Factors associated with eating performance in nursing home residents living with dementia and other comorbidities

Abstract Background Eating performance is the functional ability to get food into the mouth and chew/swallow it. Nursing home residents with dementia commonly experience compromised eating performance and subsequent consequences. Prior work examined the association between resident eating performanc...

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Main Authors: Wen Liu, Kyuri Lee, Elizabeth Galik, Barbara Resnick
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Geriatrics
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Online Access:https://doi.org/10.1186/s12877-024-05540-x
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author Wen Liu
Kyuri Lee
Elizabeth Galik
Barbara Resnick
author_facet Wen Liu
Kyuri Lee
Elizabeth Galik
Barbara Resnick
author_sort Wen Liu
collection DOAJ
description Abstract Background Eating performance is the functional ability to get food into the mouth and chew/swallow it. Nursing home residents with dementia commonly experience compromised eating performance and subsequent consequences. Prior work examined the association between resident eating performance and their cognitive and functional ability. Yet, the associations between resident eating performance and behavioral and psychological symptoms, psychotropic medication use, and comorbidities are less studied. This study aimed to examine the association between eating performance and cognition, functional ability, behavioral and psychological symptoms, psychotropic medication use, and comorbidities in nursing home residents with dementia. Methods This was a secondary analysis using baseline data from two randomized controlled trials, testing the impact of Function Focused Care on function and behavioral symptoms in 882 residents with moderate-to-severe dementia (mean age 86.55 years, 71% female, 30% non-white, 68.5% severe dementia) from 67 nursing homes in two states between 2014 and 2020. Eating performance (dependent variable) was measured using the single self-feeding item of Barthel Index. Independent variables included cognitive impairment, functional ability (Barthel Index total score excluding the self-feeding item score), behavioral and psychological symptoms (agitation, depression, resistiveness-to-care), psychotropic medication use (anti-depression, sedative, anti-psychotics, anti-seizure, anti-anxiety), and comorbidities. Results Nearly 39% of residents were dependent in eating. On average, residents had five documented comorbidities (SD = 3.06, range = 0–12) and were on approximately one psychotropic medication (SD = 1.25, range = 0–5). Eating performance was associated with cognitive impairment (OR = 0.53, 95% CI = 0.35, 0.79, p = .002), functional ability (OR = 1.05, 95% CI = 1.04, 1.06, p < .001), depressive symptoms (OR = 0.94, 95% CI = 0.89, 0.98, p = .007), and anxiolytic use (OR = 0.64, 95% CI = 0.42, 0.99, p = .046). Conclusions Findings supported that better eating performance was associated with less cognitive impairment, higher functional ability, fewer depressive symptoms, and less anxiolytic use. Targeted interventions to accommodate to cognitive function, optimize functional ability, minimize anxiolytic use, and manage depressive symptoms are encouraged to support eating performance in residents with dementia.
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spelling doaj-art-de7b0077717f4c69b13c3d355e09ff522024-11-17T12:47:36ZengBMCBMC Geriatrics1471-23182024-11-0124111210.1186/s12877-024-05540-xFactors associated with eating performance in nursing home residents living with dementia and other comorbiditiesWen Liu0Kyuri Lee1Elizabeth Galik2Barbara Resnick3University of Iowa College of NursingUniversity of Iowa College of NursingUniversity of Maryland School of NursingUniversity of Maryland School of NursingAbstract Background Eating performance is the functional ability to get food into the mouth and chew/swallow it. Nursing home residents with dementia commonly experience compromised eating performance and subsequent consequences. Prior work examined the association between resident eating performance and their cognitive and functional ability. Yet, the associations between resident eating performance and behavioral and psychological symptoms, psychotropic medication use, and comorbidities are less studied. This study aimed to examine the association between eating performance and cognition, functional ability, behavioral and psychological symptoms, psychotropic medication use, and comorbidities in nursing home residents with dementia. Methods This was a secondary analysis using baseline data from two randomized controlled trials, testing the impact of Function Focused Care on function and behavioral symptoms in 882 residents with moderate-to-severe dementia (mean age 86.55 years, 71% female, 30% non-white, 68.5% severe dementia) from 67 nursing homes in two states between 2014 and 2020. Eating performance (dependent variable) was measured using the single self-feeding item of Barthel Index. Independent variables included cognitive impairment, functional ability (Barthel Index total score excluding the self-feeding item score), behavioral and psychological symptoms (agitation, depression, resistiveness-to-care), psychotropic medication use (anti-depression, sedative, anti-psychotics, anti-seizure, anti-anxiety), and comorbidities. Results Nearly 39% of residents were dependent in eating. On average, residents had five documented comorbidities (SD = 3.06, range = 0–12) and were on approximately one psychotropic medication (SD = 1.25, range = 0–5). Eating performance was associated with cognitive impairment (OR = 0.53, 95% CI = 0.35, 0.79, p = .002), functional ability (OR = 1.05, 95% CI = 1.04, 1.06, p < .001), depressive symptoms (OR = 0.94, 95% CI = 0.89, 0.98, p = .007), and anxiolytic use (OR = 0.64, 95% CI = 0.42, 0.99, p = .046). Conclusions Findings supported that better eating performance was associated with less cognitive impairment, higher functional ability, fewer depressive symptoms, and less anxiolytic use. Targeted interventions to accommodate to cognitive function, optimize functional ability, minimize anxiolytic use, and manage depressive symptoms are encouraged to support eating performance in residents with dementia.https://doi.org/10.1186/s12877-024-05540-xDementiaCognitive impairmentEating performanceFunctional abilityBehavioral symptomsPsychotropic medication use
spellingShingle Wen Liu
Kyuri Lee
Elizabeth Galik
Barbara Resnick
Factors associated with eating performance in nursing home residents living with dementia and other comorbidities
BMC Geriatrics
Dementia
Cognitive impairment
Eating performance
Functional ability
Behavioral symptoms
Psychotropic medication use
title Factors associated with eating performance in nursing home residents living with dementia and other comorbidities
title_full Factors associated with eating performance in nursing home residents living with dementia and other comorbidities
title_fullStr Factors associated with eating performance in nursing home residents living with dementia and other comorbidities
title_full_unstemmed Factors associated with eating performance in nursing home residents living with dementia and other comorbidities
title_short Factors associated with eating performance in nursing home residents living with dementia and other comorbidities
title_sort factors associated with eating performance in nursing home residents living with dementia and other comorbidities
topic Dementia
Cognitive impairment
Eating performance
Functional ability
Behavioral symptoms
Psychotropic medication use
url https://doi.org/10.1186/s12877-024-05540-x
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AT barbararesnick factorsassociatedwitheatingperformanceinnursinghomeresidentslivingwithdementiaandothercomorbidities