Weight loss in nursing home patients: prognostic implications.

Weight loss is commonly used as a screening tool to assess quality of care and nutritional status in the nursing home setting. To evaluate the prognostic value of weight loss, the charts of 199 nursing home patients (414 nursing home patient years; mean age 87 years) were reviewed over a 3-year period. Weights recorded at nursing home admission and during the study period were compared with weights at the time of acute care hospitalization, transfer between levels of nursing home care, change in level of functional status, and death. There were no significant changes in weight before acute care hospitalizations, although patients who died lost an average of 10% of their body weight from the time of nursing home admission (P less than .001). In addition, weight loss was associated with decreased functional ability and transfer to a higher level of nursing home care. Despite the association of weight loss with subsequent morbidity and mortality, moderate weight loss of up to 20% was a poor predictor of mortality. Although weight loss is routinely used as a screening tool in the nursing home setting, it is not a sensitive marker for underlying disease. The efficacy of active intervention in nursing home patients who lose weight requires further study.