PP078-SUN
DEMENTED VS NON DEMENTED PATIENTS: CLINICAL
OUTCOMES AND COMPLICATIONS OF HOME ENTERAL
NUTRITION (HEN) AMONG FRAIL ELDERLY PATIENTS
C. Venturini, D. Sparvoli, N. Jukic-Peladic,
P. Orlandoni. Nutritional Therapy DepartmentReference Centre, INRCA-IRCCS, Ancona, Italy
Rationale: Many doubts have been risen about the
efficacy and the opportunity of tube feeding in frail
elderly patients with dementia. Our purpose was to
investigate the impact of the straight monitored HEN
therapy on clinical outcomes and complications in a
population of demented (D) and non demented (ND)
elderly patients.
Methods: An observational study on a total of 171 patients
receiving HEN during 2011 (mean HEN duration 607 days)
has been carried out. Two comparable groups have
been investigated: 82 D (mean age 84.7±6.6, 22M 60F,
mean Geriatric Nutrition Risk Index (GNRI) 82.8) and
89 ND (mean age 85.1±6.6, 30M 59F, mean GNRI 85.5).
Nutritional therapy was monthly monitored by a nutritional team and data concerning nutritional status,
complications and rehospitalisation related to HEN were
collected for statistical analysis.
Results: In both groups dysphagia was the main indication
for HEN. Multimorbility was more frequent in ND (84.3%)
than in D (62.2%) (p < 0.05). Nasogastric Tube (NGT)
was the main administration route for D (70.7% vs
53.9% of ND) while PEG Tube was more frequent in ND
(46.1% vs 29.3% of D). At enrolment D presented a higher
degree of Protein-Calorie Malnutrition (BMI < 22 kg/m2,
albumin < 3.4 g/l) than ND (67.1% vs 51.7%) (p < 0.05).
D received daily more calories (24.3 vs 22.8 kcal/kg/day)
more proteins (1.19 vs 1.05 g/kg/day) and water (33.2 vs
31.8 ml/kg/day) than ND (p < 0.05). D presented more
gastrointestinal complication (45.6% vs 31.1%) (p < 0.05),
and ND more metabolic complication (16.8% vs 7.8%)
(p < 0.05). We find no difference in the frequency of
tube displacement and of aspiration pneumonia between
the two groups as well as in the number of hospital
readmission.
Conclusion: Elderly D patients treated by HEN seems not
to present a higher rate of complications and hospital
readmission than ND patients if nutritional therapy is
correctly performed.
Disclosure of Interest: None Declared.
PP079-SUN
THE RELATIONSHIP BETWEEN DEPRESSIVE SYMPTOMS
AND MALNUTRITION IN OLDER ADULTS
E. Perez-Cruz1, D. Lizarraga1. 1Apoyo Nutricio, Hospital
Juarez de M´exico, Mexico, Mexico
Rationale: Malnutrition is a common finding in the elderly,
this is associated with medical conditions, psychological,
social, and economic. The aim of this study was
to determine the association between depression and
malnutrition in the elderly.
Methods: Cross-sectional and descriptive study. We
evaluated female and male patients clinically stables
and ambulatories of 65 and older. Between August to October 2011, 96 elderly of Hospital Juarez de M´exico
were considered. We excluded subjects with cognitive
impairments or unable to answer the questionnaires.
Data were obtained socio-demographic and medical.
Nutritional assessment were evaluated using Quetelet
index and the Mini Nutritional Assessment. The depressive
symptoms were assessed by the Geriatric Depression
Scale of Yesavage. Baseline characteristics are presented
mean and standard deviation. The association between
malnutrition and depressives symptoms was examined.
Results: A total of 96 subjects were evaluated. 79.2%
(n = 76) were female and 20.8% (n = 20) male. The mean
age was 80.4±6.9 years. The MNA score was 15.5%
(n = 15) in normal nutritional status, 72.2% (n = 70) at
risk of malnutrition and 11.3% (n = 11) in malnutrition.
The presence of depressive symptoms were established
in 63.9% (n = 62). The depression in the elderly was
associated with malnutrition. The Risk (odss ratio)
estimated were 2.4 (95% CI= 0.79 7.38).
Conclusion: Older Adults with depressive symptoms have
a high association with malnutrition. These results show
the relevance of assessing the presence or absence of
depressions as an integral part of the nutritional status in
the elderly.
References
[1] Allard JP, Aghdassi E, McArthur M et al. Nutrition risk factors
for survival in the elderly living in Canadian long-term care
facilities. JAGS 2004; 52: 59 65.
[2] Gutierrez RJ, Serralde ZA, Guevara CM. Prevalencia de
desnutrici´on del adulto mayor al ingreso hospitalario.
Nutricion Hospitalaria 2007; 22(6): 702 9.
Disclosure of Interest: None Declared.
PP080-SUN
AUGMENTED NUTRITIONAL STRATEGIES IN
NEUROREHABILITATION AFTER STROKE
C. Haider1, H. Zauner1, N. Geringer-Manakanatas2. 1Neurorehabilitation, 2Cardiac Rehabilitation,
Rehabilitation Center of PVA, Grossgmain, Austria
Rationale: Prior work documented poorer rehabilitation
potential for stroke patients with neurogenic dysphagia.
This interfers with our clinical observation that these
patients exhibit a remarkable improvement undergoing
neurorehabilitation.
Methods: 89 consecutive patients after stroke, inpatient
neurorehabilitation, outcome measurement by means
of Rivermead motor assessment, Extended and Basic
activities of daily living, Barthel Index.
Augmented nutritional strategies included: mealtime
supervision, food consistency adaption, tube feeding
nasal or via PEG.
Statistics: chi-square test, t-test, Mann Whitney U test,
Spearman’s rank.
Results: Mean age 65.8±10.9 years, median Barthel Index
at admission 5, at discharge 60.
Nutritional characteristics:
NRS 2002 median 2 (1 7)
Nutritional support in 44/89 patients
Conclusion: All swallowing compromised patients showed
significant improvement under augmented nutritional
strategies, not only for dysphagia related problems, also
for mobility, ambulation, cognitive performance.
