Aim: To test whether alerting clinicians to severe weight loss in older patients leads to higher dietitian visit rates, to higher body mass index (BMI) levels and, mainly, to lower annual death risk. Methods: The randomized controlled trial included patients aged ≥75 years, with BMI ≤23 kg/m2 that decreased ≥2 kg/m2 during the previous 2 years. All participants received usual care. Additionally, an email alert was sent only to clinicians of participants assigned to the email alert group. The follow-up period was 12 months. Results: Among 706 participants (mean age 83 ± 6 years; mean baseline BMI 20.5 kg/m2), the BMI record was updated in 541 (77%) participants, and 123 participants died. Dietitian visits were reported for 22 patients (6%) in the email group (n = 362) and 14 patients (4%) in the control group (n = 344; OR 1.5, 95% CI 0.8–2.9; P = 0.24). Measured BMI were raised by a mean of 0.69 (95% CI 0.43–0.95) kg/m2 versus 0.79 (95% CI 0.48–1.1) kg/m2 (P = 0.63). A total of 77 patients (21%) died in the intervention group versus 47 (14%) in the control group (P = 0.008; number needed to harm = 13; 95% CI 7–43). Conclusions: In this trial, alerting clinical staff to severe weight loss in patients aged ≥75 years was not associated with higher visit rates to a dietitian or change in BMI, but was associated with a significantly higher death rate than usual clinical care. Geriatr Gerontol Int 2020; 20: 329–335.
|Number of pages||7|
|Journal||Geriatrics and Gerontology International|
|State||Published - 1 Apr 2020|
Bibliographical noteFunding Information:
This work was supported by Dangoor Personalized Medicine Fund at Bar-Ilan University. The authors thank the many Northern and Southern Districts’ patients, clinicians and data experts involved in this study. We gratefully acknowledge the moral support and advice of the late Professor Michael A Weingarten.
LIMIT was sponsored and supervised by the authors (as CHS employees), and supported by the Dangoor Personalized Medicine Fund at Bar‐Ilan University.
© 2020 Japan Geriatrics Society
- electronic mail
- iatrogenic disease
- randomized controlled trial
- weight loss