3109.0: Monday, November 13, 2000 - 2:30 PM

Abstract #9461

Nutritional Risk in a Frail Homebound Older Population

Barbara E. Millen, DrPH1, Rebecca A. Silliman, MD, PhD1, Carole V. Ewart, EdD1, Christine Ritchie, MD2, Patricia Barry, MD1, Nichole Fearon, MPH1, Paula Quatromoni, MS1, and Donna Copenhafer, PhD1. (1) School of Publich Health, Causes/Consequences of Malnutrition in Homebound Elderly, Boston University Schools of Public Health and Medicine, 715 Albany Street, M810, Boston, MA 02118, 617-638-4472, bmillen@bu.edu, (2) Division of General Internal Medicine, University of Louisville, 530 South Jackson Street, Louisville, KY 40202

Purpose: We determined the prevalence of indicators of nutritional risk among urban homebound older persons (n=239; 65-105 years). Statement of Methods: Trained nutritionists conducted comprehensive in-home assessments of diet, anthropometry and sociodemographic characteristics; cognitive, psychological and functional status; physical performance and oral health. Fasting blood samples were obtained for analyses of nutritional biomarkers. Medical conditions, their severity, and medications were abstracted from medical records. Results: Subjects were female (72%), minority (72%), and poor (76% had monthly incomes <$900); 77% of subjects had ³ 3 chronic diseases; 73% were taking ³ 5 medications; and less than 10% were independent in all Katz ADL’s. Dietary assessments indicated that > 50% were non-compliant with recommendations for intake of macro- and micronutrients. While 40% had body weights in the normal range, 25% were overweight and 33% were obese. Some 6% were underweight and biomarker evidence of nutritional risk varied (albumin < 3.5g/dL=4%; hemoglobin < 10 g/dL; and B-12 <250 pg/ml=3%; folate £ 4.9 mg/ml=2%; and absolute lymphocytes <1.5 K/uL=29%). Conclusions: There is evidence of nutritional risk, primarily related to dietary quality and obesity, in this sample of frail older persons. Follow-up is needed to determine the extent to which these indicators of risk are associated with adverse clinical outcomes and, if so, the degree to which interventions can modify this risk.

Learning Objectives: Participants will 1. Be introduced to methods for assessing nutritional risk in a frail, homebound elder population; 2. Understand the prevalence of nutritional risk and selected determinants in this population; and 3. Recognized the implications of these research findings for careful consideration of preventive and medical nutrition and interventions in the homebound elder population

Keywords: Frail Elderly, Nutrition

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA