A NUTRITIONAL INDEX PREDICTING MORTALITY IN THE NURSING-HOME

OBJECTIVE: To define a sensitive and specific index, based on nutritio nal indicators, predicting mortality in nursing home patients. DESIGN: A prospective cohort study. SETTING: A nursing home. MEASUREMENTS: An thropometric and laboratory nutritional indicators were assessed in 10 4 nursing home elderly residents (20 males, 84 females). Patients were aged 60 years and older and had relatively good somatic health and nu tritional status. Mortality data were collected over an 18-month follo w-up period. Discriminant analysis was used to compute an adimensional measure (index) that could predict mortality with the highest sensiti vity and specificity. RESULTS: Mortality was 0.20/year. A nonlinear, ' 'U-shaped'' relationship of cholesterol levels with mortality was foun d. A prognostic index based on cholesterol, lymphocyte count, mid-arm circumference, hemoglobin, age, and gender was obtained. Higher values of this index were associated with progressively higher risks at 12 m onths and 18 months. Sensitivity and specificity calculated on 18-mont h mortality were 80% and 78.4%, respectively. CONCLUSIONS: This index, based on simple measures, can be a useful tool in the evaluation of h ealth status of the elderly living in nursing homes.