title: From Hospital to Home: Limited Nutritional and Functional Recovery for Older Adults.
abstract: BACKGROUND
  The post-hospital period may be a vulnerable time for elders recovering from acute illness. Few studies have examined nutrition outcomes of older people at nutrition risk after acute hospitalisation.
  
  
  OBJECTIVE
  This study aims to describe a) standard nutrition care received by recently discharged older medical patients, b) change in nutritional and functional status at six weeks post-discharge and c) clinical outcomes at twelve weeks post discharge.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Two metropolitan teaching hospitals in Brisbane, Australia.
  
  
  METHODS
  Medical patients aged ≥65 years at risk of malnutrition (Malnutrition Screening Score ≥2) and discharged to independent living in the community.
  
  
  METHODS
  Nutritional status (Mini Nutritional Assessment (MNA), weight, lean body mass), functional status (grip strength, walk speed, activities of daily living) and health-related quality of life assessed on discharge and six weeks post-discharge. Inpatient and post-discharge nutrition intervention was recorded. Death and unplanned admissions were measured at 12 weeks.
  
  
  RESULTS
  Of the 42 consented participants, only 14% (n=6) received post-discharge dietitian review and 19% (n=8) received practical nutrition supports at home (meal delivery, shopping assistance) as part of standard care. While there was a small improvement in MNA (18.4±4.0 to 20.1±4.2, p=0.004) and walk speed (0.7±0.3 m/s to 0.9±0.3, p=0.004) at six weeks, there was no difference in mean weight, lean body mass, grip strength or activities of daily living. Five (15%) participants lost ≥5% body weight. By twelve weeks, 17 participants (46%) had at least one unplanned hospital admission and four (10%) had died.
  
  
  CONCLUSIONS
  Few patients at nutrition risk received nutrition-focussed care in the post-hospital period, and most did not improve nutritional or functional status at 6 weeks.
authors.affiliation: Adrienne M Young, Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, Australia, Email: adrienne.young@health.qld.gov.au, Ph: +61 7 36468268, Fax: +61 7 3646 1874.
authors.forename: A M
authors.initials: AM
authors.lastname: Young
authors.forename: A M
authors.initials: AM
authors.lastname: Mudge
authors.forename: M D
authors.initials: MD
authors.lastname: Banks
authors.forename: L
authors.initials: L
authors.lastname: Rogers
authors.forename: J
authors.initials: J
authors.lastname: Allen
authors.forename: B
authors.initials: B
authors.lastname: Vogler
authors.forename: E
authors.initials: E
authors.lastname: Isenring