MONDAY, OCTOBER 22

POSTER SESSION: EDUCATION AND BEHAVIORAL STRATEGIES/MEDICAL NUTRITION THERAPY TITLE: UNINTENTIONAL WEIGHT LOSS IN INSTITUTIONALIZED

ELDERLY

AUTHOR(S): C.S. Carter, MS, LD, and A. Wedgwood-Stauch, MS, RD, Texas Department of Human Services, Arlington, TX; C.M. Bednar, PhD, RD and B. Grossie, PhD, Texas Woman's University, Denton, TX.

LEARNING OUTCOME: To identify failures of lonq term care facilities and health risk factors of institutionalized elderly that contribute to unintentional weight loss.

ABSTRACT TEXT: Unintentional weight loss in the institutionalized elderly is a major concern in the long term care industry. Purpose of this study was to identify failures and risk factors related to unintentional weight loss o f institutionalized elderly. Review of Texas Department of Human Services inspection reports for 25 nursing homes in north Texas revealed 53 elderly residents cited for unintentional weight loss. Six failure categories and 76 risk factors related to unintentional weight loss were identified. Frequencies of failures and risk factors in the reports were tallied. Failures were to: assist/provide adequate nutrition (71 times); follow diet orders/recommendations (45); identify/assess weight loss (36); implement/follow system/policies/care plan (24); notify appropriate discipline of weight loss (20); and monitor/track intake/weights (13). The 8 most frequent risk factors were thin/underweight (25); requires feeding assistance (24); dementia (22); therapeutic diet (18); pressure sores (17); hypertension (17); heart disease (16); and infections (15). Chi-square analysis of these risk factors supported several correlations, the most significant being between dementia and therapeutic diets (p=0.001). Nursing home staff should be trained to prevent failures in resident care that could result in unintentional weight loss and to identify residents exhibiting several risk factors related to this problem. Such action could improve the quality of life for long-term care residents as well as prevent deficiencies for nursing homes.

TITLE: THE EFFECT OF A LOW VOLUME, CALORICALLY DENSE NUTRITIONAL SUPPLEMENT TO MINIMIZE WEIGHT LOSS IN THE LONG-TERM CARE POPULATION ON PSYCHOTROPIC DRUGS.

AUTHOR (S): J. Pippin BS, C. Mitchell Phi), RD, L. Clemens EdD, RD, The University of Memphis, Memphis, TN; M. Sun, MS, RD, Beverly Healthcare Corporation, Memphis, TN.

LEARNING OUTCOME: To gain a greater understanding of the benefits of nutritional supplements on weight management in the long-term care population.

ABSTRACT TEXT: The purpose of this study was to determine the effects of Epulor, a calorically dense, soybean oil nutritional supplement, on body weight and blood lipid levels when compared to a standard house supplement. The subjects included 30 residents of a long-term care facility who had experienced a significant recent weight loss defined as 5% in one month, 7.5% in three months or 10% in six months. All participants were on psyehotropic drugs. Residents were administered either the currently used house supplement or Epulor, three times per day with each medication pass, for 28 days. Blood lipid values were obtained pre and post supplementation. Weights were obtained pre and post as well as weekly throughout supplementation. Descriptive statistics and frequencies were used to evaluate the variables. Although weight loss was stopped in both groups, there were no changes in body weight of either group. There were no significant changes in any of the blood lipid parameters. It was concluded that supplementation with Epulor had the same effects as supplementation with the standard (and lower cost) supplement. Based on the calculated amount of supplement required for the study, and the amount actually used, it was determined that the subjects did not receive the prescribed amount as ordered. It is unknown whether either of the supplements would have been beneficial in promoting a rapid weight improvement, if the entire prescribed amount had been received. Other studies have shown similar difficulties between compliance and patient benefit of antritional supplements. Further evaluation is needed in which patient compliance is carefully controlled, in order to examine the benefits of Epulor or different types of nutritional supplement.

CONFLICT OF INTEREST: None

TITLE: DIET VARIETY IS ASSOCIATED WITH ADEQUACY OF NUTRIENT INTAKE 1N COMMUNITY-DWELLING, RURAL ELDERLY

AUTHOR(S): T.A. Marshall, PhD, RD; P.J. Stumbo, PhD, RD; J.J. Warren, DDS, MS; and Xian-Jin Xie, MS; University of Iowa, Iowa City, IA

LEARNING OUTCOME: The participant will be able to describe the relationship between diet variety and adequacy of nutrient intake in a community-dwelling, rural elderly population.

ABSTRACT TEXT: Poor dietary habits and nutrient intakes are of particular importance among the elderly. An improved understanding of dietary habits and nutrient intakes in the old (75+ years) is necessary to minimize morbidity in this population. The objectives of this study were to describe the nutrient intakes and diet variety and, subsequently, to explore relationships between adequacy of nutrient intakes and diet variety in community-dwelling, rural elderly. Subjects were surviving members of the Iowa 65+ Rural Health Study electing to participate in a prevalence study of oral soft tissue lesions. 420 subjects were interviewed and had dental exams and 220 subjects completed 3- day diet records in a cross sectional design. Adequate nutrient intake from food sources was defined as consumption of the uatrient's EAR, 67% AI or 67% RDA. Diet quality was defined by the number of nutrients consumed at adequate intakes; if all 19 nutrients met the adequacy cut-offs the diet was rated "ideal," if 16-18 nutrients were adequate it was rated as "marginal," 13-15 nutrients as "limited," and <13 nutrients as "inferior." The total Diet Variety Score (DVS) was defined as the number of food items consumed during the 3- day period using a coding scheme similar to Block's HHHQ. Data were analyzed using SAS (version 8). Mean age was 85.2 ± 4.0 years. Subjects completing 3-day diet records were younger (84.7 + 3.9 y) and more cognitively intact than subjects not completing diet records. Nutrients most often inadequate were folate, vitamin D and vitamin E. Diet quality from food sources was "inferior" for 43%, "limited" for 38%, "marginal" for 18% and "ideal" for 1% of subjects. Mean total DVS was 21.8 :t: 4.3, subject's total DVS ranged from 10-32. The total DVS correlated with the number of nutrients consumed at adequate intakes from food sources (r = 0.498; p <0.05). The results suggest that nutrient intakes from food sources are inadequate for many community-dwelling, rural elderly. Recommendations to increase diet variety may improve nutrient intakes.

TITLE: THE EFFECT OF CRANBERRY JUICE ON THE RECURRENCE OF URINARY TRACT INFECTIONS AMONG RESIDENTS IN LONG-TERM CARE

AUTHOR(S): S.J. Quickel, University of Delaware Dietetic Intern; S.E. Harris, RD, The Delaware Hospital for the Chronically I11, Smyrna, DE; C. Hamilton, PhD, RD, University of Delaware, Newark, DE.

LEARNING O U T C O M E : To identify effects o f daily ingestion o f cranberry juice on the recurrence o f urinary tract infection in an institutionalized population with a history o f urinary tract infections.

A B S T R A C T TEXT: Urinary Tract Infection (UTI) is a common bacterial infection

plaguing our elderly; especially women in the long-term care setting. While antibiotics are the treatment o f choice, antibiotic resistant bacteria are on the rise and alternative therapies need to be considered. Cranberry juice is a safe commercial product that has been widely used since the early 20 th century for the prevention o f UTI. Its consumption may decrease the ability o f bacteria such as Eseherechia coli to attach itself to urinary mucosal cells. This pilot study was conducted to observe the effects o f cranberry juice on recurrence o f symptomatic UTI. Ten female and 9 male residents with a history o f UTl from a long-term care public health facility for the chronically ill participated in the study. The most recent Minimum Data Sets (MDS) were used to determine which residents qualified for the study. Those who had triggered for UTI within the reference period were selected. Five o f these residents who were prescribed cranberry juice were compared with the 13 who were not. At the end o f the 3-month study period 1 resident from each group had expired from causes unrelated to UTI. Thorough review o f the remaining 16 medical records, including all physician chart notes and recent MDS data, revealed that I o f 4 (25%) o f the residents prescribed cranberry juice experienced recurrence o f UTI compared to 4 o f 12 (33%) in the other group. Further studies in this area may be warranted.

A-58 / Sep tember 2001 Supp lemen t Volume 101 Number 9