Date of Award

5-2006

Level of Access Assigned by Author

Campus-Only Thesis

Degree Name

Master of Science (MS)

Department

Food Science and Human Nutrition

Advisor

Richard A. Cook

Second Committee Member

Phillip A. Pratt

Third Committee Member

Adrienne White

Abstract

Older adults are at greater risk for malnutrition when compared to the general population due to the physiologic and pathologic changes that occur with aging such as poor oral health, altered taste and smell and decrease in lean body mass. The term malnutrition may refer to a state of undernutrition, such as protein-energy malnutrition and vitamin and mineral deficiency, or to a state of over-nutrition, such as obesity. Researchers have discovered that underweight and obese seniors at increased risk of mortality and morbidity. Moreover, recent studies have found the BMI cutoff points for normal weight elders to be restrictive since older adults who are slightly overweight have lower mortality rates. Therefore, the major goal of this study was to compare the National Institutes of Health (NIH) classification of BMI (2—underweight; 18.5 - 24.9 kg/m2—normal weight; 25.0-29.9 kg/m2—overweight; 30.0-34.9 kg/m2—obesity class 1; 35.0-39.9 kg/m2—obesity class 2; ≥40 kg/m2—obesity class 3) with literature-based recommended BMI classification for the elderly (2—underweight; 22.0-26.9 kglm2—normal weight; 27.0-29.9 kglm2—overweight; 230 kglm2—obese) in evaluating nutrition risk in Maine seniors (≥60) who participate in Older American's Act Nutrition Programs. Also, the nature of the relationship between BMI and the DETERMINE Your Nutritional Health Checklist's cumulative risk score was assessed in this study.

The Determine Checklist surveillance data for fiscal year 2005 (October 1, 2004 to September 30, 2005) was collected by Maine Area Agencies on Aging and sent to the Food Science and Human Nutrition Department of the University of Maine for data entry and analysis. Total sample size for fiscal year 2005 was 4,121. A greater number of participants were classified as underweight according to the literature-based BMI classification versus the NIH classification of BMI. This finding was expected since the cut off point was higher for the underweight category of the literature based BMI classification.

Inverse associations were found between cumulative risk score and age (r = -.105, p≤0.01) and between BMI and age (r = -.302, p≤0.01). Also, a weak positive association was found between cumulative risk score and BMI (r = .077, p≤0.01). Furthermore, females and home delivery meal site participants had significantly higher mean Determine Checklist cumulative risk scores and were more likely to be classified as underweight according to both classifications of BMI than males and congregate meal site participants. Additionally, females and seniors who were 60-75 years (young-old) were more likely to be classified as obese than males and seniors who were 75 years or older (old-old).

The results suggest that a curvilinear relationship may exist between BMI and nutritional risk. Moreover, the findings for this study indicate 'that females, young-old participants and home delivery meal site participants are segments of the community-dwelling senior population that are at increased nutritional risk. In conclusion, the results suggest that the literature-based BMI classification can be used effectively as a preliminary indicator of malnutrition in seniors.

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