A framework for studying the nutritional health of community-dwelling elders

Background. Ensuring nutritional health for elders has been shown to reduce healthcare costs and enhance quality of life. Studies, however, have shown that malnutrition is present in 2% to 51% of community-dwelling elders, depending on the definition used and the population studied. An empirically tested framework for studying nutritional health in community-dwelling elders is not yet available. Objective: To test the goodness-of-fit exhibited by the framework of nutritional health among community-dwelling elders based on the Roy Adaptation Model using structural equation modeling (SEM). Methods: A population-based study investigated 243 elders dwelling in public housing. Demographics, polypharmacy, chronic illness, oral health, depressive symptoms, functional status, and satisfaction with social support were assessed to test their relation with nutritional health according to the propositions of the Roy Adaptation Model and scientific evidence. Results: The SEM analysis indicated that functional status, oral health, depressive symptoms, and satisfaction with social support affect nutritional health directly. Oral health, depressive symptoms, functional status, and satisfaction with support mediated the effects of age, ethnicity, education, and number of medications and chronic illnesses on nutritional health. The model accounted for 35% of the variance in nutritional health and demonstrated a good fit with the data and with the values for Bentler's Comparative Fit Index (0.94) and chi(2) (1.76). Conclusions: The propositions of the Roy Adaptation Model were supported, and the findings showed that this framework of nutritional health among community-dwelling elders could serve as a theoretical and empirical base for future inquiry.