Nutritional guidance improves nutrient intake and quality of life, and may prevent falls in aged persons with Alzheimer disease living with a spouse (NuAD trial)

• Published in: The Journal of nutrition, health & aging Vol. 19; no. 9; pp. 901 - 907
• Main Authors: Suominen, Merja H, Puranen, T. M, Jyväkorpi, S. K, Eloniemi-Sulkava, U, Kautiainen, H, Siljamäki-Ojansuu, U, Pitkalä, K. H
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01-11-2015; Springer Nature B.V
• Subjects: Accidental Falls - prevention & control; Activities of Daily Living; Aged; Aged, 80 and over; Aging; Alzheimer disease; Alzheimer Disease - complications; Alzheimer's disease; body mass index; Body Weight; breathing; Caregivers; Consent; Couples; Diet; Dietary Proteins - administration & dosage; dietary recommendations; Dietary supplements; elderly; Energy Intake; Falls; Feeding Behavior; Female; Food; food records; Geriatrics/Gerontology; Hospitals; Humans; Intervention; Long term health care; Male; males; Malnutrition; Malnutrition - prevention & control; Medical records; Medicine; Medicine & Public Health; Micronutrients - administration & dosage; Neurosciences; Nutrition; Nutrition Assessment; Nutrition Policy; Nutritional Status; Older people; Patient Education as Topic; people; Primary care; Primary Care Medicine; protein intake; Proteins; Quality of Life; Quality of Life Research; randomized clinical trials; risk; Spouses; Finland; malnutrition; falls; Randomised Controlled Trial (RCT); Alzheimer disease; protein; Nutritional intervention
• ISSN: 1279-7707; 1760-4788
• DOI: 10.1007/s12603-015-0558-0

OBJECTIVE: The aim was to examine the effect of tailored nutritional guidance on nutrition, health-related quality of life (HRQoL) and falls in persons with Alzheimer disease (AD). DESIGN: Randomised controlled trial. SETTING AND PARTICIPANTS: Persons with AD living with a spouse. INTERVENTION: Tailored nutritional guidance with home visits during one year. The control group received a written guide about nutrition in older adults and all community-provided normal care. MEASUREMENTS: The primary outcome measure was weight change, and secondary outcomes included changes in protein and micronutrient intakes from three-day food records, HRQoL (15D) and rate of falls. RESULTS: Of the participants (n = 78) with AD (mean age 77.4, 69% males), 40% were at risk for malnutrition, 77% received < 1.2 g/bodyweight (kg) of protein at baseline. We found no difference in weight change between the groups. At 12 months, the mean change in protein intake was 0.05 g/bodyweight (kg) (95% CI −0.06 to 0.15) in the intervention group (IG), and −0.06 g/kg (95% CI −0.12 to 0.02) in the control group (CG) (p = 0.031, adjusted for baseline value, age, sex, MMSE and BMI). Participants’ HRQoL improved by 0.006 (95% CI −0.016 to 0.028) in the IG, but declined by −0.036 (95% CI −0.059 to 0.013) in the CG (p = 0.007, adjusted for baseline value, age, sex, MMSE and BMI). Dimensions that differed included mental functioning, breathing, usual activities and depression. The fall rate was 0.55 falls/person per year (95% CI 0.34 to 0.83) in the IG, and 1.39 falls/person per year (95% CI 1.04 to 1.82) in the CG (IRR 0.55; 95% CI 2.16 to 6.46; p < 0.001 adjusted for age, sex and MMSE). CONCLUSIONS: Tailored nutritional guidance improves nutrition and HRQoL, and may prevent falls among AD people living with a spouse.