Factors predicting nutritional status
Hierarchical multiple regression analysis confirmed that the
background characteristics of age, educational level and
current chronic diseases were significant predictors of MNA
scores. This result is consistent with previous reports of a
relationship between ageing and decreasing nutritional status
both in Western countries (Marshall et al. 2001) and in
Taiwan (Hsu 2003, Department of Health 2004). Moreover,
older adults with higher levels of education may be more
likely to obtain nutritional information and have greater
motivation to engage in healthy eating than those with lower
levels of education (Wang 1999).
Among the psychosocial factors, nutrition self-efficacy and
HLC, the only significant predictor of MNA score was
CHLC. Even after selected background characteristics were
entered into the equation, CHLC contributed significantly
and negatively to the prediction model. This finding is
consistent with results showing that CHLC scores correlated
less with effort to improve health status than PHLC scores or
IHLC scores (Zweiback 2004). According to HLC theory, as
people get older, they increasingly depend on assistance from
others and increasingly relegate their locus of control to
chance and powerful others (Lachman 1986). In particular,
the Chinese exhibit a greater tendency than Westerners to
believe that outcomes are ultimately the results of luck and
fate and therefore, they try to enjoy their later years as best
they can (Wong & Piran 1995). Unfortunately, persons with
external control orientations believe that they are less likely
to find available resources to avoid problems (Kist-Kline &
Lipnickey 1989). This lack of a proactive stance regarding
healthy eating could represent a risk to nutritional health.
Regarding albumin level, older participants with more
current chronic diseases surprisingly had higher serum
albumin levels, which usually indicate good nutritional
status. This finding is different from another nutritional
status measure used in this study, MNA score and other
reports that participants with better health conditions