Subject recruitment, retention and protocol feasibility in a prospective study of nutritional risk among urban, frail homebound elders

The feasibility of performing comprehensive in-home nutritional risk assessments in a prospective research study of urban, frail homebound elderly patients (aged 65-105) is important, given prior reports of difficulties conducting research with older adults. Trained field teams conducted nutritional and health status assessments on 239 subjects, patients of the Boston University Geriatric Services clinical home care program. Baseline data were obtained on 153 of the 159 inter-view items from 91% of respondents; three 24 hour dietary recalls from 73%; anthropometry from 60-93%; and other physical assessments from 63-94%. Attrition was 21%, and mortality was 9% over 12 months. Well-designed, flexibly administered study protocols, modest financial incentives and careful follow-up contributed to follow-up interview re-sponse rates of 81 to 89% among enrollees over the study’s duration. Clearly, it is feasible to recruit frail, older subjects and for well-trained, two person field teams to conduct comprehensive in-home assessments of nutritional risk in under two hours with good retention over 12 months of follow-up.