Prevention of weight loss in dementia with comprehensive nutritional treatment.
OBJECTIVE
To determine whether body weight can be maintained or improved in dementia residents of special care units (SCUs) using a comprehensive intervention strategy.


METHODS
Quasi-experimental with an interventional site and a noninterventional site.


METHODS
Four SCUs in two long-term care facilities in Ontario.


METHODS
The intervention site included 33 residents; the comparison site included 49 residents.


METHODS
Weight change over time was the primary outcome. Three time periods were compared: 9-month baseline period, 9-month intervention period (enhanced dietitian monitoring and menu changes at intervention site), and 12-month postintervention period (only menu changes at intervention site). Comparisons were made within and between sites. Full nutritional assessments were completed for the intervention group. Medical charts and basic anthropometric, behavioral, and cognitive measures were completed in both groups to determine baseline site differences. Weight change over time was analyzed with a repeated measures analysis, controlling for various covariates. Bivariate analyses were completed for other outcomes of death, number of infections, falls, and hospital days.


RESULTS
The intervention period that included the dietitian time and menu changes significantly promoted weight gain, compared with the standard treatment at the comparison facility. Other covariates of pacing, type of dementia, sex, age, number of comorbid conditions, and medications were also significant predictors of weight change. Weight gain or maintenance regardless of site was associated with survival.


CONCLUSIONS
Body weight can be maintained in residents of SCUs regardless of pacing and other clinical characteristics. The comprehensive intervention of clinical dietitian time and an enhanced menu designed to be individualized for ambulatory people with dementia promoted significant gains in body weight. A minimum 5% weight gain is associated with survival in these residents of SCUs.
Keller
Heather H
HH
Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada. hkeller@uoguelph.ca
Gibbs
Amie J
AJ
Boudreau
Lynn D
LD
Goy
Richard E
RE
Pattillo
Marg S
MS
Brown
Heather M
HM
D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D003191:Comprehensive Health Care; D003704:Dementia / Q000150:complications* / Q000178:diet therapy* / Q000401:mortality; D004045:Dietary Services; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008134:Long-Term Care; D008297:Male; D009747:Nutritional Physiological Phenomena; D017063:Outcome Assessment, Health Care; D015996:Survival Rate; D013997:Time Factors; D015431:Weight Loss