Dietary Intake and Related Factors of Residents of Assisted Living Memory Care

Abstract

Assisted living memory care (ALMC) residents present with specific needs and challenges. Knowledge regarding their nutritional intake and the relationship to cognitive ability, demographics, and dining behaviors is limited. This quality improvement project was conducted to determine the dietary intake of ALMC residents and identify factors related to the adequacy of their dietary intake to inform the development of strategies to enhance their dietary intake. Ingested food and fluids and ingestion behaviors were recorded over a 12-hour (7 AM -7 PM) observation. Related factors examined were obtained from chart review. Food Processor Nutritional Analysis Software was used to determine nutrient intake with the calculation of percent of recommended amounts based on BMI, age, and activity level. Thirty-two residents (75% females; mean age 86.5 years, SD=7.84) of four ALMC units (eight per unit) were subjects of this study. Their Global Deterioration Scores ranged from 3 to 7, with 60% at 5 or greater. Average BMI was 25.47 kg/m2 (range 14.1-40.4 kg/m2). Major dietary components (protein, calories, carbohydrates) were consumed in adequate amounts based on the percent of recommended. The percent of recommended fiber intake was low (mean 61.57%) with saturated fat intake extremely high (mean 243.80%). Micronutrients were below recommended levels except for cholesterol, vitamin C, sodium, and iron. Four subject groups, relative to level (inadequate, moderately inadequate, adequate, exceeds recommended) of nutritional intake, were identified based on hierarchical clustering with all nutrient data. Using protein intake as a representative nutrient variable, regression analysis indicated that 44.1% of the variance was explained by cognitive ability and setting after adjusting for their interaction. A balance of adequate intake while allowing ALMC residents’ choice in food selection is essential. Further research is needed to address dining standards specific to the ALMC population that recognizes cognitive ability, food offerings, and dining behaviors.