Introduction: More than one-third of community-dwelling Canadians aged 65 and older are at nutritional risk (NR). NR is related to increased morbidity and mortality. It is critical to understand the factors associated with NR.
Objectives: To determine if the Social Ecological Model (SEM) can be used to analyze NR in community-dwelling older adults in Canada.
Methods: Three theories of aging examined NR in older adults: the social capital theory, the life-span theory of social support (social support theory), and the social ecological model (SEM). The databases CINAHL, Embase, Medline, and Google Scholar were searched for articles published since 1990 related to NR and these theories of aging. Search terms used the subject headings associated with each database (i.e. MESH for Medline). First titles, then abstracts were screened for relevance. After retrieving relevant articles, the factors relating to NR were mapped onto the theories.
Results: SEM was the most appropriate theory as it best explained NR. The social support and social capital theories can be incorporated into SEM, at the interpersonal and community levels. All of the factors associated with NR in older adults identified in the literature can be mapped onto SEM. NR is also affected by factors at all levels within SEM and by interactions between levels. Other theories only address some of the factors associated with NR.
Conclusions: SEM can be used to examine the factors associated with NR in community-dwelling older adults and can guide research, and program development and evaluation. Understanding these factors is critical for improving NR in older adults.
Significance to the field of dietetics: Dietitians are the health care professionals best positioned to assess community-dwelling older adults for nutritional risk and to implement nutrition interventions designed to address or mitigate these contributing factors. SEM can be used to guide the development and evaluation of these interventions. If nutritional risk can be reduced, this could improve the health and quality of life for many community-dwelling older adults.

Using the Social Ecological Model to Explore Nutritional Risk in Community-Dwelling Older Adults