Food intake assessment in acutely ill older internal medicine patients

Abstract

Aim: Poor food intake is a major concern among hospitalized older adults. This study investigated the frequency and optimal timing of in-hospital food intake assessment in terms of its ability to predict hospitalization functional outcomes.Methods: Secondary analysis of a cohort study of 699 older adults (age ≥70 years) admitted to internal medicine wards for non-disabling conditions was carried out. Daily food intake was assessed using self-reported estimation of portions consumed at each meal and calculated according to the caloric composition of the meals. Nutritional status on admission, baseline and discharge activities of daily living, and cognitive status were assessed using validated questionnaires. Repeated measures analysis of variance (n = 263) and multiple logistic regression models (n = 475) for predicting activities of daily living and cognitive decline were used to establish required frequency and optimal timing of food-intake monitoring.Results: Mean daily intake significantly increased from the first 48 h from admission (0.51 AE 0.30) to the second and third assessments (0.62 AE 0.30 and 0.63 AE 0.30, respectively). Eating half or less of the served meals both within the first 48 h of admission and after 48 h was associated with higher odds of cognitive decline (OR 1.93, 95% CI 1.27-2.94; OR 1.62, 95% CI 1.04-2.51, respectively). Low intake after 48 h of admission was associated with higher odds of activities of daily living decline (OR 1.66, 95% CI 1.03-2.67).Conclusions: Food intake increases from the first 48 h of admission onwards and becomes more consistent 3 days after admission. The associations between low food intake at various time points and worse functional outcomes show the importance of routine food intake monitoring for at least 3 days.

Patient‐reported experiences of mealtime care and food access in acute and rehabilitation hospital settings: a cross‐sectional survey

“…Poor nutritional intake is common in hospital patients in acute and rehabilitation care, 1,2 and is associated with functional and cognitive decline, longer hospitals stays and higher mortality 3–6 . Malnutrition is recognised as an important complication of hospitalisation, with quality and healthcare standards from around the world recommending systems for screening patients at risk of malnutrition, and instituting preventive measures to ensure that patients meet their nutrition needs 7–9…”

Oral nutrition interventions in hospitalised older people at nutritional risk: a network meta-analysis of individual participant data

“…Hospitalised older people (65 years and older) are at particular risk for malnutrition, as dietary intake is o en diminished, metabolic demands are increased, and bioavailability of nutrients may be reduced in case of acute diseases including gastrointestinal problems (Pourhassan 2018;Tonkikh 2019). Furthermore, nondisease-related factors may be present (e.g.…”

Recomendaciones sobre la valoración integral y multidimensional del anciano hospitalizado. Posicionamiento de la Sociedad Española de Medicina Interna

“…Además, es necesario evaluar la ingesta alimentaria a lo largo del ingreso 59 . Si se detecta malnutrición o riesgo de presentarla hay que plantear una intervención nutricional con un enfoque transversal y multidisciplinar.…”