Lower limb fracture, cognitive impairment and risk of subsequent malnutrition: a prospective evaluation of dietary energy and protein intake on an orthopaedic ward
Abstract
Objective To report the dietary energy and protein intake of undernourished older adults (with and without cognitive impairment) admitted to hospital following a lower limb fracture and to determine whether dietary intakes met estimated requirements. Design An observational study of a sequential sample. Setting The orthopaedic ward of a South Australian metropolitan teaching hospital. Subjects Sixty-eight patients aged > or =70 years screened as undernourished and admitted to hospital following lower limb fracture (50% cognitively impaired) provided 3 to 5 days of dietary data. MAJOR OUTCOME METHODS: Dietary energy and protein intake. Methods Dietary assessment using plate waste methodology and snack record charts commenced within 6 days postinjury and continued for up to five consecutive days or until discharge. Estimated resting energy requirements were calculated and adjusted for activity equivalent to bed rest and physiological stress. Protein requirements were calculated as 1 g/kg/day. Cognition was assessed using the Short Portable Mental Status Questionnaire. Results Cognitively impaired participants and those without cognitive impairment consumed, mean (95% CI) respectively, 3661 kJ/day (3201, 4121) versus 4208 kJ/day (3798, 4619) and 38 g (33, 44) versus 47 g (41, 52) protein/day. Cognitively impaired participants consumed mean (95% CI) 48% (43, 53) of estimated total energy expenditure and 78% (69, 87) of estimated protein requirements. Conclusions Orthopaedic fracture patients at greatest nutritional risk, including those with cognitive impairment, do not achieve estimated energy or protein requirements from diet alone. Effective methods of achieving requirements in this vulnerable group are needed before improvements in outcomes will be observed.
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Older adults (average age 84) with hip or leg fracture who entered the hospital undernourished did not meet estimated energy or protein targets.
“Older adults (average age 84) with hip or leg fracture who entered the hospital undernourished did not meet estimated energy or protein targets.”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [83]
With diet alone, hip fracture patients were able to meet only 50% of energy and 80% of target protein intake.
“With diet alone, patients were able to meet only 50% of energy and 80% of target protein intake.83”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [83]
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- Authors
- Miller, M. D., Bannerman, E., Daniels, L. A., & Crotty, M.
- Affiliations
- Flinders University (AU)
- Corresponding author
- Crotty, M
- Venue
- European Journal of Clinical Nutrition
- Published
- 2006-02-01
- Volume
- 60
- Issue
- 7
- Pages
- 853-861
- ISSN
- 0954-3007 (ISSN-L)
- 1476-5640
- OpenAlex
- W1969653076
- Cited by
- 32
- References
- 55
- Citations by year
- 2026: 1 · 2023: 2 · 2022: 1 · 2019: 1 · 2018: 3 · 2017: 1 · 2016: 1 · 2015: 2 · 2014: 1 · 2013: 4 · 2012: 4
- FWCI
- 1.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Queen Margaret University Publications Repository (Queen Margaret University) (acceptedVersion)
- Flinders Academic Commons (Flinders University) (submittedVersion)
- Queen Margaret University Publications Repository (Queen Margaret University) (submittedVersion)
- Funders
- National Health and Medical Research Council
- National Medical Research Council
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Surgery › Hip and Femur Fractures
- Keywords
- lower limb fractures, cognitive impairment, malnutrition, older adults, energy intake, protein intake, nutrient requirements, orthopedic ward, hospitalization, Short Portable Mental Status Questionnaire
- MeSH terms
- Aged, Aged, 80 and over, Energy Intake, Cognition Disorders, Dietary Proteins, Female, Hospitalization, Humans, Male, Nutritional Requirements, Prospective Studies, Weight Loss, Nutrition Assessment, Fracture Healing, Malnutrition, Fractures, Bone
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