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B vitamin status, dietary intake and length of stay in a sample of elderly rehabilitation patients

  • JNHA: Geriatric Science
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

To investigate the relationships between previous diet, biomarkers of selected B vitamins, nutritional status and length of stay.

Design

Cross sectional study. Setting: Geriatric rehabilitation patients, Sydney, Australia.

Participants

Fifty two consenting patients with normal serum creatinine levels and no dementia.

Measurements

Serum vitamin B12, plasma vitamin B6, serum and erythrocyte folate, homocysteine and methylmalonic acid (MMA) concentrations; dietary intake using a validated semi-quantitative food frequency questionnaire and nutritional assessment using the Mini Nutritional Assessment (MNA). Length of stay data were collected from medical records after discharge.

Results

The age was 80 ± 8 year (mean ± SD), BMI 26.4 ± 6.8 kg/m2 and MNA score 22 ± 3 indicating some risk of malnutrition. Deficiencies of vitamins B6, B12 and folate were found in 30, 22 and 5 subjects respectively. Length of stay was positively correlated with age and MMA (Spearman’s correlation 0.4, p<0.01 and 0.28, p<0.05 respectively) and negatively correlated with albumin, vitamin B6 and MNA score (Spearman’s correlation −0.35, −0.33 and −0.29, p<0.05). After adjustment for age and sex, ln vitamin B6 and ln MMA concentrations were significant in predicting ln LOS (p=0.006 and p=0.014 respectively).

Conclusion

The study indicates a high risk of vitamin B deficiencies in the elderly and suggests that deficiencies of vitamins B6 and B12 are associated with length of stay. This is concerning as B vitamin status is rarely fully assessed.

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References

  1. Compan B, di Castri A, Plaze JM, Arnaud-Battandier F. Epidemiological study of malnutrition in elderly patients in acute, sub-acute and long-term care using the MNA. J Nutr Health Aging 1999;3:146–151.

    PubMed  CAS  Google Scholar 

  2. Beck E, Patch C, Milosaljevic M, et al. Implementation of malnutrition screening and assessment by dietitians: malnutrition exists in acute and rehabilitation settings. Aust J Nutr Diet 2001;58:92–97.

    Google Scholar 

  3. Visvanathan R, Penhall R, Chapman I. Nutritional screening of older people in a subacute care facility in Australia and its relation to discharge outcomes. Age Ageing 2004;33:260–265.

    Article  PubMed  Google Scholar 

  4. Donini LM, De Bernardini L, De Felice MR, Savina C, Coletti C, Cannella C. Effect of nutritional status on clinical outcome in a population of geriatric rehabilitation patients. Aging-Clin Exp Res 2004;16:132–138.

    PubMed  Google Scholar 

  5. Milne AC, Potter J, Avenell A. Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Syst Rev 2005CD003288.

  6. Gibson RS. Principles of Nutritional Assessment. 2nd ed. New York: Oxford University Press; 2005.

    Google Scholar 

  7. Norman K, Pichard C, Lochs H, Pirlich M. Prognostic impact of disease-related malnutrition. Clin Nutr 2008;27:5–15.

    Article  PubMed  Google Scholar 

  8. O’Leary F, Samman S. Vitamin B12 in Health and Disease. Nutrients 2010;2:299–316

    Article  Google Scholar 

  9. Matteini AM, Walston JD, Fallin MD, et al. Markers of B-vitamin deficiency and frailty in older women. J Nutr Health Aging 2008;12:303–308.

    Article  PubMed  CAS  Google Scholar 

  10. O’Leary F, Wai J, Wormold L, Flood V, Petocz P, Samman S. No effect of Proton Pump Inhibitor (PPI) medications on vitamin B12 status in elderly rehabilitation patients. Is there a dietary component? Asia Pac J Clin Nutr 2007;31:S96.

    Google Scholar 

  11. Charlson M, Pompei P, Ales KL, CR M. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis 1987;40: 373–383.

    Article  PubMed  CAS  Google Scholar 

  12. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.

    CAS  Google Scholar 

  13. Storey JE, Rowland JTJ, Basic D, Conforti DA, Dickson HG. The Rowland Universal Dementia Assessment Scale (RUDAS): a multicultural cognitive assessment scale. Int Psychogeriatr 2004;16:13–31.

    Article  PubMed  Google Scholar 

  14. Guigoz Y, Vellas B. The Mini Nutritional Assessment (MNA) for grading the nutritional state of elderly patients: presentation of the MNA, history and validation. Nestle Nutrition Workshop Series Clinical Performance Programme 1999;1:3–11.

    Article  PubMed  CAS  Google Scholar 

  15. Smith W, Mitchell P, Reay EM, Webb K, Harvey PW. Validity and reproducibility of a self-administered food frequency questionnaire in older people. Aust N Z J Public Health 1998;22:456–463.

    Article  PubMed  CAS  Google Scholar 

  16. McCance RA, Widdowson EM. McCance and Widdowson’s The composition of foods. 2002, 6th ed. Cambridge, UK.

  17. Green AK. Biochemical Markers of Cobalamin Deficiency in Patients With Inborn Errors of Metabolism Managed on Low Protein Diets. MSc Med Thesis University of Sydney 2006.

  18. Magera MJ, Helgeson JK, Matern D, Rinaldo P. Methylmalonic acid measurement in plasma and urine by stable-isotope dilution and electrospray tandem mass spectrometry. Clin Chem 2000;46:1804–1810.

    PubMed  CAS  Google Scholar 

  19. Carmel R, Green R, Rosenblatt DS, Watkins D. Update on cobalamin, folate, and homocysteine. Hematology Am Soc Hematol Educ Program. 2003:62–81.

  20. Food and Nutrition Board: Institute of Medicine. Vitamin B12. In: National Research Council (ed) Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin and choline. National Academy Press; Washington DC: 1998 pp. 306–356.

    Google Scholar 

  21. Robinson K, Arheart K, Refsum H, et al. Low circulating folate and vitamin B6 concentrations: risk factors for stroke, peripheral vascular disease, and coronary artery disease. European COMAC Group.Circulation 1998;97:437–443.

    CAS  Google Scholar 

  22. Barone L, Milosavljevic M, Gazibarich B. Assessing the older person: is the MNA a more appropriate nutritional assessment tool than the SGA? J Nutr Health Aging 2003;7:13–17.

    PubMed  CAS  Google Scholar 

  23. Flood VM, Smith WT, Webb KL, Rochtina E, Anderson VE, Mitchell P. Prevalence of low serum folate and vitamin B12 in an older Australian population. Aust N Z J Public Health 2006;30:38–41.

    Article  PubMed  Google Scholar 

  24. Morris M, Sakakeeny L, Jacques PF, Picciano MF, and J. S. Vitamin B-6 intake is inversely related to, and the requirement is affected by, inflammation status. J Nutr 2010;140:103–110.

    Article  PubMed  CAS  Google Scholar 

  25. Haller J, Lowik MR, Ferry M, Ferro-Luzzi A. Nutritional status: blood vitamins A, E, B6, B12, folic acid and carotene. Euronut SENECA investigators. Eur J Clin Nutr 1991;45 63–82.

    Google Scholar 

  26. Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci 2004;59:255–263.

    PubMed  Google Scholar 

  27. Bartali B, Frongillo EA, Bandinelli S, et al. Low nutrient intake is an essential component of frailty in older persons. J Gerontol A Biol Sci Med Sci 2006;61:589–593.

    PubMed  Google Scholar 

  28. Lui A, Lumeng L, Aronoff GR, Li TK. Relationship between body store of vitamin B6 and plasma pyridoxal-P clearance: metabolic balance studies in humans. J Lab Clin Med. 1985;106:491–497.

    PubMed  CAS  Google Scholar 

  29. Meydani SN, Ribaya-Mercado JD, Russell RM, Sahyoun N, Morrow FD, Gershoff SN. Vitamin B-6 deficiency impairs interleukin 2 production and lymphocyte proliferation in elderly adults. Am J Clin Nutr 1991;53:1275–1280.

    PubMed  CAS  Google Scholar 

  30. Guigoz Y. The Mini Nutritional Assessment (MNA (R)) review of the literature — What does it tell us? J Nutr Health Aging 2006;10:466–85.

    PubMed  CAS  Google Scholar 

  31. Dzieniszewski J, Jarosz M, Szczygiel B, et al. Nutritional status of patients hospitalised in Poland. Eur J Clin Nutr 2005;59:552–560

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Discipline of Nutrition and Metabolism, School of Molecular Bioscience, University of Sydney, Sydney, NSW, 2006, Australia

    F. O’Leary, V. M. Flood, M. Allman-Farinelli & Samir Samman

  2. PHN Group, IONE, University of Sydney, Sydney, NSW, 2006, Australia

    V. M. Flood

  3. Department of Statistics, Macquarie University, Sydney, NSW, 2109, Australia

    P. Petocz

  4. Discipline of Nutrition and Metabolism, School of Molecular Bioscience, G08, University of Sydney, Sydney, NSW, 2006, Australia

    Samir Samman

Authors
  1. F. O’Leary
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  2. V. M. Flood
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  3. P. Petocz
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  4. M. Allman-Farinelli
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  5. Samir Samman
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Corresponding author

Correspondence to Samir Samman.

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O’Leary, F., Flood, V.M., Petocz, P. et al. B vitamin status, dietary intake and length of stay in a sample of elderly rehabilitation patients. J Nutr Health Aging 15, 485–489 (2011). https://doi.org/10.1007/s12603-010-0330-4

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  • DOI: https://doi.org/10.1007/s12603-010-0330-4

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