MON-P022: Improving Nutritional Status in the Frail Old after Hospital Discharge - Influencing Factors

Geriatrics 2 dynamometry and frailty evaluated using the criteria by Fried [2]. Patients were questioned regarding fall frequency within the previous 12 months. Results: 75 patients (77.3 ± 7.0 years, 54% women) were included. Mean PhA was 3.7 ± 0.7°. 51 (67%) patients were below the 5th RefPerc, while with standardisation 38 (50.7%) patients were 2 SD under the expected norm value. There was a moderate correlation between PhA and hand grip strength (r = 0.30, p = 0.010) as well as with knee extension strength (r = 0.31, p = 0.015). Patients under the 5th RefPerc had fallen significantly more frequently in the previous 12 months (70.6% vs 46.0%, p = 0.049) and were more often frail (98.0% vs 80.0%, p = 0.014). Conclusion: In the majority of geriatric patients at hospital discharge, PhA is below the reference value and is associated with reduced strength, increased fall frequency and frailty. References [1] Bosy-Westhphal et al. JPEN. 2006 [2] Fried et al. J Gerontol A Biol Sci Med Sci, 2001 Disclosure of Interest: None declared

MON-P021 EFFECT OF A THREE MONTH POST-HOSPITAL NUTRITIONAL INTERVENTION ON FUNCTIONAL PERFORMANCE IN FRAIL AND MALNOURISHED OLDER ADULTS – A RANDOMIZED CONTROLLED STUDY L. Otten1, J. Kiselev1, K. Franz1, E. Steinhagen-Thiessen1, U. Müller-Werdan1, R. Eckardt1, D. Spira1, K. Norman1. 1 Research Group on Geriatrics, Charité Universitätsmedizin Berlin, Berlin, Germany Rationale: Malnutrition at hospital discharge is common in frail older adults contributing to higher morbidity, loss of function and an increased hospital readmission rate. We investigated the effect of a 3 month nutritional supplementation compared to dietary counselling at discharge on strength, mobility, functional limitations and quality of life (QoL) in frail malnourished old patients. Methods: Malnutrition was identified with the Mini Nutritional Assessment-Short Form (MNA-SF) and frailty was evaluated with the Fried Criteria (1). Patients were randomized at discharge to receive either dietary counselling (DC) or DC and oral nutritional supplements for three months (ONS). Mobility was assessed with the Timed Up&Go Test (TUG), grip strength and knee extension strength were measured with dynamometry and QoL was evaluated with the EuroQol visual analogue scale (EQ-VAS). Self-reported functional limitations were assessed with the Longitudinal Amsterdam Aging Study (LASA) questionnaire. Results: 71 patients completed the study to date (78.2 ± 6.8 years; 56.3% women) and were analyzed according to intention-to-treat. While nutritional status (DC: 7.4 ± 2.2 to 11.0 ± 2.7, p < 0.0001; ONS: 6.8 ± 1.9 to 10.8 ± 2.5, p < 0.0001) and grip strength (DC: 24.4 ± 7.0 to 25.7 ± 7.6; p = 0.018; ONS: 21.9 ± 6.2 to 24.1 ± 8.2, p = 0.006) increased significantly in both groups, knee extension strength (14.3 ± 5.7 to 17.8 ± 6.3, p = 0.015), TUG (23.6 ± 10.9 to 18.6 ± 6.7, p = 0.020), functional limitations (4.1 ± 1.7 to 3.3 ± 1.9, p = 0.002) and QoL (50.0 ± 18.1 to 60.8 ± 20.7, p = 0.011) only improved significantly in the intervention group.

S161 Conclusion: The results of this interim analysis suggest that an intervention with ONS improves functional and strength parameters, as well as QoL in frail older adults during the vulnerable period after hospital discharge. References Fried et al. J Gerontol A Med Sci, 2001 Disclosure of Interest: None declared

MON-P022 IMPROVING NUTRITIONAL STATUS IN THE FRAIL OLD AFTER HOSPITAL DISCHARGE – INFLUENCING FACTORS L. Otten1, K. Franz1, J. Kiselev1, U. Müller-Werdan1, R. Eckardt1, D. Spira1, K. Norman1. 1Research Group on Geriatrics, Charité Universitätsmedizin Berlin, Berlin, Germany Rationale: Malnutrition upon hospital discharge is a prevalent issue which can negatively influence post-hospital recovery [1]. In a secondary analysis of a randomised controlled trial with malnourished, old patients, we looked at the factors influencing an improvement in nutritional status 3 months after discharge. Methods: Malnutrition at discharge (T0) was identified with the Mini Nutritional Assessment–Short Form (MNA). Patients were randomised at T0 to either dietary counselling (DC) or DC and oral nutrition supplements for 3 months. Grip strength was measured with dynamometry. Validated questionnaires evaluated restrictions in activities of daily life (ADL), depression (CESD) and appetite (CNAQ). Living situation (alone or not) and financial situation were self-reported. The influencing factors on good nutritional status (MNA ≥ 12) after 3 months were investigated in a logistic regression. Results: 74 patients have completed the study to date (78.2 ± 6.7 years; 56.8% women). At T0, 39 (52.7%) patients were malnourished (MNA < 8). 42 (56.8%) lived alone. 56 (75.6%) indicated that they “get by well” financially. 12 (16.2%) required help in some and 34 (45.9%) in most ADL. 53 (71.6%) were at risk of weight loss due to loss of appetite. 25 (33.8%) had a risk of depression. After 3 months, 35 (49.3%) had reached MNA ≥ 12. The logistic regression showed that the male sex (OR 8.414, CI:1.065–66.416, p = 0.043), independence in ADL (OR 1.070, CI:1.011–1.131, p = 0.019), a good appetite (OR 1.515, CI:1.137–2.017, p = 0.004) and a positive emotional state (OR 1.153, CI:1.034–1.286, p = 0.011) positively influenced the development of a normal nutritional status, while grip strength had a slight negative influence (OR 0.810, CI:0.688–0.953, p = 0.011). Conclusion: The results of this interim analysis indicate that psycho-social factors play a considerable role in the improvement of nutritional status after hospital stay. References [1] Krumholz H.M., NEJM, 2013. Disclosure of Interest: None declared

MON-P023 THE MULTIDISCIPLINARY EFFORTS FOR THE GERIATRICS WITH DYSPHAGIA M. Stauner1, C. Emborg1, T. Bossow1, M. Valentinus1. 1 Ernæringsenheden, Roskilde kommune, Roskilde, Denmark