Entering Canadian long-term care with obesity: Exploring initial assessment data

The Canadian population is aging, and rates of obesity are also on the rise. These demographic changes have implications for the long-term care (LTC) system in Canada that need to be better understood, yet little is known about the population with obesity in Canadian LTC. In this thesis, an exploratory analysis of residents newly entering LTC between 2010 and 2020 is provided. Cross-tabulations and chi-squared statistical testing (p≤0.001) were employed to analyze retroactive, consecutive cross-sectional initial assessment data (N=350,348) from the Canadian Institute for Health Information’s (CIHI) Community Care Reporting System (CCRS) to explore the levels of obesity, demographic characteristics (age, sex, primary language, rural or urban previous residency), rates of health conditions, and independence and assistance levels of activities of daily living (ADLs). Over the full study period, the rate of obesity for the population entering LTC was 19%, and 7% entered with at least class II obesity (≥35 kg/m2). Rates of obesity and BMI obesity categories tended to increase incrementally over the course of the study period. Those entering LTC with obesity were more likely to be younger, female, English/French speaking, and arriving from rural areas. Individuals with obesity had lower rates of dementia and higher levels of independence when performing ADLs. They also exhibited higher rates of diabetes and a greater need for two+ person assistance for ADLs. This thesis begins to fill in the gap in our understanding of the population with obesity in LTC, providing a broad picture of the heterogeneous nature of the population, including important differences in health and ADL profiles across the three obesity BMI categories (i.e., classes I-III).