Protein Energy Supplements in Unwell Elderly Patients—A Randomized Controlled Trial

Potter, Jan; Roberts, Margaret; McColl, John H.; Reilly, John J.

doi:10.1177/0148607101025006323

Cited by 109 publications

(75 citation statements)

References 19 publications

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“…Our data support previous observations of reduced functional ability and greater need for nursing care among elderly malnourished subjects (Landi et al, 1999;Romagnoni et al, 1999). Insufficient nutritional intake leads to increased muscle fatiguability and impaired muscle function (BourdelMarchasson et al, 2001;Bonnefoy et al, 2003) and there are reports indicating that nutritional treatment in frail elderly will improve functional ability (Unosson et al, 1992;Potter et al, 2001).…”

Section: Discussionsupporting

confidence: 89%

“…Malnutrition is associated with increased infection rates (Chandra, 1993), poor wound healing, and pressure sores (Ek et al, 1991). Undernutrition also increases the risk of deterioration in physical condition (Covinsky et al, 1999;Potter et al, 2001) and thus of hospitalisation and mortality (Larsson et al, 1990;Cederholm et al, 1995;Flodin et al, 2000;Sacks et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

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Nutritional status, well-being and functional ability in frail elderly service flat residents

Koochek²,

et al. 2004

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Objective: To investigate nutritional status and its relationship to cognition, well-being, functional ability and energy intake in frail elderly service flat residents. Design: Cross-sectional and prospective study. Setting: Two municipal service flat complexes. Subjects: A total of 80 residents (median age 85.5 (79-90) y) with regular home care assistance participated. A subgroup of 35 residents took part in a re-examination 1 y later. Methods: Mini Nutritional Assessment (MNA), Short Portable Mental Status Questionnaire, Barthel Index and Health Index were used for the evaluation of nutritional, cognitive and ADL function and well-being, respectively. Results: In all, 30% of the frail and chronically ill service flat residents were assessed as malnourished and 59% were at risk of malnutrition. The malnourished residents had worse cognitive conditions (Po0.001) and well-being (Po0.05), lower functional ability (Po0.01) and they had a greater need for daily assistance (Po0.05) than the other residents. The median night fast period was 14.0 (12.5-15.0) h. Five subjects classified as malnourished at baseline had lost a median of À9.6 kg (range À11.0 to þ 7.3 kg) (Po0.05) in body weight at the 1-y follow-up, which contrasted significantly from the weight stability in residents classified as at risk for malnutrition or well-nourished. Conclusion: Out of 10 residents, nine were assessed to have impending nutritional problems that related to impaired wellbeing, cognition, and functional ability. Malnourished residents had a significant weight loss over one year. Studies are needed to determine whether weight loss and nutrition-related dysfunction in service flat residents are preventable or treatable.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Nutritional status, well-being and functional ability in frail elderly service flat residents

Koochek²,

et al. 2004

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“…Nasogastric feeding, which potentially has more risk of complications, is likely to be targeted at those requiring higher levels of supplementation. Attempts to overcome the poor compliance with oral supplements, include specially fortified hospital meals, the provision of frequent small snacks, and small volume oral feeds prescribed with drug rounds (Gall et al, 1998;Stephen et al, 1998;Potter et al, 2001). The provision of health-care assistants, specially trained to help all aspects of patients' feeding, is being evaluated in the care of acutely ill older patients (Hickson et al, 1999).…”

Section: Discussionmentioning

confidence: 99%

A systematic review of protein and energy supplementation for hip fracture aftercare in older people

Avenell

Handoll

2003

Eur J Clin Nutr

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Objectives: To evaluate whether protein and energy supplementation influences recovery after hip fracture. Design: Systematic review of randomised and quasi-randomised trials in people aged 65 y and over. Data sources: We searched seven electronic databases from 1966 to April 2002, four journals and reference lists of relevant articles. We contacted trial investigators and experts for details of other trials. Main outcome measures: Mortality, complications and unfavourable outcome (mortality or survivors with complications) were the primary outcomes. We also sought data on length of hospital stay, functional status after hip fracture, quality of life and compliance with supplementation. Results: In total, 12 randomised trials involving 898 participants were included. Nine trials evaluated protein and energy supplementation (five oral and four nasogastric feeding), and a further three trials tested oral protein supplementation. Potential biases resulting from inadequate allocation concealment and lack of assessor blinding and intention-to-treat analysis, as well as the limited outcome data, mean that the results must be interpreted with caution. Pooled data from eight of the nine trials evaluating protein and energy supplements showed no evidence for an effect on mortality (relative risk 0.92, 95% CI 0.56-1.50). Limited data from only three trials showed that oral protein and energy supplements may reduce unfavourable outcome (relative risk 0.52, 95% CI 0.32-0.84). Conclusion: Based on limited evidence, oral protein and energy supplementation after hip fracture may reduce unfavourable outcome. Further evidence from good-quality randomised trials is required to inform clinical practice.

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“…17 Effective management of malnutrition in older persons can reduce health-care costs associated with hospital admissions. In one study, intensive nutritional support of malnourished, hospitalised, older surgery patients resulted in a 15-30% reduction in rehabilitation time and a 40% reduction in the duration of hospitalisation.…”

Section: Introductionmentioning

confidence: 99%

Poor nutritional status of older subacute patients predicts clinical outcomes and mortality at 18 months of follow-up

et al. 2012

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Protein Energy Supplements in Unwell Elderly Patients—A Randomized Controlled Trial

Abstract: Prescribing sip feed supplements in the medicine prescription chart during hospital stay reduces weight loss. Our data also support other evidence for a reduction in mortality noted in elderly patients on nutritional supplementation. There were suggestions of other clinical benefits.

Cited by 109 publications

References 19 publications

Nutritional status, well-being and functional ability in frail elderly service flat residents

Nutritional status, well-being and functional ability in frail elderly service flat residents

A systematic review of protein and energy supplementation for hip fracture aftercare in older people

Poor nutritional status of older subacute patients predicts clinical outcomes and mortality at 18 months of follow-up

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