EFFECTS OF REFEEDING BY CYCLIC ENTERAL NUTRITION ON BODY-COMPOSITION - COMPARATIVE-STUDY OF ELDERLY AND YOUNGER PATIENTS

Previous reports suggest that correcting the malnourished state may be more difficult in elderly people than in younger people. The aim of t his study was to evaluate the effect of 21 days of cyclic enteral nutr ition (CyEN) on nutritional and body composition parameters in elderly , compared with younger patients, Twenty-four patients younger than 65 years (mean age 50 years) and 26 patients 65 years of age and older ( mean age 75 years) referred for refeeding, having lost at least 20% of their body weight or at least 10% in 3 months, were studied. All pati ents were ambulatory. Cyclic enteral nutrition was administered noctur nally via a nasogastric tube; in the daytime patients were allowed to eat normally and to walk, Resting energy expenditure was measured at d ay 0 by indirect calorimetry. Ten anthropometric and biological nutrit ional parameters and a global nutritional deficiency (GND) were measur ed at day 0 and 21. Body composition was measured at day 0 and 21 by b ioelectric impedance analysis. Total energy intakes were 286% and 280% of resting energy expenditure in groups 1 and 2, respectively. Body w eight, serum prealbumin, serum transferrin, 24 h urinary creatinine, a nd the GND (39.9% vs 23.3%; P < 0.01) improved significantly more in y ounger than in elderly patients. Fat free mass (3.9 vs 2.4 kg; P < 0.0 5) and body cell mass (2.7 vs 1.6 kg; P < 0.01) but not fat mass impro ved significantly more in younger than in elderly patients, In conclus ion, 21 days refeeding by cyclic enteral nutrition with similar energy amounts is less effective to correct malnutrition in elderly than in younger patients.