Reversibility of protein-energy malnutrition in a group of chronically-ill elderly outpatients.
Nutritional status was studied in 23 elderly (74 +/- 1 years), malnourished outpatients with non-malignant diseases. The patients' recollections and medical records indicated a gradual weight loss of approximately 25% in the preceding 2-15 years; only a small amount (6%) was lost during the final 6 months. At a re-examination after 3 months, all patients were still malnourished but in general the depletion had decreased. An elevated level of serum orosomucoid (orosomucoid positive) was used as evidence of an on-going inflammatory process. The 14 orosomucoid negative patients displayed a more pronounced improvement in their nutritional status than those who were orosomucoid positive. 15 patients were prescribed a protein and energy enriched formula (40 g protein and 400/1.7 kcal/MJ per day). The orosomucoid positive and orosomucoid negative groups did not differ in number of subjects prescribed supplementation. During the follow-up period the patients that were recommended supplementation showed a more prominent improvement in their nutritional status than the 'non-supplemented' subjects. Discriminant analysis revealed that prescription of oral supplementation and, to a lesser extent, serum orosomucoid concentrations within the reference range favoured nutritional repletion. The most pronounced recovery was registered in orosomucoid negative patients who had been prescribed supplementation.
Cederholm
T E
TE
Karolinska Institute, Department of Medicine, Stockholm Söder Hospital, S-118 83 Stockholm, Sweden.
Hellström
K H
KH