NUTRITIONAL SUPPORT AND FUNCTIONAL STATUS IN UNDERNOURISHED GERIATRIC-PATIENTS DURING HOSPITALIZATION AND 6-MONTH FOLLOW-UP

The objective of this study, designed as a randomized controlled prosp ective intervention study, was to evaluate tile effect oi nutritional supplementation on functional status and need of care in undernourishe d geriatric patients during hospitalization, and up to 6 months after discharge, Participants consisted of 46 undernourished geriatric patie nts from a geriatric acute care hospital aged 75 years or older withou t malignant disease, or need for tube feeding or parenteral nutrition, Patients in the supplement group (SG, N=20) were offered 400 mL (2100 kJ) daily of a iiquid supplement during hospital stay and 200 mt (105 0 kJ) per day for the following 6 months at home, Patients in the cont rol group (CG, N=26) had usual care without supplements. The main outc ome measure was functional status based on the Barthel Activities of D aily Living score (ADL) at hospital admission, discharge and after 6 m onths, with higher scores indicating greater independence and a maximu m score of 100 points, In supplemented patients with good acceptance ( SG+, N=11), a median improvement qi 20 points was observed between adm ission and discharge, and a further improvement qi 5 points at home. M edian changes were 0 and -10 points in supplemented patients with poor acceptance (SG-, N=9) and 5 and 2.5 points ii? CGI respectively. In S G+. tile pro portion of independent patients (>65 points) increased co ntinuously from 36% at admission to 63% at discharge, to 72% after 6 m onths, and was significantly higher compared to CG at discharge (63% v s 19%, p<0.05) and after 6 months (72% vs 39%, p<0.05). 64% of the pat ients in SG+ improved during hospitalization, compared to 23% in CG (p <0.05). In tile six months at home, 18% of SG+ improved; none of SG+ d eteriorated in hospital or at home. In contrast, deterioration of the ADL score occurred in considerable proportions of SG- (22% in hospital , 22% at home) and CG (4% at hospital, 12% at home) patients, The prop ortion of patients who improved was smaller in SG- (44% at hospital. 2 2% at home) as well as in CG (23% at hospital, 35% at home). compared to SG+. In conclusion, a positive functional course was evident in sup plemented patients with good acceptance during hospitalization, and fu rther improvement was observed during the following 6 months at home. Nutritional support may contribute to reconvalescence and recovery of undernourished geriatric patients. (C) 1996, Editrice Kurtris.