Four-Year Health Outcomes Associated with Nutrition Risk in Community-Living Older Adults in the New Zealand Health, Work and Retirement Study ^†

Abstract

Objective: To determine four-year outcomes of community-living older adults identified as being at ‘malnutrition risk’ in the 2014 Health, Work and Retirement (HWR) study. Design: A longitudinal analysis of the 2014 and 2018 HWR cohort. Setting: New Zealand. Participants: 1471 adults aged 49–87. Nutrition risk was assessed using the validated Seniors in the Community: Risk Evaluation for Eating and Nutrition, abbreviated version (SCREENII-AB) by postal survey. Other measures included demographic, social and health characteristics. Physical and mental functioning and overall health-related quality of life was assessed using the 12-item Short-Form Health Survey (SF-12v2). Depression was assessed using the verified shortened 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10). Social provisions were determined with the 24-item Social Provisions Scale. Alcohol intake was determined by using the Alcohol Use Disorders Identification Test (AUDIT-C). Of the 61.6% of participants that returned both 2014 and 2018 questionnaires, one third (33.9%) of the participants were at nutritional risk (SCREEN II-AB score ≤ 38). The direct effects of nutrition risk showed that significant differences between at-risk and not-at-risk groups at baseline remained at follow up. Over time, physical health scores and alcohol use scores were reduced. Mental health improved over time for the not-at-risk group, whilst it remained static for the at-risk group. Time had non-significant interactions and small effects on all other indicators. The distinctions between the at-risk and not-at-risk groups remained the same and were not resolved with the passage of time, the only caveat being mental health. This highlights the importance of screening in primary care for targeted intervention as risk factors remain stable over time.