Malnutrition's Role in Fall Risk

Louis Stokes VA Medical Center

Status: Unknown

Conditions: Nutrition Disorder; Falling Injury

Treatments: Other: Hgb value; Other: C-Reactive Protein; Other: Data Collection prior to first fall for all fallers; Other: Vitamin D

Study type: Observational

Funder types: Other U.S. Federal agency

Identifiers

NCT03011918

13009-H06

Details and patient eligibility

About

Falls and falls related injuries are considered one of the most adverse events that a patient can experience. Several assessment instruments to assess and mitigate risks for falls have been developed. However, these instruments have not addressed nutritional risk factors.

Weight loss and low hemoglobin levels are key components of Malnutrition. Malnutrition in the hospital setting is a significant concern and may play a role as a fall risk factor.

The World Health Organization (WHO) maintains a global anemia database. WHO has identified iron deficiency anemia, based on hemoglobin value alone as the most common, wide-spread nutritional deficiency worldwide. Anemia is present in 30% of the worlds population including industrialized nations.

The consensus statement of the Academy of Nutrition and Dietetics / American Society of Parenteral and Enteral Nutrition simply defines adult under-nutrition as a continuum of inadequate intake along with a multitude of other factors. Weight loss occurs at multiple points along this continuum.

this multiphase retrospective descriptive analysis hypothesizes that degree of weight loss and degree of Hgb decline may be fall risk factors.

Full description

Eat Well, Fall Less is a multiphase retrospective descriptive analysis of single event fallers and repeat fallers. Data source: Documented falls occurring between October 1, 2010 and October 31, 2012.

Chart Review data on weight loss and decline in Hemoglobin levels were collected 12 months, 6 months and 3months and 1 month prior to the first fall along as the most recent value prior to the event. Additional data on vitamin D levels and C-reactive Protein values will be collected at the 12 month, 6month, and 1 month prior to the first fall

Statistical Analysis using SAS version 9.1. a two tailed t-test was performed to evaluate differences in HGB characteristics between single and frequent fallers. One way ANOVA evaluated changes in Hgb, c-Reactive Protein, vitamin D values and weight over time are being collected.

Two constellations of fallers emerged. Those with and those without dementia. The two groups appeared to have different nutrition risk factors. All statistical analysis was done using JMP Pro (version 10.0.0, SAS Institute, Inc, Cary, NC). Statistical significance was set at p < 0.05

Enrollment: 485 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Veteran experienced a fall during a hospitalization between October 1, 2010 and October 31, 2012
• Veteran must have at least one documented weight a minimum of 24 months prior to admission

Exclusion criteria

• Adults who suffer from neurological disease or stroke
• Adults with documented orthopedic fracture in the past 12 months
• Documented amputation of a lower limb in the past 24 months
• Blindness
• History of volume overload, renal, cardiovascular or other in nature
• current alcoholic
• It is felt that a co-morbidity exists which makes the individuals weight history inaccurate, such as a recent prosthetic device alteration.

Trial design

485 participants in 2 patient groups

Observational Single Event Faller

Description:

one documented fall as an in-patient. It is hypothesized that the nutrition factors present prior to the first fall may be related to fall frequency. Data on exposure to nutrition supplementation will be collected for future analysis. Subpopulation alalysis of individuals with dementia will also be conducted

Treatment:

Other: C-Reactive Protein

Other: Data Collection prior to first fall for all fallers

Other: Hgb value

Other: Vitamin D

Observational Multiple event faller

Description:

multiple falls documented during in-patient stay It is hypothesized that frequent fallers will demonstrate statistically greater weight decline, Hgb decline, Vitamin D deficiency and Higher C-Reactive Protein values prior to the first fall. Data on exposure to nutrition supplementation will be collected for future analysis.. Subpopulation analysis of individuals with dementia will also be conducted.

Treatment:

Other: C-Reactive Protein

Other: Data Collection prior to first fall for all fallers

Other: Hgb value

Other: Vitamin D