Intergenerational Mealtimes in Adult Day Care Settings: Impact of a Pilot Randomised Control Study on the Well-Being, Health, and Food Intake of Older Adults

Abstract

Background/Objectives: Empirical evidence on intergenerational commensality in institutional care settings remains scarce. This pilot and feasibility study evaluated the preliminary impact of an innovative intergenerational mealtime model on older adults’ subjective well-being, self-esteem, perceived health, and food consumption in an adult day care setting. Methods: A 16-week wait-list randomised controlled pilot trial with a sequential explanatory mixed-methods design was conducted in an intergenerational centre in southern Spain. Twenty-two older adults who reside in a community living setting and attend a day care service were randomly assigned to two intergenerational dining intervention/waiting-list groups or a control group. Participants in the intervention/waiting-list groups had lunch four times per week with children 2–3 years of age, following a structured protocol. The quantitative outcomes examined included subjective well-being (WHO-5 Well-Being Index), self-esteem (Rosenberg scale), perceived health (EuroQol EQ-5D), and objective assessment of plate leftovers using photographic records and the Comstock visual estimation method. Qualitative data were collected through semi-structured interviews and ethnographic observation. The trial was registered at ClinicalTrials.gov (NCT06996418). Results: Across the study period, intervention, waiting-list, and control groups showed preliminary improvements in subjective well-being and self-esteem, but with no significant group-by-time interaction. In contrast, mixed-effects models revealed an encouraging significant reduction in plate leftovers among older adults during intergenerational meals, particularly in second courses. The reduction was consolidated during the post-intervention follow-up. Qualitative findings showed perceived improvements in emotional well-being, motivation, and appetite, thus highlighting potential relational and affective mechanisms underlying changes in eating behaviour. Conclusions: This pilot study shows promise for intergenerational commensality in adult day care settings and provides preliminary evidence of its potential to promote well-being and self-esteem and reduce food waste among older adults. Larger, multi-centre, appropriately powered trials are warranted to validate these findings.