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Older Hispanic Americans are a rapidly growing minority group who are disproportionately affected by diabetes mellitus and obesity. Given the importance of physical activity, particularly leisure-time activity, in the management of diabetes mellitus and obesity, the current study examined ethnic and sex differences in walking for transportation, leisure-time walking, moderate activity (not including walking), and vigorous activity between Hispanic and non-Hispanic white (NHW) older adults (age 55 and older) using the 2009 California Health Interview Survey, a population-based survey representative of California's noninstitutionalized population. The total sample consisted of 21,702 participants (20,148 NHW (7,968 men, 12,180 women) and 1,554 Hispanic (609 men, 945 women)). Multivariable logistic and linear regression analyses were adjusted for sociodemographic characteristics. The findings revealed that Hispanic men and women were significantly less likely to engage in self-reported leisure-time walking and vigorous activity than NHW men (adjusted odds ratio (aOR) = 0.71, 95% confidence interval (CI) = 0.51-0.99) and women (aOR = 0.60, 95% CI = 0.42-0.87). Regardless of ethnic group, men were more likely than women to engage in self-reported walking for transportation (aOR = 0.71, 95% CI = 0.58-0.87), moderate activity (aOR = 0.68, 95% CI = 0.57-0.81), and vigorous activity (aOR = 0.58, 95% CI = 0.50-0.68). All types of self-reported physical activity were associated with lower body mass index (BMI; P < .001), although significant interactions between sex and leisure time walking (P < .001), moderate activity (P < .001), and vigorous activity (P < .001) indicated that women who engaged in these activities reported the lowest BMIs. The findings highlight the importance of emphasizing walking in efforts to increase moderate and vigorous activity, particularly for older women.

Objectives This study examined potential barriers to mental healthcare use of older adults from diverse ethnic and racial backgrounds. Design Data were obtained from the 2007, 2009, 2011–12, and 2013–14 California Health Interview Survey (CHIS), a population-based survey representative of California's noninstitutionalized population. Participants The total sample consisted of 75,324 non-Hispanic white (NHW), 6,600 black, 7,695 Asian and Pacific Islander (API), and 4,319 Hispanic adults aged 55 and older. Results Results from logistic regression analyses that controlled for multiple demographic and health status characteristics revealed ethnic and racial differences in reasons for not seeking treatment and for terminating treatment. Specifically, API and Hispanic adults had greater odds than NHWs of endorsing feeling uncomfortable talking to a professional as a reason for not seeking treatment. Hispanic respondents had lower odds of endorsing concerns about someone finding out than APIs, and APIs and blacks had significantly greater odds of endorsing this concern as a reason for not seeking treatment than NHWs. When asked about reasons for no longer receiving treatment, all respondents, irrespective of race or ethnicity, endorsed that they no longer needed treatment as the most frequent reason for terminating treatment, although specific ethnic and racial differences emerged with respect to perceptions of not getting better, lack of time or transportation, and lack of insurance coverage as reasons for no longer seeking treatment. Conclusion Understanding how barriers to mental health treatment differ for older adults from diverse ethnic and racial backgrounds is an important step toward designing interventions to overcome these obstacles and improve mental health outcomes.

This study examined racial and ethnic differences in healthcare use, delayed care, and management of care of older adults with a self-reported diagnosis of diabetes mellitus. Drawing on the 2009 California Health Interview Survey (CHIS), the sample included 3,003 adults (representative of N = 998,795) aged 60 and older from five racial and ethnic groups: non-Hispanic white (n = 2,153), African American (n = 213), Hispanic (n = 336), Asian (n = 306), and American Indian and Alaska Native (AI/AN) (n = 59). All self-reported a diagnosis of diabetes mellitus. Descriptive statistics and logistic regression analyses were conducted using weighted data. Results from adjusted logistic regressions indicated significant racial and ethnic differences between non-Hispanic white elderly and the other groups examined. Specifically, African Americans were significantly less likely than whites to see a doctor and to have a usual source of care, and were more likely to visit the emergency department (ED) for diabetes mellitus and to have their feet examined by a provider. Hispanics were significantly less likely to take medicine to lower cholesterol but were more likely to test their blood glucose regularly (following ADA guidelines). Asians were significantly less likely than whites to test their blood glucose regularly or have a foot examination. AI/ANs were significantly less likely than whites to see a doctor, visit an ED, and take medication to reduce heart attack risk but were more likely to use insulin, oral diabetic medication, or both. The findings suggest the need for racial- and ethnic-specific interventions for managing diabetes mellitus to help reduce existing racial and ethnic disparities among elderly adults.

Physical health problems become more common as people age and are associated with a great deal of disability. Although racial and ethnic disparities have been reported in physical health, little is known about whether these disparities remain in the latest part of older adulthood. Accordingly, the current study sought to examine racial and ethnic differences in the physical health status of three age groups of older adults, using the 2005 and 2007 California Health Interview Survey. The sample for the current study included 40,631 individuals aged 55 and older: 33,488 non-Hispanic whites, 1,858 blacks, 2,872 Asians and Pacific Islanders, and 2,412 Latinos. Respondents were compared with regard to three indicators of physical health: four chronic health conditions, difficulties with activities of daily living, and self-rated health. Analyses were conducted with and without adjustment for sex, marital status, education, English-language proficiency, nativity, and insurance status. Results revealed that, in general, racial and ethnic disparities existed for physical health in late adulthood, with differences less pronounced for Asians and Pacific Islanders and Latinos aged 75 and older after multivariable adjustment. Disparities between blacks and non-Hispanic whites and disparities across all racial and ethnic minorities in self-rated health still existed. These findings suggest that, to reduce racial and ethnic disparities, clinicians need to address specific sociodemographic and lifestyle factors related to racial and ethnic differences in health before these conditions are manifested in late adulthood.

Little is known about the unmet mental health needs of minority older adults. Racial and ethnic differences in the prevalence rates of psychological distress and reported need and use of mental health services were examined in a population-based sample of older adults using the 2005 California Health Interview Survey. The sample comprised 16,974 people aged 55 and older, with 13,974 non-Hispanic whites, 719 African Americans, 1,215 Asians, and 1,066 Latinos. Respondents were compared in terms of prevalence of symptoms of mental distress and serious mental illness, reported need for help, and access to mental health services. African Americans, Asians, and Latinos were more likely to have mental distress than whites (21.2-24.2% vs 14.4%, P

Human immunodeficiency virus (HIV)-infected patients who receive antiretroviral (ARV) therapy are surviving into older age and are more likely to die from age-associated comorbid conditions than acquired immunodeficiency syndrome (AIDS).1–3 Deterioration in physical function is a consequence of chronic infection and sarcopenia in older adults.4 Aging, HIV infection, and ARV therapy have an additive effect on metabolism, pharmacokinetics, and immune function in older HIV-infected patients,5 but the combined effect on physical function is unknown. Physical function encompasses many parameters, including fitness, strength, balance, and flexibility. In the current treatment era, difficulty with vigorous activities is the predominant functional limitation of HIV-infected patients regardless of their age.6–8 Exercise testing that shows a 42% reduction in cardiorespiratory fitness in adolescent9 and older (mean age 56)10 HIV-infected patients when measured as oxygen consumption during peak exercise performance (VO2peak). Before effective therapy was available, asymptomatic HIV infection frequently progressed to AIDS, resulting in generalized wasting and loss of muscle mass in young adults that was associated with shorter 6-minute walk distance (6-MWD)11 and weaker hand-grip strength.12 Similarly, laboratory markers of HIV disease progression, CD4 cell count, and HIV-1 viral load, were important predictors of physical function.6,13 More recently, in a large cohort of HIV-infected adults that included 447 subjects aged 50 and older it was found that self-reported physical function is associated with cardiac and pulmonary disease, independent of HIV stage and CD4 cell count.8 Although self-reported function provides important insight into physical disability, there may be limitations unique to older HIV-infected adults. Older HIV-infected patients, who represent a survival cohort, could have a different threshold for reporting functional limitations than younger HIV-infected patients or older noninfected patients. Exercise testing offers a laboratory-based measure to investigate the clinical and physiological factors underlying limitations in vigorous activities. 6-MWD is an estimate of submaximal exercise capacity that is easy to administer and predicts physical function and mortality in older adults with congestive heart failure (CHF)14 and chronic obstructive pulmonary disease (COPD)15 but has not been studied in older HIV-infected adults. In particular, the accuracy of the 6-MWD as a surrogate for treadmill testing has not been validated in this population. The objective of the study was to investigate the association between age-associated comorbidity and cardiorespiratory fitness (VO2peak) in older HIV-infected adults receiving ARV therapy. It was hypothesized that cardiac and pulmonary disease contribute to poorer fitness and that current effective HIV treatment minimizes the effects of AIDS and wasting. The secondary goal was to provide objective evidence that the 6-MWD could be used as a safe, easily administered, low-cost alternative to treadmill testing to assess fitness in older HIV-infected adults.

Vietnamese Americans are a rapidly growing minority group in the United States, yet little is known about their health status. Chronic medical conditions and self-rated health of older Vietnamese Americans were compared with those of non-Hispanic white adults living in California using the 2001 and 2003 California Health Interview Surveys (CHISs). The CHIS employed a random-digit-dial telephone survey, and its sample is representative of California's noninstitutionalized population. The sample included 359 Vietnamese and 25,177 non-Hispanic white adults aged 55 and older. Vietnamese and non-Hispanic white adults were compared in terms of limitations in activities of daily living, chronic medical conditions (diabetes mellitus, hypertension, heart disease, asthma), mental health care, and self-reported health, adjusting for age, sex, and education. Vietnamese were more likely than white participants to report needing help for mental health problems (adjusted odds ratio (aOR)=2.1, 95% confidence interval (CI)=1.4-3.1) but less likely to have had their medical providers discuss their mental health problems with them (aOR=0.3, 95% CI=0.1-0.5). In addition, Vietnamese participants reported significantly worse health than white adults on five of eight domains of the Medical Outcomes Survery 12-item Short Form survey (P

OBJECTIVE: To determine the effects of a 6-month exercise program on ambulatory function, free-living daily physical activity, peripheral circulation, and health-related quality of life (QOL) in disabled older patients with intermittent claudication. DESIGN: Prospective, randomized controlled trial. SETTING: University Medical Center and Veterans Affairs Medical Center, Baltimore, Maryland. PARTICIPANTS: Thirty-one of 61 patients with Fontaine stage II peripheral arterial occlusive disease (PAOD) were randomized to exercise rehabilitation and 30 to usual-care control. Three patients from the exercise group and six patients from the control group dropped out, leaving 28 and 24 patients, respectively, completing the study in each group. INTERVENTION: Six months of exercise rehabilitation. MEASUREMENTS: Treadmill distance walked to onset of claudication and to maximal claudication, ambulatory function, peripheral circulation, perceived QOL, and daily physical activity. RESULTS: Compliance with the exercise program was 73% of the possible sessions. Exercise rehabilitation increased treadmill distance walked to onset of claudication by 134% (P < .001) and to maximal claudication by 77% (P < .001), walking economy by 12% (P = .003), 6-minute walk distance by 12% (P < .001), and maximal calf blood flow by 30% (P < .001). Changes in distance walked to maximal pain correlated with changes in walking economy (r = −.50, P = .013) and changes in maximal calf blood flow (r = .38, P = .047). Exercise rehabilitation increased accelerometer-derived daily physical activity by 38% (P < .001); this change correlated with the change in distance walked to maximal pain (r = .45, P = .020). These improvements were significantly better than the changes in the control group (P < .05). CONCLUSION: Improvements in claudication following exercise rehabilitation in older PAOD patients are dependent on improvements in peripheral circulation and walking economy. Improvement in treadmill claudication distances in these patients translated into increased accelerometer-derived physical activity in the community, which enabled the patients to become more functionally independent. J Am Geriatr Soc 49:755–762, 2001.

OBJECTIVES Before men older than age 45 participate in vigorous exercise programs, the American Heart Association and the American College of Sports Medicine recommend they undergo a screening maximal exercise treadmill test. We examined the predictive value for subsequent cardiac events of exercise-induced silent myocardial ischemia (SI) during the exercise treadmill test in healthy, sedentary, obese, middle-aged and older men recruited for research studies. DESIGN A cohort study with 7 years of follow-up SETTING Out-patient research at a tertiary hospital PARTICIPANTS 170 healthy, sedentary, obese, middle-aged and older (ages 45–79 years) men with no prior history of coronary artery disease (CAD) recruited for research studies MEASUREMENTS Cardiac risk factors, exercise-induced SI (ST segment depression on the electrocardiogram during a maximal exercise treadmill test), maximal aerobic capacity (VO2max), and 7- year follow-up data on incident CAD RESULTS At baseline, 37 of the men (22%) had exercise-induced SI on their treadmill tests. Seven-year follow-up data was obtained in 97% of the patients. In the interim, 31 men had cardiac endpoints (sudden cardiac death, myocardial infarction, angioplasty, coronary artery bypass graft surgery, angina), and four had noncardiac deaths. Seventeen of the 37 men (46%) with exercise-induced SI on their baseline exercise tests had cardiac endpoints compared with 14 of 133 (11%) men with normal exercise tests (P < .001). Compared with the men with no cardiac endpoints, the men with subsequent cardiac endpoints were older (63 ± 1 vs 58 ± 1 years, mean ± SEM, P < .001) and had a lower maximal aerobic capacity (VO2max) (24 ± 1 vs 29 ± 1 mL/kg/min, P < .001). In Cox proportional hazards analysis, exercise-induced SI and a low VO2max were independent predictors of subsequent cardiac endpoints. CONCLUSION In a healthy population of obese, sedentary, middle-aged and older men, exercise-induced SI and low VO2max were predictors of incident CAD. This suggests that exercise treadmill testing is beneficial in assessing risk for future cardiac events in obese, sedentary individuals. J Am Geriatr Soc 47:923–929, 1999.

Language-related communication barriers between minority patients and their physicians may contribute to racial and ethnic disparities in mental health care. Accordingly, the current study sought to examine whether perceived mental health needs and discussion of these needs differed as a function of race or ethnicity and language concordance in older Latinos and Asian and Pacific Islanders (APIs). Using the 2007 California Health Interview Survey, the analytical sample included Latinos and APIs aged 55 and older (N = 2,960) who reported having seen a primary care provider within the past 2 years. Multivariable logistic regression was used to examine differences according to race or ethnicity and language concordance status (three groups: English-language concordant, other-language concordant, language discordant) in perceived mental health needs and discussion of those needs with a physician, adjusting for respondents� sociodemographic characteristics and mental health status. There were no significant differences in respondents� perceptions of their mental health needs across race or ethnicity or level of language concordance status (Ps > .41), although there were significant differences in whether respondents had discussed their mental health needs with their physicians according to participant race or ethnicity and language concordance status (adjusted odds ratio = 0.47, P = .04). Specifically, Spanish language-concordant Latinos were just as likely to discuss their mental health needs with their physicians as English language-concordant Latinos. In contrast, Asian language-concordant APIs were less likely to discuss their mental health needs with their physicians than English language-concordant APIs. There were no significant differences between language-discordant and English language-concordant older adults in predicting discussion of mental health concerns. These findings underscore the importance of overcoming language-related and cultural barriers to improve patient-provider discussions of older adults� mental health needs.

Physical health problems become more common as people age and are associated with a great deal of disability. Although racial/ethnic disparities have been reported in physical health, little is known about whether these disparities remain in the latest part of older adulthood. Accordingly, the current study sought to examine racial/ethnic differences in the physical health status of three age groups of older adults, using the 2005 and 2007 California Health Interview Survey. The sample for the current study included 40,631 individuals aged 55 and older, with 33,488 non-Hispanic whites, 1,858 African American/blacks, 2,872 Asian/Pacific Islanders, and 2,412 Latinos. Respondents were compared with regard to three indicators of physical health, which included presence of four chronic health conditions, difficulties with activities of daily living, and self-rated health. Analyses were conducted with and without adjustment for gender, marital status, education, English language proficiency, nativity, and insurance status. Results revealed that, in general, racial/ethnic disparities existed for physical health in late adulthood, with differences less pronounced for Asian/Pacific Islanders and Latinos ≥ 75 years after multivariable adjustment. Disparities between African American/blacks and non-Hispanic whites, as well as disparities across all racial/ethnic minorities in self-rated health, still existed, however. These findings suggest that in order to reduce racial/ethnic disparities, clinicians need to address specific sociodemographic and lifestyle factors related to racial/ethnic differences in health before these conditions are manifested in late adulthood.

Little is known about the unmet mental health needs of minority older adults. Racial and ethnic differences in the prevalence rates of psychological distress and reported need and use of mental health services were examined in a population-based sample of older adults using the 2005 California Health Interview Survey. The sample comprised 16,974 people aged 55 and older, with 13,974 non-Hispanic whites, 719 African Americans, 1,215 Asians, and 1,066 Latinos. Respondents were compared in terms of prevalence of symptoms of mental distress and serious mental illness, reported need for help, and access to mental health services. African Americans, Asians, and Latinos were more likely to have mental distress than whites (21.2-24.2% vs 14.4%, P.001) and a higher prevalence of serious mental illness (4.1-7.7% vs 2.5%, P.001). After adjustment for age, sex, birthplace, marital status, education, limited English proficiency, chronic health conditions, and insurance status, older African-American (adjusted odds ratio (aOR)=1.37, 95% confidence interval (CI)=1.04-1.81) and Asian (aOR=1.50, CI=1.13-2.00) adults still had greater odds of mental distress than whites. Furthermore, all three groups had worse access to mental health services than whites (African American aOR=0.64, 95% CI=0.43-0.96; Asian aOR=0.32, CI=0.16-0.63; Latino aOR=0.35, CI=0.17-0.70). Clinicians caring for older individuals should be aware of their high risk for mental health needs. Given that minorities' access to mental health services is worse than whites', even after adjusting for health insurance status, providing insurance alone will not eliminate this disparity. Innovative clinical and systemic strategies are needed to better identify individuals at risk and to provide needed services.

To investigate factors related to cardiorespiratory fitness in older human immunodeficiency virus (HIV)-infected patients and to explore the utility of 6-minute walk distance (6-MWD) in measuring fitness.Cross-sectional study in clinic-based cohort.Veterans Affairs Medical Center, Baltimore, Maryland.Forty-three HIV-infected men, median age 57 (range 50-82), without recent acquired immunodeficiency syndrome-related illness and receiving antiretroviral (ARV) therapy.Peak oxygen utilization (VO(2)peak) according to treadmill graded exercise testing, 6-MWD, grip strength, quadriceps maximum voluntary isometric contraction, cross-sectional area, muscle quality, and muscle adiposity.There was a moderate correlation between VO(2)peak (mean +/- SD; 18.4 +/- 5.6 mL/kg per minute) and 6-MWD (514 +/- 91 m) (r=0.60, P.001). VO(2)peak was lower in subjects with hypertension (16%, P.01) and moderate anemia (hemoglobin 10-13 gm/dL; 15%, P=.09) than in subjects without these conditions. CD4 cell count (median 356 cells/mL, range 20-1,401) and HIV-1 viral load (84% nondetectable) were not related to VO(2)peak. Among muscle parameters, only grip strength was an independent predictor of VO(2)peak. Estimation of VO(2)peak using linear regression, including age, 6-MWD, grip strength, and hypertension as independent variables, explained 61% of the variance in VO(2)peak.Non-AIDS-related comorbidity predicts cardiorespiratory fitness in older HIV-infected men receiving ARV therapy. The 6-MWD is a valuable measure of fitness in this patient population, but a larger study with diverse subjects is needed.

OBJECTIVES: To determine the cognitive and demographic factors that affect the performance of a predominantly African-American population in the use of a computerized version of the Center for Epidemiologic Studies Depression Scale (CES-D). DESIGN: Cross-sectional. SETTING: University Medical Center and Veterans Affairs Medical Center in Baltimore, Maryland. PARTICIPANTS: Forty-three healthy community-dwelling adults from a predominantly African-American Apostolic church; mean age ± standard deviation 57 ± 14 (range 29–83). MEASUREMENTS: Cognitive measurements (Mini-Mental State Examination, digits span, word list learning, letter number sequencing, executive interview, and clock-drawing task), education level, computer experience, and age. The CES-D was administered on three occasions: a paper form CES-D once and a computerized version twice. Time to completion the computer CES-D (Time 1), differential in time to completion of both computer tests (delta-time) and scores of the CES-D with both forms of administration were recorded. RESULTS: There was no difference between the scores from the paper and the computer CES-D or between the two computer forms. Computer experience predicted Time 1 (partial correlation R = 15%, P = .017) and delta-time (partial correlation R = 10%, P = .048). Age, education, and cognitive function did not affect performance. CONCLUSION: Computerized assessment techniques are valid and unaffected by age, education level, or cognitive factors in healthy individuals.

To compare the longitudinal changes in maximal aerobic capacity (VO2max) in healthy middle aged and older athletes and sedentary men.A cohort study with mean follow-up of 8.7 years (range 4.0-12.8).Outpatient research at a tertiary hospital.Forty-two healthy, middle aged, and older athletes (initial age 64 +/- 1 year) and 47 healthy sedentary men of comparable age recruited for research studies.VO2max during a maximal treadmill test.At baseline, the cross-sectional rates of decline in VO2max with age (slope) were virtually identical in the athletes and sedentary men (-0.42 versus -0.43 mL x kg(-1) x min(-1) x year(-1)). At follow-up, the VO2max had declined by 11.9 +/- 1.1 mL x kg(-1) x min(-1) (22%) in the athletes, a crude average rate of -1.4 +/- 0.14 mL x kg(-1)x min(-1) x year(-1). By comparison, the VO2max declined by 4.4 +/- 0.6 mL x kg(-1) x min(-1) (14%) in the sedentary men, a crude average rate of change of -0.48 +/- 0.07 mL x kg(-1) x min(-1) x year(-1). Therefore, the observed absolute rate of longitudinal decline in VO2max in the athletes was triple that of the sedentary men (P= .001) and significantly greater than the decline predicted by their baseline cross-sectional data (P= .001). Post hoc analyses of the longitudinal data in the athletes based on the training regimens over the follow-up period demonstrated that the seven individuals who continued to train vigorously ("high training") had no significant decline in VO2max (0.28% change in VO2max per year). By contrast, the VO2max declined by 2.6% per year in the "moderate training" group (N=21), 4.6% per year in the "low training" group (N=13), and 4.7% per year in the two individuals who developed cardiovascular disease.The longitudinal decline in VO2max in older male endurance athletes is highly dependent upon the continued magnitude of the training stimulus. The majority of the athletes reduced their training levels over time, resulting in longitudinal reductions in VO2max two to three times as large as those predicted by cross-sectional analyses or those observed longitudinally in their sedentary peers.

OBJECTIVES: It is well recognized that a favorable lipid profile provides protection from atherosclerotic cardiovascular disease. Because the major cause of nontraumatic death in the western world is considered to be due to cardiovascular disease, centenarians (defined here as subjects over 95 years of age) are believed to possess “atherosclerotic protective” factors. However, it is impossible to study comparatively the lipid profile in centenarians because of lack of controls. Assuming that certain genes responsible for encoding the lipid phenotype may be inherited, we studied the lipid profile characteristics of offspring of centenarians and compared them with control groups. DESIGN: Prospective cohort study. SETTING: The study was part of the Longevity Genes Project at Albert Einstein College of Medicine. PARTICIPANTS: Ashkenazi Jewish centenarians (n = 27, 98.4 ± 10.4 years) and their offspring (n = 33, 67.4 ± 1.4 years). The Ashkenazi Jewish offsprings' spouses, who were not related by blood to the centenarians or their offspring, were used as a control group (n = 26, 68.4 ± 1.2 years). MEASUREMENTS: The lipoprotein profile of the offspring was compared with the above control group and to a larger control group (age and gender matched) from the National Health and Nutrition Examination Survey (NHANES) III study (without the sample weights, n = 394, 60 to 69 years). RESULTS: Female offspring of centenarians had significantly higher plasma levels of high density lipoprotein-cholesterol (HDL-C) levels compared with controls (70.2 ± 3.1 vs 59.0 ± 4.1 mg/dl, P = .029). Male offspring of centenarians had higher plasma levels of HDL-C levels (56.2 ± 7.1 vs 44.3 ± 3.4 mg/dl, P = 0.130) and significantly lower LDL-cholesterol (LDL-C) levels (95.0 ± 6.0 vs 127.0 ± 8.0 mg/dl, P = .009) compared with controls. CONCLUSION: Offspring of centenarians have a favorable lipid profile compared with controls. These data support the notion that a certain phenotypic lipid profile may be transmitted in families and suggest that a favorable lipid profile may play a role in longevity.

Objective: To determine whether a 1-day calorie count can replace the labor-intensive 3-day calorie count commonly performed in hospitalized patients when estimates of caloric and protein intake are required. Design: Pilot study using prospective, non-concurrent review of medical records. Setting: Hospital. Participants: Thirty patients (mean age 67 years). Results: Mean 3-day intake (952 ± 91 calories, 41 ± 4 g protein) was about half of calculated requirements; first-day intake was similar (918 ± 116 calories, 40 ± 5 g protein). The first day had high sensitivity (calories 96%; protein 93%) and positive predictive value (calories 100%; protein 96%). Malnutrition was evident; three-fourths of patients had weights below recommended ranges, and 83% were hypoalbuminemic. Conclusions: Three-day calorie counts are frequently performed in patients suspected of eating poorly. Results of this pilot study suggest that 1-day calorie counts may be a valid alternative. However, readily available anthropometric and biochemical data may be as good an indicator of inadequate dietary intake.