Objectives: We studied the nutritional status and the effects of nutritional intervention on body weight, cognition and activities of daily life (ADL)-function in demented individuals. Design: Controlled non-randomised study. Setting: Group-living for demented elderly (GLD), ie community assisted housing. Subjects and interventions: Twenty-two residents living in one of two units (GLD-I), received oral liquid supplements (1720 kJ=410 kcal=day) and the personnel of the GLD-I were given nutritional education. Fourteen residents in the other unit (GLD-C) served as controls. After 6 months 21 (83 (4) y, 81% women) and 12 (85 (4) y, 100% women) of the participants, respectively, were re-examined according to body mass index (BMI, kg=m 2 ), cognitive function (Mini Mental State Examination (MMSE, 0 -30 p) and Clinical Dementia Rating Scale (CDR) and the Katz' ADL index. Results: Body mass index (BMI) 20 was found in 19% of the participants and 44% had BMI 23. BMI correlated with MMSE (r ¼ 0.43, P < 0.01). The weight of the residents in the intervention group increased by 3.4 (3) kg (P ¼ 0.001) at follow-up, whereas the weight remained unchanged in the control group. The cognitive function was low at the start in both groups, ie MMSE 9 and no apparent positive effect of the nutritional intervention was seen. In addition, the ADL functions appeared to deteriorate in both groups. Conclusions: Being underweight was common among demented elderly in group-living and was related to low cognitive capacity. Five months of oral supplementation, along with education of personnel, was followed by a weight gain. In this study the nutritional treatment did not affect the rate of decline in cognitive function or Katz' ADL index. Sponsorship: Supported by grants from the Swedish National Board of Health and Social Welfare. Semper Foods AB provided the liquid supplements.

Objective: We investigated the nutritional, cognitive and functional status in residents of two service-flat (SF) complexes and the effects of a nutrition education programme for care staff. Design: Controlled nonrandomised study. Setting: Two SF complexes, that is community-assisted accommodation. Subjects: Of 115 eligible SF residents, 80 subjects participated (age 8377 y, 70% women). Intervention: The nutritional status was assessed using body mass index (BMI, kg/m 2 ), subjective global assessment (SGA), serum concentrations of albumin, insulin-like growth factor-I (IGF-I) and vitamin B 12 . Cognitive and functional status were evaluated using the Mini Mental State Examination (MMSE, 0-30 points, o24 points indicates impaired cognition) and the Katz activities of daily living (ADL) index, respectively. Two assessments were made with a 5-month interval. At the start, a 12-h education programme was given to the staff at one of the SF complexes. Results: At baseline, the means of BMI and the biochemical nutritional indices were normal, whereas one-third had BMI o22 kg/m 2 and one-fourth had lost Z10% of previous weight. According to SGA, 30% demonstrated possible or serious malnutrition. The median MMSE was 23 points (19.5-26.5, 25-75th percentile). Nearly 70% were ADL-independent. At the 5-month follow-up there were no differences in the nutritional and cognitive status of the residents. The nutritional knowledge of the staff improved slightly (Po0.05) at both SF complexes (NS between groups). Conclusions: Around one-third of SF residents appeared to be at nutritional risk. Five months after a 12-h staff nutrition education programme, no objective changes were seen in the nutritional status of the SF residents.