To investigate factors associated with poor nutritional status in older people living in residential care facilities.

188 residents (136 women, 52 men) with physical and cognitive impairments participated. Mean age was 84.7 y (range 65–100). The Mini Nutritional Assessment (MNA), Barthel ADL Index, Mini Menial State Examination (MMSE), and Geriatric Depression Scale were used to evaluate nutritional status, activities of daily living, cognitive status and depressive symptoms. Medical conditions, clinical characteristics and prescribed drugs were recorded. Univariate and multivariate regressions were used to investigate associations with MNA scores.

The mean MNA score was 20.5 ±3.7 (range 5.5–27) and the median was 21 (interquartile range (IQR) 18.8–23.0). Fifteen per cent of participants were classified as malnourished and 66% at risk of malnutrition. Lower MNA scores were independently associated with urinary-tract infection (UTI) during the preceding year (β = − 0.21, P = 0.006), lower MMSE scores (β = 0.16, P = 0.030), and dependent in feeding (β = − 0.14, P = 0.040).

The majority of participants were at risk of or suffering from malnutrition. Urinary tract infection during the preceding year was independently associated with poor nutritional status. Dependence in feeding was also associated with poor nutritional status as were low MMSE scores for women. Prospective observations and randomized controlled trials are necessary to gain an understanding of a causal association between malnutrition and UTI.