1. Duplicate diet analysis for energy, protein, zinc and copper with estimates of biochemical status for Zn and Cu were undertaken in twenty-one elderly long-stay inpatients (mean age 82 (range 63-89) years) consuming their customary hospital diet and in a stable medical condition. Fourteen patients had a long-standing and significant healing problem, either a leg ulcer or pressure sore.2. Mean daily intakes of energy (5.2 MJ), protein (45 g), Zn (85 pmol) and Cu (14 /Lmol) were low in comparison with both official recommendations and levels of intake at which metabolic equilibrium was observed in healthy elderly people studied by the same methods (Bunker et al. 1984a).3. Mean leucocyte Zn (9 pmol/106 cells) and Cu (7.5 pmol/106cells) were low in comparison with results from healthy elderly people (Bunker et al. 1984a), implying suboptimal status for these elements. Those patients with healing problems tended to have the lower values within the range.4. Recommendations are made with respect to improving nutritional status in this disadvantaged group of people.

~~The calcium, magnesium and phosphorus status of a group of elderly inpatients was studied by use of duplicate meal analysis over a 5 d period and biochemical indices in twenty-one patients, and metabolic balance (5 d) in six of these. Mean daily Ca intake was lower than that of apparently healthy elderly subjects in metabolic equilibrium, although commensurate with present UK recommendations. Metabolic balance was negative for Ca. Mean daily M g intake was approximately half the US recommendation, and half the intake a t which metabolic balance has been observed in healthy elderly people. The five patients studied were in metabolic balance for Mg. Mean daily P intake was close to the UK recommendation, but negative metabolic balance was observed. The disparity between official recommendations for Ca intake, factors contributing to suboptimal Ca status, and measures that may improve Ca status in this group are discussed. Calcium : Magnesium : Phosphorus : Old age.Over the next decade in the UK there will be a 45 YO increase in the frailest section of the elderly population, those. aged 85 years and over (Office of Population Censuses and Surveys, 1985). In 1984 over one-third of all general medical and surgical beds, and over one-quarter of orthopaedic beds were occupied by elderly patients (Department of Health and Social Security, 1986). Old age, intercurrent illness and hospital admission may threaten the nutritional adequacy of dietary intake, and the elderly should probably be considered as a separate group with regard to recommendations for nutrient intake (Schneider et al. 1986).The optimal level of calcium intake in the elderly is disputed, and its relative importance in the aetiology of osteoporosis, whether in the achievement of peak adult bone mass or the decline to critical levels in old age, is unknown. There are few studies of magnesium status in the elderly, despite the existence of a number of factors which might lead to deficiency. Little is known of the importance of differing levels of phosphorus in the diet, much of the published work relating to inter-relations with other elements.In an earlier study of the nutrient content of hospital meals we found that the amounts of Ca and P in the food and drink offered to elderly people contained more Ca and less Mg than current recommendations (Thomas et al. 1986). We now report values for actual intake measured by duplicate meal analysis in twenty-one elderly long-stay patients, together with metabolic balance information on six of this number. Our findings are discussed with regard to improving the nutritional status of these elements in this group of old people. P A T I E N T S A N D METHODSTwenty-one inpatients of a geriatric long-stay and rehabilitation unit (seventeen women and four men) mean age 81.7 (range 63-89) years, were studied. None of the patients smoked, eighteen were edentulous and eleven reported problems with ill-fitting dentures that 9 N U T 62

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