Dietary Supplementation and Quality of Life of Older Patients: A Randomized, Double‐Blind, Placebo‐Controlled Trial
Abstract
Objectives To test the effect of nutritional support on older patient's quality of life. Design Double-blind, randomized, placebo-controlled trial conducted from March 2001 to January 2004. Setting United Kingdom. Participants Two hundred twenty-five hospitalized acutely ill older patients. Intervention Normal hospital diet plus 400-mL oral nutritional supplements daily for 6 weeks. The composition of the supplement was such as to provide 995 kcal for energy and 100% of the Reference Nutrient Intakes for a healthy older person for vitamins and minerals. Measurements Baseline, 6-week, and 6-month nutritional status and quality of life. Results Randomization to the supplement group led to significantly better quality-of-life scores than in the placebo group at 6 months but not at 6 weeks, after adjustment for baseline quality of life, age, and sex. The effect of supplementation was seen in higher physical function, role physical, and social function scores. Corresponding treatment effects were 7.0 (95% confidence interval (CI)=0.5-13.6, P=.04), 10.2 (95% CI=0.1-20.2, P=.047), and 7.8 (95% CI=0.0-15.5, P=.05), respectively. There was no evidence of difference in Barthel scores at 6 months. Conclusion Oral nutritional supplementation of acutely ill hospitalized older patients led to a statistically significant benefit in quality of life.
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The ONS containing 995 kcal from macronutrients and covering 100% of the RDA for healthy older adults in vitamins and minerals had no other effect on cognitive performance in older medical inpatients.
“In addition, provision of ONS containing 995 kcal from macronutrients and covering 100% of the RDA for healthy older adults in vitamins and minerals led to a lower incidence of depressive symptoms (p ¼ 0.021) in older medical inpatients, with no other effect on their cognitive performance but with a significant positive effect on their self-reported QoL”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [40]
The ONS containing 995 kcal from macronutrients and covering 100% of the RDA for healthy older adults in vitamins and minerals had a significant positive effect on self-reported quality of life (treatment effect in QoL scores using the SF-36 form at 6 months was 7.0, 95% CI 0.5 to 13.6, p=0.04 for physical function, 10.2, 95% CI 0.1 to 20.2, p=0.047 for role physical, and 7.8, 95% CI 0.0 to 15.5,
“with a significant positive effect on their self-reported QoL (i.e. the treatment effect in QoL scores using the SF-36 form at 6 months was 7.0, 95% CI 0.5 to 13.6, p ¼ 0.04 for physical function, 10.2, 95% CI 0.1 to 20.2, p ¼ 0.047 for role physical, and 7.8, 95% CI 0.0 to 15.5, p ¼ 0.05 for social function domains, compared to placebo) [40,41] (Level of evidence 1þþ for both).”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [40]
Provision of ONS containing 995 kcal from macronutrients and covering 100% of the RDA for healthy older adults in vitamins and minerals led to a lower incidence of depressive symptoms (p=0.021) in older medical inpatients.
“In addition, provision of ONS containing 995 kcal from macronutrients and covering 100% of the RDA for healthy older adults in vitamins and minerals led to a lower incidence of depressive symptoms (p ¼ 0.021) in older medical inpatients, with no other effect on their cognitive performance but with a significant positive effect on their self-reported QoL”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [40]
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Bjelakovic, G., Nikolova, D., Gluud, L. L., Simonetti, R. G., & Gluud, C. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007176.pub2 · Cited by 924 · see citing works
Protein and energy supplementation in elderly people at risk from malnutrition
Milne, A. C., Potter, J., Vivanti, A., & Avenell, A. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003288.pub3 · Cited by 849 · see citing works
ESPEN guidelines on nutritional support for polymorbid internal medicine patients
Gomes, F., Schuetz, P., Bounoure, L., Austin, P., Ballesteros-Pomar, M., Cederholm, T., Fletcher, J., Laviano, A., Norman, K., Poulia, K.-A., et al. (2018) · Clinical Nutrition · doi:10.1016/j.clnu.2017.06.025 · Cited by 363 · see citing works
Stratton, R. J., Hébuterne, X., & Elia, M. (2013) · Ageing Research Reviews · doi:10.1016/j.arr.2013.07.002 · Cited by 183 · see citing works
ESPEN guideline on nutritional support for polymorbid medical inpatients
Wunderle, C., Gomes, F., Schuetz, P., Stumpf, F., Austin, P., Ballesteros-Pomar, M. D., Cederholm, T., Fletcher, J., Laviano, A., Norman, K., et al. (2023) · Clinical Nutrition · doi:10.1016/j.clnu.2023.06.023 · Cited by 105 · see citing works
“…in QoL scores using the SF-36 form at 6 months was 7.0, 95% CI 0.5 to 13.6, p ¼ 0.04 for physical function, 10.2, 95% CI 0.1 to 20.2, p ¼ 0.047 for role physical, and 7.8, 95% CI 0.0 to 15.5, p ¼ 0.05 for social function domains, compared to placebo) [40,41] (Level of evidence 1 þþ for both).”
InfluentialCheng, H., Kong, J., Underwood, C., Petocz, P., Hirani, V., Dawson, B., & O’Leary, F. (2018) · British Journal of Nutrition · doi:10.1017/s0007114517003816 · Cited by 72 · see citing works
Pedersen, J. L., Pedersen, P. U., & Damsgaard, E. M. (2016) · The Journal of nutrition, health and aging · doi:10.1007/s12603-015-0629-2 · Cited by 40 · see citing works
- Authors
- Gariballa, S., & Forster, S.
- Affiliations
- United Arab Emirates University (AE)
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2007-12
- Volume
- 55
- Issue
- 12
- Pages
- 2030-2034
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- OpenAlex
- W1587377947
- Cited by
- 58
- References
- 0
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 4 · 2022: 2 · 2021: 3 · 2020: 2 · 2018: 3 · 2017: 4 · 2016: 3 · 2015: 4 · 2014: 3 · 2013: 5 · 2012: 3
- FWCI
- 3.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
- Keywords
- oral nutritional supplementation, elderly patients, quality of life, hospitalized older adults, acute illness, nutritional status, physical function, social function, role physical, Barthel Index
- MeSH terms
- Acute Disease, Aged, Double-Blind Method, Female, United Kingdom, Hospitalization, Humans, Male, Nutritional Status, Placebos, Quality of Life, Treatment Outcome, Dietary Supplements
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