Hip Fracture Patients in Geriatric Rehabilitation Show Poor Nutritional Status, Dietary Intake and Muscle Health.

Inge Groenendijk,Charlotte S Kramer,Lisette C P G M De Groot,Hans S M Hobbelen,Laura M Den Boeft,Gert-Jan Van Der Putten

doi:10.3390/nu12092528

Abstract

The aim of this study was to gain insight into the nutritional status, dietary intake and muscle health of older Dutch hip fracture patients to prevent recurrent fractures and to underpin rehabilitation programs. This cross-sectional study enrolled 40 hip fracture patients (mean ± SD age 82 ± 8.0 years) from geriatric rehabilitation wards of two nursing homes in the Netherlands. Assessments included nutritional status (Mini Nutritional Assessment), dietary intake on three non-consecutive days which were compared with Dietary Reference Intake values, and handgrip strength. Muscle mass was measured using Bioelectrical Impedance Analysis and ultrasound scans of the rectus femoris. Malnutrition or risk of malnutrition was present in 73% of participants. Mean energy, protein, fibre and polyunsaturated fat intakes were significantly below the recommendations, while saturated fat was significantly above the UL. Protein intake was <0.8 in 46% and <1.2 g/(kg·day) in 92%. Regarding micronutrients, mean intakes of calcium, vitamin D, potassium, magnesium and selenium were significantly below the recommendations. The prevalence of low muscle mass, low handgrip strength and sarcopenia were 35, 27 and 10%, respectively. In conclusion, a poor nutritional status, dietary intake and muscle health are common in older hip fracture patients in geriatric rehabilitation wards.

Highlights

Hip fractures are common injuries seriously affecting the health status and quality of life of older patients [1]
Between October 2017 and April 2018, 44 hip fracture patients were admitted to the geriatric rehabilitation (GR) wards of which 40 patients (91%) were included
27 participants lived independently, 11 participants received home care and 2 participants lived with their family

Summary

Introduction

Hip fractures (i.e., proximal femur fractures) are common injuries seriously affecting the health status and quality of life of older patients [1]. 22 percent of older hip fracture patients die and only 40 to 60 percent of the survivors regain their pre-fracture functional level [2,3]. Sarcopenia, defined by low levels of muscle strength, muscle quantity/quality and physical performance [5], is common in older hip fracture patients with higher prevalence rates compared to older adults without a hip fracture [8,9]. While sarcopenia might already have been present prior to the fracture, an acute period of disuse of muscles during hospitalization is likely to induce further and rapid decline of muscle mass, strength and function [12,13,14]

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