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 prospective intervention study, was to evaluate the effect of nutritional supplementation on functional status and need of care in undernourished geriatric patients during hospitalization, and up to 6 months after discharge, Participants consisted of 46 undernourished geriatric patients from a geriatric acute care hospital aged 75 years or older without 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 (1050 kJ) per day for the following 6 months at home, Patients in the control group (CG, N=26) had usual care without supplements. The main outcome measure was functional status based on the Barthel Activities of Daily Living score (ADL) at hospital admission, discharge and after 6 months, with higher scores indicating greater independence and a maximum score of 100 points, In supplemented patients with good acceptance (SG+, N=11), a median improvement qi 20 points was observed between admission and discharge, and a further improvement qi 5 points at home. Median 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 SG+. the pro portion of independent patients (>65 points) increased continuously from 36% at admission to 63% at discharge, to 72% after 6 months, and was significantly higher compared to CG at discharge (63% vs 19%, p<0.05) and after 6 months (72% vs 39%, p<0.05). 64% of the patients in SG+ improved during hospitalization, compared to 23% in CG (p<0.05). In the six months at home, 18% of SG+ improved; none of SG+ deteriorated 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 proportion of patients who improved was smaller in SG- (44% at hospital. 22% 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 supplemented patients with good acceptance during hospitalization, and further 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.