"...all doctors should be able to diagnose and treat nutritional deficiencies."

Royal College of Physicians. Nutrition and Patients: A Doctor's Responsibility. London 2002

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National Diet and Nutrition Survey:
British People aged 65 years and over

Methodology

Two populations of elderly people were surveyed.  The free-living volunteers were identified randomly from their postal address and thus in-patients were excluded.  In the institutionalised sample a sample of those residing in care homes were identified and the very ill elderly were excluded. The following information was collected from both groups:

  1. a 4-day weighed dietary intake record of all food eaten within and outside the home including alcohol intake
  2. blood samples for assessment of micronutrient status
  3. measurements of anthropometry, grip strength as well as memory and depression

In the free-living sample 1,275 adults completed the dietary record and 986 provided a blood sample.

In the institutionalised group 412 participants completed the dietary record and 290 provided a blood sample.

Main Findings

The report breaks the data down by sex and age (65-74 yrs, 75-84 yrs and 85 yrs and over) for the free-living and (65-84 yrs and 85 yrs and over) for those in institutions.

  • Intake of most nutrients fell with increasing age and were approximately 10% lower in those aged > 85 years compared with those aged 65-74 years
  • Deficiencies of virtually all nutrients increased in prevalence with increasing age and with a fall in socioeconomic status
  • A low BMI, <18.5 kg/m2, was found in 1% of free-living men and 3% of free-living women and in 4% of men and 3% of women in institutions
  • A borderline or poor protein intake was observed in 5% of both the free-living and those in institutionalised care
  • Plasma albumin levels were below 35 g/l in 8% of the free-living and 23% of those in institutions
  • Alcohol intakes exceeded the advised weekly maximum intakes of 21 units for men and 14 units for women in approximately 10% of the free-living and 5% of those in institutions
  • Anaemia was found in 10% of the free-living and in 40% of those in institutions
  • Iron deficiency (plasma ferritin < 15-20 ug/l) was found in 8% of the free-living and in 10% of those in institutions
  • Folate deficiency (red cell folate < 350 nmol/l) was found in 8% of the free-living and in 10% of those in institutions
  • Vitamin B12 deficiency (plasma vitamin B12 <118 pmol/l) was found in 6% of the free-living and in 9% of those in institutions
  • Vitamin D deficiency (plasma 25 hydroxy-vitamin D <25.0 nmol/l) was found in 8% of the free-living and in 37% of those in institutions
  • Vitamin C deficiency (plasma vitamin C <11.0 umol/l) was found in 14% of the free-living and in 41% of those in institutions
  • Vitamin B1 deficiency (erythrocyte transketolase activation coefficient, ETKAC, >1.25) was found in 8% of the free-living and in 14% of those in institutionalised care
  • Vitamin A deficiency was rare but plasma retinol levels above 3.5 umol/l in 2%-3% of free-living elderly and are associated with osteoporosis

Reference:

inch S, Doyle W, Lowe C, Bates CJ, Prentice A, Smithers G, Clarke PC. National Diet and Nutrition Survey: people aged 65 years and over:  Volume I; Report of the diet and nutrition survey. London; The Stationery Office, 1998



Copyright Dr. Alan Stewart M.B.B.S.M.R.C.P. (UK)M.F. Hom.
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