We have studied the association of muscle strength (quadriceps, biceps, handgrip), measured by a portable chair technique, with functional status (Barthel Index, manual dexterity, Mental Test Score, history of falls, fracture, prescribed drugs), in a sample of 92 elderly subjects attending a Local Authority Day Centre and Day Hospital. Anthropometric measurements and hand-grip strength were also measured in 30 young controls. Muscle area, mass and strength were significantly greater in young controls. Elderly men had significantly greater muscle area, mass and strength than elderly women. Muscle strength correlated with several measures of functional status. Using stepwise multiple regression, an independent association of muscle strength with manual dexterity, Barthel Index and receipt of domiciliary services is demonstrated.

Two sample groups of elderly were compared from a population living in South London. One group attended a local day centre (a socially orientated establishment), and the other attended a local day hospital (a therapeutically orientated establishment). The aim of the study was to compare nutritional intake, functional status and muscle strength between these two groups. The mean nutritional intakes of the day hospital and day centre attenders were similar. Intake of macronutrients, with the exception of fibre, met Recommended Daily Allowances (RDAs) in both groups. In take of folic acid, vitamin D and zinc fell below recommendations in both groups. Low intake of folic acid was improved by supplementation, and some individual blood levels of folate reflected this. Blood folate levels were generally within normal limits. Low intake of vitamin D was improved by supplementation, but blood levels were generally normal anyway. There was, however, a tendency for the more dependent day hospital patients to have lower vitamin D levels. This group also had less sunshine exposure. Communal dining, whether in the setting of day hospital or day centre, may have been an essential means of bolstering nutritional intake for many ‘at risk’ elderly. There were significant differences in functional status and muscle strength in favour of the day centre group and these indicate that anthropometric indices rather than nutritional or biochemical indices were the most reliable markers of disease and disability in this study. The effect of fortifying local meals‐on‐wheels was also highlighted, and suggests that this may be one means of preventing nutritional deficiencies in the vulnerable, house‐bound elderly. Alcohol intake was reported as being modest. However, discrepancies were noted on review of biochemical indices known to be influenced by alcohol intake.

Parental awareness was high EDITOR,-We wish to report the results of an observational study that a group of us undertook recently as part of our community medicine attachment. We chose the topic of measles immunisation because it was a current issue.' There had also been public concern that the campaign contained information contradicting that given in the previous measles, mumps, and rubella campaign, launched in October 1988. At that time the parliamentary secretary for health, Mrs Edwina Curry, stated that "It [measles, mumps, and rubella vaccine] provides life-long protection against all three infections with a single jab."2 A third point of interest was the controversy surrounding the rubella component of the vaccine.The aim of our project was to discover whether parents of 4-16 year old children were aware of the current measles immunisation campaign, understood and accepted the information provided, and were prepared to have their children immunised. This was undertaken with a questionnaire administered during an interview.Questionnaires were answered by 190 parents; 185 of the 190 were aware of the current publicity, with 110 of 189 identifying school leaflets as their first source of information. The predicted epidemic was identified as the reason for the campaign by 143 of the 190. Previous immunisation and previous measles infection were recognised as not exempting a child from the campaign by 139 and 129 parents respectively. Altogether 163 of 181 stated that they would allow their children to be immunised, although only 82 of the 190 identified the correct constitutents of the vaccine. Parents aged over 40 were more likely to refuse the vaccine (7/31 (23%) of those over 40 refused v 11/151 (7%) aged 40 and under; P=0 02). There was no variation in uptake between ethnic groups (uptake was 90% (143/159) among white children v 910% (20/22) among non-white children).Awareness of the impending epidemic correlated with uptake (uptake was 94% (128/136) among children whose parents were aware of the epidemic v 78% (35/45) among children whose parents were not; P=0 003). Knowledge about the vaccine's content did not correlate with uptake (uptake was 94% (73/78) among children whose parents correctly identified the vaccine's components v 87% (90/103) among children whose parents responded incorrectly). Knowledge about the irrelevance of previous immunisation and previous measles infection both correlated with uptake (uptake was 97% (131/135) among children whose parents responded correctly v 70% (32/46) among children whose parents responded incorrectly regarding previous immunisation; it was 97% (120/124) among children whose parents responded correctly v 75% (43/57) among children whose parents responded incorrectly regarding previous infection; P < 0-001 for both analyses).We therefore conclude that most parents were aware of the measles immunisation campaign. Most of them understood and accepted the information given to them (except with regard to the vaccine's content). Furthermore, in the light of the g...