Malnutrition's Role in Fall Risk



Status:Enrolling by invitation
Healthy:No
Age Range:18 - Any
Updated:1/7/2017
Start Date:April 2013
End Date:December 2018

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Eat Well, Fall Less

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.

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

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.
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