Differences in Medical and Life-style Risk Factors for Malnutrition in Limited-Resource Older Adults in a Rural U.S. State: A Descriptive Study.

Objectives: Medical and life-style factors are associated with malnutrition in older adults. This study assessed the presence of these risk factors in limited-resource, community-dwelling older adults to inform the development of a nutrition education interventions.
Design: Quantitative descriptive study.
Setting: A total of 24 randomly selected congregate nutrition sites (where limited-resource older adults can receive one hot meal/day, five days/week) in the rural state of South Carolina, USA.
Participants: Data were collected from 477 older adults (of the 407 who reported race, 219 were African American and 171 were White).
Measurements: Extension Educators who work for the Cooperative Extension Service (a formalized educational outreach system associated with some U.S. universities) read aloud a 27-item instrument designed to assess risk factors for malnutrition. Response frequencies were tabulated and chi-square tests were performed using SAS 9.3.
Results: More African Americans reported having a chronic illness or condition (81.2 vs. 68.3%; p=0.003), eating alone (66.2 vs. 53.6%; p=0.012), having a refrigerator that sometimes did not keep food cold (31.8 vs. 8.4%; p<0.0001), and sometimes not having enough money to buy food (38.9 vs. 18.5%; p<0.0001) compared to White older adults.
Conclusion: Rural older adults who attend congregate nutrition sites, especially African Americans, could be at risk for malnutrition due to health status and food preparation-related factors. Evidence-based, tailored programs are needed to minimize malnutrition among limited-resource older adults living in rural areas in the U.S.