Abstract :
To assess the effectiveness of health and nutrition program (NutriAlz) versus usual care on
functional level in elderly people with dementia living at home, as well as on clinical practice related to nutrition
and on the caregiver’s burden. Design: Cluster randomized multi-centre study with one-year follow-up. Setting:
11 Alzheimer outpatients and day care centres (Barcelona, Spain). Participants: Nine hundred and forty six
home-living Alzheimer patients with identified caregiver were consecutively recruited (intervention group: 6
centres, 448 patients vs control group: 5 centres, 498 patients). Intervention: The intervention was a teaching and
training intervention on health and nutrition program, NutriAlz, directed both to physician and main caregiver, as
well as persons affected by Alzheimerʹs disease or other dementias, including a standardised protocol for feeding
and nutrition. Main Outcome Measures: The main outcome measure was the reduction in the loss of autonomy
(Activities of daily living (ADL/IADL) scales) assessed at 6 and 12 months. Secondary outcomes measures were
Improvement in nutritional status (Mini Nutritional Assessment (MNA), BMI, and weight changes), and
caregiver burden (Zarit scale). Results: The one-year assessment was completed for 293 patients (65.4%) in the
intervention group and 363 patients (72.9%) in the control group (usual care). The annual rate of ADL change
was -0.83 vs -0.62 (p=0.984), and the caregiver’s subjective burden 0.59 vs 2.36 (p=0.681) in intervention and
control group, respectively. MNA, however, showed an improvement (+0.46 vs -0.66, p=0.028), suggesting an
effective nutritional behaviour. Conclusion: The NutriAlz program had no effect on functional decline in
Alzheimer disease patients living at home over one year, but reduced the risk for malnutrition, as
recommendations concerning diet and exercise were provided
