53 | “Weancare”- Casa di Dio Foundation intervention

A. Ranzenigo¹, S. Mosconi¹, A. Romano², M. Zanini³ | ¹Casa di Dio Foundation, Brescia; ²Healthy Aging Research Group SB, Brescia; ³Department of Health Sciences, University of Genova.

The “Weancare” intervention, a nutritional protocol based on enriched meals and fortified nutrition, evaluated the efficacy of personalized nutritional support in 52 frail elderly subjects with dysphagia, living in four Nursing Homes managed by Casa di Dio Foundation in Brescia (Italy). A key feature of the protocol was that the introduction of Weancare meals replaced all pre-existing caloric-protein oral nutritional supplements, which were entirely discontinued upon enrolment. Dysphagia is a condition that significantly increases the risk of malnutrition, pneumonia, and pressure sores. The study monitored clinical and functional parameters at 3 and 6 months to measure the treatment's impact. At baseline, the sample had an average age of 84, high comorbidities (high CIRS), cognitive impairment (MMSE often <24), and significant nutritional risk (MUST). Results after 3 months showed significant increase in BMI (+0.59) and lymphocyte counts, indicating improved nutritional and immunological status. Concurrently, the prevalence of pressure sores dropped drastically from 21% to 5.8%. Other biochemical parameters, such as albumin and haemoglobin, remained stable, suggesting a slower response due to the chronic nature of the underlying diseases. The 6 month analysis confirmed the sustainability of the recovery, with a steady BMI increase (+0.68 total, +0,11 per month in 6 month) and a continuous reduction in the probability of sores (prevalence of 0.19%). However, the intervention's efficacy was influenced by initial frailty: patients with multiple pathologies (high CIRS) and low autonomy (low Barthel index) responded less to the treatment. "Complete responders" (those who increased weight and resolved their sores) generally displayed moderate frailty and partial autonomy. In conclusion, integrating nutritional intervention into a multidisciplinary care model improves the prognosis of dysphagic elderly patients, though success remains tied to the individual clinical profile.