Abstract :
Limousin in France has the second oldest regional population in Europe, with people
over 65-years-old who have Alzheimerʹs disease accounting for more than 9%. In France as a whole, a large
number of residents in nursing homes (NH) have dementia, leading to many nutritional problems. LINUT is a
health network that assesses the nutritional status of elderly NH residents and provides support where necessary.
Aims of the present study were to use this network to evaluate the nutritional status of NH residents with and
without dementia and to review changes after 4 months of intervention. Methods: A cross-sectional survey was
conducted by a doctor and a dietician at baseline (T0) and 4 months (T4) among residents at the 26 NH in
Limousin that agreed to take part. The evaluation criteria included presence of dementia, depression and
autonomy, weight, height, body mass index, Mini Nutritional Assessement (MNA™), and a 3-day survey of food
intake. Results: The 346 residents assessed at T0 were aged 87.9±6.9 years, 83.4% were women, 66.8% had
dementia, 53.3% were malnourished and 27.4% obese. Autonomy was not affected by obesity. Residents with
dementia had a lower Activities of Daily Living score and a lower weight than non-demented individuals
(2.2±1.2 vs. 2.7±1.7 p=0.03 and 60.1±16.3 vs. 64.7±20.0 kg p=0.03, respectively), were more often malnourished
(56.1% vs. 46.4% p=0.004) and less often obese (22.0% vs. 39.1% p=0.004) but consumed more protein
(62.6±17.8 vs. 58.2±16.9 g/d p=0.04, 1.1±0.4 vs. 1.0±0.4 g/kg/d p=0.005). Energy intake was at the lower limit
of French recommendations (26.4±8.8 vs. >25.0 kcal/kg/d). Assessment of all residents at T4 showed improved
MNA™ (+0.4 points/month p=0.02), protein intake (+3.3 g/d p=0.0007), and energy intake (+41.4 kcal/d p=0.01
and 0.1 kcal/kg/d p=0.03). Variations in prevalences of malnutrition and obesity were not statistically significant.
MNA™ increased in the dementia group (+0.29±0.8 points/month p=0.003). All other changes were comparable,
and nutritional status did not differ more between the two groups at T4 than at T0. Conclusion: The prevalence of
dementia was high in the population studied. Malnutrition was the main problem, particularly if residents had
dementia. Protein intake was satisfactory, but energy intake often insufficient. The nutritional status of dementia
patients improved after 4 months of follow-up, suggesting that effective action to support such services would be
worthwhile.
Keywords :
nutritional status , Nursing home , dementia , Home network , nutritional assessment
