Effects of an enhanced iron dense foods offering in the daily meals served in geriatric institutions on measures of iron deficiency anemia

Abstract Background Iron deficiency is one of the most common causes of anemia in geriatric patients. Although the oral iron intake is often inadequate, the potential of iron dense foods in the daily meals of geriatric institutions is rarely considered. To test during a 1- year span whether an improved frequency of iron dense foods in the daily meals has an impact on the oral iron intake, the hemoglobin concentration and anemia prevalence of institutionalized geriatric patients. A parallel, open, pre-and post-oral nutrition intervention study. Two geriatric hospitals participated as intervention centers and one as comparison center. Methods In the two intervention centers, a menu plan adapted with iron dense foods was applied. In the comparison center the regular meals provisions was continued. At months 1, 6 and 12 of the intervention time the routine blood-parameter hemoglobin was taken from the geriatric hospital’s medical report. Component analysis assessed the nutrient density of the offered meals. 2-day-weighing records realized at month 1 and 6 of intervention-time assessed the iron intake. Ninety-nine geriatric patients in the intervention centers and 37 in the comparison center. All of them had multiple chronic diseases and an average age of 84 years. With the non-parametric Friedmann-Test for repeated measurements, we establish differences within the groups. With the Mann-Whitney-U-Test, we establish differences between the groups. For dichotomous variables, the chi-square-test was used. A p-value of< 0.05 was considered statistically significant for all analyses. Results In the intervention centers the iron intake (p < 0.001) and the hemoglobin concentration (p = 0.002) improved significantly (p < 0.001). As in the comparison center the frequency of meat and sausage offerings was twice as much as recommended also the hemoglobin concentration improved (p = 0.001). Conclusion Geriatric patients with anemia or low hemoglobin level benefit optimally from a diet rich in iron dense foods. Enhanced access to such can indeed correct iron deficiency anemia. Trial registration The ethics committee of the Municipality of Vienna (EK-13-043-0513) approved the study

ADMA and NT proBNP are associated with overall mortality in elderly

Background Increased asymmetrical dimethylarginine (ADMA) and NT proBNP concentrations have been associated with mortality in patients with cardiovascular (CV) disease and the general population. The use of these prognostic markers in an older population is not established yet. The aim of the present study was to investigate the prognostic value of age, sex, BMI, comedication and CV laboratory risk markers in geriatric care patients. Materials and methods In this prospective observational singlecentre cohort study data of longterm geriatric care patients were collected. Blood samples were collected between 14.09.2009 and 16.12.2009, and mortality was recorded up to 90 months. ADMA, its symmetric isomer SDMA, Larginine, NT proBNP and CRP were determined at study entry. Simple associations of risk factors for survival period were explored by Spearman correlation coefficient. Significant univariate predictors for survival period were used in the Cox proportional hazard model. Results A total of 481 patients were screened, and data from 449 patients were analysed. A total of 381 patients died during the observation period. Full data sets from 344 patients were used for Cox regression analysis. Male sex, older age, lower BMI, use of neuroleptic medicine, peripheral artery disease, and elevated plasma concentrations of ADMA, NT proBNP, and CRP were significant predictors of mortality. Conclusion The concentration of ADMA and NT proBNP may be used as an early risk marker for overall mortality in geriatric care. Neuroleptic medicine is associated with increased mortality in this population.(VLID)339868

Effects of an enhanced iron dense foods offering in the daily meals served in geriatric institutions on measures of iron deficiency anemia

Background: Iron deficiency is one of the most common causes of anemia in geriatric patients. Although the oral iron intake is often inadequate, the potential of iron dense foods in the daily meals of geriatric institutions is rarely considered. To test during a 1- year span whether an improved frequency of iron dense foods in the daily meals has an impact on the oral iron intake, the hemoglobin concentration and anemia prevalence of institutionalized geriatric patients. A parallel, open, pre-and post-oral nutrition intervention study. Two geriatric hospitals participated as intervention centers and one as comparison center. Methods: In the two intervention centers, a menu plan adapted with iron dense foods was applied. In the comparison center the regular meals provisions was continued. At months 1, 6 and 12 of the intervention time the routine blood-parameter hemoglobin was taken from the geriatric hospital’s medical report. Component analysis assessed the nutrient density of the offered meals. 2-day-weighing records realized at month 1 and 6 of intervention-time assessed the iron intake. Ninety-nine geriatric patients in the intervention centers and 37 in the comparison center. All of them had multiple chronic diseases and an average age of 84 years. With the non-parametric Friedmann-Test for repeated measurements, we establish differences within the groups. With the Mann-Whitney-U-Test, we establish differences between the groups. For dichotomous variables, the chi-square-test was used. A p-value of< 0.05 was considered statistically significant for all analyses. Results: In the intervention centers the iron intake (p < 0.001) and the hemoglobin concentration (p = 0.002) improved significantly (p < 0.001). As in the comparison center the frequency of meat and sausage offerings was twice as much as recommended also the hemoglobin concentration improved (p = 0.001). Conclusion: Geriatric patients with anemia or low hemoglobin level benefit optimally from a diet rich in iron dense foods. Enhanced access to such can indeed correct iron deficiency anemia. Trial registration: The ethics committee of the Municipality of Vienna (EK-13-043-0513) approved the study.© The Author(s) 201