Predicting falls in elderly receiving home care: the role of malnutrition and impaired mobility.

UNLABELLED: To investigate the role of malnutrition, impaired mobility and care dependency in predicting fallers in older Dutch home care clients. DESIGN: This study is a secondary analysis of data of the annual independent national prevalence measurement of care problems of Maastricht University. The design involves a cross-sectional, multicentre point prevalence measurement (malnutrition, mobility), and a 30 days incidence measurement (falls). SETTING: Dutch home care organisations. PARTICIPANTS: 2971 clients (older than 65 years) from 22 home care organizations participated. MEASUREMENTS: A standardized questionnaire was used to register amongst others data of weight, height, number and type of diseases (like for example neurologic diseases, dementia, CVA, COPD, eye/ear disorders, musculoskeletal disorders), nutritional intake, use of psychopharmaca, undesired weight loss, fall history, mobility, and care dependency. RESULTS: The study was able to show that fallers are more often malnourished than non-fallers in the univariate analysis. Most importantly the study indicated by multivariate analysis that fallers could be predicted by the risk factors immobility ((OR 2.516 95% CI 1.144-5.532), high care dependency (OR 1.684 95% CI 1.121-2.532) and malnutrition (OR 1.978 95% CI 1.340-2.920). CONCLUSION: The findings of this study stress that malnutrition, impaired mobility and care dependency are potential reversible factors related to falls. Therefore early identification and management of nutritional status, impaired mobility and care dependency are important aspects for a possible fall prevention strategy.

Effects of oral bovine colostrum supplementation on serum insulin-like growth factor-I levels.

OBJECTIVES: We investigated whether supplementation with 60 g/d of bovine colostrum affects blood levels of insulin-like growth factor-I (IGF-I) and IGF binding protein-3 in relation to doping testing. Nine endurance-trained men ingested 60 g/d of bovine colostrum for 4 wk. METHODS: Blood and urine were sampled before starting supplementation. After 4 wk urine and blood samples were taken after an overnight fast and 2 h after ingestion of the last portion to study possible acute effects. RESULTS: Blood IGF-I levels before supplementation were (mean +/- standard deviation) 31 +/- 13 nM/L, and no acute effects were observed after 4 wk of supplementation (33 +/- 9 nM/L). Levels of IGF-binding protein-3 were 136 +/- 11 nM/L before supplementation and 135 +/- 16 nM/L after 4 wk of supplementation. Two hours after ingestion of the last portion, the level of IGF binding protein-3 was 131 +/- 19 nM/L, which was not different from baseline values. Drug testing in a laboratory accredited by the International Olympic Committee did not show any forbidden substance before or after 4 wk of supplementation. CONCLUSIONS: Daily supplementation with 60 g of bovine colostrum for 4 wk does not change blood IGF-I or IGF binding protein-3 levels and does not elicit positive results on drug tests.