Investigating the Nutritional Status of New Zealand Adults in Residential Aged-Care: the New Zealand Nutrition in Aged-care Project (NZNAPs)

Data regarding factors associated with dietary intake and nutrient deficiencies of rest-home level care residents was collected by trained research assistants (RAs) based in each of the participating rest homes (n=16). RAs were final year Master of Dietetic students who had undertaken training in clinical nutrition, food service management, communication and cultural competency. The study dietitian provided specific training for study protocols and operating procedures. RAs worked with individual participants and care staff regarding the timing of data collection. Assessments were staged over a one week period for each participant so as not to over-burden or fatigue participants. Data Collected: - demographic data, physical activity levels, medical history, oral health (oral health impact profile) and medication and dietary supplement use was collected from medical records and discussions with participants and aged-care staff using standardised questionnaires developed specifically for the NZNAPs study. - mental (geriatric depression scale, clock drawing test and modified mini-mental state examination (3MS) test) and physical function (grip strength and timed walk test) tests were administered using standardised protocols developed for the NZNAPs study. - anthropometric measurements (weight, ulna length, standing height, waist circumference), were taken according to standardised procedures. Malnutrition screening (mini-nutrition assessment short form) and frailty (SHARE-FI) scores were derived from this data. - dietary intake data was collected using weighed 3-day diet records. Dietary data was collected over non-consecutive days and included one weekend day. Details of evening snacks were recorded by care staff and any foods and/or beverages consumed away from the rest home were collected using food diaries and interviewer-administered food recalls. Checking of the food diaries and diet recalls occurred as close to the eating period as possible (e.g. if participant out for lunch a review of the food diary/ recall occurred on their return to the aged-care facility that afternoon). Recalls lasted for 5- 15 minutes per eating period. - fasting blood (collected by trained phlebotomists in a single early morning session) and spot-urine samples (collected by aged-care staff during regular toileting) were used to determine the biochemical nutrition status of participants.