The nutritional implications of food wastage in continuing care wards for elderly patients with mental health problems

Determinants of depression and insomnia among institutionalized elderly people in Malaysia

Depression and insomnia are common psychiatric disorders among elderly people and reported to be related to several social and health factors. However, their occurrences in relation to food intake have rarely been investigated. Therefore, this study was to identify determinants of depression and insomnia, with emphasised on food intake among 71 elderly people residing in a government funded institution in Malaysia. An interview based questionnaire was used to obtain information on socio-demography, health and functional status, depression, insomnia and food intake. A total of 71.8% subjects had depression and 53% had insomnia. Subjects who had insomnia [Adjusted Odds Ratio (AOR) 19.55, 95% CI=4.04-94.64], needed help/unable to perform >4 items of IADL (AOR=16.65, 95% CI=3.95-70.22), had hypertension (AOR=7.66, 95% CI=1.37-42.76), had >50% wastage of poultry or fish (AOR=3.66, 95% CI=1.06-12.60) and wastage of vegetables (AOR 3.31, 95% CI=1.03-10.60) were more likely to have depression. Subjects who had depression (AOR 19.55, 95% CI=4.04-94.64), needed help/unable to perform >4 items of IADL (AOR 2.97, 95% CI=1.12-7.84), needed help/unable to handle financial matters (AOR 5.01, 95% CI=1.37-18.27) and had >50% wastage of vegetables (AOR 3.91, 95% CI=1.42-10.82) were at a higher risk to develop insomnia. Depression and insomnia affected more than half of the subjects, interrelated, and associated with functional inability, socioeconomic factor and high food wastage of specific foods.

Nutritional status and clinical outcome in elderly femalesurgical orthopaedic patients

The possible relationship between nutritional status and clinical outcome following orthopaedic hip surgery was investigated. The nutritional status of 60 elderly female patients admitted for elective total hip replacement (THR) and emergency fractured neck of femur surgery (FNF) was measured over time. Specific measures of clinical outcome, including well-being and functional status, were monitored during hospital stay and at 4, 8 and 26 weeks following discharge. Patients were allocated to a high nutritional risk group where any three of the following were less than the 5th percentile value: serum albumin, haemoglobin, triceps skinfold thickness, mid-upper arm muscle circumference and body weight. Using this definition, malnutrition was present in 4% of THR patients and 41% of FNF patients. It was found that the high risk patients had significantly longer convalescence periods, (median stay 27.5 days compared with 0 days, P < 0.0009), and a greater proportion were dependent upon walking frames at 6 months (46% compared with 11%, P < 0.01). Fifty percent of the high risk patients had been living independently prior to admission, in contrast only 29% had returned to their homes at 6 months after discharge. The results indicate an apparent link between clinical outcome and nutritional status based upon the allocation procedure employed, which has the potential for ensuring cost-effective nutritional intervention.