Browsing by Subject "OLDER-PEOPLE"

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  • Kouvonen, A.; Vahtera, J.; Pentti, J.; Korhonen, M. J.; Oksanen, T.; Salo, P.; Virtanen, M.; Kivimaki, M. (2016)
    Background. Adverse effects of antidepressants are most common at the beginning of the treatment, but possible also later. We examined the association between antidepressant use and work-related injuries taking into account the duration of antidepressant use. Method. Antidepressant use and work-related injuries between 2000 and 2011 were measured among 66 238 employees (mean age 43.8 years, 80% female) using linkage to national records (the Finnish Public Sector study). We analysed data using time-dependent modelling with individuals as their own controls (self-controlled case-series design). Results. In 2238 individuals who had used antidepressants and had a work-related injury during a mean follow-up of 7.8 years, no increase in the risk of injury was observed in the beginning of antidepressant treatment. However, an increased injury risk was seen after 3 months of treatment (rate ratio, compared with no recent antidepressant use, 1.27, 95% confidence interval 1.10-1.48). This was also the case among those who had used only selective serotonin re-uptake inhibitors (n = 714; rate ratio 1.41, 95% confidence interval 1.08-1.83). Conclusions. Antidepressant use was not associated with an increased risk of work-related injury at the beginning of treatment. Post-hoc analyses of antidepressant trials are needed to determine whether long-term use of antidepressants increases the risk of work-related injury.
  • Salminen, K. S.; Suominen, M. H.; Soini, H.; Kautiainen, H.; Savikko, N.; Saarela, R. K. T.; Muurinen, S.; Pitkälä, K. H. (2019)
    ObjectivesWe evaluated the associations between nutritional status and health-related quality-of-life (HRQoL) among older long-term care residents in Helsinki.Design and participantsAll 3767 older (65 years) long-term care residents in Helsinki in 2017 were invited to participate in this cross-sectional study. After refusals and exclusions of residents without sufficient information, 2160 residents remained.MeasurementsData on characteristics, nutritional status (Mini Nutritional Assessment, MNA) and HRQoL (15D) were collected by trained nurses.ResultsOf the participants, 64% were at-risk of malnutrition and 18% suffered from malnutrition. Residents in the malnourished group were more dependent in activities of daily living (ADL) functioning, suffered more often from dementia, had lower cognitive level, used less medications, and were eating more often inadequately. HRQoL was statistically significantly associated with MNA total score in both female and male residents. There was a curvilinear correlation between MNA and 15D score in females: 0.50 (95% CI 0.46 to 0.53) and males: 0.56 (95% CI 0.50 to 0.61). In partial correlation analysis, all dimensions of 15D, except for sleeping and breathing, were positively associated with MNA score. In these analyses no significant differences emerged between males and females when the results were adjusted for age and dementia.ConclusionsNutrition plays an important role in HRQoL among older long-term care residents.
  • Lindroos, Eeva K.; Saarela, Riitta K.; Suominen, Merja H.; Muurinen, Seija; Soini, Helena; Kautiainen, Hannu; Pitkälä, Kaisu H. (2019)
    Objectives: To explore how oral problems, chewing problems, dry mouth, and swallowing difficulties cluster and whether their burden is associated with nutritional status, eating habits, gastrointestinal symptoms, psychological well-being, and mortality among institutionalized residents. Design: Cross-sectional study with 1-year mortality. Setting and participants: 3123 residents living in assisted facilities and nursing homes in Helsinki, Finland. Measures: Trained nurses assessed residents in all nursing homes and assisted living facilities in Helsinki in 2011. A personal interview, the Mini Nutritional Assessment (MNA), oral symptoms, questions about eating habits, and psychological well-being were used to assess each resident. We divided the subjects first according to the number of oral symptoms into 4 groups: no oral symptoms (G0), 1 oral symptom (G1), 2 oral symptoms (G2), and all 3 symptoms (G3); and second according to the symptoms: dry mouth, chewing problems, and swallowing difficulties. The diagnoses and medications were retrieved from medical records, and mortality data were obtained from central registers. Results: In all, 26% of the subjects had 1 oral problem (G1), 11% had 2 oral problems (G2), and 4% had all 3 oral problems (G3), whereas 60% (n = 1870) had no oral symptoms. Thus, the oral symptoms moderately overlapped. The burden of oral symptoms was linearly associated with malnutrition, higher numbers of comorbidities, dependency in physical functioning, gastrointestinal symptoms, and eating less and more often alone. The higher the burden of oral symptoms, the lower the self-rated health and psychological well-being. Mortality increased along with the higher oral symptoms burden. Among residents having 1 or more symptoms, 26% had chewing problems, 18% swallowing difficulties, and 15% dry mouth. Conclusions/Implications: The burden of oral health problems was associated in a stepwise fashion with poor health and psychological well-being, malnutrition, and mortality. Clinicians should routinely assess older institutionalized residents' oral health status to improve residents' well-being. (C) 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
  • Pirhonen, Jari; Tiilikainen, Elisa; Pekkarinen, Satu; Lemivaara, Marjut; Melkas, Helina (2020)
    This future-oriented study examines the opportunities and challenges offered by social robots and communication technology when aiming to decrease emotional and social loneliness in older people residing in assisted living (AL). The paper draws on prior literature on loneliness, elder care and social robots. The aim is to scan the futures regarding technology support for the frail older people in future AL. The analytical frame was built on Robert Weiss’ division of relational functions: attachment, social integration, opportunity for nurturance, reassurance of worth, sense of reliable alliance, and guidance in stressful situations, and on a distinction between direct and indirect social robots. Our examinations show that social robots could tackle both emotional and social loneliness in assisted living by empowering people to engage in different forms of social interaction inside and outside the facility. However, ethical concerns of objectification, lack of human contact, and deception need to be thoroughly considered when implementing social robots in care for frail older people.
  • Jansson, A. H.; Savikko, N.; Kautiainen, H.; Roitto, H. -M.; Pitkälä, K. H. (2020)
  • Rapo-Pylkkö, Susanna; Haanpää, Maija; Liira, Helena (2016)
    Objective: To present the occurrence, characteristics, etiology, interference, and medication of chronic pain among the elderly living independently at home. Design/setting: A total of 460 subjects in three cohorts aged 75, 80 and 85 years respectively received visits by communal home-care department nurses for a cross-sectional survey. Of them, 175 had chronic (duration 3 months) pain with an average intensity of 4/10 and/or moderate interference in daily life. Main outcome measures: Clinical assessment was performed for consenting subjects to define the location, intensity, etiology, type, interference and medications of chronic pain. Results: According to home visits, elderly people with chronic pain rated their health and mobility worse and felt sadder, lonelier and more tired than those without chronic pain. A geriatrician made clinical assessments for 106 patients with chronic pain in 2009-2013. Of them, 66 had three, 35 had two and 5 had one pain condition. The worst pain was musculoskeletal in 88 (83%) of patients. Pain was pure nociceptive in 61 (58%), pure neuropathic in 9 (8%), combined nociceptive and neuropathic pain in 34 (32%), and idiopathic in 2 (2%) patients. On a numerical rating scale from 0 to 10, the mean and maximal intensity of the worst pain was 5.7 and 7.7, respectively, while the mean pain interference was 5.9. Mean pain intensity and maximal pain intensity decreased by age. Duration of pain was longer than 5 years in 51 (48%) patients. Regular pain medication was used by 82 (77%) patients, most commonly paracetamol or NSAIDs. Although pain limited the lives of the elderly with chronic pain, they were as satisfied with their lives as those without chronic pain. Conclusions: Elderly people in our study often suffered from chronic pain, mostly musculoskeletal pain, and the origin of pain was neuropathic in up to 40% of these cases. However, elderly people with chronic pain rarely used the medications specifically for neuropathic pain. Based on increased loneliness, sadness and tiredness, as well as decreased subjective health and mobility, the quality of life was decreased among those with chronic pain compared with those without pain.
  • Rantsi, Mervi; Pitkälä, Kaisu H.; Kautiainen, Hannu; Hyttinen, Virva; Kankaanpää, Eila (2022)
    Background Educational interventions can reduce potentially inappropriate medication (PIM) use in older people. Their effectiveness has been measured mainly as changes in PIM use. In this economic evaluation, we analyse the impact of an educational intervention in terms of costs and quality-adjusted life years (QALYs). Methods The educational intervention consisted of activating and interactive training sessions for nursing staff and consulting physicians, and was compared with treatment as usual (TAU). Participants (n = 227) in a cluster randomised trial (cRCT) were residents living permanently in assisted living facilities (n = 20 wards). For economic evaluation, participants' healthcare service use costs and costs for the intervention were estimated for a 12 month period. Incremental cost-effectiveness ratios (ICERs) were estimated for QALYs per participant. Cost-effectiveness analysis was conducted from a healthcare perspective. A bootstrapped cost-effectiveness plane and one-way sensitivity analysis were undertaken to analyse the uncertainty surrounding the estimates. Results The educational intervention was estimated to be less costly and less effective in terms of QALYs than TAU at the 12 month follow-up [incremental costs -euro1,629, confidence interval (CI) -euro5,489 to euro2,240; incremental effect -0.02, CI -0.06 to 0.02]. The base case ICER was >euro80,000/QALY. Conclusion The educational intervention was estimated to be less costly and less effective in terms of QALYs compared with TAU, but the results are subject to some uncertainties. Reduction in PIM use or benefits in quality of life did not seem to translate into improvements in QALYs. Our findings emphasise the need for better understanding of the impact of decreasing PIM use on health outcomes.
  • Hu, Yaoyue; Ruiz, Milagros; Bobak, Martin; Martikainen, Pekka (2020)
    Background: While living alone predicts depression in diverse ageing populations, the impact of multi-generational living is unclear. This study compared mid-late life depressive symptoms by living arrangements between societies with distinct kinship ties. Methods: Repeated data on depressive symptoms and living arrangements over 4 years from 16,229 Chinese (age >= 45) and 10,403 English adults (age >= 50) were analyzed using multilevel mixed-effects logistic regression. Elevated depressive symptoms were identified using the Center for Epidemiological Depression Scale criteria in each study. Results: Higher odds ratios (ORs) of elevated depressive symptoms were found in both Chinese and English adults aged Limitations: Bias may exist because depressed participants are more likely to experience divorce or separation prior to baseline. Conclusions: The relationship between living arrangements and depressive symptoms appears robust and consistent across social contexts, although the mechanisms differ. The protective role of partners in both China and England supports targeting those who do not live with partners to reduce depression.
  • Evans, Jay; Grant, Elizabeth; Pessi, Anne Birgitta; Evans, Laura; Voolma, Silja (2021)
    Introduction There is widespread agreement that medical care without compassion cannot be patient-centred, but patients still routinely cite that they feel a lack of compassion in the care environment. There is a dearth of research on how compassion is experienced in a non-hospital setting such as a care home, not just by residents but by staff and other key stakeholders. This scoping review aims to determine the body of existing, published research that explicitly refers to compassion or empathy in the context of care homes. Methods and analysis This scoping review will follow the methodology described by Arksey and O'Malley and the PRISMAextension for scoping reviews guideline to adhere to an established methodological framework. Relevant publications will be searched on the EMBASE, MEDLINE, PubMed, CINAHL, EBM Reviews and PsycInfo databases. Peer-reviewed literature focusing on experiences of compassion or empathy in care home settings from the perspective of either staff, residents (or clients), family members or their combined perspectives will be included. We will focus on literature published from 2000 up to 1 November 2021, in English, Spanish, Portuguese Finnish and Estonian. The review process will consist of three stages: a title review to identify articles of interest, this will be followed by an abstract review and finally, a full-text review. These three stages will be conducted by two reviewers. Data will be extracted, collated and charted and a narrative synthesis of the results will be presented. Ethics and dissemination Ethical approval is not required for this scoping review. This study supports the first part of a larger programme to understand the importance of technologies in care homes. The scoping review will examine data from publicly available documentation, reports and published papers. Dissemination will be achieved through engagement with stakeholder communities, and publishing results. Our team will include representatives from the different communities involved.
  • Grau-Sanchez, Jennifer; Foley, Meabh; Hlavova, Renata; Muukkonen, Ilkka; Ojinaga-Alfageme, Olatz; Radukic, Andrijana; Spindler, Melanie; Hundevad, Bodil (2017)
    Music is a powerful, pleasurable stimulus that can induce positive feelings and can therefore be used for emotional self-regulation. Musical activities such as listening to music, playing an instrument, singing or dancing are also an important source for social contact, promoting interaction and the sense of belonging with others. Recent evidence has suggested that after retirement, other functions of music, such as self-conceptual processing related to autobiographical memories, become more salient. However, few studies have addressed the meaningfulness of music in the elderly. This study aims to investigate elderly people's habits and preferences related to music, study the role music plays in their everyday life, and explore the relationship between musical activities and emotional well-being across different countries of Europe. A survey will be administered to elderly people over the age of 65 from five different European countries (Bosnia and Herzegovina, Czechia, Germany, Ireland, and UK) and to a control group. Participants in both groups will be asked about basic sociodemographic information, habits and preferences in their participation in musical activities and emotional well-being. Overall, the aim of this study is to gain a deeper understanding of the role of music in the elderly from a psychological perspective. This advanced knowledge could help to develop therapeutic applications, such as musical recreational programs for healthy older people or elderly in residential care, which are better able to meet their emotional and social needs.
  • Varg, Sofi; Vicente, Veronica; Castren, Maaret; Lindgren, Peter; Rehnberg, Clas (2020)
    Background A decision system in the ambulance allowing alternative pathways to alternate healthcare providers has been developed for older patients in Stockholm, Sweden. However, subsequent healthcare resource use resulting from these pathways has not yet been addressed. The aim of this study was therefore to describe patient pathways, healthcare utilisation and costs following ambulance transportation to alternative healthcare providers. Methods The design of this study was descriptive and observational. Data from a previous RCT, where a decision system in the ambulance enabled alternative healthcare pathways to alternate healthcare providers were linked to register data. The receiving providers were: primary acute care centre or secondary geriatric ward, both located at the same community hospital, or the conventional pathway to the emergency department at an acute hospital. Resource use over 10 days, subsequent to assessment with the decision system, was mapped in terms of healthcare pathways, utilisation and costs for the 98 included cases. Results Almost 90% were transported to the acute care centre or geriatric ward. The vast majority arriving to the geriatric ward stayed there until the end of follow-up or until discharged, whereas patients conveyed to the acute care centre to a large extent were admitted to hospital. The median patient had 6 hospital days, 2 outpatient visits and costed roughly 4000 euros over the 10-day period. Arrival destination geriatric ward indicated the longest hospital stay and the emergency department the shortest. However, the cost for the 10-day period was lower for cases arriving to the geriatric ward than for those arriving to the emergency department. Conclusions The findings support the appropriateness of admittance directly to secondary geriatric care for older adults. However, patients conveyed to the acute care centre ought to be studied in more detail with regards to appropriate level of care.
  • Michalcova, Jana; Vasut, Karel; Airaksinen, Marja; Bielakova, Katarina (2020)
    Background Falls are common undesirable events for older adults in institutions. Even though the patient's fall risk may be scored on admission, the medication-induced fall risk may be ignored. This study developed a preliminary categorization of fall-risk-increasing drugs (FRIDs) to be added as a risk factor to the existing fall risk assessment tool routinely used in geriatric care units. Methods Medication use data of older adults who had experienced at least one fall during a hospital ward or a nursing home stay within a 2-year study period were retrospectively collected from patient records. Medicines used were classified into three risk categories (high, moderate and none) according to the fall risk information in statutory summaries of product characteristics (SmPCs). The fall risk categorization incorporated the relative frequency of such adverse drug effects (ADEs) in SmPCs that were known to be connected to fall risk (sedation, orthostatic hypotension, syncope, dizziness, drowsiness, changes in blood pressure or impaired balance). Also, distribution of fall risk scores assessed on admission without considering medications was counted. Results The fall-experienced patients (n = 188, 128 from the hospital and 60 from nursing home records) used altogether 1748 medicaments, including 216 different active substances. Of the active substances, 102 (47%) were categorized as high risk (category A) for increasing fall risk. Fall-experienced patients (n = 188) received a mean of 3.8 category A medicines (n = 710), 53% (n = 375) of which affected the nervous and 40% (n = 281) the cardiovascular system. Without considering medication-related fall risk, 53% (n = 100) of the patients were scored having a high fall risk (3 or 4 risk scores). Conclusion It was possible to develop a preliminary categorization of FRIDs basing on their adverse drug effect profile in SmPCs and frequency of use in older patients who had experienced at least one documented fall in a geriatric care unit. Even though more than half of the fall-experienced study participants had high fall risk scores on admission, their fall risk might have been underestimated as use of high fall risk medicines was common, even concomitant use. Further studies are needed to develop the FRID categorization and assess its impact on fall risk.
  • Jansson, Anu; Karisto, Antti; Pitkälä, Kaisu (2021)
    Background: More than one in three older people in assisted living facilities suffer from loneliness that leads to adverse health outcomes. Group work may have the potential to improve residents' quality of life. Aims/Objectives: The purpose of this feasibility study was to thoroughly describe a facilitated group process and compare its effects on cognitively impaired (n = 6) and cognitively intact (n = 7) lonely resident groups in assisted living facilities. Material and Methods: We used a closed, occupational therapy-oriented group model designed for lonely people. The study used a qualitative, multi-method approach. Material included individual and focus group interviews, observations and the facilitators' field diaries. Results: Loneliness was reflected in diverse ways in both groups. Meaningful activities in mutual interaction played an important role in empowering the participants and enabling the development of the group process. Group processes had similar, parallel steps, from which the participants seemed to benefit. Surprisingly, the cognitively impaired group progressed towards self-direction more quickly than the cognitively intact group. Conclusions: A group process with clearly progressing steps revealed that lonely older people are capable of empowerment and self-direction - despite their frailty and cognitive impairment. Facilitators should be familiar with group processes to enable them to progress effectively.
  • Kara, Hanna; Wrede, Sirpa (2021)
    This article develops sociological knowledge on daughterhood through an analysis of how separation shapes the emotional and moral dynamics of transnational daughterhood. Building on Finch, we look at daughtering as a set of concrete social practices that constitute kinship and carry the symbolic dimension of displaying the family-like character of relationships. Within this framework, we analyse how Latin American women living in Barcelona discuss their transnational family lives and filial responsibilities. We see family as finite, evolving in the past, present and future, and develop a threefold understanding of filial love as an institution imbued with formal expectations, a strong and complex emotion, and reciprocal embodied caring. We consider persisting physical separation in migration as a circumstance that demands not only practical solutions but also ongoing moral labour that sustains transnational bonds and notions of being a ‘good enough’ daughter.
  • Sahraravand, Ahmad; Haavisto, Anna-Kaisa; Holopainen, Juha M.; Leivo, Tiina (2018)
    Purpose To describe epidemiology, causes, treatments and outcomes of all ocular injuries in southern Finland among people aged 61 and older. MethodsResultsAll new ocular trauma patients, admitted to the Helsinki University Eye Hospital, during 1year in 2011-2012. The data were from hospital records and prospectively from patient questionnaires. The follow-up time was 3months. The incidence for ocular injuries among the elderly was 38/100000/year. From 118 patients 69% were men. The mean age was 70.9years old (median 67). The hospitalization rate was 14%. Injury types were minor traumas (48%), contusions (22%), chemical injuries (10%), eyelid wounds (8%), open globe injuries (OGI; 7%) and orbital fractures (5%). The injuries occurred at home (58%), institutions (12%) and in other public places (12%). The main causes of ocular injury were falls (22%), sticks (19%), superficial foreign bodies (18%) and chemicals (12%). All OGI and 88% of contusions needed a lifelong follow-up. A permanent visual or functional impairment occurred in 15 (13%) patients. Of these 53% were OGI, 40% contusions and 7% chemical injuries. The causes of permanent injuries were falls (seven cases, 47%), work tools, sports equipment, sticks, chemicals and eyeglasses. The incidence for legal blindness was 2.3/100000. ConclusionMinor trauma was the most frequent type, and home was the location of the most occurred eye injuries. Falls were the most frequent and serious cause, but behavioural causes were not significant. Preventive measures should be directed towards the main identified causes and risk factors of the eye injuries in the elderly.
  • Aalto, Ulla L.; Finne-Soveri, H.; Kautiainen, H.; Öhman, H.; Roitto, H.-M.; Pitkälä, K. H. (2021)
    Objectives Anticholinergic burden defined by the Anticholinergic Risk Scale (ARS) has been associated with cognitive and functional decline. Associations with health-related quality of life (HRQoL) have been scarcely studied. The aim of this study was to examine the association between anticholinergic burden and HRQoL among older people living in long-term care. Further, we investigated whether there is an interaction between ARS score and HRQoL in certain underlying conditions. Design and participants Cross-sectional study in 2017. Participants were older people residing in long-term care facilities (N=2474) in Helsinki. Measurements Data on anticholinergic burden was assessed by ARS score, nutritional status by Mini Nutritional Assessment, and HRQoL by the 15D instrument. Results Of the participants, 54% regularly used ARS-defined drugs, and 22% had ARS scores >= 2. Higher ARS scores were associated with better cognition, functioning, nutritional status and higher HRQoL. When viewing participants separately according to a diagnosis of dementia, nutritional status or level of dependency, HRQoL was lower among those having dementia, worse nutritional status, or being dependent on another person's help (adjusted for age, sex, comorbidities). Significant differences within the groups according to ARS score were no longer observed. However, interactions between ARS score and dementia and dependency emerged. Conclusion In primary analysis there was an association between ARS score and HRQoL. However, this relationship disappeared after stratification by dementia, nutritional status and dependency. The reasons behind the interaction concerning dementia or dependency remain unclear and warrant further studies.
  • Öhman, H.; Karppinen, H.; Lehti, Tuuli; Knuutila, Mia T; Tilvis, R.; Strandberg, T.; Kautiainen, Hannu; Pitkälä, K. H. (2021)
    Background: Life expectancy has increased markedly in the past decades. Thus, it is of great importance to understand how people are ageing and if the trajectories of health and disability are changing over time. This study aimed to examine trends in functional abilities and health in independent cohorts of people aged 75-95 over three decades. Methods: This Helsinki Ageing Study consists of repeated cross-sectional postal surveys examining independent cohorts of old people (75, 80, 85 and 90+ years old). This study combined data from four waves (1989, 1999, 2009 and 2019). Results: In the most recent wave, there was an increase in the portion of participants who were able to walk outdoors easily (75-year-olds p=0.03, 80-year-olds p=0.002, 85-year-olds pp for linearity for the study year effect, all adjusted for sex). Fewer people in the youngest age group (75-year-olds) needed daily help from another person in 2019 compared to the earlier waves (p=0.02 for linearity for the study year). Over the past three decades, the proportions of self-reported good mobility have risen 8.7% (95% confidence interval (CI) 2.3-15.1) in 75-year-olds, 11.7% (95% CI 3.9-19.6) in 80-year-olds and 20.1% (95% CI 10.7-29.4) in 85-year-olds, after adjusting for sex. Furthermore, in 2019, more people rated their health as good and scored better in psychological well-being than in the previous waves among 75-, 80- and 85-year-olds. However, no improvements were found among 90+-year-olds in any of these variables. Conclusions: People between 75 and 85 years old are presently feeling and functioning better than their predecessors. This may be an important objective for both economics and health policy.
  • Uusi-Rasi, Kirsti; Kannus, Pekka; Karinkanta, Saija; Pasanen, Matti; Patil, Radhika; Lamberg-Allardt, Christel; Sievanen, Harri (2012)
  • Lindroos, Eeva K; Jyväkorpi, S.; Soini, H.; Muurinen, S.; Saarela, R. K. T.; Pitkala, K. H.; Suominen, M. H. (2017)
    Background: Swallowing difficulty (SWD) commonly occurs and is associated with malnutrition in old age. Less is known of how SWD is associated with various nutrient intakes. Objectives: To examine how SWD among residents in assisted living facilities. Materials and methods: In this cross-sectional study, we examined 345 residents in Helsinki in 2007. Detailed energy, protein and nutrient intakes were calculated from 1-day food diaries and compared with the Nordic Nutrition Recommendations (NNRs) as a measure of dietary adequacy. Swallowing was assessed by the closest nurse knowing the resident well. Nutritional status was assessed using the Mini-Nutritional Assessment (MNA). Results: Of the participants, 14% (n = 48) suffered from SWD, often had prior stroke, increased comorbidities and lower body-mass index. A larger proportion of residents with SWD consumed oral nutritional supplements. The MNA showed that over 52% of residents with SWD were malnourished, whereas the respective figure was 17% among residents without SWD. A large proportion of the study population had lower than recommended intakes of energy, protein and micronutrients. However, those with SWD differed significantly from those without only in higher protein and lower zinc and folic acid intakes. Conclusion: Although malnutrition was more common among those with SWD than those without, the daily intakes of energy, protein and micronutrients were similar in these groups, highlighting that the risk of malnutrition and low nutrient intakes commonly occurred in both groups of residents in assisted living facilities. (C) 2017 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.