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Transmural communication in the approach of malnutrition in geriatric patients
S84
8th Congress of the EUGMS / European Geriatric Medicine 3S (2012) S33–S143
results, evidence summary, commentary, and bottom line conclusions. Literature search yielded 326 citations. Three studies were selected: Lauque 2004, Pivi 2011, and de Sousa 2011. These studies investigated the effect of ONS compared with care as usual or a nutrition educational program. They demonstrated that ONS improved AD patients’ nutritional status. However, these studies had several shortcomings: the place of residence was unclear (n = 2) or patients were hospitalized (n = 1), undernutrition was not an inclusion criterion (n = 1), study groups were small (n = 2) and the process of randomisation and blinding was not described (n = 3). Despite the negative consequences of weight loss in AD patients, insufficient data exist regarding the effect of ONS in undernourished community-dwelling AD patients. We are therefore planning a RCT to answer this question. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.171 P171
Transmural communication in the approach of malnutrition in geriatric patients D. Van Asselt ∗ , D. Haringa , T. Schuur , J. Van Steijn , C. Van Der Hooft , P. Van Walderveen , E. Huinink Geriatric Medicine, Medical Center Leeuwarden, Leeuwarden, Netherlands
Introduction.– Because hospital admissions are getting shorter recovery largely takes place at home. To ensure continued treatment of malnutrition after discharge, appropriate transfer of information to the general practitioner (GP) is crucial. In September 2011, we changed the format of our discharge letter in such a way that information on the nutritional status would be provided in the conclusions and advices. Text.– We hypothesized that the new format would improve the amount of information on malnutrition in our discharge letters. We retrospectively studied discharge letters from the same periods in the year before (2010) and after (2011) the change of format. In addition, GP’s where asked to qualify the information on malnutrition in our discharge letter. The discharge letters of 87 (2010, mean age 84 ± 7 years; malnutrition n = 28; length of hospital stay 16 ± 8 days) and 98 (2011, mean age 83 ± 7 years; malnutrition n = 33; length of hospital stay 15 ± 8 days) patients were studied. There was no change in the number of diagnosis mentioned in the conclusion (9/28 in 2010 vs. 10/33 in 2011; P = 1.0) or in advices (2/28 in 2010 vs. 4/33 in 2011; P = 0.7). GP’s rated the information on malnutrition unclear without a difference between years (2010 unclear 57% versus 2011 unclear 52% (P = 0.8). The new format of our discharge letter did not result in more information on malnutrition. Therefore, other measures are needed to ensure adequate transfer of information to the GP’s. Maybe the dietician should be responsible for the transfer. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.172 P172
Nutritional status and its association with the mortality in community dwelling Turkish elderly
G. Bahat ∗ , Y. Aydin , F. Tufan , S. Akin , B. Saka , N. Erten , M.A. Karan Internal Medicine Division Of Geriatrics, Istanbul University Istanbul Medical School, Istanbul, Turkey Introduction.– Detection of malnutrition and its differentiation from changes related to aging may not be easy. However, malnutrition may end with rapid detoriation in health and mortality. We aimed
to study the relation of malnutrition with mortality in a group of community-dwelling Turkish elderly. Methods.– Geriatrics outpatient clinics patients were assessed retrospectively. Age, gender, marital-status, nutritional-state (via MNA), diseases, drugs, total number of chronic diseases and drugs, MMSE-GDS points, habits of smoking and alcohol-use were noted. Mortality was assessed. Results.– Among 608 patients, 72.1%, 24.3%, 4.6% had normal nutrition (NN),) malnutrition-risk (MNR) and malnutrition (MN), respectively. Mean follow-up was 40.4 ± 25.3 months. One hundred and eight patients had (17.8%) died in the follow-up. Mortality rates were 35.7%, 22.9%, and 14.8% in patients with MN, MNR and NN, respectively (MN vs NN, P = 0.022; MNR vs NN, P = 0.003; MNR vs MN, P = 0.177). Mean time-to-mortality were 16 ± 16, 21.3 ± 14.5, 30.4 ± 20.3 months in patients with MN, MNR and NN, respectively (MN vs NN, P = 0.004; MNR vs NN, P = 0.055; MNR vs MN, P = 0.153). Factors related-to-mortality were age, gender, nutritional status, total number of chronic diseases, MMSE, diabetes, Parkinson’s disease, and use of angiotensin receptor blockers, sulfonylurea, L-dopa, rivastigmine, memantine, antipsychotics by univariate analysis. Multivariate analysis yielded only nutritional status and use of sulfonylurea as related-to-mortality. Antipsychotic-use was almost significant (P = 0.05). Conclusion.– Poor nutritional status was related to higher and quicker mortality. MNR was as effective and important as MN in mortality. The mortality enhancer effect of poor nutritional status was independent and more important than many factors. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.173 P173
The demographic, disease and drug correlates of nutrition in community dwelling elderly
G. Bahat ∗ , Y. Aydin , F. Tufan , S. Akin , B. Saka , N. Erten , M.A. Karan Internal Medicine Division Of Geriatrics, Istanbul University Istanbul Medical School, Istanbul, Turkey Introduction.– Malnutrition may end with rapid detoriation in health and mortality. We aimed to study the demographic, disease and drug correlates of nutrition in community-dwelling elderly. Methods.– Geriatrics outpatient clinics patients were assessed retrospectively. Age, gender, marital-status, nutritional-state (via MNA), diseases, drugs, total number of chronic-diseases/drugs, MMSE, GDS, smoking and alcohol-use were noted. Results.– Among 608 patients, 72.1%, 24.3%, 4.6% had normal nutrition (NN), malnutrition-risk (MNR) and malnutrition (MN), respectively. Mean age was 76.3 ± 8, 75.1 ± 6.8, 73.0 ± 6.8 years in MN, MNR and NN patients, respectively (MNvsMNR, P > 0.05; MNvsNN and MNRvsNN, P < 0.001). Mean no-of-chronic diseases were 3.2 ± 1.3, 3.1 ± 1.5, 2.6 ± 1.3 in MN, MNR and NN patients, respectively (MNRvsMN and MNvsNN, P > 0.05; MNRvsNN, P = 0.001). Mean GDS-point was only higher in MNR patients than NN (P = 0.008). Mean MMSE-point was lower in poor nutrition (NNvsMNR, P = 0.000; NNvsMN, P = 0.003; MNRvsMN, P > 0.05). Factors related to nutrition were age, number-of-chronic diseases, number-of drugs, MMSE, GDS, dementia, Parkinson’s disease, hyperlipidemia, use of rivastigmine, alpha-blockers, antipsychotics, TCA, SSRI, metformin, mirtazapine, clopidogrel. Multivariate analysis yielded only age, number-of-chronic diseases, MMSE and GDS points related to nutritional-status. Conclusion.– Factors related to nutrition were age, number of chronic diseases, number of drugs, MMSE, GDS, dementia, Parkinson’s disease, hyperlipidemia, use of rivastigmine, alpha-blockers, antipsychotics, TCA, SSRI, metformin, mirtazapine, clopidogrel of which advanced age, high no. of chronic diseases, low MMSE and high GDS points were independently related. The elderly
8th Congress of the EUGMS / European Geriatric Medicine 3S (2012) S33–S143
results, evidence summary, commentary, and bottom line conclusions. Literature search yielded 326 citations. Three studies were selected: Lauque 2004, Pivi 2011, and de Sousa 2011. These studies investigated the effect of ONS compared with care as usual or a nutrition educational program. They demonstrated that ONS improved AD patients’ nutritional status. However, these studies had several shortcomings: the place of residence was unclear (n = 2) or patients were hospitalized (n = 1), undernutrition was not an inclusion criterion (n = 1), study groups were small (n = 2) and the process of randomisation and blinding was not described (n = 3). Despite the negative consequences of weight loss in AD patients, insufficient data exist regarding the effect of ONS in undernourished community-dwelling AD patients. We are therefore planning a RCT to answer this question. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.171 P171
Transmural communication in the approach of malnutrition in geriatric patients D. Van Asselt ∗ , D. Haringa , T. Schuur , J. Van Steijn , C. Van Der Hooft , P. Van Walderveen , E. Huinink Geriatric Medicine, Medical Center Leeuwarden, Leeuwarden, Netherlands
Introduction.– Because hospital admissions are getting shorter recovery largely takes place at home. To ensure continued treatment of malnutrition after discharge, appropriate transfer of information to the general practitioner (GP) is crucial. In September 2011, we changed the format of our discharge letter in such a way that information on the nutritional status would be provided in the conclusions and advices. Text.– We hypothesized that the new format would improve the amount of information on malnutrition in our discharge letters. We retrospectively studied discharge letters from the same periods in the year before (2010) and after (2011) the change of format. In addition, GP’s where asked to qualify the information on malnutrition in our discharge letter. The discharge letters of 87 (2010, mean age 84 ± 7 years; malnutrition n = 28; length of hospital stay 16 ± 8 days) and 98 (2011, mean age 83 ± 7 years; malnutrition n = 33; length of hospital stay 15 ± 8 days) patients were studied. There was no change in the number of diagnosis mentioned in the conclusion (9/28 in 2010 vs. 10/33 in 2011; P = 1.0) or in advices (2/28 in 2010 vs. 4/33 in 2011; P = 0.7). GP’s rated the information on malnutrition unclear without a difference between years (2010 unclear 57% versus 2011 unclear 52% (P = 0.8). The new format of our discharge letter did not result in more information on malnutrition. Therefore, other measures are needed to ensure adequate transfer of information to the GP’s. Maybe the dietician should be responsible for the transfer. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.172 P172
Nutritional status and its association with the mortality in community dwelling Turkish elderly
G. Bahat ∗ , Y. Aydin , F. Tufan , S. Akin , B. Saka , N. Erten , M.A. Karan Internal Medicine Division Of Geriatrics, Istanbul University Istanbul Medical School, Istanbul, Turkey Introduction.– Detection of malnutrition and its differentiation from changes related to aging may not be easy. However, malnutrition may end with rapid detoriation in health and mortality. We aimed
to study the relation of malnutrition with mortality in a group of community-dwelling Turkish elderly. Methods.– Geriatrics outpatient clinics patients were assessed retrospectively. Age, gender, marital-status, nutritional-state (via MNA), diseases, drugs, total number of chronic diseases and drugs, MMSE-GDS points, habits of smoking and alcohol-use were noted. Mortality was assessed. Results.– Among 608 patients, 72.1%, 24.3%, 4.6% had normal nutrition (NN),) malnutrition-risk (MNR) and malnutrition (MN), respectively. Mean follow-up was 40.4 ± 25.3 months. One hundred and eight patients had (17.8%) died in the follow-up. Mortality rates were 35.7%, 22.9%, and 14.8% in patients with MN, MNR and NN, respectively (MN vs NN, P = 0.022; MNR vs NN, P = 0.003; MNR vs MN, P = 0.177). Mean time-to-mortality were 16 ± 16, 21.3 ± 14.5, 30.4 ± 20.3 months in patients with MN, MNR and NN, respectively (MN vs NN, P = 0.004; MNR vs NN, P = 0.055; MNR vs MN, P = 0.153). Factors related-to-mortality were age, gender, nutritional status, total number of chronic diseases, MMSE, diabetes, Parkinson’s disease, and use of angiotensin receptor blockers, sulfonylurea, L-dopa, rivastigmine, memantine, antipsychotics by univariate analysis. Multivariate analysis yielded only nutritional status and use of sulfonylurea as related-to-mortality. Antipsychotic-use was almost significant (P = 0.05). Conclusion.– Poor nutritional status was related to higher and quicker mortality. MNR was as effective and important as MN in mortality. The mortality enhancer effect of poor nutritional status was independent and more important than many factors. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.173 P173
The demographic, disease and drug correlates of nutrition in community dwelling elderly
G. Bahat ∗ , Y. Aydin , F. Tufan , S. Akin , B. Saka , N. Erten , M.A. Karan Internal Medicine Division Of Geriatrics, Istanbul University Istanbul Medical School, Istanbul, Turkey Introduction.– Malnutrition may end with rapid detoriation in health and mortality. We aimed to study the demographic, disease and drug correlates of nutrition in community-dwelling elderly. Methods.– Geriatrics outpatient clinics patients were assessed retrospectively. Age, gender, marital-status, nutritional-state (via MNA), diseases, drugs, total number of chronic-diseases/drugs, MMSE, GDS, smoking and alcohol-use were noted. Results.– Among 608 patients, 72.1%, 24.3%, 4.6% had normal nutrition (NN), malnutrition-risk (MNR) and malnutrition (MN), respectively. Mean age was 76.3 ± 8, 75.1 ± 6.8, 73.0 ± 6.8 years in MN, MNR and NN patients, respectively (MNvsMNR, P > 0.05; MNvsNN and MNRvsNN, P < 0.001). Mean no-of-chronic diseases were 3.2 ± 1.3, 3.1 ± 1.5, 2.6 ± 1.3 in MN, MNR and NN patients, respectively (MNRvsMN and MNvsNN, P > 0.05; MNRvsNN, P = 0.001). Mean GDS-point was only higher in MNR patients than NN (P = 0.008). Mean MMSE-point was lower in poor nutrition (NNvsMNR, P = 0.000; NNvsMN, P = 0.003; MNRvsMN, P > 0.05). Factors related to nutrition were age, number-of-chronic diseases, number-of drugs, MMSE, GDS, dementia, Parkinson’s disease, hyperlipidemia, use of rivastigmine, alpha-blockers, antipsychotics, TCA, SSRI, metformin, mirtazapine, clopidogrel. Multivariate analysis yielded only age, number-of-chronic diseases, MMSE and GDS points related to nutritional-status. Conclusion.– Factors related to nutrition were age, number of chronic diseases, number of drugs, MMSE, GDS, dementia, Parkinson’s disease, hyperlipidemia, use of rivastigmine, alpha-blockers, antipsychotics, TCA, SSRI, metformin, mirtazapine, clopidogrel of which advanced age, high no. of chronic diseases, low MMSE and high GDS points were independently related. The elderly