What refrigerator contents can tell us about health

Background: Refrigerator contents may provide observable clues to food availability, cooling resources, medication management, and the health and social circumstances of older adults. Aims: To examine associations between refrigerator characteristics and the vulnerability profiles of community-dwelling older adults in Hong Kong and to consider the potential use of refrigerator observation during community home visits. Methods: This cross-sectional study used data from the first two years of a community project designed to mitigate the health effects of hot weather among vulnerable adults aged over 60 years. Refrigerator contents and storage conditions were assessed visually during home visits, supported by photographs. Associations with heat-risk level, frailty status, and multimorbidity, defined as five or more chronic diseases, were examined using chi-square tests and logistic regression. Heat-risk and frailty analyses were unadjusted and considered exploratory. Multivariable models for multimorbidity were adjusted for demographic, socioeconomic, housing, and functional characteristics. Results: Refrigerator assessments were available for 894 participants. A freezer compartment was present in 83.0% of refrigerators, while 28.0% were overloaded, 7.5% were empty, and 27.4% contained medication. A freezer compartment, ice packs, and fresh or frozen meat were associated with lower odds of high heat risk, whereas leftovers and an empty refrigerator were associated with higher odds. Ice was associated with a lower proportion of participants classified as frail, while refrigerated medication storage was associated with a higher proportion classified as frail. After adjustment, an overloaded refrigerator remained associated with multimorbidity (adjusted odds ratio 1.75, 95% confidence interval 1.21-2.52). Refrigerated medication storage was associated with multimorbidity in a secondary model, but this association was attenuated after adjustment for other refrigerator characteristics. Conclusion: Refrigerator contents may provide useful clues to food provision, cooling preparedness, and health-management needs among vulnerable older adults. Refrigerator observation during home visits may help community-service providers identify unmet needs and provide personalised advice. Further longitudinal research is needed before this approach can be used as a formal screening method.