CH’s reference values for vitamin B1, B6, C, D, E, folate, calcium, iron and magnesium. Additionally, 61% of the migrants had a low B12 intake.
Conclusions: The group investigated in this study was relatively small and restricted to two nursing homes. Therefore, our findings can not be generalized to the broader community and are less representative for the whole population. Nevertheless, the results indicated that undernourishment was more frequent in elderly migrants and associated with more nutritional problems and decreased functional ability than in matched non migrants. By increasing attention to the nutritional status and dietary habits of elderly migrants, it might be possible to reduce the prevalence of their undernourishment and increase their quality of life. Individualizing residents’care by serving food they want and enjoy or familiar ethnic food can also help to improve nutritional status.},

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