The efficacy of nutritional support in the elderly.

Abstract

One hundred two consecutively nutritionally supported patients were studied to determine the effect of age on the response to nutritional support and outcome of hospital stay. The patients were divided into two groups: group 1 (n = 37) consisted of all patients under 65 years of age, and group 2 (n = 65) consisted of patients 65 years of age and older. All patients underwent a complete nutritional assessment prior to the initiation of nutritional support and weekly thereafter. The patients' somatic compartments were assessed using weight, arm muscle circumference, creatinine height index, and triceps skinfold thickness. The visceral compartments were assessed using serum albumin level, transferrin total iron binding capacity (TIBC) level, and total lymphocyte count. Nitrogen balance was evaluated and cell-mediated immunity was determined using a standard battery of antigens. The patients' nutritional assessment parameters at the start of therapy were compared with those at discharge or death and correlated with outcome of hospital stay. The difference in crude mortality rates between the two groups was statistically significant; however, there was no significant difference between the type and degree of nutritional depletion and mean length of nutritional therapy between the two groups. There was also no significant difference between the degree of improvement or maintenance of somatic or visceral parameters, nitrogen balance, or cell-mediated immunity between the two groups. It is therefore concluded that age alone is not a deterrent to the use of aggressive nutritional support in the elderly.