title: First assessment at home of amyotrophic lateral sclerosis (ALS) patients by a nutrition network in the French region of Limousin.
abstract: Malnutrition is associated with poor survival among patients with amyotrophic lateral sclerosis (ALS). This study aimed to evaluate nutritional assessment by a network during first consultations in patients' homes. Patients identified by the regional ALS centre gave their informed consent. Assessment included functional, nutritional issues, evaluation of the need for help, whether personal or the use of aids, and noted any dietary supplementation and modification of the texture of food. Forty patients were seen a mean of 7.4 months after diagnosis; 52.5% had bulbar disease, 7.5% were malnourished; 29.4 ± 10.1 kcal/kg/day were consumed and protein intake was 1.3 ± 0.5 g/kg/day. Thirty-five percent of patients were anorexic, 43.8% reported taste disorders, and 70% had dysphagia, significantly associated with salivary stasis. Only 30% of dysphagic patients ate texture-modified food, and 90% of patients with problems drinking liquids did not use a thickener. In conclusion, assessment at home by a nutritional network can be conducted promptly. Malnutrition is rare in early disease, despite the fact that patients' diets are often low in energy and dysphagia is common. Unexpected taste disorders are detected. Dysphagia is very common but inadequately addressed. Consequently, home assessment by the network led several beneficial interventions.
authors: CHU Limoges, Service d'Hépato-Gastro-Entérologie, Unité Fonctionnelle de Nutrition, Limoges, France.
authors: Pierre
authors: P
authors: Jesus
authors: Aude
authors: A
authors: Massoulard
authors: Benoit
authors: B
authors: Marin
authors: Marie
authors: M
authors: Nicol
authors: Olivier
authors: O
authors: Laplagne
authors: Aurelie
authors: A
authors: Baptiste
authors: Laurence
authors: L
authors: Gindre-Poulvelarie
authors: Philippe
authors: P
authors: Couratier
authors: Jean Louis
authors: JL
authors: Fraysse
authors: Jean Claude
authors: JC
authors: Desport
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy; D019587:Dietary Supplements; D002149:Energy Intake; D004750:Enteral Nutrition; D005260:Female; D005602:France / Q000453:epidemiology; D006699:Home Care Services; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status / Q000502:physiology*; D011446:Prospective Studies; D012189:Retrospective Studies; D018709:Statistics, Nonparametric