%0 Journal Article
%T Financial Strain Is Associated with Malnutrition Risk in Community-Dwelling Older Women
%A Laura J. Samuel
%A Sarah L. Szanton
%A Carlos O. Weiss
%A Roland J. Thorpe Jr.
%A Richard D. Semba
%A Linda P. Fried
%J Epidemiology Research International
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/696518
%X This study examined the relationship between financial strain, or difficulty acquiring necessities, and malnutrition risk in a community dwelling sample of frail and nonfrail women aged 70¨C79 in the Women¡¯s Health and Aging Study ( ). Malnutrition risk was measured with a modified version of the Mini-Nutritional Assessment Short Form (MNA-SF) and defined as a score <11, financial strain was measured by (1) sufficiency of money on a monthly basis and (2) adequacy of income for food, and income was measured by ordinal categories. Mean (SD) modified MNA-SF score was 12.2 (1.80), and 14.7% of women had malnutrition risk. Women who usually did not have enough money to make ends meet had more than four-fold increased odds of malnutrition risk ( ; 95% CI: 2.26, 9.14) compared to their counterparts who had some money left over each month. This was only slightly attenuated after control for income and education, ( ; 95% CI: 1.95, 8.52) remaining robust. These results show an association between financial strain and malnutrition risk, independent of income, in older women. Self-reported financial strain may be preferable to income as a screener for malnutrition risk in older adults in clinical and research settings. 1. Introduction Malnutrition, which is a risk factor for disability and mortality, [1, 2] poses a burden for community dwelling older adults, particularly those of low socioeconomic status. Exact rates of this often undiagnosed condition are difficult to estimate in this population [3¨C5], but an estimated 9% of community dwelling older adults are malnourished and up to 45% have malnutrition risk and should have clinical diagnostic evaluation [6]. Rates are consistently higher, however, among low income compared to high income individuals [3, 7, 8]. Malnutrition is generally understood to be a deficiency of both energy and protein, combined with decreased fat-free mass [9], although older adults of low socioeconomic status can be malnourished even if consuming a high energy diet [10, 11], probably because they consume foods with lower nutrient content [10, 12]. Also, there is evidence that food insecure adults, or adults who lack regular access to food, have poorer dietary quality than food secure adults, despite similar caloric intake [11, 13¨C15]. Although income is associated with malnutrition, income alone may not accurately predict malnutrition in older adults, since cost of living, household size, and competing needs cause variation in the purchasing power of retirees [16]. Rising health care costs push many older adults into poverty, even if
%U http://www.hindawi.com/journals/eri/2012/696518/