(P20-029-24) Are Participants in Older Americans Act (OAA) Programs at Risk of Malnutrition?

Objectives: 1) Estimate the prevalence of malnutrition risk (MR) among older adults participating in Older Americans Act (OAA) programs (i.e., home-delivered meals (HDM), congregate meals (CM), homemaker (HM), case management (CS) and transportation (T)), and 2) assess associations with MR and duration of program participation, food insecurity, and % daily food intake among HMD and CM participants.

Methods: Nationally representative data from the 2022 National Survey of Older Americans Act Participants (NSOAAP) were analyzed. MR was defined using the Malnutrition Screening Tool, a 2-question tool on reported recent unintentional weight loss and decreased food intake due to poor appetite (scored 0 to 5; ≥2 =MR). While malnutrition encompasses undernutrition and overnutrition, our report focuses on undernutrition. Prevalence was estimated within each OAA program included in NSOAAP and by selected demographic and health-related characteristics. Multivariable logistic regression models (for HDM & CM participants combined) were constructed to assess associations between MR and duration of program participation, food insecurity, and % daily food intake met by OAA meals, adjusting for sex age, race, rurality, food insecurity, income, and living alone.

Results: The prevalence of MR was 19.4% (HDM, n=941), 16.7% (CM, n=738), 22.5% (HM, n=457) 22.1% (CS, n=490), and 21.4% (T, n=905) and no differences between programs1) were observed. In fully adjusted regression models, participants who had received HDMs or CMs for 2-5 years were 59.6% less likely to be classified as “at risk for malnutrition” compared with those who had only been receiving HDMs or CMs for 6 months or less, (OR 0.404 [0.226, 0.724; p < 0.0217]). Associations were not observed for MR and food insecurity or MR and % daily food intake from OAA meals.

Conclusions: In 2022, MR was high among meal program and other OAA program participants, indicating need for continued malnutrition monitoring, assessment, and appropriate interventions. MR was inversely associated with longer participation in HDM and CM.

Funding Sources: None