Vision impairment is a risk factor for malnutrition in older long-term care residents.

Vision impairment is a risk factor for malnutrition in older long-term care residents. | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Vision impairment is a risk factor for malnutrition in older long-term care residents. Satu K Jyvakorpi, Helena Soini, Kaisu H Pitkala, Riitta KT Saarela, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5825686/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 6 You are reading this latest preprint version Abstract Purpose To examine how vision is associated with nutritional status in long-term residents Methods A random sample of 17 assisted-living facilities and nursing home including 2513 permanent long-term care residents (age ≥ 65 years) were examined by trained nurses about various health-related aspects. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) long version and vision was estimated using a question from 15D-health-related quality of life questionnaire. Results 18% of the participants were characterised of having vision impairment. Vision impairment was an independent predictor of residents’ malnutrition (OR 1.62, 95% [1.22, 2.15], p < .001). Chewing problems (OR 2.78, 95% [2.18, 3.55], p < .001) and CDR memory item (OR 2.20, 95% [1.68, 2.87], p < 0.001) were also associated with malnutrition. Conclusion Vision impairment was associated with malnutrition, problems with oral health and poorer cognition, thus vision impairment should be considered as a risk factor for malnutrition in this vulnerable population. vision nutritional status older residents chewing problems oral health Introduction Long-term older residents often have cognitive and physical impairments accompanied with many chronic diseases [1]. Malnutrition is common in long-term care residents, and it leads to poor quality of life and increases morbidity and mortality [2,3]. Vision impairment, poor cognitive status, polypharmacy, gastro-intestinal symptoms, poor oral health, and swallowing difficulties often lead to weight loss and malnutrition in long-term care residents [2–6]. Vision impairment and malnutrition are both associated with poor self-reported health and mobility, and they may increase the risk of mortality [4–7]. In a previous study in Helsinki long-term care facilities, vision impairment was associated with malnutrition, poor cognition and chewing problems [8]. After the study, a program was launched to improve residents’ nutrition. In recent years, the population in long-term care in Finland has changed substantially. Now residents are in poorer condition, have more cognitive and physical impairments and thus need more care and assistance than previously [9]. We repeated the previous study performed 10 years earlier with this new resident population in the same setting [8]. We were especially interested in finding out how vision impairment is related to malnutrition and its’ associative factors, and finding out, whether the previous program has had positive effects on nutrition of this new population. Methods Volunteer residents from a sample of 17 assisted-living settings and nursing homes in Helsinki, Finland were recruited for this study in 2017/2018. The long-term care facilities were randomly selected within voluntary institutions. In all the institutions included, registered nurses oversaw the units and constant 24/7 assistance was available. The inclusion criteria for this present study were as follows: age ≥ 65 years, living permanently in long-term care setting, sufficient demographic information available and informed consent available. Trained nurses collected the data. The participants’ weights were measured, whereas their heights and demographic information were obtained from the medical records. The body mass index (BMI) was calculated as weight divided by height squared (kg/m2). Charlson Comorbidity Index was calculated using diagnoses retrieved from medical records [10]. The cognitive status of the residents was measured using Clinical Dementia Rating Memory item. For statistical purposes, the memory item was recoded as no dementia or mild dementia = 1, moderate or severe dementia = 2 [11]. Nutritional status was assessed, using the Mini Nutritional Assessment (MNA) long version [5]. In addition, several questions associated with oral health were assessed. These included: 1) chewing problems (yes, no); 2) dry mouth (yes, no); 3) dysphagia (yes, no) and psychological well-being with Psychological Well-Being score [12]. Vision impairment was estimated using a question from 15D health-related quality of life (HRQoL) questionnaire; 1) I see normally, i.e. I can read newspapers and TV text without difficulty (with or without glasses). 2) I can read papers and/or TV text with slight difficulty (with or without glasses). 3) I can read papers and/or TV text with considerable difficulty (with or without glasses), 4) I cannot read papers or TV text either with glasses or without, but I can see enough to walk about without guidance. 5) I cannot see enough to walk about without a guide, i.e. I am almost or completely blind [13]. Options 4–5 were considered vision impairment and for statistical purposes the options were changed to 1 to 3 = adequate vision and 4–5 = vision impairment. Ethics approvals were obtained from the Ethics Committee of the Department of Medicine at Helsinki University Hospital and the City of Helsinki (HUS/2042/2016). Informed written consent was asked from all participants or in cases of moderate to severe dementia (MMSE < 20 points), from their closest proxies. Results In total, 2513 residents participated in the study. 18 % of the participants were characterised of having vision impairment. Malnutrition according to MNA was more frequently encountered in those with vision impairment of whom 27 % was classified as malnourished compared to 15 % of those with normal vision (Table 1). In addition, those with vision impairment were older, had lower BMI and had poorer cognition. Vision impairment was associated with many eating and oral health-related problems. Those with vision impairment had more often chewing problems, experienced dry mouth and dysphagia compared to persons with normal vision. In logistic regression analysis controlling for age and gender, chewing problems, cognition and Charlson comorbidity index, vision impairment was an independent predictor of residents’ malnutrition (OR 1.62, 95% [1.22, 2.15], p<.001). Chewing problems (2.78, 95% [2.18, 3.55], p<.001) and CDR memory item (OR 2.20, 95% [1.68, 2.87], p<0.001) were also associated with malnutrition. (Table 1.) Discussion In our study, those with vision impairment were more frequently malnourished compared to those with normal vision. In addition, vision impairment was an independent predictor of malnutrition in older long-term care residents. It was also associated with oral health problems and poorer cognition. There are very few previous studies about vision and malnutrition in older long-term care setting. In a previous study conducted in the same setting 10 years prior to this study, vision impairment was similarly associated with malnutrition [8]. In a British study, home-dwelling older people with vision impairment consumed less energy and other nutrients than recommended for their age group and when compared with an age-matched control group [14]. In a systematic review of 14 studies of all age groups concluded that visual impairment significantly affects nutritional status. The included studies showed that visually impaired people had an abnormal body mass index (BMI); a higher prevalence of obesity and malnutrition, where obesity was more common in younger age group and malnutrition in older people [15]. The strengths of our study include its relatively large sample of long-term residents. All the measurements were performed by trained nurses and all the questionnaires and measurements used were validated. Moreover, demographic information and diagnoses, were retrieved from verified medical records, which increase the reliability of our results. The study was not without its limitations, as the cross-sectional design of the study prevented us from drawing conclusions about temporal relationships. Our study shows that there is still place for improvement in managing nutrition among those with vision impairment in long-term care population. Oral problems and vision impairment go hand in hand as both increase the risk of malnutrition. In conclusion, those with vision impairment were more likely malnourished, although the prevalence of malnutrition and its’ risk were high in this population in general. Vision impairment should always be considered as a risk factor for malnutrition. Thus, the residents’ nutritional status should be closely monitored and assistance with oral hygiene and when necessary, eating assistance and nutrition care provided. Declarations The authors report no conflict of interest. The sponsors had no role in the design, execution, interpretation, or writing of the study. Acknowledgements: This work was supported by the Päivikki and Sakari Sohlberg Foundation, Finland. The sponsor had no role in the design, methods, subject recruitment, data collections, analysis and preparation of paper. The researchers were independent. Vision impairment is a risk factor for malnutrition in older long-term care residents. References Boscart V, Crutchlow LE, Sheiban Taucar L, et al. Chronic disease management models in nursing homes: a scoping review. BMJ Open. 2020;10:e032316. doi: 10.1136/bmjopen-2019-032316. Suominen M, Muurinen S, Routasalo P, et al. Malnutrition and associated factors among aged residents in all nursing homes in Helsinki. Eur J Clin Nutr. 2005;59:578–583. doi: 10.1038/sj.ejcn.1602111. [DOI] [PubMed] [Google Scholar] Blaum CS, Fries BE, Fiatarone MA. Factors associated with low body mass index and weight loss in nursing home residents. J Gerontol A Biol Sci Med Sci. 1995;50:M162–M168. doi: 10.1093/gerona/50a.3.m162. Elliot, A.F., Dreer, L.E., McGwin Jr, G., Scilley, K. & Owsley, C. The personal burden of decreased vision-targeted health-related quality of life in nursing home residents. Journal of Aging and Health, 2010;22 (4), 504-521. Guigoz Y. The Mini Nutritional Assessment (MNA) review of the literature--What does it tell us? J Nutr Health Aging. 2006 Nov-Dec;10(6):466-85 Söderström, L, Rosenblad A. Long-term association between malnutrition and all-cause mortality among older adults: A 10-years follow-up study Clinical Nutrition 2023;12;2554 - 61 Rubin G, Roche KB, Prasada-Rao P, Fried L. Visual Impairment and Disability in Older Adults. Optometry and Vision Science 1994;71(12):750-60. Muurinen SM, Soini HH, Suominen MH, Saarela RK, Savikko NM, Pitkälä KH. Vision impairment and nutritional status among older assisted living residents. Arch Gerontol Geriatr. 2014;58(3):384-7. doi: 10.1016/j.archger.2013.12.002. THL. Kotihoito 2020. Internet: https://thl.fi/fi/web/ikaantyminen/muuttuvat-vanhuspalvelut/kotihoito. Accessed Feb, 6th, 2021. (in Finnish). Charlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol. 1994;47(11):1245-51. doi: 10.1016/0895-4356(94)90129-5. Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia. Br J Psychiatry. 1982 Jun;140:566-72. doi: 10.1192/bjp.140.6.566. Routasalo PE, Tilvis RS, Kautiainen H, Pitkala KH. Effects of psychosocial group rehabilitation on social functioning, loneliness and well-being of lonely, older people: randomized controlled trial. J Adv Nurs 2009;65(2):297-305. doi: 10.1111/j.1365-2648.2008.04837.x. Sintonen H. The 15D instrument of health-related quality of life: properties and applications. Ann Med. 2001;33(5):328-36. doi: 10.3109/07853890109002086. Jones N, Bartlett HE. Comparison of the eating behaviour and dietary consumption in older adults with and without visual impairment. Br J Nutr. 2020; 123:712-720. doi:10.1017/S000711451900312X. Jones N, Bartlett HE. The impact of visual impairment on nutritional status: A systematic review. Br J Visual Impairment 2018; 36:17-30. https://doi.org/10.1177/0264619617730860 Table Table 1. Baseline characteristics of residents in long-term facilities divided according to their vision and variables associated with residents’ nutritional status. Characteristics Normal vision Vision impairment p - value Participants, number (%) 2065 (82) 448 (17) <.001 1 Age, years 82.8 (8.6) 85.8 (8.8) <.001 Sex, % female male 73 75.2 27 24.8 .330 BMI, kg/m 2 , (SD) 25.3 (5.2) 23.6 (5.0) <.001 CDR, memory, % moderete or sever dementia 54.5 73.7 <.001 MNA, score, (SD) Normal nutritional status (%) Risk of malnutrition (%) Malnourished (%) 20.4 (3.6) 20 65 15 18.9 (3.6) 11 61 27 <.001 <.001 Self-rated health, % good self-rated health 80.3 19.7 <.001 Charlson comorbidity index, (SD) 8.9 (3.6) 8.4 (3.7) .003 PWB, score , (SD) 0.72 (0.2) 0.68 (0.3) .003 Chewing prolems, % 26 45 <.001 Dry mouth, % 14 23 <.001 Dysphagia, % 19 30 <.001 Odd’s ratio for nutritional status Model Odd’s ratio 95% p- value Age 1.00 [.99, 1.02] .965 Sex .846 [.64, 1.13] .251 Vision impairment 1.62 [1.22, 2.25] 1 2.196 [1.68, 2.87] <.001 Chewing problems 2.781 [2.18, 3.55] <.001 Charlson comorbidity index 1.019 [.96, 1.11] .562 1 Statistical tests: Differences between groups were analyzed using the Chi2 -test or Fisher’s exact test for categorical variables and t-test for continuous variables. Odd’s ratio was analyzed using logistic regression analysis. BMI = body mass index; CDR= Clinical Dementia Rating 11 ; MNA = Mini Nutritional Assessment 5 ; PWB = Psychological Well-Being 12 Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Major revisions 27 May, 2025 Reviewers agreed at journal 23 Feb, 2025 Reviewers invited by journal 03 Feb, 2025 Editor invited by journal 25 Jan, 2025 Editor assigned by journal 16 Jan, 2025 First submitted to journal 13 Jan, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5825686","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":410611036,"identity":"2a1188d6-d7f6-4aa7-8da3-0834c6a46b02","order_by":0,"name":"Satu K Jyvakorpi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABC0lEQVRIie2RsWrDMBCGDwTVcpDVhWK/goqXQEv6KhaCZAuG7lkC9WLwKuhL5A0iOPCk1KshS4NfoCVLhg61o2YIjTJn0Adafu7T/UIAgcDNgn8HxHMGHMCAiYAvfePsTJlmQ3BUkK4pp00AlLnA9IG5LCRFU0fwQLIqqd7neTMfMb6j3I4B+WVFWHU3dJB686betdi+3i9RkG77kHkUcEoKDaYMxVauCIHwK4IXj5JUnVMSp3zINfHPo+LbAq3bEotNOShGrhgIwmvF2i4dZziLH22tmBZKaurfgjZCn5JUctd+l08YW0Us/5nIqii6PdaLGEfG06xHlu6jz65F//zAYfFfCQQCgcCJXzSxVfQm2MwDAAAAAElFTkSuQmCC","orcid":"https://orcid.org/0000-0001-5901-3584","institution":"Helsingin Yliopisto","correspondingAuthor":true,"prefix":"","firstName":"Satu","middleName":"K","lastName":"Jyvakorpi","suffix":""},{"id":410611037,"identity":"b4a539ce-b4a1-463f-8864-69c123d3677d","order_by":1,"name":"Helena Soini","email":"","orcid":"","institution":"University of Helsinki: Helsingin Yliopisto","correspondingAuthor":false,"prefix":"","firstName":"Helena","middleName":"","lastName":"Soini","suffix":""},{"id":410611038,"identity":"f32455b6-78ce-4e96-a786-0b886b19753e","order_by":2,"name":"Kaisu H Pitkala","email":"","orcid":"","institution":"University of Helsinki: Helsingin Yliopisto","correspondingAuthor":false,"prefix":"","firstName":"Kaisu","middleName":"H","lastName":"Pitkala","suffix":""},{"id":410611039,"identity":"daa078d7-df01-4d05-9c50-2f088acf876d","order_by":3,"name":"Riitta KT Saarela","email":"","orcid":"","institution":"City of Helsinki: Helsingin Kaupunki","correspondingAuthor":false,"prefix":"","firstName":"Riitta","middleName":"KT","lastName":"Saarela","suffix":""},{"id":410611040,"identity":"6755463a-721f-4c27-bef5-f8bf0b08b72b","order_by":4,"name":"Seija Muurinen","email":"","orcid":"","institution":"University of Helsinki: Helsingin Yliopisto","correspondingAuthor":false,"prefix":"","firstName":"Seija","middleName":"","lastName":"Muurinen","suffix":""}],"badges":[],"createdAt":"2025-01-14 09:13:20","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5825686/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5825686/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":75551189,"identity":"f7692682-2ed4-4e75-bd96-85cafacd7340","added_by":"auto","created_at":"2025-02-05 18:36:02","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":327278,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5825686/v1/b0cee547-f326-40ab-9235-38ef2aca6e5c.pdf"}],"financialInterests":"","formattedTitle":"Vision impairment is a risk factor for malnutrition in older long-term care residents.","fulltext":[{"header":"Introduction","content":"\u003cp\u003eLong-term older residents often have cognitive and physical impairments accompanied with many chronic diseases [1]. Malnutrition is common in long-term care residents, and it leads to poor quality of life and increases morbidity and mortality [2,3]. Vision impairment, poor cognitive status, polypharmacy, gastro-intestinal symptoms, poor oral health, and swallowing difficulties often lead to weight loss and malnutrition in long-term care residents [2–6]. Vision impairment and malnutrition are both associated with poor self-reported health and mobility, and they may increase the risk of mortality [4–7]. In a previous study in Helsinki long-term care facilities, vision impairment was associated with malnutrition, poor cognition and chewing problems [8]. After the study, a program was launched to improve residents’ nutrition. In recent years, the population in long-term care in Finland has changed substantially. Now residents are in poorer condition, have more cognitive and physical impairments and thus need more care and assistance than previously [9]. We repeated the previous study performed 10 years earlier with this new resident population in the same setting [8]. We were especially interested in finding out how vision impairment is related to malnutrition and its’ associative factors, and finding out, whether the previous program has had positive effects on nutrition of this new population.\u003c/p\u003e \u003cp\u003e\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eVolunteer residents from a sample of 17 assisted-living settings and nursing homes in Helsinki, Finland were recruited for this study in 2017/2018. The long-term care facilities were randomly selected within voluntary institutions. In all the institutions included, registered nurses oversaw the units and constant 24/7 assistance was available. The inclusion criteria for this present study were as follows: age ≥ 65 years, living permanently in long-term care setting, sufficient demographic information available and informed consent available. Trained nurses collected the data. The participants’ weights were measured, whereas their heights and demographic information were obtained from the medical records. The body mass index (BMI) was calculated as weight divided by height squared (kg/m2). Charlson Comorbidity Index was calculated using diagnoses retrieved from medical records [10]. The cognitive status of the residents was measured using Clinical Dementia Rating Memory item. For statistical purposes, the memory item was recoded as no dementia or mild dementia = 1, moderate or severe dementia = 2 [11]. Nutritional status was assessed, using the Mini Nutritional Assessment (MNA) long version [5]. In addition, several questions associated with oral health were assessed. These included: 1) chewing problems (yes, no); 2) dry mouth (yes, no); 3) dysphagia (yes, no) and psychological well-being with Psychological Well-Being score [12]. Vision impairment was estimated using a question from 15D health-related quality of life (HRQoL) questionnaire; 1) I see normally, i.e. I can read newspapers and TV text without difficulty (with or without glasses). 2) I can read papers and/or TV text with slight difficulty (with or without glasses). 3) I can read papers and/or TV text with considerable difficulty (with or without glasses), 4) I cannot read papers or TV text either with glasses or without, but I can see enough to walk about without guidance. 5) I cannot see enough to walk about without a guide, i.e. I am almost or completely blind [13]. Options 4–5 were considered vision impairment and for statistical purposes the options were changed to 1 to 3 = adequate vision and 4–5 = vision impairment.\u003c/p\u003e\u003cp\u003eEthics approvals were obtained from the Ethics Committee of the Department of Medicine at Helsinki University Hospital and the City of Helsinki (HUS/2042/2016). Informed written consent was asked from all participants or in cases of moderate to severe dementia (MMSE \u0026lt; 20 points), from their closest proxies.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eIn total, 2513 residents participated in the study. 18 % of the participants were characterised of having vision impairment. Malnutrition according to MNA was more frequently encountered in those with vision impairment of whom 27 % was classified as malnourished compared to 15 % of those with normal vision (Table 1). In addition, those with vision impairment were older, had lower BMI and had poorer cognition. \u0026nbsp;Vision impairment was associated with many eating and oral health-related problems. Those with vision impairment had more often chewing problems, experienced dry mouth and dysphagia compared to persons with normal vision.\u003c/p\u003e\n\u003cp\u003eIn logistic regression analysis controlling for age and gender, chewing problems, cognition and Charlson comorbidity index, vision impairment was an independent predictor of residents’ malnutrition (OR 1.62, 95% [1.22, 2.15], p\u0026lt;.001). Chewing problems (2.78, 95% [2.18, 3.55], p\u0026lt;.001) and CDR memory item (OR 2.20, 95% [1.68, 2.87], p\u0026lt;0.001) were also associated with malnutrition. (Table 1.)\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn our study, those with vision impairment were more frequently malnourished compared to those with normal vision. In addition, vision impairment was an independent predictor of malnutrition in older long-term care residents. It was also associated with oral health problems and poorer cognition.\u003c/p\u003e \u003cp\u003eThere are very few previous studies about vision and malnutrition in older long-term care setting. In a previous study conducted in the same setting 10 years prior to this study, vision impairment was similarly associated with malnutrition [8]. In a British study, home-dwelling older people with vision impairment consumed less energy and other nutrients than recommended for their age group and when compared with an age-matched control group [14]. In a systematic review of 14 studies of all age groups concluded that visual impairment significantly affects nutritional status. The included studies showed that visually impaired people had an abnormal body mass index (BMI); a higher prevalence of obesity and malnutrition, where obesity was more common in younger age group and malnutrition in older people [15].\u003c/p\u003e \u003cp\u003e The strengths of our study include its relatively large sample of long-term residents. All the measurements were performed by trained nurses and all the questionnaires and measurements used were validated. Moreover, demographic information and diagnoses, were retrieved from verified medical records, which increase the reliability of our results. The study was not without its limitations, as the cross-sectional design of the study prevented us from drawing conclusions about temporal relationships.\u003c/p\u003e \u003cp\u003eOur study shows that there is still place for improvement in managing nutrition among those with vision impairment in long-term care population. Oral problems and vision impairment go hand in hand as both increase the risk of malnutrition. In conclusion, those with vision impairment were more likely malnourished, although the prevalence of malnutrition and its\u0026rsquo; risk were high in this population in general. Vision impairment should always be considered as a risk factor for malnutrition. Thus, the residents\u0026rsquo; nutritional status should be closely monitored and assistance with oral hygiene and when necessary, eating assistance and nutrition care provided.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eThe authors report no conflict of interest. The sponsors had no role in the design, execution, interpretation, or writing of the study.\u003c/p\u003e\u003ch2\u003eAcknowledgements:\u003c/h2\u003e \u003cp\u003eThis work was supported by the P\u0026auml;ivikki and Sakari Sohlberg Foundation, Finland. The sponsor had no role in the design, methods, subject recruitment, data collections, analysis and preparation of paper. The researchers were independent.\u003c/p\u003e \u003cp\u003eVision impairment is a risk factor for malnutrition in older long-term care residents.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBoscart V, Crutchlow LE, Sheiban Taucar L, et al. Chronic disease management models in nursing homes: a scoping review. BMJ Open. 2020;10:e032316. doi: 10.1136/bmjopen-2019-032316.\u003c/li\u003e\n\u003cli\u003eSuominen M, Muurinen S, Routasalo P, et al. Malnutrition and associated factors among aged residents in all nursing homes in Helsinki. Eur J Clin Nutr. 2005;59:578\u0026ndash;583. doi: 10.1038/sj.ejcn.1602111. [DOI] [PubMed] [Google Scholar]\u003c/li\u003e\n\u003cli\u003eBlaum CS, Fries BE, Fiatarone MA. Factors associated with low body mass index and weight loss in nursing home residents. J Gerontol A Biol Sci Med Sci. 1995;50:M162\u0026ndash;M168. doi: 10.1093/gerona/50a.3.m162.\u003c/li\u003e\n\u003cli\u003eElliot, A.F., Dreer, L.E., McGwin Jr, G., Scilley, K. \u0026amp; Owsley, C. The personal burden of decreased vision-targeted health-related quality of life in nursing home residents. Journal of Aging and Health, 2010;22 (4), 504-521.\u003c/li\u003e\n\u003cli\u003eGuigoz Y. The Mini Nutritional Assessment (MNA) review of the literature--What does it tell us? J Nutr Health Aging. 2006 Nov-Dec;10(6):466-85\u003c/li\u003e\n\u003cli\u003eS\u0026ouml;derstr\u0026ouml;m, L, Rosenblad A. Long-term association between malnutrition and all-cause mortality among older adults: A 10-years follow-up study Clinical Nutrition 2023;12;2554 - 61\u003c/li\u003e\n\u003cli\u003eRubin G, Roche KB, Prasada-Rao P, Fried L. Visual Impairment and Disability in Older Adults. Optometry and Vision Science 1994;71(12):750-60.\u003c/li\u003e\n\u003cli\u003eMuurinen SM, Soini HH, Suominen MH, Saarela RK, Savikko NM, Pitk\u0026auml;l\u0026auml; KH. Vision impairment and nutritional status among older assisted living residents. Arch Gerontol Geriatr. 2014;58(3):384-7. doi: 10.1016/j.archger.2013.12.002.\u003c/li\u003e\n\u003cli\u003eTHL. Kotihoito 2020. Internet: https://thl.fi/fi/web/ikaantyminen/muuttuvat-vanhuspalvelut/kotihoito. Accessed Feb, 6th, 2021. (in Finnish).\u003c/li\u003e\n\u003cli\u003eCharlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol. 1994;47(11):1245-51. doi: 10.1016/0895-4356(94)90129-5.\u003c/li\u003e\n\u003cli\u003eHughes CP, Berg L, Danziger WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia. Br J Psychiatry. 1982 Jun;140:566-72. doi: 10.1192/bjp.140.6.566. \u003c/li\u003e\n\u003cli\u003eRoutasalo PE, Tilvis RS, Kautiainen H, Pitkala KH. Effects of psychosocial group rehabilitation on social functioning, loneliness and well-being of lonely, older people: randomized controlled trial. J Adv Nurs 2009;65(2):297-305. doi: 10.1111/j.1365-2648.2008.04837.x. \u003c/li\u003e\n\u003cli\u003eSintonen H. The 15D instrument of health-related quality of life: properties and applications. Ann Med. 2001;33(5):328-36. doi: 10.3109/07853890109002086.\u003c/li\u003e\n\u003cli\u003eJones N, Bartlett HE. Comparison of the eating behaviour and dietary consumption in older adults with and without visual impairment. Br J Nutr. 2020; 123:712-720. doi:10.1017/S000711451900312X.\u003c/li\u003e\n\u003cli\u003eJones N, Bartlett HE. The impact of visual impairment on nutritional status: A systematic review. Br J Visual Impairment 2018; 36:17-30. https://doi.org/10.1177/0264619617730860\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Table","content":"\u003cp\u003eTable 1. Baseline characteristics of residents in long-term facilities divided according to their vision and variables associated with residents\u0026rsquo; nutritional status.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003eCharacteristics\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003eNormal vision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003eVision impairment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003ep - value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003eParticipants, number (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003e2065 (82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e448 (17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003eAge, years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003e82.8 (8.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e85.8 (8.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003eSex, %\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;female\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e73\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e75.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003cp\u003e24.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e.330\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003eBMI, kg/m\u003csup\u003e2\u003c/sup\u003e, (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003e25.3 (5.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e23.6 (5.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003eCDR, memory, %\u003c/p\u003e\n \u003cp\u003emoderete or sever dementia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e54.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e73.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003eMNA, score, (SD)\u003c/p\u003e\n \u003cp\u003eNormal nutritional status (%)\u003c/p\u003e\n \u003cp\u003eRisk of malnutrition (%)\u003c/p\u003e\n \u003cp\u003eMalnourished (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003e20.4 (3.6)\u003c/p\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e18.9 (3.6)\u003c/p\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003eSelf-rated health, %\u003c/p\u003e\n \u003cp\u003egood self-rated health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e80.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e19.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003eCharlson comorbidity index, (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003e8.9 (3.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e8.4 (3.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e.003\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003ePWB, score , (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003e0.72 (0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e0.68 (0.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e.003\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003eChewing prolems, %\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003eDry mouth, %\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003eDysphagia, %\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOdd\u0026rsquo;s ratio for nutritional status\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003eModel\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003eOdd\u0026rsquo;s ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e95%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003ep- value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e[.99, 1.02]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e.965\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003e.846\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e[.64, 1.13]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e.251\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003eVision impairment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003e1.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e[1.22, 2.25]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003ecognition CDR memory \u0026gt;1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003e2.196\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e[1.68, 2.87]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003eChewing problems\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003e2.781\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e[2.18, 3.55]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.5476%;\"\u003e\n \u003cp\u003eCharlson comorbidity index\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.2873%;\"\u003e\n \u003cp\u003e1.019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e[.96, 1.11]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0826%;\"\u003e\n \u003cp\u003e.562\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eStatistical tests: Differences between groups were analyzed using the Chi2 -test or Fisher\u0026rsquo;s exact test for categorical variables and t-test for continuous variables. Odd\u0026rsquo;s ratio was analyzed using logistic regression analysis.\u003c/p\u003e\n\u003cp\u003eBMI = body mass index; CDR= Clinical Dementia Rating\u003csup\u003e11\u003c/sup\u003e; MNA = Mini Nutritional Assessment\u003csup\u003e5\u003c/sup\u003e; PWB = Psychological Well-Being\u003csup\u003e12\u003c/sup\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"european-geriatric-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"EGEM","sideBox":"Learn more about [European Geriatric Medicine](https://www.springer.com/journal/41999)","snPcode":"41999","submissionUrl":"https://www.editorialmanager.com/egem/default2.aspx","title":"European Geriatric Medicine","twitterHandle":"","acdcEnabled":false,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"vision, nutritional status, older residents; chewing problems; oral health","lastPublishedDoi":"10.21203/rs.3.rs-5825686/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5825686/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003ePurpose\u003c/b\u003e\u003c/p\u003e \u003cp\u003eTo examine how vision is associated with nutritional status in long-term residents\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e \u003cp\u003eA random sample of 17 assisted-living facilities and nursing home including 2513 permanent long-term care residents (age\u0026thinsp;\u0026ge;\u0026thinsp;65 years) were examined by trained nurses about various health-related aspects. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) long version and vision was estimated using a question from 15D-health-related quality of life questionnaire.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003e18% of the participants were characterised of having vision impairment. Vision impairment was an independent predictor of residents\u0026rsquo; malnutrition (OR 1.62, 95% [1.22, 2.15], p\u0026thinsp;\u0026lt;\u0026thinsp;.001). Chewing problems (OR 2.78, 95% [2.18, 3.55], p\u0026thinsp;\u0026lt;\u0026thinsp;.001) and CDR memory item (OR 2.20, 95% [1.68, 2.87], p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were also associated with malnutrition.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion\u003c/b\u003e\u003c/p\u003e \u003cp\u003eVision impairment was associated with malnutrition, problems with oral health and poorer cognition, thus vision impairment should be considered as a risk factor for malnutrition in this vulnerable population.\u003c/p\u003e","manuscriptTitle":"Vision impairment is a risk factor for malnutrition in older long-term care residents.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-02-05 18:27:54","doi":"10.21203/rs.3.rs-5825686/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revisions","date":"2025-05-27T14:22:04+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"","date":"2025-02-23T16:10:12+00:00","index":0,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-02-03T15:08:36+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"European Geriatric Medicine","date":"2025-01-25T08:32:25+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-01-16T06:56:51+00:00","index":"","fulltext":""},{"type":"submitted","content":"European Geriatric Medicine","date":"2025-01-14T04:12:23+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"european-geriatric-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"EGEM","sideBox":"Learn more about [European Geriatric Medicine](https://www.springer.com/journal/41999)","snPcode":"41999","submissionUrl":"https://www.editorialmanager.com/egem/default2.aspx","title":"European Geriatric Medicine","twitterHandle":"","acdcEnabled":false,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"1e353d7c-5fed-4058-bee0-1c699a2c44e6","owner":[],"postedDate":"February 5th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-07-12T16:08:06+00:00","versionOfRecord":[],"versionCreatedAt":"2025-02-05 18:27:54","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5825686","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5825686","identity":"rs-5825686","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}