THE EVOLUTION OF NUTRITIONAL STATUS OF GERIATRIC PATIENTS WITHOUT CACHEXIA IS ASSOCIATED WITH FOOD INTAKE IN SUB-ACUTE CARE

Objectives: To determine if changes in patients’ nutritional status during hospitalization are related to daily energy and protein intakes when cachectic/inflammatory conditions are controlled for. Design: Prospective study. Subjects: A total of 32 non-cachectic patients (21 women; 65-92y). Methods: Nutritional status was evaluated at admission and discharge using the Protein-Energy Malnutrition Index which includes BMI, %IBW, TS, MAC, albumin, hemoglobin and lymphocyte count. Food intake was assessed 3 meals/day every other day for an average of 46.2 ± 14.6 meals/participant. Results: In all, 47% of the study sample was malnourished at admission. Nutritional status improved in 73% of patients who had been identified as malnourished and in 30 % of non-malnourished patients at admission. Total energy intake correlated with improvements in BMI, %IBW and total lymphocyte count (all p < 0.04). Improvement in PEMI score for the whole group was associated with functional status (p < 0.05). Controlling for this variable, energy (kj/kg body weight) and protein (g/kg body weight) intakes correlated positively with improvements in BMI, %IBW and MAC (Energy: partial r = 0.644, 0.624, 0.466 respectively; Protein: partial r = 0.582, 0.554, 0.433 respectively; all p < 0.05). Conclusions: Results from this study offer strong evidence that when cachectic/inflammatory conditions are controlled for, standard nutrition care is compatible with the maintenance or improvement of nutritional status during the hospital stay.