Nutritional status in elderly female hip fracture patients: comparison with an age-matched home living group attending day centres
- 1 May 2001
- journal article
- research article
- Published by Cambridge University Press (CUP) in British Journal of Nutrition
- Vol. 85 (6), 733-740
- https://doi.org/10.1079/bjn2001350
Abstract
Fractured neck of femur occurs mostly in the older female population and is generally caused by falls. Malnutrition has been postulated as a factor that increases the tendency to suffer falls. Nutritional status of older female hospital patients admitted for emergency surgery for fractured neck of femur recruited (n 75), was compared with an age-matched independent-living group of females attending one of three local day centres (n 50). Dietary assessment was undertaken using three consecutive 24 h dietary recalls and, in the hip fracture group, completed menu cards were used as memory prompts. Data concerning key lifestyle characteristics were obtained using a face-to-face administered questionnaire. Blood samples were taken to determine levels of plasma albumin, transferrin, C-reactive protein (CRP), cholesterol, vitamin C, Se, Zn and total antioxidant status. Haemolysate samples were analysed for Se-dependent glutathione peroxidase activity. There were no significant differences in age between the two groups, but the hip fracture patients had lower mean values for body weight (59.6 v. 67.5 kg; p = 0.005), mindex (weight/demispan) (83· v. 94.4 kg/m; P < 0·0001), calculated BMI (24·1 v. 27·5 kg/m2 P<0·0001), mid-upper arm circumference; 27·1 v. 31·3 cm, p = 0.001) and triceps skinfold thickness; 17·0 v. 18.9 mm, p = 0·005) than the home-living group. The hip fracture patients had lower intakes of energy (4·3 v. 5·4 MJ, p = 0·001), fat (p = 0·025), carbohydrate (p = 0·002), protein (p = 0·006), thiamine (p = 0·017), vitamin B6 (p = 0·001), calcium (p = 0·01), K (p = 0·001), Mg (p = 0·001), P (p = 0·001), Fe (p = 0·007), Se (p = 0·008) and NSP (p = 0·001). Mean intakes of both groups were below the estimated average requirement for energy and below the reference nutrient intakes for folate, Ca, vitamin D, Mg, K, Se and Zn. In a high percentage of the hip fracture group the dietary intake of particular nutrients fell below the lower reference nutrient intake for Se (73 %), Mg (54 %) and Fe (19 %). As expected, the fracture patients had reduced plasma albumin (P<0·0001) and increased CRP (P<0·001) values. They had higher plasma vitamin C levels (P<0·001) and lower cholesterol levels (p = 0.04) than the day centre attendees. There were no significant differences in plasma levels of Se, Zn, transferrin or haemolysate glutathione peroxidase activity between the two groups. However, there was evidence of under-nutrition in both groups as key anthropometric values were low, plasma nutrient and metabolite levels were below the standard reference ranges and many individuals had low dietary intakes for specified nutrients.Keywords
This publication has 28 references indexed in Scilit:
- Evaluation of validity of British anthropometric reference data for assessing nutritional state of elderly people in Edinburgh: cross sectional studyBMJ, 1997
- Relationships between micronutrient intake and biochemical indicators of nutrient adequacy in a ‘free-living’ elderly UK populationBritish Journal of Nutrition, 1997
- Nutrition and Subsequent Hip Fracture Risk among a National Cohort of White WomenAmerican Journal of Epidemiology, 1996
- Weight, Height and Body Mass Index Distributions in Geographically and Ethnically Diverse Samples of Older PersonsAge and Ageing, 1996
- Selenium status, fatty acids, vitamins A and E, and aging: the Nove StudyThe American Journal of Clinical Nutrition, 1994
- Serum lipids and depressionThe Lancet, 1993
- The Use of Armspan in Nutritional Assessment of the ElderlyJournal of the American Geriatrics Society, 1991
- Dietary supplementation in elderly patients with fractured neck of the femurThe Lancet, 1990
- Red blood cell and serum selenium concentrations as influenced by age and selected diseases.Journal of the American College of Nutrition, 1983
- UNDERNUTRITION, HYPOTHERMIA, AND INJURY IN ELDERLY WOMEN WITH FRACTURED FEMUR: AN INJURY RESPONSE TO ALTERED METABOLISM?The Lancet, 1983