Journal Article

Intensive dietary intervention by a dietitian as a case manager among community dwelling older adults: The edit study

Endevelt, Ronit, Berger-Fecht, I., Lander, H., Bregman, J., Lemberger, J., Shahar, D.R., Kowen, G., Karpati, T.

2011

Overview

Clinical trials that have assessed the best approach for treating under-nutrition in old age are scarce. To determine the impact of an intensive nutritional intervention program led by a dietitian on the health and nutritional status of malnourished community dwelling older adults. Sixty-eight eligible participants (age<75) were randomly assigned to a Dietetic Intervention Treatment (DIT), an intensive nutritional intervention led by a dietitian, or a Medical Treatment (MT), a physician-led standard care group, with an educational booklet regarding dietary requirements and recommendations for older adults. An additional 59 eligible participants who were unable to participate in the randomization were included as a non-randomized “untreated nutrition” group (UNG). Over the 6-month follow-up, the DIT group showed significant improvement in cognitive function (from 25.8±4.5 to 26.8±4, p=0.04), and depression score (from 7.3±3.9 to 5.4 ±3.9, p=0.04) compared with the change in the other 2 groups. The DIT group showed a significant improvement in intake of carbohydrates (+15% vs. +1% in the MT and+3% in the UNG), protein (+8% vs. +2% in the MT and −3% in the UNG), vitamin B6 (+20% vs. +7% in the MT and +8% in the UNG), and vitamin B1 (+22% vs. +11% in the MT and 0% in the UNG). The DIT group had a significantly lower cost of physician visits than the other 2 groups ($172.1±232.0 vs. $417.2±368.0 in the MT and $428.1±382.3 in the UNG, p=0.005). Intensive dietary intervention was moderately effective in lowering cost of services used and improving medical and nutritional status among community dwelling older adults.

• Publisher: Elsevier Masson SAS,Springer-Verlag,Springer Nature B.V
• Subject: Aged / Aged, 80 and over / Aging / Case Management / Clinical trials / Cognition - physiology / Cognition Disorders - economics / Cognition Disorders - prevention & control / Cognitive ability / Depression - diet therapy / Depression - economics / Dietary Carbohydrates - administration & dosage / Dietary Proteins - administration & dosage / Dietary supplements / dietary treatment / Dietetics - methods / dietitian case manager / Dietitians / Energy Intake / Female / Food / Geriatrics / Geriatrics/Gerontology / Health care use / Health Education - economics / Health Education - methods / Humans / Intensive Dietary Intervention Among Older Adults / Intervention / Length of stay / Male / Malnutrition / Malnutrition - diet therapy / Malnutrition - economics / Medicine / Medicine & Public Health / Mortality / Neurosciences / Nutrition / Nutritional Status / nutritional treatment / Office Visits - economics / older adults / Older people / Primary Care Medicine / Public health / Quality of Life Research / Standard of Care - economics / Thiamine - administration & dosage / undernutrition / Vitamin B 6 - administration & dosage