title: Energy-containing nutritional supplements can affect usual energy intake postsupplementation in institutionalized seniors with probable Alzheimer's disease.
abstract: OBJECTIVE
  To determine whether increases in caloric intake associated with consumption of a mid-morning nutritional supplement for 3 weeks were maintained in the week after stopping the supplement and to investigate the effects of body mass index (BMI) and cognitive and behavioral measures on this response.
  
  
  METHODS
  Secondary analysis of a previously published randomized, crossover, nonblinded clinical trial.
  
  
  METHODS
  A fully accredited geriatric care facility affiliated with the University of Toronto.
  
  
  METHODS
  Thirty institutionalized seniors with probable Alzheimer's disease (AD) who ate independently.
  
  
  METHODS
  Investigator-weighed food intake, body weight, cognitive (Severe Impairment Battery; Global Deterioration Scale) and behavioral (Neuropsychiatric Inventory--Nursing Home version; London Psychogeriatric Rating Scale) assessments.
  
  
  RESULTS
  Individuals who responded successfully to supplementation as indicated by increases in daily energy intake were likely to maintain 58.8% of that increase postsupplementation, although stopping the supplement was associated with decreased habitual energy intake in low-BMI individuals who reduced their daily intakes during supplementation in response to the extra calories. Cognitive/behavioral tests were not reliable predictors of postsupplement intake.
  
  
  CONCLUSIONS
  Institutionalized seniors with probable AD are likely to alter their usual energy intakes to maintain changes resulting from 3 weeks of supplementation. This effect may allow for rotating supplementation schedules in nursing homes that could reduce staff burden, but only for those individuals who are most likely to respond favorably. These data indicate that nutritional supplements and diet plans should be carefully prescribed in low-BMI individuals to limit variability in total energy provided and thus prevent lower-than-normal intake.
authors.affiliation: Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada. matthew.parrott@utoronto.ca
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Parrott
authors.forename: Karen W H
authors.initials: KW
authors.lastname: Young
authors.forename: Carol E
authors.initials: CE
authors.lastname: Greenwood
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology*; D015992:Body Mass Index; D018592:Cross-Over Studies; D019587:Dietary Supplements; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007326:Institutionalization; D008297:Male