Multidisciplinary nutritional support for undernutrition in nursing home and home-care: A cluster randomized controlled trial
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Objective To assess the effect of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home-care identified with the validated Eating Validation Scheme (EVS). Methods An 11 wk cluster randomized trial with a home-care (3 clusters) or nursing home (3 clusters) setting as the unit of randomization. Before starting the study, a train-the-trainer course was performed to educate the nutrition coordinators. In addition to the nutrition coordinator, the participants assigned to the intervention group strategy received multidisciplinary nutrition support. Focus was on treatment of the potentially modifiable nutritional risk factors identified with the EVS, by involving the physiotherapist, registered dietitian, and occupational therapist, as relevant and independent of the municipality's ordinary assessment and referral system. Outcome parameters were quality of life (by means of EuroQol-5D-3L), physical performance (30-seconds chair stand), nutritional status (weight and hand-grip strength), oral care, fall incidents, hospital admissions, rehabilitation stay, moving to nursing homes (participants from home-care), and mortality. Results Respectively, 55 (46 from 2 home-care clusters) and 40 (18 from 1 home-care cluster) were identified with the EVS and comprised the intervention and control group. A difference after 11 wk in quality of life (0.758 [0.222] versus 0.534 [0.355], P = 0.001), 30-seconds chair stand (47% versus 17% improved, P = 0.005) and oral care (1.1 [0.3] versus 1.3 [0.5], P = 0.021) was observed. There was a almost significant difference in mortality (2% versus 13%, P = 0.079). Conclusions Multidisciplinary nutritional support in older adults in nursing home and home-care could have a positive effect on quality of life, muscle strength, and oral care.
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Four relevant RCTs with several sub-studies of low to acceptable quality focusing on multimodal and multidisciplinary interventions were identified.
“Four relevant RCTs with several sub-studies of low to acceptable quality focusing on multimodal and multidisciplinary interventions (combining more than two intervention strategies) were identified (48)(49)(50)(51)(52)(53)(54)(55)(56)(57):”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [48]
Positive effects on various outcome parameters were reported in multimodal and multidisciplinary intervention studies, but results were not always consistent.
“Positive effects on various outcome parameter were reported (e.g.dietary intake (49,50,53), nutritional status, the incidence of falls (53,56), fall-related injuries (56), health status (55), physical performance (48)(49)(50)(51)57), social activity (49,50), costeffectiveness (52) and quality of life (48,51)), results were however not always consistent.”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [48]
Some of the included RCTs had participants with impaired cognition.
“some of the included RCTs had participants with impaired cognition [26,41,42,53]”
From Effects of Protein Supplementation Combined with Exercise Intervention on Frailty Indices, Body Composition, and Physical Function in Frail Older Adults (2018) · cites this paper as [41]
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ESPEN practical guideline: Clinical nutrition and hydration in geriatrics
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- Authors
- Beck, A. M., Christensen, A. G., Hansen, B. S., Damsbo-Svendsen, S., & Kreinfeldt Skovgaard Møller, T.
- Affiliations
- Metropolitan University College (DK)
- Corresponding author
- Beck, Anne Marie
- ORCID
- Beck, Anne Marie
- Venue
- Nutrition
- Publisher
- Elsevier BV
- Published
- 2016-02
- Volume
- 32
- Issue
- 2
- Pages
- 199-205
- ISSN
- 0899-9007 (ISSN-L)
- OpenAlex
- W2139955578
- Cited by
- 73
- References
- 20
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 9 · 2023: 5 · 2022: 5 · 2021: 11 · 2020: 7 · 2019: 7 · 2018: 9 · 2017: 2 · 2016: 2 · 2015: 2
- FWCI
- 3.69
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Nutrition (publishedVersion)
- PubMed (publishedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- malnutrition, older adults, nursing homes, home care, quality of life, physical performance, grip strength, oral care, mortality, nutritional risk factors
- MeSH terms
- Aged, Aged, 80 and over, Body Weight, Cost-Benefit Analysis, Female, Home Care Services, Homes for the Aged, Humans, Male, Nursing Homes, Nutritional Status, Patient Compliance, Quality of Life, Socioeconomic Factors, Reproducibility of Results, Exercise, Body Mass Index, Cluster Analysis, Treatment Outcome, Nutritional Support, Hand Strength, Malnutrition, Muscle Strength, Nutritionists
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