A prospective randomised controlled trial of nutritional supplementation in malnourished elderly in the community: clinical and health economic outcomes.
OBJECTIVE
Malnutrition is common in sick elderly people on admission to hospital and in the community. We conducted a randomised controlled trial to determine if nutritional supplementation after discharge from hospital improved nutritional status and functional outcomes, or reduced health-care costs.


METHODS
Elderly malnourished subjects were randomised to 8 weeks of supplementation or no supplementation post discharge, and followed up for 24 weeks. Weight, body mass index, anthropometrics, handgrip strength, quality of life and requirements for health-care professionals' services and social services were measured throughout the study.


RESULTS
Nutritional status improved significantly from baseline to week 24 in the intervention group (P<0.05), but not in the control group. There was no significant difference in nutritional status between groups at week 24. Handgrip strength improved significantly in the intervention group during supplementation, and was significantly different from that of the control group at week 8, but decreased thereafter. There was no significant difference in quality of life or health economic outcomes between groups at week 24.


CONCLUSIONS
In already malnourished elderly subjects, it may be too late to expect to improve function or quality of life or to reduce health-care costs simply by providing nutritional supplements after hospitalisation. Prevention is key. All elderly patients should be nutritionally assessed as part of their routine care, and appropriate intervention initiated early.
Edington
J
J
Abbott Laboratories, Medical Division, Abbott House, Norden Road, Maidenhead, Berkshire SL6 4XE, UK. jackie.edington@abbott.com
Barnes
R
R
Bryan
F
F
Dupree
E
E
Frost
G
G
Hickson
M
M
Lancaster
J
J
Mongia
S
S
Smith
J
J
Torrance
A
A
West
R
R
Pang
F
F
Coles
S J
SJ
D000368:Aged; D000375:Aging; D000553:Ambulatory Care / Q000706:statistics & numerical data; D015992:Body Mass Index; D001835:Body Weight; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D002149:Energy Intake; D005526:Food, Formulated; D018737:Hand Strength; D017048:Health Care Costs; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D044342:Malnutrition / Q000628:therapy*; D009752:Nutritional Status; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome