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A nutritionally focused program for community-living older adults resulted in improved health and well-being

2022; Elsevier BV; Volume: 41; Issue: 7 Linguagem: Inglês

10.1016/j.clnu.2022.05.003

1532-1983

Gabriel Gómez, Felipe Botero‐Rodríguez, Juan Diego Misas, Elkin García-Cifuentes, Suela Sulo, Cory Brunton, Luis Carlos Venegas‐Sanabria, Daniela Alejandra Gracia, Carlos Cano,

Clinical Nutrition and Gastroenterology

ObjectivesAmong older adults, malnutrition is common and is associated with increased risk for impaired health and functionality, conditions further associated with poorer quality of life. In this study of community-living older adults, our objective was to quantify outcome changes following identification and treatment of malnutrition or its risk.DesignOur intervention was a nutritional quality improvement program (QIP). The nutritional QIP included: (i) education of participants about the importance of complete and balanced macro- and micronutrient intake plus physical exercise, (ii) nutritional intervention with dietary counseling; and (iii) provision of oral nutritional supplements (ONS) for daily intake over 60 days. Follow-up measurements took place 30 days after ONS treatment ended, i.e., 90 days after start of intervention.Setting and participantsWe recruited 618 transitional-care, chronically ill, older adults (>60 years) with malnutrition/risk (per Mini Nutrition Assessment-Short Form, MNA-SF) from the outpatient clinic of Hospital Universitario San Ignacio, in Bogotá, Colombia.MethodsFor pre-post comparisons, we examined cognition (Mini-Mental State Exam, MMSE), physical abilities (Barthel Activities of Daily Living, ADL; Short Physical Performance Battery, SPPB), affective disorder status (Global Depression Scale, GDS), and quality of life (QoL; EuroQoL-5D-3L, EQ-5D-3L; EuroQoL-Visual Analog Scale, EQ-VAS).ResultsParticipants were mean age 74.1 ± 8.7 y, female majority (69.4%), and had an average of 2.6 comorbidities with cardiovascular and respiratory diseases predominant (28.5%). QIP-based nutritional intervention led to significant improvements in cognitive (MMSE) and physical functions (ADL and SPPB), affective disorder status (GDS), and health-related quality of life (EQ-VAS); all differences (P < 0.001). Self-reported QoL (EQ-5D-3L) also improved.Conclusions and implicationsOver 90 days, the nutritional QIP led to improvements in all measured outcomes, thus highlighting the importance of addressing malnutrition or its risk among community-living older adults. From a patient's perspective, maintaining mental and physical function are important and further linked with quality of life.Brief summaryFor older, community-living adults, nutrition care can improve health and well-being outcomes. Care includes screening for malnutrition risk, dietary and exercise counseling, and daily nutritional supplements when needed.ClinicalTrials.gov IdentifierNCT04042987.