G. Akner, H. Flöistrup

Correspondence: Gunnar Akner, Nutrition- and Pharmacotherapy Unit A1:05, Research and Development Unit for the Elderly NorthWest , Dept. of Geriatric Medicine, Karolinska Hospital, Karolinska Institute, 171 76 Stockholm , Sweden. Tel: 46 - 8 - 651 01 29. Fax: 46 - 8 - 651 14 41. e-mail: gunnar.akner@chello.se

PURPOSE: Examination of the individual intake of energy, nutrients and water in clinically stable multidiseased nursing-home residents. METHODS: Comprehensive clinical assessment of 54 elderly nursing-home residents (80 ± 10 years, mean ± SD). The intake of food and beverages was measured by the weighed food intake method during five consecutive week days followed by computerized transformation to energy, 21 different nutrients, dietary fiber, alcohol and water. The resting energy expenditure was determined by indirect calorimetry. RESULTS: There was at least 2-3-fold, variation in intake of energy, nutrients and water, present also when expressed per kg body weight. For some micronutrients the relative intake variation was more than 8-fold. The results are compared with the present swedish recommended dietary allowences as well as with seven other studies of dietary intake in elderly using the weighed food intake method. The residents had on average 14.1 (range 6-31) different current clinical problems and were treated with a mean of 9.5 different drugs. The nursing staff spent 40 % of the total daytime working hours (7 am to 7 pm) on nutrition related issues. CONCLUSIONS: The nursing-home residents exhibited a large interindividual heterogeneity regarding intake of energy, nutrients and water. More emphasis should be given to individualized nutrition assessment in clinical geriatric care as a more solid base for nutrition treatment programmes integrated with the regular medical management and evaluation.

Keywords: Weighed dietary analysis, nutrition, multidiseased, elderly, nursing-home, clinical analysis.