Montclair State University, USA
Angela Chalé is an Assistant Professor, Montclair State University, transitioning into older adult health policy and public health. She has published articles in nutritional supplementation and physical activity in relation to the age-related loss in muscle mass, sarcopenia, and other health-related correlates of aging. Ilona Khasin and Kristin Monk are graduate students of nutrition (New York University and MSU, respectively). Raymond Liang is Clinical Assistant Professor, UMDNJ, and Associate Program Director of the Internal Medicine Residency Program, Mountainside Hospital, NJ. Christina Chalé is Senior Communications Specialist, Sanofi-Aventis, UK. She oversees Core Brands and Commercial Divisions’ needs and also has a M.A. in bioethics.
The major causes of death among older adults have underlying nutritional determinants. With an ever-expanding older adult population, there will be a demand for emergent health promotion models relevant to traditional physician-centered practices, hospitals and the nascent patient-centered medical home. We propose a model that combines nutrition education (NE) with advanced care planning (ACP). ACP, when coupled with NE, may provide a whole life approach. A goal would be to involve life policy insurers and planners in the delivery and management of NE and ACP. Policyholders would then receive incentives, e.g., greater whole life coverage and/or reduced premiums, for taking preventive measures. We conducted a pilot study of 20 adults, 50 years of age and older, designed to determine the feasibility of process steps, the resources that would be required, the sample size needed for a larger study and scientific integrity of combining these two life outcomes together. Participants were divided into two groups. Both groups received nutrition and physical activity education and bi-weekly phone calls to encourage participation and set new goals. Only one group received explicit ACP. There were significant improvements in nutritional status and quality of life and increased physical activity. However, there were no differences between the groups. This pilot study had limited statistical power to measure the effects of ACP. The data obtained from this preliminary investigation will provide the basis for a future larger scale study. Integration of ACP with NE, delivered by life insurers and planners, may be an incentivized approach to chronic disease prevention.