Evaluation of nutritional status and skin condition among elderly residents in a long-term care hospital

Objective: The availability of nutritional screening tools for older adults is limited, depending on their physical characteristics or the setting. We investigated the relationships between various nutritional indicators and skin conditions as possible screening indicators. Design: Cross-sectional study. Setting: A long-term care hospital in Japan. Participants: 90 elderly residents who were aged ≥65 years old. Measurements: The nutritional status of the residents was assessed by body mass index (BMI), involuntary weight loss, arm muscle area, and serum albumin and prealbumin levels. Leg skin condition was evaluated by: 1) functional factors including pH, hydration and transepidermal water loss; 2) skin color including Lc a*, b*and individual typology angle (ITA^o) using a tristimulus colorimetric instrument; and 3) skin morphology. Repeated measures analysis of variance was employed, adjusted for demographic characteristics and room temperature, with measurement site as the repeated variable. Results: Among the skin indicators, b*was significantly correlated with BMI (p=0.018), and weight loss over the previous month (p=0.042) and 6 months (p=0.002). Additionally, ITA^o was associated with weight loss over 1 month (p=0.013). Both b*and ITA ^o showed the area under the receiver operating characteristic curve of 0.64 to 0.80 for weight loss >2% over 1 month. Conclusions: Residents with poorer nutritional status had yellower and darker skin color.