P696 - DETERMINANTS OF MALNUTRITION IN COMMUNITY-LIVING OLDER ADULTS: TESTING THE DOMAP FRAMEWORK.

P696

DETERMINANTS OF MALNUTRITION IN COMMUNITY-LIVING OLDER ADULTS: TESTING THE DOMAP FRAMEWORK.

H. Keller^1,2,*, J. Koechl¹, Y. Chen³, N. Singh⁴, P. Xi⁵, S. Kirkpatrick⁴

¹Kinesiology and Health Sciences, University of Waterloo, ²Schlegel-UW Research Institute for Aging, ³Systems Design Engineering, ⁴School of Public Health Sciences, University of Waterloo, Waterloo, ⁵Digital Technologies Research Centre, National Research Council, Ottawa, Canada

Rationale: Older adults living in the community are at increased risk of malnutrition due to a variety of direct and indirect risk factors, as outlined by the Determinants of Malnutrition in Aged Persons (DoMAP) framework. This framework has yet to be tested empirically. 

Methods: A secondary analysis of the National Health and Nutrition Examination Surveys (2011- 2018; those 65+ years of age) was conducted with malnutrition (self-reported unintentional weight loss and/or low BMI) as the dependent variable. Independent variables aligned with DoMAP factors were selected as well as gender and ethnicity. Logistic regression was completed; 39 variables were entered into the model. Variables with a p-value<0.10 were retained. 

Results: 5434 participants were included; 50.9% were female, 30.4% were 65-69 years, 20.3% were non-Hispanic Black and 49.2% were non-Hispanic White. Low BMI and/or unintentional weight change was present in 23.7%.  Lower odds of malnutrition was associated with: low % protein intake (Odds Ratio (OR) 0.94, 95% CI 0.88, 1.00), restricted diet (OR 0.65, 95% CI 0.48, 0.87), inflammatory disease (OR 0.56, 95% CI 0.46, 0.69) and multimorbidity (OR 0.59 95% CI 0.47, 0.75). Increased odds of malnutrition was associated wtih: age 80+ years (OR 2.6, 95% CI 1.99, 3.39), health decline (OR 1.82 95% CI 1.34, 2.47), oral pain (OR 1.65 95% CI 1.06, 2.57), hospitalization (OR 1.63, 95% CI 1.31, 20.2), chronic obstructive pulmonary disease (OR 1.63 95% CI 1.11, 2.4), Asian (OR 1.52, 95% CI 1.16, 1.98), non-Hispanic Black (OR 1.41 95% CI 1.15, 1.74), low education (OR 1.41 95% CI 1.16, 1.71), frailty (OR 1.36 95% CI 1.31, 2.02), and poverty (OR 1.22 95% CI 0.98, 1.52).   

Conclusion: Fourteen of 39 DoMAP variables were associated with malnutrition indicators however, most were indirect determinants. Confirmation of the model in different population groups is needed. Funding: National Research Council Canada (AiP-006-2)

Disclosure of Interest: None declared