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Nutritional support and functional status in undernourished geriatric patients during hospitalization and 6-month follow-up

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Abstract

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 liquid supplement during hospital stay and 200 mL (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 of 20 points was observed between admission and discharge, and a further improvement of 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 in CG, respectively. In SG+, the proportion 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%, pš 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.

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  1. Geriatrisches Zentrum Bethanien, Klinikum der Universität Heidelberg, Rohrbacherstraße 149, D-69126, Heidelberg, Germany

    D. Volkert, S. Hübsch, P. Oster & G. Schlierf M.D.

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  1. D. Volkert
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  2. S. Hübsch
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  3. P. Oster
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  4. G. Schlierf M.D.
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Volkert, D., Hübsch, S., Oster, P. et al. Nutritional support and functional status in undernourished geriatric patients during hospitalization and 6-month follow-up. Aging Clin Exp Res 8, 386–395 (1996). https://doi.org/10.1007/BF03339600

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