An in-home nurse-administered geriatric assessment for hypoalbuminemic older persons: development and preliminary experience

J Am Geriatr Soc. 1999 Oct;47(10):1244-8. doi: 10.1111/j.1532-5415.1999.tb05206.x.

Abstract

Background: Although malnutrition in older persons is a common, potentially treatable condition, few data indicate that treatments for this disorder can be effective.

Objective: To develop and preliminarily evaluate a two-component intervention that includes a nurse-administered, in-home assessment to identify potentially remediable causes of hypoalbuminemia and protocols to treat these problems.

Design: A pre-test post-test case-series.

Setting: An academic geriatrics practice.

Participants: Seventeen persons aged 65 and older with serum albumin levels < or = 3.8 g/dL; eight of the participants received pre-and post-test outcome measures.

Intervention: Nurse-administered standardized assessment and intervention protocols.

Measurements: Serum albumin, Medical Outcome Study (MOS) SF-36, serum IL-1a and b, TNF alpha, IL-6, and lymphocyte markers of immune function.

Results: The assessment took 87 minutes, on average, and generated a mean 4.2 recommendations. Among the eight subjects with pre- and post-test measures, serum albumin increased by 0.2 g/dL (P = .035). Compared with baseline, two T cell markers of immune function demonstrated changes consistent with better function.

Conclusions: These preliminary data support the potential benefit of a nurse-administered assessment coupled with protocols to address remediable contributors to hypoalbuminemia.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Cytokines / blood
  • Enzyme-Linked Immunosorbent Assay
  • Evaluation Studies as Topic
  • Female
  • Geriatric Assessment*
  • Health Status
  • Home Care Services*
  • Humans
  • Male
  • Nursing Assessment / methods
  • Nutrition Disorders / diagnosis*
  • Nutrition Disorders / immunology
  • Quality of Life
  • Serum Albumin / deficiency*
  • Statistics, Nonparametric
  • T-Lymphocyte Subsets / immunology

Substances

  • Cytokines
  • Serum Albumin