Nutritional Status and Dietary Intake in Institutionalized Patients With Alzheimer's Disease and Multiinfarct Dementia

Sandman, Per‐Olof; Adolfsson, Rolf; Nygren, Charlotte; Hallmans, Göran; Winblad, Bengt

doi:10.1111/j.1532-5415.1987.tb01316.x

Cited by 205 publications

(119 citation statements)

References 30 publications

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“…Nearly half of the GLD residents had a BMI 23. According to the NuSc more than half were classified as malnourished or being at risk for PEM, a finding in line with several previous reports (Sandman et al, 1987;Burns et al, 1989;Carver & Dobson, 1995;Gillette-Guyonnet et al, 2000).…”

Section: Discussionsupporting

confidence: 90%

“…One may speculate that this lack of response was an effect of the severity of the disease (White et al, 1998). It has been suggested that AD patients may lose weight although they have a positive energy balance (Sandman et al, 1987;Burns et al, 1989;Poehlman & Dvorak, 2000). Serum albumin decreased during the study period in both groups.…”

Section: Discussionmentioning

confidence: 93%

“…Certain groups, such as people with dementia, especially Alzheimer's disease (AD) have been identified to be at particularly high risk for PEM (Elmståhl & Steen, 1987;Burns et al, 1989;Wolf-Klein et al, 1995;Carver & Dobson, 1995;CroninStubbs et al, 1997;Wang et al, 1997;Gillette-Guyonnet et al, 2000). It is still not resolved whether the weight loss in demented patients is due to inadequate dietary intake, increased energy expenditure or dementia-related metabolic disturbances (Sandman et al, 1987;Singh et al, 1988;Donaldson et al, 1996;Grundman et al, 1996;Barrett-Connor et al, 1996;Poehlman et al, 1997, Poehlman & Dvorak, 2000. In order to find means to improve quality of life for the elderly it is important to understand the relationships between nutrition, cognition and physical functioning (Tucker et al, 1990).…”

Section: Introductionmentioning

confidence: 99%

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The effect of nutritional intervention in elderly subjects residing in group-living for the demented

Faxén‐Irving¹,

Andrén-Olsson²,

Geijerstam³

et al. 2002

Eur J Clin Nutr

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Objectives: We studied the nutritional status and the effects of nutritional intervention on body weight, cognition and activities of daily life (ADL)-function in demented individuals. Design: Controlled non-randomised study. Setting: Group-living for demented elderly (GLD), ie community assisted housing. Subjects and interventions: Twenty-two residents living in one of two units (GLD-I), received oral liquid supplements (1720 kJ=410 kcal=day) and the personnel of the GLD-I were given nutritional education. Fourteen residents in the other unit (GLD-C) served as controls. After 6 months 21 (83 (4) y, 81% women) and 12 (85 (4) y, 100% women) of the participants, respectively, were re-examined according to body mass index (BMI, kg=m 2 ), cognitive function (Mini Mental State Examination (MMSE, 0 -30 p) and Clinical Dementia Rating Scale (CDR) and the Katz' ADL index. Results: Body mass index (BMI) 20 was found in 19% of the participants and 44% had BMI 23. BMI correlated with MMSE (r ¼ 0.43, P < 0.01). The weight of the residents in the intervention group increased by 3.4 (3) kg (P ¼ 0.001) at follow-up, whereas the weight remained unchanged in the control group. The cognitive function was low at the start in both groups, ie MMSE 9 and no apparent positive effect of the nutritional intervention was seen. In addition, the ADL functions appeared to deteriorate in both groups. Conclusions: Being underweight was common among demented elderly in group-living and was related to low cognitive capacity. Five months of oral supplementation, along with education of personnel, was followed by a weight gain. In this study the nutritional treatment did not affect the rate of decline in cognitive function or Katz' ADL index. Sponsorship: Supported by grants from the Swedish National Board of Health and Social Welfare. Semper Foods AB provided the liquid supplements.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The effect of nutritional intervention in elderly subjects residing in group-living for the demented

Faxén‐Irving¹,

Andrén-Olsson²,

Geijerstam³

et al. 2002

Eur J Clin Nutr

View full text Add to dashboard Cite

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“…Instead, weight loss of 3.5 kg or more was characterised by disability at baseline and the prevalence of more chronic diseases at follow-up. Furthermore, in a comparison of malnourished and nonmalnourished institutionalised older adults (Sandman et al, 1987), no difference in dietary intake was found; however, over the 3 y study period, malnourished patients experienced 4 times as many infections treated with antibiotics compared with non-malnourished patients.…”

Section: Discussionmentioning

confidence: 90%

Changes in dietary intake during a 6-year follow-up of an older population

et al. 1999

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Objective: To examine prospective changes in food habits and nutrient intakes in a representative New Zealand sample of community dwelling adults aged 70 y and over. Design: Longitudinal study with food intake data collected in 1988a89 and again in 1995a96. In an attempt to distinguish age, time and cohort effects, data were analysed longitudinally, cross-sectionally and timesequentially. Subjects: The sample for study consisted of all non-institutionalised people aged 70 years and over registered with the Mosgiel Health Centre in 1988. In 1988a89, 678 adults completed a dietary survey (85% of those eligible) and 248 adults participated again in 1995a96 (66% of those eligible). Results: Energy intakes declined longitudinally in men only; however, this decline appeared not to be an aging effect as energy intake was not found to decrease with age cross-sectionally. Percentage of energy from protein increased by 0.7% in women (95% con®dence interval 0.2 ± 1.2) in both the longitudinal and time-sequential analysis, suggesting a time effect. The percentage of energy from saturated fat decreased 0.7% (95% con®dence interval 7 1.4 to 7 0.1) and percentage of energy from polyunsaturated fat increased 0.4% (95% con®dence interval 0.0 ± 0.7) in women, and appears to be a time effect. However, the increase in saturated fat and decrease in polyunsaturated fat with advancing age seen cross-sectionally suggests a cohort effect also occurring. In 1995a96, more people were using margarine as a spread and vegetable oils to cook meat. Milk and milk product consumption increased (not signi®cantly), and meat intake decreased signi®cantly by 5 and 4 servings per month in men and women, respectively. There was an increase in the proportion of people who ate breakfast cereal at least once a week, and more women ate brown or wholemeal bread in 1995a96. Conclusion: Over the 6 y follow-up period studied, there was no indication of an age effect on nutrient intakes in adults aged 70 y and older; however, the changes occurring over time demonstrate that older adults, particularly women, are making changes towards healthier food choices. Sponsorship: Health Research Council of New Zealand and the University of Otago Medical School.

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“…Malnutrition in the long term residential care setting has been extensively documented to be a prevalent problem, with adverse effects on morbidity and mortality (Munci & Carbonetto, 1982;Pinchcofsky-Devin & Kaminski Jr, 1986;Sandman et al, 1987;Rudman & Feller, 1989;Thomas et al, 1991;Abbasi & Rudman, 1993;Sullivan & Walls, 1994;Morley & Silver, 1995). The causes are largely reversible (Morley & Kraenzle, 1994;Morley & Silver, 1995;Sullivan, 1995), and nutritional assessment has been incorporated as one of several performance indicators linked to reimbursement in countries such as the US (Hawes et al, 1997), as part of the Resident Assessment Instrument (Brown, 1995).…”

Section: Introductionmentioning

confidence: 99%

Low staffing level is associated with malnutrition in long-term residential care homes

et al. 2005

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Objective: To determine if staffing level is associated with poor nutrition in the long-term residential care setting, adjusting for other confounding factors. Design: Cross-sectional survey. Setting: In total, 14 residential care facilities in Hong Kong, stratified by nature (government subvention or for-profit) to reflect the overall proportion in Hong Kong. Subjects: A total of 1914 subjects were assessed, using the Resident Assessment Instrument (RAI) 2.0. The response rate was 95% (1820 subjects), of which 1699 subjects had complete nutritional information. Intervention: Body mass index (BMI) was calculated by weighing and height measurement, and arm span was used if the subject could not stand. Subjects who were receiving parenteral or enteral nutrition via nasogastric of enterostomy tubes were excluded. A history of weight loss of 5% in the past month or 10% in the past 6 months, leaving 25% of food uneaten, and BMI o18.5 kg/m 2 were examined as nutritional indicators. Association with age, gender, functional disability, oral problems, taste problems, presence of physical diseases and psychological well-being was examined using w 2 -test, and multiple logistic regression. Results: In all, 26% of residents had a BMI o18.5 kg/m 2 , with a higher prevalence in the for-profit homes. History of weight loss and the record that 25% of food was left uneaten were poor indicators of low BMI. Multivariate analysis showed that having chronic obstructive airways disease, requiring help with feeding, being female, older age, were factors associated with an increased risk of poor nutrition, while being independent in activities of daily living and higher staff levels were associated with a reduced risk. Conclusion: Poor nutrition is a persistent problem in the long-term care setting, and inadequate staffing levels may be a reversible cause. However, resource limitations may render efforts at improvement difficult. Sponsorship: SK Yee Memorial Fund.

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Nutritional Status and Dietary Intake in Institutionalized Patients With Alzheimer's Disease and Multiinfarct Dementia

Cited by 205 publications

References 30 publications

The effect of nutritional intervention in elderly subjects residing in group-living for the demented

The effect of nutritional intervention in elderly subjects residing in group-living for the demented

Changes in dietary intake during a 6-year follow-up of an older population

Low staffing level is associated with malnutrition in long-term residential care homes

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