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S124
Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
P-346
Cost-effectiveness of multidisciplinary nutrition support in
frail old adults: cluster RCT
A.M. Beck
1
, H. Keiding
2
1
Effect, Herlev University Hospital, Herlev, Denmark;
2
Department
of Economics, Faculty of Social Sciences, University of Copenhagen,
Copenhagen, Denmark
Objective:
To assess the cost-effectiveness of multidisciplinary
nutritional support for undernutrition in older adults in nursing
home and home-care identified with the validated Eating Validation
Scheme (EVS).
Methods:
An 11 week cluster randomized trial with setting (home-
care or nursing home) as the unit of randomization. Before start of
the study a train-the-trainer intervention was performed involving
educated nutrition coordinators.
In addition to the nutrition coordinator, the participants assigned
to the intervention group strategy received multidisciplinary
nutrition support. Focus was on treatment of the potentially
modifiable nutritional risk factors identified with EVS, by involving
physiotherapist, registered dietician, and occupational therapist, as
relevant and independent of the municipality’s ordinary assessment
and referral system.
Outcome parameters used for the cost-effectiveness analysis were
costs and time of the intervention, quality of life (by means of
Euroquol-5D-3L); and change in weight.
Results:
Respectively, 55 (46 from home-care) and 40 (18 from
home-care) were identified by EVS and comprised the intervention
and control group.
A difference was seen after 11 weeks in quality of life [0.758 (0.222)
vs. 0.534 (0.355), p = 0.001]. Even though a small gain in weight
was observed in the intervention group there was no difference in
change in weight [0.12 (1.94) vs. −0.36 (3.89), p = 0.817]. The effect
on quality of life, measured in terms of QALY gain relatively to
control group, gave a cost-effectiveness ratio of DKK 46,000 per
QALY gained.
Conclusion:
Multidisciplinary nutritional support in older adults
in nursing home and home-care identified with EVS compares
reasonably well to other interventions found worthwhile in the
Danish healthcare sector.
P-347
Prevalence of hypophosphatemia and relation to
undernutrition in hospitalized geriatric patients
C. Boonstra
1
, D. Van Asselt
2
1
Medisch Centrum Leeuwarden, Leeuwarden, Netherlands;
2
Netherlands
Objectives:
Hypophosphatemia is common in hospitalized patients
with described prevalences from 5% to over 20%. It is associated
with unfavourable outcomes and a risk factor for the refeeding
syndrome. The growing geriatric population might be more prone
to develop hypophosphatemia because of the frequent co-morbidity
and relatively higher prevalence of undernutrition. Since data
regarding hypophosphatemia in elderly patients is scarce, the aim
of this study was to determine the prevalence of hypophosphatemia
and the relation with nutritional status.
Methods:
We conducted a retrospective cohort study including
all patients electively admitted to the 24-bed acute geriatric
unit of a large teaching hospital (Medical Centre Leeuwarden)
between 1 January and 31 January 2014. Computerised charts
were available for all patients and data was collected regarding
patient demographics, laboratory findings and nutritional status.
Hypophosphatemia was defined as serum phosphate
<
0.8mmol/l.
Serum phosphate levels were measured on the Roche Modular
Analyzer and nutritional status was determined with the Mini
Nutritional Assessment (MNA).
Results:
We included 215 patients with a mean age of 83.3
±
7.0
years of whom 61.9% were female. Serum phosphate was measured
in 173 (80.5%) of patients. At the time of admission, 16.8% (23.4% of
males, 12.8% of females, ns) had hypophosphatemia. Undernutrition
and risk of undernutrition was present in respectively 24.5% and
47.9% of patients. There was no association between nutritional
status and hypophosphatemia (Chi Square, p = 0.85).
Conclusion:
The prevalance of hypophosphatemia was 16.8%.
Although (risk of) undernutrition was frequently present, no
association was found between hypophosphatemia and nutritional
status.
P-348
Energy and nutrient contents of food served and consumed
by nursing home residents
F. Buckinx
1
, N. Paquot
1
, S. Allepaerts
1
, J.-Y. Reginster
1
, J. Petermans
1
,
O. Bruy `ere
1
1
University of Li`ege, Li`ege, Belgium
Background:
The aim of this study was to compare the amount
of energy and protein of served food in nursing homes with that
actually consumed by the residents.
Methods:
Nutrient content of the served food and the actual
real food consumption was calculated for all meals during a 5-
day period by a precise weighting method. Difference between
consumed and served dietary intake was evaluated by the Chi
2
test.
Results:
Twenty-seven subjects (77.8% of women, 86.4
±
7.79 years)
from one nursing home in Li `ege, Belgium, were included in this
study. These subjects had a mean BMI of 24.7
±
5.16 kg/m
2
, a
mean Tinetti score of 21.6
±
6.05 points and an average MMSE
score of 22.1
±
5.32 points. Out of the 27 subjects, 17(63%) had
a normal nutritional status according to the MNA, 9(33.3%) were
at risk of malnutrition and 1(3.7%) was malnourished. The mean
energy content of the served food was 1622
±
29.3kcal per day.
However, residents did not eat the whole meal (1464.9
±
201.5kcal).
The difference between energy served and energy consumed was
statistically significant (p
<
0.001). The average protein content of
the food served was equal to 0.9
±
0.22 g/kg/day and the average
consumption of protein by the residents was 0.89
±
0.22 g/kg/day.
The difference between protein served and consumed was not
significant (p = 0.89).
Conclusion:
Meals served in a nursing home are not entirely
consumed by patients. Indeed, the energy consumed is significantly
less than that provided.However, residents consume almost all of
the served proteins. These dietary intakes should be compared to
nutritional needs, which varies according to nutritional status, BMI
and functional status.
P-349
Malnutrition in older patients with type 2 diabetes is
associated with increased frailty
A.B. Christiaens
1
, M. Beeckmans
2
, M.P. Hermans
3
, B. Boland
4
1
Geriatric Medicine, UCLouvain, Brussels, Brussels, Belgium;
2
Geriatric Medicine, Clin. Univ. St-Luc, Brussels, Brussels, Belgium;
3
Endocrinology & Nutrition, Clin. Univ. St-Luc, Brussels, Brussels,
Belgium;
4
Geriatric Medicine, Cliniques Universitaires Saint-Luc,
Brussels, and Research Institute of Health a, Louvain-la-Neuve, Belgium
Introduction:
Type 2 diabetes may be associated with malnutrition.
This study explored the relationship between this association and
frailty features in older patients.
Methods:
Cross-sectional study among 172 older diabetic patients
(83
±
4 years; sex ratio 1:1) admitted in a Belgian teaching
hospital (2012–2013). Included patients had old age (≥75 years),
type 2 diabetes mellitus, risk of functional decline (ISAR ≥2)
and comprehensive geriatric assessment including a short mini-
nutritional assessment (MNA-SF, range 0–14). We compared the