An in-home nurse-administered geriatric assessment for hypoalbuminemic older persons: development and preliminary experience.
BACKGROUND
Although malnutrition in older persons is a common, potentially treatable condition, few data indicate that treatments for this disorder can be effective.


OBJECTIVE
To develop and preliminarily evaluate a two-component intervention that includes a nurse-administered, in-home assessment to identify potentially remediable causes of hypoalbuminemia and protocols to treat these problems.


METHODS
A pre-test post-test case-series.


METHODS
An academic geriatrics practice.


METHODS
Seventeen persons aged 65 and older with serum albumin levels < or = 3.8 g/dL; eight of the participants received pre-and post-test outcome measures.


METHODS
Nurse-administered standardized assessment and intervention protocols.


METHODS
Serum albumin, Medical Outcome Study (MOS) SF-36, serum IL-1a and b, TNF alpha, IL-6, and lymphocyte markers of immune function.


RESULTS
The assessment took 87 minutes, on average, and generated a mean 4.2 recommendations. Among the eight subjects with pre- and post-test measures, serum albumin increased by 0.2 g/dL (P = .035). Compared with baseline, two T cell markers of immune function demonstrated changes consistent with better function.


CONCLUSIONS
These preliminary data support the potential benefit of a nurse-administered assessment coupled with protocols to address remediable contributors to hypoalbuminemia.
Reuben
D B
DB
Multicampus Program in Geriatric Medicine and Gerontology, UCLA School of Medicine, Los Angeles, California 90095-1687, USA.
Effros
R B
RB
Hirsch
S H
SH
Zhu
X
X
Greendale
G A
GA
D000368:Aged; D016207:Cytokines / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005069:Evaluation Studies as Topic; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006699:Home Care Services; D006801:Humans; D008297:Male; D009730:Nursing Assessment / Q000379:methods; D009748:Nutrition Disorders / Q000175:diagnosis* / Q000276:immunology; D011788:Quality of Life; D012709:Serum Albumin / Q000172:deficiency*; D018709:Statistics, Nonparametric; D016176:T-Lymphocyte Subsets / Q000276:immunology
D016207:Cytokines; D012709:Serum Albumin