Nutritional Care of Ambulatory Residents in Special Care Units for Alzheimer's Patients

Abstract

The availability and an assessment of the nutritionally-relevant information from 100 medical records of ambulatory residents in ten special care units (SCU) for Alzheimer's patients was determined. Eight facilities had estimated calorie and fluid needs and four estimated protein needs of residents. Over 40% of the residents were underweight and significant weight loss was reported for 20%. Values for hemoglobin, hematocrit, albumin and cholesterol were available on 61, 60, 36, and 25% of the patients, respectively. Hemoglobin, hematocrit and albumin were 8% lower and cholesterol was 24% higher than the levels associated with high death rates among institutionalized elderly. Many factors existed placing patients at high risk for malnutrition. Staff at all the facilities monitor the nutritional status of Alzheimer's patients to a variable extent.

Prevention of Weight Loss in Dementia with Comprehensive Nutritional Treatment

“…Others have suggested that individualized strategies around the eating environment and diet may enhance body weight and therefore nutritional health. 18,19 Special care units (SCUs) have been specifically designed for demented seniors in LTCFs so that specialized care can be provided, 20,21 although variations exist in the quality of this care. Some researchers have found that institutionalized seniors with dementia can maintain their weight and improve their survival if sufficient calories are provided.…”

Weight Loss, Dysphagia, and Outcome in Advanced Dementia

“…Other studies [3][4][5][6][7][8][9][10] have examined causes of weight change and its impact on morbidity and mortality in community dwelling as well as institutionalized older persons. No studies, however, have attempted to link patterns of weight change and feeding dysfunction with cause of death in a demented population.…”

“…This is somewhat surprising as dysphagia is indeed associated with weight loss in inpatients [11,12]. Furthermore, undernutrition, as measured by body mass, appears to be prevalent in patients with Alzheimer's disease [10,13]. Finally, aspiration is the initiating event in most episodes of pneumonia [14].…”

Studies on the Effect of the Apolipoprotein E Genotype on the Lipid Profile in Alzheimers Disease

“…Subsequent studies found that individuals with hypercholesterolemia exhibit a greater susceptibility to AD [2,3,4]. Further, abnormalities of cholesterol levels in AD patients have been noted both in serum and in the brain [5,6,7,8,9,10]. Some studies implicated high-density lipoprotein (HDL) as the central agent in AD development, with AD patients having lower HDL levels and the extent of decrease being associated with AD severity [8].…”