SUN-P043: Nutritional Evaluation in Geriatric Amyotrophic Lateral Sclerosis Patients

S60 SUN-P042 EFFICACY OF A NEW INTERVENTION “WIPING PLUS PROVIDING ORAL NUTRITIONAL SUPPLEMENTS” IN PREVENTING ASPIRATION PNEUMONIA IN ELDERLY PEOPLE: A MULTICENTER, RANDOMIZED COMPARATIVE TRIAL H. Ohara1, T. Higashiguchi1, M. Kuzuya2, T. Kikutani3, H. Sanada4, M. Maruyama5, M. Matsuzaki6, Y. Kamakura7, A. Ito1, N. Mori8. 1Surgery & Palliative Medicine, Fujita Health University, School of Medicine, Tsu, 2Community Healthcare and Geriastrics, Nagoya University, Aichi, 3School of Life Dentistry at Tokyo, The Nippon Dental University, 4 Gerontrogical Nursing/Wound Management Division of Health Science and Nursing, Graduated School of Medicine The University of Tokyo, 5Surgery, Tanashi Hospital, 6College of Nutrition, Kanto-Gakuin University, Tokyo, 7School of Nursing & Health, Aichi prefectura | University, Nagoya, 8Surgery & Palliative Medicine, Fujita Health University, School of Medicine, Aichi, Japan Rationale: Aspiration pneumonia is the third leading cause of death in Japan. It would be extremely important for future medical care especially in elderly persons with dysphagia and with malnutrition. In this study about 75 institutions, including special elderly nursing homes, long-term care health facilities and the others participated, aimed to reveal with the efficacy of a intervention “wiping plus providing ONS: Oral Nutritional Supplements” in preventing aspiration pneumonia in elderly people. Methods: We collect total of 252 subjects who met all the inclusion criteria (age ≥75 yrs, BMI < 18.5 and serum albumin <3.5 g/dL, symptoms of dysphagia, and written informed consents were obtained) from December 2013 to May 2015. In all facilities were assigned to the control group (with conventional oral care and meals) and to the intervention group, in which subjects are received “wiping” after oral care and “ONS”. The cumulative incidences of pneumonia were analyzed by log-rank tests. Student’s t-tests were performed to analyze differences between the two groups. Results: The cumulative incidences of pneumonia at Month 8 were 7.8% and 17.7% in the intervention and control groups ( p = 0.056). In subgroup analyses, the incidence in male subjects was significantly higher in the control group than in the intervention group ( p = 0.046), and from analyses in 197 subjects (108 from special elderly nursing homes, and 89 from elderly nursing care facilities), the incidence of pneumonia were found to be 6.3% and 15.6%, respectively, in the intervention and control groups, significantly lower in the intervention group ( p = 0.048). Conclusion: This study showed that this new prophylactic intervention i.e. “wiping plus ONS” is effective for preventing aspiration pneumonia, so we are planning to disseminate it throughout Japan. Disclosure of Interest: None declared

SUN-P043 NUTRITIONAL EVALUATION IN GERIATRIC AMYOTROPHIC LATERAL SCLEROSIS PATIENTS I. Bretón1, M. Requena1, Á. Martínez1, M. Camblor1, C. Velasco1, M. Motilla1, I. Catalina2, P. Garcia-Peris1. 1 Nutrition Unit, 2Neurology Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain

Poster Rationale: Malnutrition is common in ALS patients. Advanced age may prone an additional risk factor. The aim was to describe nutritional and micronutient status in elderly ALS patients in comparison to younger ALS patients. Methods: Retrospective study in a cohort of ALS patients. Nutritional evaluation at diagnosis included BMI, albumin, prealbumin, transferrin, ferritin, Cu, Zn, B12, folate, vit A, E and D. Data are expressed as mean ± SD or frequencies. Statistical analysis: Pearson’s correlation, T test, and χ2. Results: We evaluated 213 patients (121 M), aged 61.9 ± 13.3 y. Of them, 46.5% were over 65 y (22.5% > 75 y). 68.5% experimented a spinal onset (SO). Age at diagnosis was higher in bulbar onset (BO) patients: 67.4 ± 12 vs 59.4 ± 13.2 p < 0.001. BO was significantly more common in >65 y. BMI was 26.1 ± 4.7 kg/m2 in >65 y and 25.1 ± 3.7 in >75 y. BMI was <22 kg/m2 in 13.8% and 17.4% (<18.5 in 3.2% and 6.5%) in patients over 65 and 75 y respectively. The percentages of deficiencies are expressed in table.

>65 y/>75 y

Vit D

Vit E

Prealb

Ferritin

Zn

Cu

58.6/54.2

8.1/4.2

23.2/27.1

5.1/4.2

36.4/39.6

7.1/6.3

Albumin and other micronutrients were normal in most patients. Micronutrient serum levels or risk of deficiency were not age-dependent except for Cu in BO. BMI was higher and albumin and prealbumin was lower in SO elderly patients; a positive correlation between age and BMI and negative between age and albumin and prealbumin was found. We did not find any difference in BO patients. Conclusion: At diagnosis, protein energy malnutrition is infrequent in elderly ALS patients. Micronutrient deficiency is also uncommon, with the exception of vit D and Zn. BMI is higher while albumin and prealbumin are lower in SO ALS patients. Age itself does not seem to have any influence on micronutrient serum levels or risk of deficiency. Due to the high percentage of elderly patient in ALS populations, clinicians should pay special attention to their specific needs. Disclosure of Interest: None declared

SUN-P044 IMPROVING PROTEIN INTAKE OF HOSPITALIZED OLDER PATIENTS WITH PROTEIN-ENRICHED FAMILIAR FOODS AND DRINKS: THE RANDOMIZED CONTROLLED CATER WITH CARE® TRIAL J. Beelen1, E. Vasse2, N. Janssen2, A. Janse3, N. M. de Roos1, L. C. de Groot1. 1Human Nutrition, Wageningen University, Wageningen, 2Dietetics, 3Geriatric Medicine, Hospital Gelderse Vallei, Ede, Netherlands Rationale: Adequate protein intake is important in preventing and treating undernutrition. Hospitalized older patients are recommended to consume 1.2–1.5 g of protein per kg body weight per day (g/kg/d) but most of them fail to do so. Therefore, we investigated whether a range of newly developed protein-enriched familiar foods and drinks were effective in increasing protein intake of hospitalized older patients. Methods: This randomized controlled trial involved 147 patients of ≥65 years (mean age: 78.5 ± 7.4 years). The control group (n = 80) received the standard energy and