A longitudinal study on the nutritional state of elderly women at a nursing home in Japan.
OBJECTIVE
Elderly people at nursing homes often suffer from malnutrition, which is characterized by a loss of muscle mass and hypoalbuminemia. This malnourished state is closely associated with an impaired activity of daily living (ADL). We analyzed the nutritional state of such elderly individuals longitudinally over 3 years by anthropometry, serum albumin, and muscle and fat volume as estimated by MRI.


METHODS
The subjects consisted of 16 elderly women aged 83 +/- 7 (mean +/- SD) years who resided at a nursing home in an urban area of central Japan. We determined their ADL levels using the Barthel Index (BI) at entry. Seven women belonged to group A (BI; 65-100), thus implying either a mild or no decline in ADL, while the other 9 were in group B (BI; 0-60) and they demonstrated a severe decline in ADL. We measured the following parameters every year from 2000 to 2003; anthropometry including height, body weight, arm circumference (AC), and arm muscle circumference (AMC), thigh muscle and fat volume as estimated by MRI [thigh muscle volume (TMV) and thigh fat volume (TFV)], serum albumin, and plasma amino acid levels by blood biochemistry. The anthropometric values were converted into percentages of the age- and sex-matched reference values for Japanese.


RESULTS
In all subjects, the TMV, %AMC, and serum albumin level decreased significantly during the three-year period (p<0.05, respectively). The change in TMV correlated significantly with those in the %AC and %AMC (p<0.05, respectively). Group B showed significantly larger decreases in the %AMC and serum albumin level than group A.


CONCLUSIONS
Both the muscular and visceral protein levels were found to decrease with aging in the subjects at the nursing home. This decrease depends partly on the ADL level of each subject.
Nakamura
Hironori
H
Department of Internal Medicine, Gifu University School of Medicine.
Fukushima
Hideki
H
Miwa
Yoshiyuki
Y
Shiraki
Makoto
M
Gomi
Ikuko
I
Saito
Masaya
M
Mawatari
Kazunori
K
Kobayashi
Hisamine
H
Kato
Masahiko
M
Moriwaki
Hisataka
H
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000596:Amino Acids / Q000097:blood; D000886:Anthropometry; D001132:Arm / Q000033:anatomy & histology; D015992:Body Mass Index; D002149:Energy Intake; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007866:Leg / Q000033:anatomy & histology; D008137:Longitudinal Studies; D018482:Muscle, Skeletal / Q000033:anatomy & histology; D009133:Muscular Atrophy / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D009735:Nursing Homes / Q000706:statistics & numerical data; D009749:Nutrition Surveys; D009752:Nutritional Status; D011502:Protein-Energy Malnutrition / Q000097:blood / Q000453:epidemiology / Q000473:pathology; D012709:Serum Albumin / Q000032:analysis; D012885:Skinfold Thickness; D013851:Thinness / Q000097:blood / Q000453:epidemiology
D000596:Amino Acids; D012709:Serum Albumin