Abstract
To investigate how the energy intake of institutionalized long-term-care patients through the regular nontherapeutic meals provision is associated with the nutritional status and the Geriatric Nutritional Risk Index (GNRI). A 9 month longitudinal, observational study. Long-term-care Hospital. 66 long-term-care patients with multiple medical conditions and solely oral food-intake. 47 (71 %) patients, predominantly women (n = 39/47), with a mean age of 83.04 (±9.58) years completed study time and 19 (29 %) deceased. At week 1 and week 36 of observation time energy intake was measured by means of three-days-weighing-records. Body composition was assessed with bioelectrical impedance analysis. Serum albumin, body weight and body height were taken from the medical report. Albumin content, body weight and height were used to calculate the Geriatric Nutritional Risk Index: GNRI = [1.489 × albumin (g/L)] + [41.7 × (weight/ideal body weight)]. Energy intake was significantly below 24 kcal/kg body weight per day. The GNRI of the deceased patients was significantly (p = 0.002) lower than the GNRI of the completers. During observation time energy-intake p < 0.001, body fat (p = 0.001) and phase angle (PA) of bio impedance measurement (p = 0.018) and likewise the GNRI (p = 0.021) of the completers decreased significantly. At the beginning and at the end of observation time energy intake correlated significantly with PA (p = 0.028/p < 0.001) and GNRI (p = 0.436/p = 0.004). Also GNRI and PA correlated significantly at the beginning (p = 0.001) and at the end (p < 0.001) of observation time. The energy intake through non therapeutic meals provision was too low for sustaining the nutritional status and likewise the GNRI. The malnourishment and the nutrition related clinical risk of the geriatric patients aggrevated during observation time.
Highlights
Energy undernutrition is a prominent problem for institutionalized long-term-care patients
To investigate how the energy intake of institutionalized long-term-care patients through the regular nontherapeutic meals provision is associated with the nutritional status and the Geriatric Nutritional Risk Index (GNRI)
Of the 66 patients enrolled in the study 19 geriatric patients with a mean age of 88.7 (±6.8) years died during observation time
Summary
Energy undernutrition is a prominent problem for institutionalized long-term-care patients. With low energy intake, results in a state of under nutrition. Energy undernutrition results in a wasting of both fat and lean mass. Sturtzel et al SpringerPlus (2016) 5:136 in malnourished persons, within lean mass, body cell mass is depleted relative to extracellular mass (Pencharz and Azcue 1996). For avoiding harmful nutrition related clinical consequences it is important to assess whether the energy intake through regular non therapeutic meals provision meets the energy requirement of the geriatric patients (Anbar et al 2014). To our best knowledge there is no sufficient information about the relationship between the oral energy intake through the regular non therapeutic meals provision and possible effects on the nutrition related clinical complications risks (Cereda et al 2008; Volkert et al 2013; Pedrolli and Cereda 2008)
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