Disability is associated with malnutrition in institutionalized elderly people. The IRA study

Several factors, such as disability, malnutrition, weight loss, and the int eractive effect of diseases and aging have been associated with morbidity a nd mortality in the elderly population. Nevertheless, the relationship betw een disability and biological parameters has nor been extensively investiga ted as a primary focus. In a cross sectional survey, 344 institutionalized elderly subjects were evaluated. Disability was measured according to the K atz index, and patients were divided into three groups: low, (0-1 lost ADL) , mild (2-4 lost ADL), and severe (5-6 lost ADL). Anthropometric, metabolic , and nutritional parameters were assessed; age, gender, number of patholog ies, and number of drugs were also recorded. Data were analyzed by multiple comparison of means according to Scheffe, and by multivariate logistic reg ression analysis. An impairment in functional status was associated with se veral modifications in biological parameters. Logistic regression analysis showed that severe disability (5-6 lost ADL) was associated with low, waist /hip ratio <0.9 vs >0.9, OR:1.56, CI 95%:1.08-2.25 high body resistance (>6 25 vs <575 Omega, OR:1.39, CI 95%:1.38-1.39), low plasma albumin levels (<3 .5 vs >4.0 g/dL, OR:6.02, CI 95%:5.18-6.85), and lour plasma transferrin le vels (<200 vs >250 mg/dL, OR:5.47, CI 95%:4.56-4.58) independently of age, gender, comorbidity, and other confounding factors. Our results indicate th at severe disability in ADL is strongly associated with anthropometric metr ic and biohumoral parameters suggesting the presence of malnutrition. A car eful evaluation of the nutritional state appears to be of primary importanc e, and efforts to improve nutritional status are needed in approaching disa bled elderly patients. (C) 1999. Editrice Kurtis.