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The aim of this study was to assess the energy

expenditure of nursing home residents with indirect calorimetry

and then to compare it with the calculated energy intake of the



An indirect calorimetry was performed for each nursing

home resident included in this study to estimate their basal

metabolism. Then, the basal metabolismwas multiplied by a physical

activity level (PAL) coefficient. Finally, energy expenditure related to

thermogenesis (i.e. 10% of the basal metabolism) was added. In this

way, we obtained the total energy expenditure of each nursing home

resident. Nutritional intake of each resident was calculated by the

precise weighing food method, over a 3-day period.


A total of 29 subjects, all residing in one nursing home

in Liège, Belgium, and meeting the selection criteria (i.e. to be

oriented, stable condition and able to walk, with or without technical

assistance) were included in this study. The mean age of this

population was 88.1 ± 5.8 years and 84% of them were women. The

mean basal metabolism estimated was 1087.2 ± 163.2 kcal. When

multiplied by the PAL (1.29 ± 0.1) and added to the energy expenditure

due to thermogenesis (155.7 ± 24.7 kcal), we obtained the mean

energy expenditure of 1557.3 ± 247.1 kcal, which was similar to the

calculated energy intake of the residents (1631.5 ± 289.3 kcal). Indeed,

the difference was not statistically significant (p = 0.33)


The estimated energy intake of nursing home residents

seems appropriate for their energy expenditure.




an atypical presentation

A. Canelas


, C. Machado


, P. Tavares


, C. Silva


, G. Rocha


, L. Andrade



V. Dias




Internal Medicine Department, Centro Hospitalar Vila Nova de



Endocrinology Department, Centro Hospitalar Vila Nova

de Gaia / Espinho, Porto, Portugal



Disease (GD) its responsible for 80% of

hyperthyroidism cases. Usually has distinctive signs and symptoms

(goiter, oftalmopathy, palpitations) [1]. Thyroid disorders are very

common in the elderly, and correlatewith high morbidity if untreated.

The typical symptoms may be absent, or mistakenly associated to the

age or comorbidities [2,3].


We report on an elderly woman with an atypical

presentation of GD. The relevant literature was reviewed.

Case report:

81 year-old, female, with a 2-month history of proximal

muscle weakness, depressed humor, lethargy and constipation.

Admitted for fever of unknown origin. On physical: lethargic,

dehydrated, pale and feverish. Laboratory findings: Hemoglobin

9.8 g/dL; white blood count 16.69X10^3, 85% neutrophils; C-reactive

protein 45.53 mg/dL; Sodium 127 mmol/L; Sedimentation velocity

rate 120 mms. Excluded respiratory, urinary, abdominal, orthopedic,

neurological, spondylodiscitis or endocarditis, as cause. Endoscopic

studies: esophagi candidiasis. Virology, serology and tuberculosis were

negative. Thyroid study: TSH 0.11 microiU/mL, free T4 2.46 pmol/mL;

Echography: enlarged, heterogeneous, multiple nodules; Positive

Anti-TSH antibodies. Therefore, diagnosed with GD, but without

criteria for thyrotoxicotic storm, initiating tiamazole. On the 11th day,

deteriorated and was admitted in the Intermediary Care Unit for

Severe Sepsis with multiple organ dysfunction, caused by intestinal

occlusion with megacolon and RCD aggravated by tubular necrosis.

There wasn

t surgical treatment to be offered. The patient ultimately

died, regardless of all the efforts.


In 1931, Lahey, described a form of hyperthyroidism in

which the patients were


, showing few, or none of the

typical symptoms [4,5]. The pathogeny is unknown, but seems to

be related with brain defiance of catecholamines [6]. This alerts us

for the fact that in cases of clinical stress, they can rapidly



Comparison of nutritional status among elderly in hospital and in

community environments

M. Cebola, A. Mahendra, M. Pombo, B. Marques, H. Pinto, E. Carolino,

L. Mendes.

Licnciatura em Dietética e Nutrição, Escola Superior de

Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa


The elderly is considered vulnerable population by the

senescence process, which puts them at high risk of morbidity and

mortality. Several studies indicate a high prevalence of malnutrition in

the elderly in community and in hospital admissions, so the main

purpose of this study is to compare the nutritional status of the elderly

persons in both settings, located in Lisbon.


The screening tool Mini Nutritional Assessment (MNA



body mass index (BMI), arm circumference (AC), arm muscle area

(AMA) and C-reactive protein (CRP) were used to assess nutritional

status. Based on MNA


questions, food and water intake were



A total of 99 elderly were evaluated (57.6% in hospital and

42.4% in the community). A higher level of inflammationwas observed

in hospital, according to CRP levels. It was reported a lower intake in

the hospital for: number of meals (15% less), portions of fruit and

vegetables (10.5% less), protein intake (33.4% less) and water intake

(44.3% less). In hospital, BMI indicated that 26.7% of the elderly were

malnourished whilst in community it was observed to be 20%. 43.9%

had a form of malnutrition in hospital and 45% in community,

when AMA was evaluated. MNA


detected 63.1% of patients were

malnourished or at risk of malnutrition in hospital and 62% in

community. Overall the elderly revealed worse nutritional status is in

hospital. The results suggest the need to regularly assess nutritional

status allowing to identify and decrease complications associated with

malnutrition, regardless of where the elderly are to remain.


Nutritional assessment of an elderly population by application of

24-hour recall and the Mini Nutritional Assessment

M. Cebola, M. Pombo, H. Pinto, E. Carolino, L. Mendes.

Licenciatura em

Dietética e Nutrição, Escola Superior de Tecnologia da Saúde de Lisboa,

Instituto Politecnico de Lisboa


Aging is characterized by physiological, social and

psychological changes that compromise food intake and nutritional

status. To ensure good nutritional status it

s crucial to assess the

nutritional status through a validated tool and evaluate the food

intake, which is the purpose of this study.


An analytical, observational, transversal, correlational and

quantitative study was conducted. The elderly

s assessment and

characterization was done by the application of Mini Nutritional

Assessment (MNA), arm circumference (AC), laboratory parameters

and 24 hours recall.


In the study, 42 elderly people were assessed, from which 26

women. By applying the MNA_Long Form




) 0 were

undernourished, 26 (62%) at risk of desnutrition and 16 (38%)

eutrophic. By applying the body mass index (BMI) 2 (5%) undernour-

ished, 6 (15%) at risk of desnutrition, 7 (17%) eutrophic e 26 (63%)

overweight. By the AC 19 (45%) exhibit depletion of lean body mass, 20

(48%) good nutritional state and 3 (7%) excess of body fat. The 24 hours

recall indicated low intake of macronutrients and of some micro-

nutrients (vitamins A, D and E, folate, potassium, calcium and

magnesium) and high intake of sodium and phosphorus. The AC

correlated with IMC (r = 0,61; p = 0) and MNA_LF (r = 0,45; p = 0,003).

The IMC correlated with the presence of dyslipidemia (r = 0,41;

p = 0,01), diabetes mellitus (r = 0,45; p = 0,003) and arterial hyperten-

sion (r = 0,375; p = 0,02).

Key conclusions:

The population being studied showed high

prevalence of malnutrition, similar percentage of risk of desnutrition

and overnutrition, and deficit of food intake, as seen in other

Portuguese studies about the elderly in community.

Poster presentations / European Geriatric Medicine 7S1 (2016) S29