title: An in-home nurse-administered geriatric assessment for hypoalbuminemic older persons: development and preliminary experience.
abstract: 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.
authors.affiliation: Multicampus Program in Geriatric Medicine and Gerontology, UCLA School of Medicine, Los Angeles, California 90095-1687, USA.
authors.forename: D B
authors.initials: DB
authors.lastname: Reuben
authors.forename: R B
authors.initials: RB
authors.lastname: Effros
authors.forename: S H
authors.initials: SH
authors.lastname: Hirsch
authors.forename: X
authors.initials: X
authors.lastname: Zhu
authors.forename: G A
authors.initials: GA
authors.lastname: Greendale
mesh_terms: 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
chemical_list: D016207:Cytokines; D012709:Serum Albumin