PP024-SUN
Fall incidents decrease after short-term oral nutritional
Titel voorbeeld titel
intervention in malnourished elderly patients: a RCT
F Neelemaat1,2, PTAM Lips2,3, A Thijs4, JC Seidell2,5, MAE van Bokhorst-de van der Schueren1,2
3
Departments of 1 Nutrition and Dietetics, Internal Medicine 2 EMGO Institute for Health and Care Research
Internal Medicine, Section Endocrinology 4 Internal Medicine 5 Health Sciences, Faculty of Earth and Life Sciences
VU University Medical Center & VU University, Amsterdam, The Netherlands
Rationale
Falls are a common and serious cause of morbidity
and mortality in elderly. This RCT evaluates the
effects of a short-term nutritional intervention on
falls in malnourished elderly patients.
dietetic counselling was 80%, 96% and 96%,
respectively. At three months, energy intake
(+280 kcal, 95% CI 37 to 524), protein intake
(+11 g, 95% CI 1 to 25) and serum vitamin D
levels (+10.9 nmol/L, 95% CI 2.9 ; 18.9) were
significantly higher in intervention patients than in
controls.
Methods
Results
A total of 207 patients (55.2% female) was
included. Mean age was 74.6 (SD 9.5) years (range
60-97 years). There were 16 fall incidents (in 10
patients) in the intervention group and 41 fall
incidents (in 24 patients) in the control group, HR
0.41 (95% CI 0.19;0.86), p=0.018 (log rank). Fifty
six patients were censored due to drop-out and
death (Figure 1 and Table 1). Compliance to oral
nutritional support, vitamin D supplementation and
We assume that the increased intake attributed
to the decreased number of falls in patients in the
intervention group.
1.0
0.9
N on fa lle rs
Malnourished elderly patients (≥60 y) received
either nutritional intervention (energy and protein
enriched diet, oral nutritional support (600 kcal/d,
24 g E/d), Ca/vitamin D supplement (400 IU D3,
500 mg Ca) supported by dietetic counselling) or
usual care for 3 months post-discharge. Number of
fallers, fall incidents, serum vitamin D levels, and
dietary intake were measured at admission and at 3
months after discharge.
0.8
0.7
In te rv e n tio n (I)
0.6
C o n tro l (C )
0.5
0
14
28
42
56
70
84
T ime (days)
N o . o f p a t ie n t s a t ris k
I:
103
90
82
79
77
75
66
C:
104
82
78
73
69
62
51
Figure 1: Kaplan-Meier curve for the time to a fall incident
Table 1: Fallers and fall incidents after three months nutritional intervention in malnourished elderly patients.
Mean number of fall incidents
Among the whole group (n=I:76, C:75)
Among fallers (n= I:10, C:24)
Intervention group
Control group
Effect
0.21 (0.57)
1.6 (1.1)
0.55 (0.84)
1.7 (0.91)
0.001#
0.550#
I: intervention group, C: control group, #: Mann Whitney U
Conclusions
Short-term nutritional intervention, consisting of oral nutritional support and vitamin D,
supported by dietetic counselling, decreases the number of fallers and fall incidents in
malnourished elderly patients.
Correspondence: F.Neelemaat@vumc.nl