Institutionalized elderly people and malnutrition: research on the patients of a nursing home

Protein-energy malnutrition (PEM) is a common finding in hospitalized or institutionalized elderly people. In the literature, PEM is not mentioned as being related to individual ability of the patient to feed him or herself correctly. This study analyzed the 56 patients of a nursing home divided into two groups: self-sufficient and non self-sufficient regarding feeding. Levels of serum albumin, transferrin, prealbumin and hemoglobin (Hb) were examined and compared to body mass index (BMI) calculated with bioelectrical impedance analysis. Fifty-three percent of patients were self-sufficient, while 47% were not self-sufficient for feeding of which 83.3% were women and 16.7% men. Levels below the average range were 49.1% for lymphocyte count, 52.9% for serum albumin, 13.7% for serum transferrin and 52.9% for serum prealbumin. No significant differences were found in terms of patient age, while the mean values of the parameters examined in the two groups, self-sufficient and not, were lower in the patients who were not self-sufficient, even if statistical significance was not reached. Serum albumin was in inverse proportion to age (P<0.05) and 46.1% of individuals with low levels of transferrin also showed low levels of Hb. Anemia was in direct proportion (P<0.05) to age. Measurement of BMI showed values below 22.5 (cut off for risk for malnutrition) in 33.4% of the subjects examined. Of the three hematochemical parameters, analysis of a possible relationship with BMI showed only a significant and directly proportional correlation with prealbumin (P<0.05%). These data should be considered in the context of an epidemiological research study carried out in a conditioned and limited environment, where PEM, detected using hematochemical parameters, amounted to 50% of the patients, whereas BMI identified only approximately one-third of patients at risk of malnutrition. There were no statistically significant differences between men and women. Mean values of the surrogate hematochemical parameters were lower in patients non-self-sufficient for feeding, but the comparison does not reach significance due to the small sample size