title: A Dedicated Nutritional Care Program (NUTRICARE) to reduce malnutrition in institutionalised dysphagic older people: A quasi-experimental study.
abstract: OBJECTIVE
  To assess the effects of a texture-modified food program for dysphagia on the nutritional, biochemical and functional profile in a cohort of institutionalised older people in Italy.
  
  
  BACKGROUND
  Dysphagic institutionalised older people, often also affected by dementia, are frequently exposed to malnutrition. Malnutrition in older people has negative effects on mortality, days of hospitalisation, infection, wound healing and risk of pressure injuries. Therefore, it is very important to prevent malnutrition in this frail population.
  
  
  METHODS
  A pre-post study without a control group.
  
  
  METHODS
  The study included 479 dysphagic institutionalised older people from 20 nursing homes. Anthropometrical, biochemical, nutritional and functional parameters were collected retrospectively, 6 months before the study intervention, at time zero and, prospectively for 6 months after implementing the NUTRICARE food programme, for a total of nine evaluations. The NUTRICARE programme includes meals without nutritional supplementation, and personalised levels of density, viscosity, texture and particle size.
  
  
  RESULTS
  The total mean body mass index of our sample passed from 17.88-19.00; body weight averagely improved by 7.19%, as well as their nutritional and biochemical profiles. There was a progressive improvement of total protein and serum albumin values. Nutritional parameters (serum transferrin and lymphocytes) displayed similar changes. Plasma lymphocytes reached normal levels in 98.23% of the sample. Plasma creatinine levels remained steady throughout the study and within the normal range. No side effects were reported.
  
  
  CONCLUSIONS
  The NUTRICARE food programme with a adequate proteins, calories, balanced nutritional and bromatological properties, and appropriate texture and palatability significantly improved the nutritional, biochemical and functional profile in a cohort of institutionalised dysphagic older people.
  
  
  CONCLUSIONS
  The introduction of a balanced nutritional programme, using high-quality natural ingredients, appropriate texture and palatability can significantly improve health and quality of life in dysphagic older people.
authors.affiliation: Department of Health Sciences, University of Genoa, Genoa, Italy.
authors.forename: Milko
authors.identifier: http://orcid.org/0000-0002-1081-6279
authors.initials: M
authors.lastname: Zanini
authors.affiliation: Department of Health Sciences, University of Genoa, Genoa, Italy.
authors.forename: Annamaria
authors.identifier: http://orcid.org/0000-0002-9079-8460
authors.initials: A
authors.lastname: Bagnasco
authors.affiliation: Department of Health Sciences, University of Genoa, Genoa, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Catania
authors.affiliation: Department of Health Sciences, University of Genoa, Genoa, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Aleo
authors.affiliation: Department of Health Sciences, University of Genoa, Genoa, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Sartini
authors.affiliation: Department of Health Sciences, University of Genoa, Genoa, Italy.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Cristina
authors.affiliation: Private Outpatient Nutritional Service, Brugherio, MB, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Ripamonti
authors.affiliation: Department of Internal Medicine & Medical Specialties, University of Genoa, Genoa, Italy.
authors.forename: Fiammetta
authors.initials: F
authors.lastname: Monacelli
authors.affiliation: Department of Internal Medicine & Medical Specialties, University of Genoa, Genoa, Italy.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Odetti
authors.affiliation: Department of Health Sciences, University of Genoa, Genoa, Italy.
authors.forename: Loredana
authors.initials: L
authors.lastname: Sasso
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001835:Body Weight; D003680:Deglutition Disorders / Q000150:complications / Q000451:nursing*; D003704:Dementia / Q000150:complications / Q000451:nursing*; D005260:Female; D016330:Frail Elderly; D006801:Humans; D007558:Italy; D008297:Male; D044342:Malnutrition / Q000517:prevention & control; D065228:Non-Randomized Controlled Trials as Topic; D009735:Nursing Homes; D015596:Nutrition Assessment; D009752:Nutritional Status; D018529:Nutritional Support / Q000379:methods*; D011788:Quality of Life
keywords: dementia; dysphagia; institutionalised older people; malnutrition; modified food texture; nutrition