title: Nutritional supplementation and dietary advice in geriatric patients at risk of malnutrition.
abstract: OBJECTIVE
  Effects of combined nutritional treatment of patients at risk of protein-energy malnutrition (PEM) discharged from a geriatric service were evaluated.
  
  
  METHODS
  Patients (n=108, age 85+/-6 years) at risk of malnutrition according to the short form of the mini nutritional assessment were randomly allocated to dietary counseling, including liquid and multivitamin supplementation, i.e. intervention (I, n=51) and to controls (C, n=57). Body weight, biochemical indices (e.g. insulin-like growth factor I (IGF-I)), Katz activities of daily living (ADL) index, mini mental status examination (MMSE) and quality of life (QoL) by SF-36 were assessed at the start of the study and after 4 months. Statistical analyses were performed on "intention-to-treat" and on "treated-as-protocol" bases.
  
  
  RESULTS
  Fifty-four patients, 29 in the I-group (86+/-7 years, 66% females) and 25 in the C-group (85+/-7 years, 72% females) completed the study according to the protocol. Both modes of analysis revealed a significant positive effect of the combined nutritional intervention on weight maintenance. Treated-as-protocol analyses showed that Katz ADL index improved in the I-group (p<0.001; p<0.05 between the groups). Serum IGF-I levels increased in the I-group (p<0.001), but were unchanged in the C-group (p=0.07 between the groups). QoL was assessed to be low and had not changed after nutritional treatment.
  
  
  CONCLUSIONS
  Combined nutritional intervention prevented weight loss and improved ADL functions in discharged geriatric patients at risk of malnutrition.
authors.affiliation: Department of Geriatric Medicine, Dalens Hospital and Karolinska Institutet, Stockholm, Sweden. margareta.persson@sll.se
authors.forename: Margareta
authors.initials: M
authors.lastname: Persson
authors.forename: Asa
authors.initials: A
authors.lastname: Hytter-Landahl
authors.forename: Kerstin
authors.initials: K
authors.lastname: Brismar
authors.forename: Tommy
authors.initials: T
authors.lastname: Cederholm
mesh_terms: D000203:Activities of Daily Living; D000369:Aged, 80 and over; D004032:Diet / Q000592:standards*; D019587:Dietary Supplements; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D015596:Nutrition Assessment; D011502:Protein-Energy Malnutrition / Q000178:diet therapy*; D014815:Vitamins / Q000008:administration & dosage*; D015430:Weight Gain; D015431:Weight Loss
chemical_list: D014815:Vitamins; D007334:Insulin-Like Growth Factor I