Improvement in the nutritional status of very elderly stroke patients who received long-term complete tube feeding

Abstract

Summary Background & aims Elderly patients who receive enteral nutrition after stroke are at a high risk of malnutrition. However, there are few investigations of the changes in the nutritional status of very elderly tube-fed patients in the long-term. We aimed to clarify the improvement in the nutritional status of very elderly patients who receive long-term complete tube feeding after stroke. Methods Our subjects were 68 elderly bedridden patients who received complete enteral nutrition after stroke. All subjects had hypoalbuminemia and low body weight. The subjects were divided into the Elderly group ( n = 37) and the Very elderly group ( n = 31). Their nutritional indices were measured at the time of admission, and at 6 and 12 months after admission. Changes in the nutritional indices of each group were assessed. Results In both groups, the albumin, prealbumin, total cholesterol, and hemoglobin levels and body mass index, mid-arm circumference, and triceps skinfold thickness after 12 months were significantly higher than baseline levels. There was no significant difference between the C-reactive protein level and mid-upper-arm muscle circumference at baseline and after 12 months. The raise in albumin and prealbumin levels were significantly higher in the Elderly group as compared with in the Very elderly group. However, there were no significant differences in the change in other biochemical and anthropometric parameters between the Elderly and Very elderly groups. The BMI in both groups improved to within the normal range. However, the serum albumin levels in both groups did not improve to within the normal range. Both groups showed a mild inflammatory response during the study period. Albumin and prealbumin levels were negatively associated with age. Conclusions Long-term complete tube feeding after stroke is effective for improving the nutritional status of very elderly patients. Both in the elderly and in the very elderly patients, most of the biochemical parameters and anthropometric parameters improved. However, the change in albumin levels differed between elderly patients and very elderly patients, probably because albumin levels are influenced by aging. In addition, it was difficult to improve the low serum albumin levels of bedridden elderly patients who exhibited an inflammatory response to within the normal range. Especially, in the very elderly patients, serum albumin levels were hard to reflect improvement of malnutrition.