Arch. Gerontol. Geriatr. suppl. 5 (1996) 599-604 0167-4943/96/$15.00 0 1996 Elsevier Science Ireland Ltd. All rights reserved 599 ROLE OF AGING IN MALNUTRITION AND IN RESTITUTION OF NUTRITIONAL PARAMETERS BY TUBE FEEDING F. VETTA, W. GIANNI, S. RONZONI, L.M. DONINI, L. PALLESCHI, T. PEPPE, P.F.A. LATO, M. MIGLIORI, M. CACCIAFESTA and V. MARIGLIANO Geriatric Department, Institute of 1st Medical Clinic, University of Rome “La Sa- pienza”, Viale del Policlinico, 2. l-00161 Roma, Italy SUMMARY Aging and malnutrition are connected by social and pathological factors; many studies show that 60-80 9, of hospitalized elderly patients are malnourished. The aim of this study was to establish a correlation between age and nutritional parameters in malnourished, hospitalized, elderly patients before and after re- stitution by tube feeding (using Clintec chemicals) for 45 days, with a mean cal- oric contribution of 2670 + 235 Kcaliday. Twenty-three patients were examined, matched for age (80.59 + 8.35 years) and sex (11 females and 12 males). Pati- ents affected by malignant, chronic or acute diseases that could directly increase cytokine production (TN F-a, IL-l, etc.) were excluded. Anthropometric measure- ments were carried out always by the same operator using a fiberglass tape mea- sure and a Harpenden skinfold caliper. Statistical analysis was carried out by ANOVA test and linear regression analysis. The main observations before and after tube feeding were the following: (i) Significant increases were found in serum albumin, triglyceride and cholesterol levels, whereas slightly increasing tendencies occurred, without reaching statistical significance, in serum trans- ferrin levels, in triceps skinfold (TSF) and mid arm muscle crcumference (LlAMC) values. In malnourished patients close correlations were found between the age and serum albumin (r = 0.486; p = 0.022), as well as between age and MAMC (r = 0.576; p = 0.005). however, these correlations disappeared after tube feeding. These data show that age itself does not represent an important impe- diment for nutritional restitution; the possibiiities of the latter appear to be de- pendent on the self-sufficiency and cognitive faculty of the patient, as measured by the activity of daily living [ADL). instrumental activity of daily living (IADL) and mini mental state evaluation (MMSE) scores (p < 0.005). Keywords: enteral nutrition, geriatric assessment, nutritional assessment INTRODUCTION The geriatric approach requires the application of multiple assessments of the elderly patients, including evaluation of self-sufficiency and cognitive fa- culties, as well as a nutritional assessment by means of biochemical and anthro- pometric indexes (Horwat, 1989). Protein-energy malnutrition is common in cl- derly people and is often associated to social and economic factors. There are also other important conditions to be considered in development of situations of malnutrition in older patients, such as: acute or chronic diseases, deficits in masticatory function, reduction of sense of smell and taste (hypogeusia and hy- posmia, respectively), pharmacological treatments, functional gastroenteropathies, self-insufficiency and cognitive deficiencies. There is a causal interrelationship