Combination of flavor enhancement and chemosensory education improves nutritional status in older cancer patients.
BACKGROUND
Abnormalities in taste and smell functioning occur with elevated frequency in both older adults and patients with cancer. With the predicted increase in both of these populations in the coming decades, it is imperative to evaluate potential interventions that are designed to help older cancer patients compensate for the additive burden of this disease and its treatment on age-related taste and smell losses.


OBJECTIVE
The purpose of the current study was to determine if providing instruction and products for flavor enhancement of foods to elderly cancer patients in addition to nutritional information would improve their nutritional status, and, by extension, functional and immune status as well as quality of life.


METHODS
One hundred and seven subjects enrolled in the study. Fifty-four subjects were in the experimental group that received flavor enhancement plus nutritional information; fifty-three control subjects received only nutritional information. Subjects were evaluated 1 month, 3 months, and 8 months after beginning chemotherapy. At every session, subjects completed taste and smell assessments as well as questionnaires related to nutritional status, activities of daily living, and quality of life. Blood samples were also obtained to determine immune parameters.


RESULTS
At the eight-month time point, experimental subjects had better scores on the mini nutritional assessment (MNA) and the physical function assessment of the quality of life questionnaire. Also at eight months, self-reported taste and smell perception for experimental subjects was better than that of controls as well as better than at earlier time points. Tests that assessed quantity and quality of food intake, as well as a number of immune parameters declined over time and did not differ significantly between groups.


CONCLUSIONS
The combination of flavor enhancement, chemosensory education, and nutritional information for elderly cancer patients improved their nutritional assessment on the MNA and physical function over time. On the whole, experimental subjects perceived themselves to be better functioning at eight months than did their control counterparts.
Department of Psychiatry, Duke University Medical Center, Durham, NC 27710, USA. schif003@mc.duke.edu
S S
SS
Schiffman
E A
EA
Sattely-Miller
E L
EL
Taylor
B G
BG
Graham
L R
LR
Landerman
J
J
Zervakis
L K
LK
Campagna
H J
HJ
Cohen
S
S
Blackwell
J L
JL
Garst
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy; D005260:Female; D005421:Flavoring Agents / Q000627:therapeutic use*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy; D008297:Male; D044342:Malnutrition / Q000139:chemically induced / Q000628:therapy; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D000857:Olfaction Disorders / Q000139:chemically induced / Q000628:therapy*; D011788:Quality of Life; D012903:Smell / Q000502:physiology; D013649:Taste / Q000502:physiology; D013651:Taste Disorders / Q000139:chemically induced / Q000628:therapy*; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D005421:Flavoring Agents