A Dedicated Nutritional Care Program (NUTRICARE) to reduce malnutrition in institutionalised dysphagic older people

Milko Zanini, Annamaria Bagnasco, Gianluca Catania, Giuseppe Aleo, Marina Sartini, Maria Luisa Cristina, Stefania Ripamonti et al.

A Dedicated Nutritional Care Program (NUTRICARE) to reduce malnutrition in institutionalised dysphagic older people: A quasi-experimental study. J Clin Nurs. 2017; 00:1–10. https://doi.org/10.1111/jocn.13774

Aims and objectives: To assess the effects of a texture-modified food program for dysphagia on the nutritional, biochemical and functional profile in a cohort of insti- tutionalised older people in Italy.
Background: Dysphagic institutionalised older people, often also affected by dementia, are frequently exposed to malnutrition. Malnutrition in older people has negative effects on mortality, days of hospitalisation, infection, wound healing and risk of pressure injuries. Therefore, it is very important to prevent malnutrition in this frail population.

Design: A pre–post study without a control group.
Methods: The study included 479 dysphagic institutionalised older people from 20 nursing homes. Anthropometrical, biochemical, nutritional and functional parameters were collected retrospectively, 6 months before the study intervention, at time zero and, prospectively for 6 months after implementing the NUTRICARE food pro- gramme, for a total of nine evaluations. The NUTRICARE programme includes meals without nutritional supplementation, and personalised levels of density, viscosity, texture and particle size.
Results: The total mean body mass index of our sample passed from 17.88–19.00; body weight averagely improved by 7.19%, as well as their nutritional and biochemi- cal profiles. There was a progressive improvement of total protein and serum albu- min values. Nutritional parameters (serum transferrin and lymphocytes) displayed similar changes. Plasma lymphocytes reached normal levels in 98.23% of the sample. Plasma creatinine levels remained steady throughout the study and within the normal range. No side effects were reported.
Conclusion: The NUTRICARE food programme with a adequate proteins, calories, balanced nutritional and bromatological properties, and appropriate texture and palatability significantly improved the nutritional, biochemical and functional profile in a cohort of institutionalised dysphagic older people.