Serum trace elements in elderly frail patients with oropharyngeal dysphagia

Microelements have an important role in many vital enzymatic functions. Their optimal intake and serum concentration are not properly defined. For nursing home residents, this issue is further complicated by the high prevalence of oropharyngeal dysphagia. The purpose of this study was to measure microelement concentrations in 3 groups of elderly subjects that differ in their feeding methods and functional state. Forty-six frail elderly patients, in stable clinical condition, 15 on naso-gastric tube (NGT) feeding, 15 orally fed (OF), from skilled nursing departments were recruited to this study. As controls, we studied a group of 16 elderly independent ambulatory patients. A battery of 16 microelements was examined using the Inductively Coupled Plasma Atomic Emission Spectrometry (ICP-AES) and Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The OF frail elderly patients had significantly lower levels of chromium as compared to the NGT fed and the control group. Both frail elderly groups had lower levels of zinc and copper as compared to the controls. In contrast, in the nursing groups, we found higher levels of aluminum, boron, barium, bromine and nickel. Elderly, in particular frail and disabled subjects, are vulnerable to insufficiency or overload of microelements. There is a need to evaluate the actual requirements for each microelement for this population.