The efficacy of a nutrition education intervention to prevent risk of malnutrition for dependent elderly patients receiving Home Care: A randomized controlled trial

ObjectiveTo assess the effect of a nutrition education intervention included in the Home Care Program for caregivers to prevent the increasing risk of malnutrition of dependent patients at risk of malnutrition.DesignRandomized controlled multicenter trial of 6 months of duration and 12 months follow-up.Settings10 Primary Care Centers, Spain.ParticipantsPatients enrolled in the Home Care Program between January 2010 and March 2012, who were dependent and at risk of malnutrition, older than 65, and had caregivers (n = 190).InterventionThe nurses conducted initial educational intervention sessions for caregivers and then monitored at home every month for 6 months.MeasurementsThe nutritional status was assessed using the Mini Nutritional Assessment test (primary outcome), diet, anthropometry, and biochemical parameters (albumin, prealbumin, hemoglobin and cholesterol). Other descriptive and outcome measures were recorded: current medical history, Activities of daily living (Barthel test), cognitive state (Pfeiffer test), and mood status (Yesavage test). All the measures were recorded in a schedule of 0-6-12 months.Results173 individuals participated after exclusions (intervention n = 101; control n = 72). Mean age was 87.8 ± 8.9 years, 68.2% were women. Difference were found between the groups for Mini Nutritional Assessment test score change (repeated measures ANOVA, F = 10.1; P < 0.001), the intervention improved the Mini Nutritional Assessment test score of the participants in the intervention group. The egg consumption (F = 4.1; P = 0.018), protein intake (F = 3.0; P = 0.050), polyunsaturated fatty acid intake (F = 5.3; P = 0.006), folate (F = 3.3; P = 0.041) and vitamin E (F = 6.4; P = 0.002) showed significant group × time interactions.ConclusionA nutrition education intervention for caregivers halted the tendency of nutritional decline, and reduced the risk of malnutrition of older dependent patients.Trial registration: Clinical Trial Registration-URL: www.clinicaltrials.gov. Identifier: NCT01360775