Outcome of protein-energy malnutrition in elderly medical patients

Cederholm, Tommy; Jägrén, Christina; Hellström, Kjell

doi:10.1016/s0002-9343(99)80082-5

Cited by 236 publications

(122 citation statements)

References 36 publications

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“…Malnutrition is associated with increased infection rates (Chandra, 1993), poor wound healing, and pressure sores (Ek et al, 1991). Undernutrition also increases the risk of deterioration in physical condition (Covinsky et al, 1999;Potter et al, 2001) and thus of hospitalisation and mortality (Larsson et al, 1990;Cederholm et al, 1995;Flodin et al, 2000;Sacks et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Nutritional status, well-being and functional ability in frail elderly service flat residents

Koochek²,

et al. 2004

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Objective: To investigate nutritional status and its relationship to cognition, well-being, functional ability and energy intake in frail elderly service flat residents. Design: Cross-sectional and prospective study. Setting: Two municipal service flat complexes. Subjects: A total of 80 residents (median age 85.5 (79-90) y) with regular home care assistance participated. A subgroup of 35 residents took part in a re-examination 1 y later. Methods: Mini Nutritional Assessment (MNA), Short Portable Mental Status Questionnaire, Barthel Index and Health Index were used for the evaluation of nutritional, cognitive and ADL function and well-being, respectively. Results: In all, 30% of the frail and chronically ill service flat residents were assessed as malnourished and 59% were at risk of malnutrition. The malnourished residents had worse cognitive conditions (Po0.001) and well-being (Po0.05), lower functional ability (Po0.01) and they had a greater need for daily assistance (Po0.05) than the other residents. The median night fast period was 14.0 (12.5-15.0) h. Five subjects classified as malnourished at baseline had lost a median of À9.6 kg (range À11.0 to þ 7.3 kg) (Po0.05) in body weight at the 1-y follow-up, which contrasted significantly from the weight stability in residents classified as at risk for malnutrition or well-nourished. Conclusion: Out of 10 residents, nine were assessed to have impending nutritional problems that related to impaired wellbeing, cognition, and functional ability. Malnourished residents had a significant weight loss over one year. Studies are needed to determine whether weight loss and nutrition-related dysfunction in service flat residents are preventable or treatable.

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Section: Introductionmentioning

confidence: 99%

Nutritional status, well-being and functional ability in frail elderly service flat residents

Koochek²,

et al. 2004

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“…lack of social support, having a limited social network or being socially isolated, are also associated with nutritional status in elderly individuals (19,20) . Although research shows that malnutrition is related with disease (10)(11)(12) , socio-economic (5) and social factors (19,20) , the relative contribution of the various types of factors to nutritional status of the elderly population in low-income countries is not well recognized.…”

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confidence: 99%

The multidimensional background of malnutrition among rural older individuals in Bangladesh – a challenge for the Millennium Development Goal

Ferdous

Kabir

Wåhlin

et al. 2009

Public Health Nutr.

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Objective: To investigate the associations and relative impact of illness, socioeconomic and social indicators for nutritional status among elderly persons in rural Bangladesh. Design: A multidisciplinary, cross-sectional study employing home interviews to collect information on demographic, socio-economic and social status; clinical examination to classify medical diagnoses; and Mini Nutritional Assessment (MNA) to assess the nutritional status of each participant. Setting: Matlab, Bangladesh. Subjects: A total of 625 randomly selected individuals ($60 years of age) participated in home interviews and 473 underwent clinical examination. Complete information on nutritional status was available for 457 individuals, median age 68 years, 55 % women. Results: Twenty-six per cent of the elderly participants were undernourished and 62 % were at risk of malnutrition according to MNA. More than three-quarters of the participants had acute infections, 66 % suffered from chronic illnesses, 36 % had sensory impairments and 81 % were suffering from gastrointestinal disorders. Acute infections (P , 0?001), gastrointestinal disorders (P , 0?01), depressive symptoms (P , 0?001) and impaired cognitive function (P , 0?01) were significantly and independently associated with poorer nutritional status. Moreover, female gender (P , 0?05), having no income (P , 0?01), being illiterate (P , 0?01) and not receiving regular financial support (P , 0?05) were also independently associated with poor nutritional status. Conclusions: Malnutrition among elderly people in rural Bangladesh is associated with female gender, medical, psychological, socio-economic and social indicators. A multidimensional approach is probably needed to reduce undernutrition in older populations in low-income countries like Bangladesh.

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“…Unexpectedly, as many as one-fourth of the residents had a CRP410 g/l, indicating the presence of a subclinical inflammation of unclear origin. Somewhat more expectedly, serum CRP correlated negatively with serum albumin, underlining the observation that low serum albumin concentration is a marker of on-going inflammation, and thus also of on-going catabolism (Fleck, 1988;Minuto et al, 1989;Cederholm et al, 1993Cederholm et al, , 1995.…”

Section: Discussionmentioning

confidence: 98%

“…Chronic disease and old age are risk factors for protein-energy malnutrition (PEM) (Cederholm et al, 1995;Pennington, 1998), which occurs in 25-40% of elderly subjects admitted to hospital (Unosson et al, 1991;Larsson et al, 1994;McWhirter & Pennington, 1994) and in about 5% of elderly subjects living at home (Thorslund et al, 1990;Cederholm & Hellström, 1992). In sheltered accommodation, an average of one-third are assessed as being malnourished (Saletti et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Nutrition education for care staff and possible effects on nutritional status in residents of sheltered accomodation

et al. 2005

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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.

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Outcome of protein-energy malnutrition in elderly medical patients

Cited by 236 publications

References 36 publications

Nutritional status, well-being and functional ability in frail elderly service flat residents

Nutritional status, well-being and functional ability in frail elderly service flat residents

The multidimensional background of malnutrition among rural older individuals in Bangladesh – a challenge for the Millennium Development Goal

Nutrition education for care staff and possible effects on nutritional status in residents of sheltered accomodation

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