[Effectiveness of geriatric rehabilitation in patients at risk of malnutrition.]

The aim of the study was evaluate effectiveness of 21-day comprehensive functional activity restoration programs among patients 60 years and older with risk of malnutrition («RM+») and normal nutritional status («RM-»). The study included 482 patients (81% women), with 96 (19,9%) patients at risk of malnutrition. At Visit 1, a comprehensive geriatric assessment was performed and an individual geriatric rehabilitation program was developed. Visit 2 was conducted after completion of the rehabilitation programs to evaluate the course's effectiveness. Patients in the RM+ group were older than RM- patients (80,3±7,5 vs 78,2±7,7 years respectively, p=0,014), had a lower body mass index (27,8±5 vs 29,5±6,2 kg/m2 respectively, p=0,017) and took more medications (5,4±2,6 vs 4,7±2,6 respectively, p=0,017). In the RM+ group, compared to the RM- group, there were significantly more patients with frailty (52,1% vs 30,9% respectively, p=0,006), dependence on outside help - both basic (25% vs 13.6%, p=0,012) and instrumental (7,3% vs 0,8%, p=0,001), more frequent falls over the past year (36,8% vs 25,3%, p=0,03), cognitive impairment (61,5% vs 49,5%, p=0,04), 2 times more often symptoms of depression were detected (40,6% vs 20,8%, p<0,001). In both groups, the comprehensive programs turned out to be effective - over time, a significant increase in functional activity indicators, improvement in cognitive testing results, a decrease in the severity of chronic pain syndrome, insomnia and symptoms of depression were noted. The RM+ group of patients demonstrated significantly greater improvements in baseline and instrumental functional activity compared to the RM- group. The study demonstrated the effective implementation of a comprehensive domain-based 21-day geriatric rehabilitation approach, improving functional and psycho-emotional status, and reducing pain and insomnia. Patients in the RM+ group, who had a more pronounced decline in functional activity at baseline, demonstrated better recovery.