To Örebro University

Objectives: There is a lack of detailed information on dietary intake in elderly people at an individual level, which is crucial for improvement of nutritional support. The aim of this study was to investigate the dietary intake in elderly people in two types of living situations. 

Design: Observational study, analysing prospective data.

Setting: The dietary intake was studied in elderly people living at home or in nursing home, in different cities of Sweden.

Participants: A total of 264 elderly people (mean age 84) participated in the observational study.

Measurements: Dietary intake was measured using weighed food records and food diaries, comparing females and males. The observed dietary intake was related to Recommended intake and Lower intake level.

Results: All dietary intake and patient characteristic variables showed large individual differences (ranges). We found no significant differences (p>0.05) between those living at home and nursing home residents regarding the average intake of energy, protein and water when expressed as total intake per kg of body weight. A very low daily intake of energy (<20 kcal/kg body weight/day) was observed in 16% of the participants. For vitamin D and iron, 19% and 15%, respectively, had intakes below the Lower intake level. There was no correlation between intake of energy, protein or water and resident characteristics such as age, autonomy, morbidity, nutritional state or cognition.

Conclusions: The large individual differences (ranges) in energy, nutrients and water show that the use of mean values when analysing dietary intake data from elderly people is misleading. From a clinical perspective it is more important to consider the individual intake of energy, nutrients and water. Ageism is intrinsic in the realm of ‘averageology’.

Background and aim: Hip fracture is a leading cause of mortality, morbidity, and disability in older people. The aim of thepresent study was to prospectively assess the development of physical performance in patients with hip fracture after surgery.

Setting: Prospective, observational study in a Swedish university hospital.

Methods: Assessment of 102 consecutive patients(65 females), with a mean age of 82 years (range 35-98) without specific inclusion or exclusion criteria. Seven physical functionswere assessed using the following 4 measuring methods and 3 rating scales at baseline 7 to 10 days after surgery and follow-upafter 4 months (F4): 10-m habitual walking speed (HWS), timed up and go (TUG), 30-second chair stand test (CST), handgripstrength (HGS), Berg balance scale (BBS), functional ambulation category (FAC), and general mobility.

Results: The 47% dropoutpatients were significantly older and more often lived alone or in nursing homes and used indoor walking aids. At baseline, themean HWS was 0.4/0.5 (females/males) m/s; TUG 53/30 s; CST 4/5 kg, and HGS 17.4/31.2 kg. The medians of BBS and FAC were20/20 and 4/4, respectively. There were significant mean improvements at F4 for all 4 measured functions, except for HGS inmales but for neither of the rating scales. There was a large heterogeneity in all assessed variables, both at baseline and regardingchange at 4 months. Therefore, the mean/median results are depicted in figures, showing all individual results at baseline and F4,compared to reference values and discussed in relation to degree of improvement.

Conclusion: The observed large heteroge-neity at baseline as well as F4 makes it essentially meaningless to report means and median data of functional assessment ofpatients with hip fracture. There is a strong need for individualization in both health analysis and how the treatment programis targeted, carried through, and evaluated over time in patients with hip fracture