Energy and protein intake, anthropometrics, and disease burden in elderly home-care receivers - A cross-sectional study in Germany (ErnSIPP study)

• Published in: The Journal of nutrition, health & aging Vol. 20; no. 3; pp. 361 - 368
• Main Authors: Pohlhausen, S, Uhlig, K, Kiesswetter, E, Diekmann, R, Heseker, H, Volkert, D, Stehle, P, Lesser, Stephanie
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01.03.2016; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Aging; Ambulatory care; Animals; Anthropometry; Appetite; arm circumference; Body Mass Index; body weight; burden of disease; calf circumference; Caregivers; Chronic Disease - epidemiology; chronic diseases; Colleges & universities; Cross-Sectional Studies; deglutition; Deglutition Disorders - epidemiology; Dementia; Dementia - epidemiology; Depression - epidemiology; Diet Records; Dietary Proteins - administration & dosage; Disease; elderly; Energy Intake; Female; females; Geriatric Assessment; Geriatrics/Gerontology; Germany - epidemiology; Home Care Services; Homes for the Aged; Humans; ingestion; Interviews; Male; males; Mastication; Medicine; Medicine & Public Health; men; nausea; Neurosciences; Nutrition; Nutritional Status; Older people; Physiology; Prevalence; Primary Care Medicine; Prospective Studies; protein intake; Proteins; Quality of Life Research; respiratory tract diseases; stroke; Stroke - epidemiology; Urban areas; vomiting; women; Germany; nutritional status; disease status; anthropometrics; Elderly home-care receivers
• ISSN: 1279-7707; 1760-4788
• DOI: 10.1007/s12603-015-0586-9

OBJECTIVE: To date, no study has examined the nutritional status and disease burden of elderly home-care receivers living in Germany. Aim of this cross-sectional study was, first, to assess disease burden and nutritional status, denoted in anthropometrics, and, second, to investigate associations between anthropometrics and disease burden. DESIGN: Cross-sectional multi-centre study. SETTING: Home-care receivers living in three urban areas of Germany in 2010. PARTICIPANTS: 353 elderly (>64 years) in home care (128 males aged 79.1 ±7.8 years, 225 females aged 82.0 ±7.5 years). MEASUREMENTS: Nutritional status was assessed by body mass index (BMI), mid upper arm circumference (MUAC) and calf circumference (CC). Medical conditions were assessed in personal interviews. A 3-day prospective nutrition diary was kept. Metric data are reported as mean±SD or median (interquartile range), p<0.05 was considered significant. RESULTS: Most participants were substantially (59%), and 11% severest in need of care. The seniors suffered from 5 (4–7) chronic diseases; dementia, depression, stroke, and respiratory illness were most prevalent (each 20–40%). More than one-third of participants had only moderate or poor appetite, nearly half were unable to eat independently. Chewing problems were reported for 52% of study participants, and more than one quarter of elderly had swallowing problems. Daily mean energy intake was 2017±528 kcal in men (n=123) and 1731±451 kcal in women (n=216; p<0.001). Mean protein intake amounted to 1.0 g/kg body weight. Mean BMI was 28.2±6.2 kg/m² (n=341), 14% of seniors had a BMI <22 kg/m² (including 4% with BMI <20 kg/m²). Critical MUAC (<22 cm) was indicated in 6% of subjects; and CC <31 cm in 11% of men, 21% of women (p<0.05). After adjusting for sex and age, BMI, MUAC and CC were negatively associated with high care level, hospitalization in the previous year, nausea/vomiting, prevalence of dementia, poor appetite, and eating difficulties like dependency, chewing and swallowing problems. CONCLUSION: We recommend to pay special attention to the nutritional status of elderly persons in home-care exhibiting named disease burden.