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Beneficial Effects of Oral Nutrition Supplements on the Nutritional Status and Physical Performance of Older Nursing Home Residents at Risk of Malnutrition.

ABSTRACT: The purpose of this study was to compare the effects of nutritional supplement drinks (NSDs) and nutritional education (NE) on the nutritional status and physical performance of older nursing home residents who were at risk of malnutrition. This study was a clustered, randomized, parallel, multi-center clinical trial, with 107 participants more than 65 years old and at risk of malnutrition recruited from several nursing homes in this study. Participants were divided into two groups: an NE group (n = 50) and an NSD group (n = 57). The NE group was given NE by a dietitian, while the NSD group was provided with two packs of NSD except receiving NE (Mei Balance, Meiji Holdings, Tokyo, Japan) per day as a snack between meals and before bed. Anthropometric data, blood pressure, nutritional status, blood biochemical biomarkers, and physical performance were measured before and after 12-week interventions. After 12 weeks of NE combined with NSD intervention, body weight, body-mass index, the mini nutritional assessment-short form (MNA-SF) score, walking speed, and SF-36 questionnaire score were improved in older nursing home residents at risk of malnutrition.

SUBMITTER: Chen YH

PROVIDER: S-EPMC10574690 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Beneficial Effects of Oral Nutrition Supplements on the Nutritional Status and Physical Performance of Older Nursing Home Residents at Risk of Malnutrition.

Chen Yi-Hsiu YH Lee Che-Yu CY Chen Jiun-Rong JR Ding Min-Yu MY Liang Feng-Qi FQ Yang Suh-Ching SC

Nutrients 20231008 19

The purpose of this study was to compare the effects of nutritional supplement drinks (NSDs) and nutritional education (NE) on the nutritional status and physical performance of older nursing home residents who were at risk of malnutrition. This study was a clustered, randomized, parallel, multi-center clinical trial, with 107 participants more than 65 years old and at risk of malnutrition recruited from several nursing homes in this study. Participants were divided into two groups: an NE group ...[more]

PMID: 37836574

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Project description:BackgroundOlder adults living in nursing homes (NHs) are considered a vulnerable population in terms of nutrition. The aim of the present study was to explore the usual intake of energy, macronutrients, and specific food groups, along with offers in the NH menus on a nationally representative sample of Slovenian NH residents and compare dietary patterns with the established recommendations.MethodsThe study was conducted as part of a cross-sectional NutriCare study on 317 residents (65-101 years) from 20 Slovenian NHs in 9 health regions. Relatively independent residents were selected using quota sampling by sex and age. Data collection involved interviews and anthropometric measurements. Usual dietary intake was assessed by a multiple-source method from two 24-h dietary recalls and food frequency questionnaires. Adherence of dietary intake to the recommendations and dietary composition of NH menus were assessed. The Mini Nutritional Assessment (MNA) was used to explore nutritional status.ResultsNotable variability in energy and macronutrient intakes was observed with some participants showing intakes below and others above the recommended values. A high prevalence of BMI > 30 kg/m2 was observed in 39% of participants, indicating potential discrepancies between total energy intake and expenditure. The usual intake of fat was 36% of total energy intake (TEI). The intake of foods of animal origin exceeded dietary guidelines. Intake of carbohydrates (46% TEI in men and 47% TEI in women) as well as dietary fibre (20 g/day for both sexes) was below recommendations. A scarce intake of fruits, vegetables, and cereals was observed. In total, 40% of men and 35% of women had usual daily protein intakes lower than 1 g/kg of body weight. The protein content of breakfast and dinner could be improved. NH residents consumed little food from outside NH. The usual nutrient and food group intakes of residents reflected the NH menu offers.ConclusionThe study results on the usual intake of energy, macronutrients, specific food groups, and offers in the NH menus indicate the potential for optimisation. According to the World Health Organisation, the prevalence of BMI > 30 kg/m2 is notable and warrants attention. Careful meal planning and regular monitoring of the nutritional status of NH residents should be considered.

Project description:Nursing home residents with advanced dementia commonly experience burdensome and costly hospitalizations that may not extend survival or improve the quality of life. Fragmentation in health care has contributed to poor coordination of care for acutely ill nursing home residents.To compare patterns of care and quality outcomes for nursing home residents with advanced dementia covered by managed care with those covered by traditional fee-for-service Medicare.Choices, Attitudes, and Strategies for Care of Advanced Dementia at the End-of-Life (CASCADE) was a prospective cohort study including 22 nursing homes in the Boston, Massachusetts, area that monitored 323 nursing home residents for 18 months to better understand the course of advanced dementia at or near the end of life. Data from CASCADE and Medicare were linked to determine the health insurance status of study participants.The health insurance status of the resident, either managed care or traditional fee for service.The outcomes included survival, symptoms related to comfort, treatment of pain and dyspnea, presence of pressure ulcers, presence of a do-not-hospitalize order, treatment of pneumonia, hospital transfer (admission or emergency department visit) for an acute illness, hospice referral, primary care visits, and family satisfaction with care.Residents enrolled in managed care (n = 133) were more likely to have do-not-hospitalize orders compared with those in traditional Medicare fee for service (n = 158) (63.7% vs 50.9%; adjusted odds ratio, 1.9; 95% CI, 1.1-3.4), were less likely to be transferred to the hospital for acute illness (3.8% vs 15.7%; adjusted odds ratio, 0.2; 95% CI, 0.1-0.5), had more primary care visits per 90 days (mean [SD], 4.8 [2.6] vs 4.2 [5.0]; adjusted rate ratio, 1.3; 95% CI, 1.1-1.6), and had more nurse practitioner visits (3.0 [2.1] vs 0.8 [2.6]; adjusted rate ratio, 3.0; 95% CI, 2.2-4.1). Survival, comfort, and other treatment outcomes did not differ significantly across groups. CONCLUSIONS AND RELEVANCE Medicare managed-care programs may offer a promising approach to ensure that nursing homes are able to provide appropriate, less burdensome, and affordable care, especially at the end of life.

Dataset Information

Beneficial Effects of Oral Nutrition Supplements on the Nutritional Status and Physical Performance of Older Nursing Home Residents at Risk of Malnutrition.

Publications

Beneficial Effects of Oral Nutrition Supplements on the Nutritional Status and Physical Performance of Older Nursing Home Residents at Risk of Malnutrition.

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