Nutritional Intervention Reduces Falls in Malnourished Older Adults

March 06, 2012

NEW YORK (Reuters Health) Mar 05 - Malnourished seniors consuming energy- and protein-enriched foods plus extra calcium and vitamin D were less likely to fall over three months, according to a secondary analysis of data from a randomized trial.

The nutritional intervention provided an additional 600 kcal, 24 g of protein, and 600 IU of vitamin D per day and included telephone counseling by a dietitian.

The 210 study participants, all at least 60 years old, were hospitalized for acute indications at baseline. In the primary study, three months of treatment after discharge (as opposed to usual care) led to weight gain and a decrease in functional impairment.

In the newer analysis, Dr. Floor Neelemaat at VU University Medical Center in Amsterdam and colleagues tabulated falls over a three-month period following hospital discharge. The risk of falling at least once was far lower in the nutritional invention group: 10 of 105 vs 24 of 105 (10% vs 23%; hazard ratio 0.41). Overall, there were 57 fall incidents - 16 in the intervention group vs 41 in the usual care group.

In a report online February 8 in the Journal of the American Geriatrics Society, the authors note that roughly 30% of community-dwelling persons aged 65 and older fall once a year, and 15% fall at least twice a year.

They say the rate of falls in the three-month study was as expected in the intervention participants (10%) but higher than expected in the control group (30%).

They saw similar physical activity in the two groups, with no change over the study period, suggesting that altered activity level did not account for the between-group difference in falls.

The researchers say patients in the intervention and control groups had similar functional limitations, body weight, grip strength, and physical performance. Data on all well-known risk factors for falls were lacking, however, as were data on polypharmacy and vision impairment, which could affect the results.

A strength of the study is that adherence to the nutritional intervention was higher than 80%, which may explain the better results than in other studies, the researchers write. They believe the high adherence to the intervention may be due to the counseling component of the study.

Summing up, they say, "This is one of the first studies showing these effects in such a short period and in a participant sample consisting of exclusively malnourished individuals. It would be of interest to study the cost effectiveness of this intervention in the future."

SOURCE: https://bit.ly/xvpQGQ

J Am Geriatr Soc 2012.

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