WEIGHT LOSS LINKED TO DEATH IN NURSING HOMES, STUDY SHOWS

COLUMBUS, Ohio -- For elderly residents of nursing homes, losing weight can be deadly.

In a new study of 146 residents of an intermediate-care nursing home, scientists found that those patients who lost 10 percent or more of their body weight over a six-month period were significantly more likely to die in the next six months than residents who maintained a stable weight. This was true for residents regardless of age, gender or principal medical problem.

"We're not suggesting that weight loss causes death," said Robert A. Murden, an associate professor of internal medicine at Ohio State University and lead author of the study. "Rather, significant weight loss seems to be a marker for problems that could lead to death."

Murden conducted this research with Nina K. Ainslie, a physician with the Kansas City Veterans Affairs Medical Center. The pair's work was published in a recent issue of the Journal of General Internal Medicine.

For their study, Murden and Ainslie reviewed the records of all patients who lived in a Kansas City nursing home between

November 1989 and November 1991. During that time, each patient was weighed at least four times -- every six months. For each patient, the researchers noted age, gender, principal medical problem and pattern of weight gain or loss. For patients who died during the study period, they noted the cause of death and the amount and duration of weight loss before death, if any.

The results:

_ Almost two-thirds (62 percent) of residents who lost 10 percent of their body weight or more over a six-month period died in the next six months. Conversely, 90 percent of residents who didn't lose weight were still alive six months later.

_ Residents who died were not significantly older than residents who survived. In fact, the average age of those who died was 81.5; the average age of the survivors was 83.2. "This means that the results we found can't be explained by old age," Murden said.

_ Gender appeared to play no role in survival. Women made up 83 percent of those who survived and 77 percent of those who died.

_ Cancer was significantly more common among those who died. But when the cancer victims were removed from the analysis, weight loss was still a strong predictor of death, Murden said. "Cancer was not the predictor of death for the group -- weight loss was," he said.

Murden said it's still unclear whether the effects of severe weight loss are reversible.

"If a patient is losing weight because he's dehydrated, then a physician can intervene," he said. "But in other cases, it's unknown what kind of interventions might prevent death."

However, he said, in the meantime, physicians and families who care for nursing home patients should take careful notice of patients who are losing weight.

"A physician who notices a weight loss of 10 percent should look for causes that might have been missed and ways to interrupt it," he said. "If it's a natural, expected weight loss because someone is dying of cancer, then there's nothing you can do. But if the weight loss is out of the blue, the physician should look for some new diagnosis or try to intervene."

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Contact: Robert A. Murden, (614) 293-8105

Written by Kelly Kershner, (614) 292-8308