Lack of energy is associated with malnutrition in nursing home residents: Results from the INCUR study

Background Lack of energy is a symptom frequently complained by older people, leading to the inability to continue functioning at the expected level of activity. This study aimed to investigate whether nutritional status was associated with lack of energy in nursing home (NH) residents. Methods This was a cross-sectional study. A total of 570 NH residents (72.1% women) in 13 French NHs from the Incidence of pNeumonia and related ConseqUences in nursing home Residents study cohort were included in the study. Lack of energy was measured by the question "Did you feel full of energy during the past week?" from the geriatric depression scale. Nutritional status was evaluated according to Mini Nutritional Assessment Short-Form (MNA-SF). Unadjusted and adjusted logistic regression models were performed to test the association of nutritional status with lack of energy. Results The mean age of participants was 86.5 (SD 7.5) years. A total of 246 NH residents (43.2%) reported a lack of energy. Overall, 71 (12.5%) residents were malnourished and 323 (56.7%) residents were at risk of malnutrition. Malnutrition was significantly associated with lack of energy (OR = 3.42, 95% CI = 1.92-6.08, P < 0.001), even after adjustment for potential confounders (OR = 2.41, 95% CI = 1.29-4.52, P = 0.006). Among the single items of the MNA-SF, decrease in food intake, low mobility, and psychological stress or acute disease were individually associated with lack of energy, independently of potential confounders (OR = 1.85, 95% CI = 1.24-2.77, P = 0.003; OR = 1.43, 95% CI = 1.10-1.86, P = 0.008; OR = 1.48, 95% CI = 1.19-1.84, P < 0.001; for each point respectively). Conclusions Lack of energy and malnutrition were closely associated. The reporting of lack of energy should lead to a comprehensive assessment of the aging individual (as happening for malnutrition) in order to preventively/promptly act on potentially reversible causes.