Diet, Nutritional Status, Inflammation and Functional Outcomes in Older Adults Residing in Long Term Care Homes

Many older adults residing in long term care (LTC) homes have underlying health conditions and limited functionality. The objective of this research was to address the issues which might affect the health status and functionality of older adults (age ≥ 60y) living in LTC homes. To achieve this objective, the research was carried out as four studies. In the first study, supplement and medication use was examined, specifically exploring the impact of dementia, and to assess pill burden in older adults residing in LTC home. In the second study, menu served in this LTC was assessed for recommendations of Canada’s Food Guide servings, macro, micro nutrients, and diet quality score. This menu analysis was compared to a similar analysis conducted a decade ago to find out what changes had occurred over time. In the third study, LTC residents were assessed for blood inflammatory markers, 25-hydroxyvitamin D (25(OH)D), metabolic syndrome, physical functioning, cognition, pain, and associations between inflammation and markers of functionality. Similar analyses on healthy community dwelling older and younger adults was conducted to draw differences amongst all three groups, i.e., older frail (LTC residents), older healthy, and younger healthy (community dwelling). In the fourth study the option of adding an anti-inflammatory diet was explored to address the issues of inflammation and compromised menus in LTC. Major findings suggested that there was inappropriate overuse of supplements, yet vitamin D supplements were consumed by only one-third residents of the LTC home. The LTC menu did not meet the recommendations for Canada’s Food Guide servings except for Fruits & Vegetables. Diet quality of the LTC menu was low and indicated the need of improvement, however, the comparison of current menu to a decade old menu showed some improvements. Inflammatory markers in LTC older adults were high, and the majority of subjects had insufficient 25(OH)D. Metabolic syndrome was seen in about more than one-third of subjects. Significant correlations between C-reactive protein, cognition and activities of daily living were detected. The anti-inflammatory diet was validated from research, and strategies of incorporating it into the diets of LTC residents were addressed