Associations between underlying disease and nutritional status following acute illness in older people

Background & aims: Undernutrition in hospitalised patients is likely to be contributed to by the dual action of the underlying disease and acute catabolism associated with it. The aim of this study was to measure the association between underlying disease and nutritional status in acutely ill older patients. Methods: Four hundred and forty-five randomly selected patients had their nutritional status assessed from anthropometric, haematological and biochemical data within 72 h of admission, at 6 weeks and at 6 months. Data were also collected on age, disability, chronic illness, medications, smoking and acute-phase response. Results: Patients admitted with chronic obstructive pulmonary disease (COPD), heart failure and falls had significantly lower anthropometric measurements compared with all study populations than for example those admitted with ischaemic heart disease (IHD), chest infections and for elective hip surgery. Nutritional status has deteriorated between admission and 6 weeks among those with COPD, heart failure and falls compared with all study populations. Over 6-months 33 (52%) COPD patients and 14 (39%) heart failure patients were readmitted to hospital compared with 137 (35%) patients of all study populations. Nutritional supplements lead to a limited but significant benefit in transferrin and red cell folate among patients with heart failure and IHD. Conclusion: In older patients, underlying diseases have variable contributions to the poor nutritional status associated with acute illness.