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Vidaña-Espinoza HJ, López-Teros MT, Esparza-Romero J, Rosas-Carrasco O, Luna-López A, Alemán Mateo H. Association between the risk of malnutrition and sarcopenia at 4.2 years of follow-up in community-dwelling older adults. Front Med (Lausanne) 2024; 11:1363977. [PMID: 38476442 PMCID: PMC10929268 DOI: 10.3389/fmed.2024.1363977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 02/13/2024] [Indexed: 03/14/2024] Open
Abstract
Introduction Currently, there is only scarce evidence of a causal association between risk of malnutrition (RM) by the mini-nutritional assessment (MNA) and the incidence of sarcopenia. This study was designed to assess such an association at 4.2 years of follow-up in community-dwelling subjects over 60 years old. Methods The data used were from the FraDySMex cohort study. The exposition variables were RM diagnosed by the long forma of the MNA (MNA-LF) and short form (MNA-SF). The last one included the body mass index and calf circumference at baseline, while sarcopenia was diagnosed by the EWGSOP2 at follow-up and taken as the response variable. Several covariates involved in the association were also considered. A multiple logistic regression analysis was performed to test the association. Results At baseline, 27.0 and 37.9% of subjects had RM by the MNA-LF and MNA-SF, respectively. The incidence of sarcopenia was 13.7%. The fat mass variable significantly modified the association, so it was tested in each stratum. Two independent models showed that subjects with RM by the MNA-LF in the normal fat mass stratum were at a higher risk for developing sarcopenia at follow-up than those without RM (OR 9.28; IC 95% 1.57-54.76) after adjusting for age, sex, and waist circumference. No association was found for the excess fat mass stratum subjects. Subjects with RM by the MNA-SF in the excess fat mass stratum were more likely to develop sarcopenia at follow-up than those without RM by the MNA-SF (OR 3.67; IC 95% 1.29-10.43). This association was not found in the subjects in the normal fat mass stratum. Conclusion The association was dependent on the variable fat mass. The two forms of the MNA should not be applied indistinctly with older adults. Based on these results, it is clear that the risk of malnutrition precedes the onset of sarcopenia.
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Affiliation(s)
- Helen J. Vidaña-Espinoza
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo (CIAD), A.C., Hermosillo, Sonora, Mexico
| | - Miriam T. López-Teros
- Centro de Evaluación del Adulto Mayor, Departamento de Salud, Universidad Iberoamericana Ciudad de México, Ciudad de México, Mexico
| | - Julián Esparza-Romero
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo (CIAD), A.C., Hermosillo, Sonora, Mexico
| | - Oscar Rosas-Carrasco
- Centro de Evaluación del Adulto Mayor, Departamento de Salud, Universidad Iberoamericana Ciudad de México, Ciudad de México, Mexico
| | - Armando Luna-López
- Dirección de Investigación, Instituto Nacional de Geriatría, Ciudad de México, Mexico
| | - Heliodoro Alemán Mateo
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo (CIAD), A.C., Hermosillo, Sonora, Mexico
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López-Teros MT, Vidaña-Espinoza HJ, Esparza-Romero J, Rosas-Carrasco O, Luna-López A, Alemán-Mateo H. Incidence of the Risk of Malnutrition and Excess Fat Mass, and Gait Speed as Independent Associated Factors in Community-Dwelling Older Adults. Nutrients 2023; 15:4419. [PMID: 37892494 PMCID: PMC10610336 DOI: 10.3390/nu15204419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/14/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND AND AIMS Only one cohort study exists on the incidence of the risk of malnutrition (RM) in older adults, though numerous cross-sectional reports, identified several risk factors associated with the prevalence and incidence of this condition. However, alterations in body composition and impaired physical performance as exposition variables of RM have not been explored. This study assessed the incidence of RM and determined its association with excess fat mass, low total lean tissue, gait speed, and handgrip strength as exposition variables for RM in community-dwelling older adults. METHODS This is a secondary analysis of older adults (≥60 years) derived from the study "Frailty, dynapenia, and sarcopenia in Mexican adults (FraDySMex)", a prospective cohort project conducted from 2014 to 2019 in Mexico City. At baseline, volunteers underwent body composition analysis and physical performance tests. Several covariates were identified through comprehensive geriatric assessment. At baseline and follow-up, RM was assessed using the long form of the mini nutritional assessment (MNA-LF) scale. Associations between the exposition variables and RM were assessed by multiple logistic regression. RESULTS The cohort included 241 subjects. The average age was 75.6 ± 7.8 years, and 83.4% were women. The mean follow-up period was 4.1 years, during which 28.6% of subjects developed RM. This condition was less likely to occur in those with an excess fat mass, even after adjusting for several covariates. Regarding total lean tissue, the unadjusted model showed that RM was more likely to occur in men and women with a low TLT by the TLTI classification, compared to the normal group. However, after adjusting for several covariates (models 1 and 2), the association lost significance. Results on the association between gait speed and RM showed that this condition was also more likely to occur in subjects with low gait speed, according to both the unadjusted and adjusted models. Similar results were found for RM in relation to low handgrip strength; however, after adjusting for the associated covariates, models 1 and 2 no longer reached the level of significance. CONCLUSIONS RM diagnosed by MNA-LF was significantly less likely to occur among subjects with excess fat mass, and a significant association emerged between low gait speed and RM after 4.1 years of follow-up in these community-dwelling older adults. These results confirm the association between some alterations of body composition and impaired physical performance with the risk of malnutrition and highlight that excess fat mass and low gait speed precede the risk of malnutrition, not vice versa.
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Affiliation(s)
- Miriam T. López-Teros
- Centro de Evaluación del Adulto Mayor, Departamento de Salud, Universidad Iberoamericana Ciudad de México, Prolongación Paseo de Reforma 880, Lomas de Santa Fe, Ciudad de México 01219, Mexico; (M.T.L.-T.)
| | - Helen J. Vidaña-Espinoza
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo (CIAD), A.C., Carretera Gustavo Enrique Astiazarán Rosas, No. 46, Col. La Victoria, Hermosillo 83304, Sonora, Mexico
| | - Julián Esparza-Romero
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo (CIAD), A.C., Carretera Gustavo Enrique Astiazarán Rosas, No. 46, Col. La Victoria, Hermosillo 83304, Sonora, Mexico
| | - Oscar Rosas-Carrasco
- Centro de Evaluación del Adulto Mayor, Departamento de Salud, Universidad Iberoamericana Ciudad de México, Prolongación Paseo de Reforma 880, Lomas de Santa Fe, Ciudad de México 01219, Mexico; (M.T.L.-T.)
| | - Armando Luna-López
- Dirección de Investigación, Instituto Nacional de Geriatría, Ciudad de México 10200, Mexico;
| | - Heliodoro Alemán-Mateo
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo (CIAD), A.C., Carretera Gustavo Enrique Astiazarán Rosas, No. 46, Col. La Victoria, Hermosillo 83304, Sonora, Mexico
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Taveira A, Sousa B, Costa P, Macedo AP. Health management of malnourished elderly in primary health care: a scoping review. BMC PRIMARY CARE 2022; 23:272. [PMID: 36329398 PMCID: PMC9632089 DOI: 10.1186/s12875-022-01883-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 05/03/2022] [Indexed: 11/06/2022]
Abstract
Objectives The aim of this study, as the first review directed at Primary Health Care, is to identify the screening practices and health outcomes related to the care provided by Family Health Teams to the malnourished elderly people/population. Methods Following PRISMA and PICO strategies, searches were conducted in four electronic databases (PubMed, Web of Science, Scopus & EMBASE) on observational, qualitative, quantitative, or mixed studies, written in Portuguese, Spanish and English language, with participants of 65 years old or older at a community setting. The literature selected for this study ranges from the period 2011 to 2021; additional articles were included through reference lists. Results From the 483 studies identified, 16 were considered eligible to use in this work. The Mini Nutritional Assessment (MNA) score appears as the main criteria of choice, however, a standardized practice in the health systems regarding the use of screening methods has not been demonstrated. Studies are more oriented towards the analysis of the relationship of mortality/morbidity and malnutrition than towards the relationship of the cost and quality of life and malnutrition of the elderly. Discussion Malnutrition is one of the modifiable risk factors which contributes to the vulnerable condition of the elderly, with serious effects, especially when related to other comorbidities. Yet, several authors argue that the Primary Health Care intervention can minimize the negative impacts and improve the health outcomes.
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Affiliation(s)
- Adriana Taveira
- grid.10328.380000 0001 2159 175XSchool of Medicine, Life and Health Sciences Research Institute (ICVS), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal ,grid.10328.380000 0001 2159 175XICVS/3B’s - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Bárbara Sousa
- grid.10328.380000 0001 2159 175XSchool of Medicine, Life and Health Sciences Research Institute (ICVS), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal ,grid.10328.380000 0001 2159 175XICVS/3B’s - PT Government Associate Laboratory, Braga/Guimarães, Portugal ,grid.10328.380000 0001 2159 175XSchool of Psychology, University of Minho, Braga, Portugal
| | - Patrício Costa
- grid.10328.380000 0001 2159 175XSchool of Medicine, Life and Health Sciences Research Institute (ICVS), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal ,grid.10328.380000 0001 2159 175XICVS/3B’s - PT Government Associate Laboratory, Braga/Guimarães, Portugal ,grid.5808.50000 0001 1503 7226Faculty of Psychology and Education Sciences of the University of Porto, Porto, Portugal
| | - Ana Paula Macedo
- grid.10328.380000 0001 2159 175XHealth Sciences Research Unit: Nursing (UICISA: E), Portugal/School of Nursing (ESE), Nursing School of Coimbra (ESEnfC), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
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The Influence of Exercise, Nutritional Status, and Disease on the Functional Ability to Undertake Activities of Daily Living and Instrumental Activities of Daily Living in Old Taiwanese People. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to examine the influence of changes in exercise status, nutritional status, and a number of comorbidities on functional ability in Taiwanese community-dwelling older adults. Data were obtained from the Taiwan Longitudinal Study of Aging. The results revealed that current exercise and consistent exercise were negatively associated with subsequent 4- and 8-year activities of daily living (ADL) and instrumental ADL (IADL) decline (all p < 0.05). The Mini-Nutritional Assessment (MNA) score was negatively associated with subsequent 8-year IADL decline (all p < 0.05), while the number of diseases was positively associated with subsequent 4- and 8-year IADL decline (all p < 0.05). Current exercise and consistent exercises are beneficial for adults aged ≥ 65 years to maintain their functional ability in ADL and IADL and to prevent declines in functional ability. Consistency of exercise, MNA score, and the number of chronic diseases are good predictors of IADL decline.
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Functionality of Bread and Beverage Added with Brosimum alicastrum Sw. Seed Flour on the Nutritional and Health Status of the Elderly. Foods 2021; 10:foods10081764. [PMID: 34441541 PMCID: PMC8394985 DOI: 10.3390/foods10081764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 07/25/2021] [Accepted: 07/28/2021] [Indexed: 11/22/2022] Open
Abstract
Physiological changes in elderly individuals (EI) can contribute to nutritional deterioration and comorbidities that reduce their quality of life. Factors such as diet can modulate some of these effects. The aim was to evaluate the functionality of foods added with Brosimum alicastrum Sw. seed flour in EI. EI (n = 23) living in nursing home conditions agreed to participate. A control stage was carried out (30 days) and subsequently, an intervention stage (30 days) was realized in which a muffin and a beverage, designed for EI, were added to the participants’ their usual diet. In both stages, anthropometric parameters, body composition, nutritional status, dietary intake, sarcopenic status, cognitive and affective states, biometric parameters, and total phenolic compounds (TPC), and antioxidant capacity in foods and plasma of EI were determined. The results showed that the consumption of the foods improved the energy intake and preserved the muscle reserves of the EI. The EI gained body weight (+1.1 kg), increased their protein (+18.6 g/day; 1.5 g/kg BW/day), dietary fiber (+13.4 g/day), iron (+4.4 mg/day), zinc (+1.8 mg/day), folic acid (+83.4 µg/day) consumption while reducing their cholesterol (−66 mg/day) and sodium (−319.5 mg/day) consumption. LDL-C lipoproteins reduced (14.8%) and urea (33.1%) and BUN (33.3%) increased. The TPC increased (7.8%) in the plasma, particularly in women (10.7%). The foods improve the EI nutritional status, and this has a cardiovascular protective effect that can benefit the health of the EI.
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Avila JC, Samper-Ternent R, Wong R. Malnutrition Risk among Older Mexican Adults in the Mexican Health and Aging Study. Nutrients 2021; 13:nu13051615. [PMID: 34065807 PMCID: PMC8151238 DOI: 10.3390/nu13051615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/30/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022] Open
Abstract
Few studies assess the malnutrition risk of older Mexican adults because most studies do not assess nutritional status. This study proposes a modified version of the Mini Nutritional Assessment (MNA) to assess the risk of malnutrition among older Mexicans adults in the Mexican Health and Aging Study (MHAS). Data comes from the 2012, 2015, and 2018 waves of the MHAS, a nationally representative study of Mexicans aged 50 and older. The sample included 13,338 participants and a subsample of 1911 with biomarker values. ROC analysis was used to calculate the cut point for malnutrition risk. This cut point was compared to the definition of malnutrition from the ESPEN criteria, BMI, low hemoglobin, or low cholesterol. Logistic regression was used to assess predictors of malnutrition risk. A score of 10 was the optimal cut point for malnutrition risk in the modified MNA. This cut point had high concordance to identify malnutrition risk compared to the ESPEN criteria (97.7%) and had moderate concordance compared to BMI only (78.6%), and the biomarkers of low hemoglobin (56.1%) and low cholesterol (54.1%). Women, those older than 70, those with Seguro Popular health insurance, and those with fair/poor health were more likely to be malnourished. The modified MNA is an important tool to assess malnutrition risk in future studies using MHAS data.
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Affiliation(s)
- Jaqueline C. Avila
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI 02903, USA
- Correspondence:
| | - Rafael Samper-Ternent
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX 77555, USA; (R.S.-T.); (R.W.)
- Department of Internal Medicine, Division of Geriatrics, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Rebeca Wong
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX 77555, USA; (R.S.-T.); (R.W.)
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX 77555, USA
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Yılmaz M, Arguvanlı Çoban S, Şahin H, Ongan D. A Comparison of Cognitive Functions and Nutritional Status in Nursing Home Residents and Community-Dwelling Elderly. ALPHA PSYCHIATRY 2021; 22:90-93. [PMID: 36425937 PMCID: PMC9590677 DOI: 10.5455/apd.134256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 11/01/2020] [Indexed: 06/16/2023]
Abstract
OBJECTIVE This descriptive and comparative study was conducted to determine the cognitive functions and nutritional status of nursing-home-residing and community-dwelling elderly. METHODS The study was carried out with a total of 204 elderly people who were community dwelling (n = 104) and nursing home residents (n = 100). Data were collected with the Mini Nutritional Assessment (MNA) and standardized with the Mini Mental State Examination (MMSE). RESULTS Mean age of the nursing home residents and community-dwelling elderly people was 77.4 (SD = 6.7) years and 76.5 (SD = 7.4) years, respectively. Mean MMSE score was significantly different between nursing home residents (18.5 [SD = 4.5]) and community-dwelling elderly (22.1 [SD = 4.7]) (P < .05). Mean MNA score of nursing home residents (23.0 [SD = 3.7]) and community-dwelling elderly (24.6 [SD = 3.1]) was significantly different (P < .05). CONCLUSION Nursing home residents were at risk of malnutrition and cognitive impairment. Precautions for the protection of the residents for maintaining nutritional status and cognitive functions were recommended.
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Affiliation(s)
- Müge Yılmaz
- Department of Nutrition and Dietetics, Erciyes University Faculty of Health Sciences,
Kayseri,
Turkey
| | - Sibel Arguvanlı Çoban
- Department of Psychiatric Nursing, Zonguldak Bülent Ecevit University Faculty of Health Sciences,
Zonguldak,
Turkey
| | - Habibe Şahin
- Department of Nutrition and Dietetics, Erciyes University Faculty of Health Sciences,
Kayseri,
Turkey
| | - Dilek Ongan
- Department of Nutrition and Dietetics, İzmir Katip Çelebi University Faculty of Health Sciences,
İzmir,
Turkey
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Benksim A, Ait Addi R, Khalloufi E, Habibi A, Cherkaoui M. Self-reported morbidities, nutritional characteristics, and associated factors in institutionalized and non-institutionalized older adults. BMC Geriatr 2021; 21:136. [PMID: 33627088 PMCID: PMC7903776 DOI: 10.1186/s12877-021-02067-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 02/03/2021] [Indexed: 12/03/2022] Open
Abstract
Background As the world’s population ages and people live longer, it seems important to ensure that older people have a good quality of life and positive subjective well-being. The objective of this study is to determine socio-economic, health and nutritional characteristics of institutionalized and non-institutionalized elders in the province of Marrakech. Methods This study was conducted among 368 older adults in the province of Marrakech between March 2017 and June 2019. Of all participants, 180 older adults reside in a public institution and 188 of them live in their own homes. Data on health conditions, nutritional status, functional and socio-economic characteristics were collected. Data was analyzed using SPSS Statistics for Windows, Version 16.0. Statistical significance was set at p < 0.05. Results Institutionalized elders were illiterate (80.0%), had low incomes (95.5%), and unmarried (73.3%), they reported also no children (56.1%) and no health insurance (98.9%). Institutional residents suffered from malnutrition (22.2%), hearing impairments (35.6%) and severe edentulism (43.3%). There was no significant difference between both groups on daily activities and depression. A multivariate analysis identified a model with three significant variables associated with non-institutionalized elders: health insurance (P = 0.001; OR = 107.49), number of children (P = 0.001; OR = 1.74) and nutritional status (p = 0.001; OR = 3.853). Conclusions This study shows that the institutionalization of older adults is considerably induced by various factors such as nutritional problems, lack of health insurance and family structure. To mitigate the effects of this phenomenon, home care strategies and preventive actions should be implemented to delay the institutionalization of older adults and therefore keep them socially active in their own homes.
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Affiliation(s)
- Abdelhafid Benksim
- Nursing Care Department, Higher Institute of Nursing Professions and Health Techniques (ISPITS-M), Health department of Marrakech-Safi region, 40000, Marrakech, Morocco. .,Laboratory of Human Ecology, Faculty of sciences Semlalia, Cadi Ayyad University, 40000, Marrakesh, Morocco.
| | - Rachid Ait Addi
- Nursing Care Department, Higher Institute of Nursing Professions and Health Techniques (ISPITS-M), Health department of Marrakech-Safi region, 40000, Marrakech, Morocco
| | - Elhassania Khalloufi
- Nursing Care Department, Higher Institute of Nursing Professions and Health Techniques (ISPITS-M), Health department of Marrakech-Safi region, 40000, Marrakech, Morocco.,Laboratory of Human Ecology, Faculty of sciences Semlalia, Cadi Ayyad University, 40000, Marrakesh, Morocco
| | - Aziz Habibi
- Nursing Care Department, Higher Institute of Nursing Professions and Health Techniques (ISPITS-M), Health department of Marrakech-Safi region, 40000, Marrakech, Morocco
| | - Mohamed Cherkaoui
- Nursing Care Department, Higher Institute of Nursing Professions and Health Techniques (ISPITS-M), Health department of Marrakech-Safi region, 40000, Marrakech, Morocco
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Abate T, Mengistu B, Atnafu A, Derso T. Malnutrition and its determinants among older adults people in Addis Ababa, Ethiopia. BMC Geriatr 2020; 20:498. [PMID: 33228557 PMCID: PMC7684921 DOI: 10.1186/s12877-020-01917-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 11/17/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND In Ethiopia, malnutrition among older adults is under detected and, neglected area because the entire problem related with aging considered as fate of aging. Also, older adults are often omitted from public health research. Literatures are scarce in Ethiopia; there is limited information in the current study area among older adults using Min Nutritional Assessment (MNA). Therefore, this paper investigated the prevalence of malnutrition and its predictors among older adults people aged 65 years or above in Addis Ababa, Ethiopia. METHODS A community-based cross-sectional study was employed from January 1 to march 30, 2020 in Addis Ababa. Nutritional status of the older adults was measured by using Min nutritional assessment (MNA). Data from 662 older adults were collected through face to face interviews using a structured questionnaire. Bivariable and multivariable logistic regression analysis was done to identify factors associated with malnutrition. RESULT The prevalence of malnutrition among older adults was found to be 26.6%[95% Confidence interval (CI):22.8, 30.1]. Depression [Adjusted Odds Ratio (AOR) = 7.57 95%CI: 5.01, 11.45], being poor [AOR = 1.95 95% CI: 1.166, 3.25], occupation; daily laborer and guard [AOR = 2.78 95% CI: 1.12, 7.17] and being old old [AOR = 2.62 95% CI: 1.62, 4.25] were significantly associated with the higher odds of malnutrition. CONCLUSION This study illustrated that considerably high proportion of older adults were malnourished in Addis Ababa. Socio-economic characteristics and depression were significantly associated with malnutrition. Therefore, nutritional and social support activities are essential for older adults, particularly of those who are socio-economically disadvantaged and advanced age. In addition, regular nutritional screening and management as well as behavioral interventions should be strengthened as a pillar component of therapeutic interventions. Specific nutritional requirements, at later stages of life is changing, and with the population aged over 65 years increasing in low-income countries like Ethiopia, the research in this field is likely to increase further.
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Affiliation(s)
- Tadele Abate
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Berhanu Mengistu
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asmamaw Atnafu
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Terefe Derso
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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Besora-Moreno M, Llauradó E, Tarro L, Solà R. Social and Economic Factors and Malnutrition or the Risk of Malnutrition in the Elderly: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients 2020; 12:nu12030737. [PMID: 32168827 PMCID: PMC7146387 DOI: 10.3390/nu12030737] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/03/2020] [Accepted: 03/08/2020] [Indexed: 12/31/2022] Open
Abstract
Malnutrition in the elderly could be tackled by addressing socioeconomic factors. This study aimed to determine the magnitude of the relationship between socioeconomic factors and the malnutrition or malnutrition risk (MR) in the elderly. The PubMed and SCOPUS databases were searched for observational studies that included assessment of malnutrition or/and MR and socioeconomic variables (educational level, living alone, marital status, income and occupational level, feeling of loneliness, place of residence, and food expenditure) in ≥60-year-old subjects, published in English among 2000–2018 (PROSPERO: CRD42019137097). The systematic review included 40 observational studies (34 cross-sectional and 4 cohort studies) and 16 cross-sectional studies in the meta-analysis (34,703 individuals) of malnutrition and MR in relation to low educational level (Odds Ratio (OR): 1.48; 95% Confidence Interval (CI): 1.33–1.64; p < 0.001), living alone (OR: 1.92; 95% CI: 1.73–2.14; p < 0.001), being single, widowed, or divorced (OR: 1.73; 95% CI: 1.57–1.90; p < 0.001), and low income level (OR: 2.69; 95% CI: 2.35–3.08; p < 0.001), and considering these four socioeconomic factors, malnutrition and MR is associated with them (OR: 1.83; 95% CI: 1.73–1.93; p < 0.001). Malnutrition and MR could be reduced by increasing economic level, supporting people living alone or being single, widowed, and divorced, and improving lifelong learning.
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Affiliation(s)
- Maria Besora-Moreno
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), 43201 Reus, Spain; (M.B.-M.); (L.T.); (R.S.)
| | - Elisabet Llauradó
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), 43201 Reus, Spain; (M.B.-M.); (L.T.); (R.S.)
- Correspondence: ; Tel.: +34-977-75-89-20
| | - Lucia Tarro
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), 43201 Reus, Spain; (M.B.-M.); (L.T.); (R.S.)
- Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Eurecat, 43204 Reus, Spain
| | - Rosa Solà
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), 43201 Reus, Spain; (M.B.-M.); (L.T.); (R.S.)
- Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Eurecat, 43204 Reus, Spain
- Hospital Universitari Sant Joan de Reus, Department of Internal Medicine, 43204 Reus, Spain
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Wong MMH, So WKW, Choi KC, Cheung R, Chan HYL, Sit JWH, Ho B, Li F, Lee TY, Chair SY. Malnutrition risks and their associated factors among home-living older Chinese adults in Hong Kong: hidden problems in an affluent Chinese community. BMC Geriatr 2019; 19:138. [PMID: 31122189 PMCID: PMC6533669 DOI: 10.1186/s12877-019-1148-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 04/26/2019] [Indexed: 01/04/2023] Open
Abstract
Background Although China is undergoing rapid economic development, it is facing an ageing population. No data exists on malnutrition risks of older adults in an affluent Chinese society. The aim of this study is to examine these risks and identify their associated factors among home-living older Chinese adults in Hong Kong. Methods This is a cross-sectional study, to which home-living subjects aged 60 or above were recruited, between May and September 2017, from a non-governmental community organisation located in three different districts of Hong Kong. Nutritional status was assessed by the Mini Nutritional Assessment (MNA), and its associated factors examined included socio-demographic characteristics, lifestyle, health status and diet. Multivariable logistic regression analysis was performed to identify factors associated with malnutrition risks (MNA < 24). Results Six hundred thirteen subjects (mean age: 78.5 ± 7.4; 54.0% females) completed the survey. Nearly 30% (n = 179) were at risk of malnutrition. By multivariable logistic regression, subjects (1) whose vision was only fair or unclear, (2) with poor usual appetite and (3) with main meal skipping behaviour had significantly higher malnutrition risk (all p < 0.05). Conclusions In this affluent Chinese society, the malnutrition risk in older adults is close to the global average, which is a matter for much concern. Interventions are therefore warranted that target vulnerable groups with poor vision, appetite, and meal skipping behaviour. Trial registration Not applicable.
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Affiliation(s)
- Martin M H Wong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Winnie K W So
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China.
| | - Kai Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Regina Cheung
- The Neighbourhood Advice-Action Council, North Point, Hong Kong, China
| | - Helen Y L Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Janet W H Sit
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Brenda Ho
- The Neighbourhood Advice-Action Council, North Point, Hong Kong, China
| | - Francis Li
- The Neighbourhood Advice-Action Council, North Point, Hong Kong, China
| | - Tin Yan Lee
- The Neighbourhood Advice-Action Council, North Point, Hong Kong, China
| | - Sek Ying Chair
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
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Hallit S, Daher MC, Hallit R, Hachem D, Kheir N, Salameh P. Correlates associated with mental health and nutritional status in Lebanese older adults: A cross-sectional study. Arch Gerontol Geriatr 2019; 87:103879. [PMID: 31160065 DOI: 10.1016/j.archger.2019.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 02/23/2019] [Accepted: 05/07/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess correlates of mental and nutritional health among elderly in Lebanon, inside nursing homes compared to their private homes. METHODS This cross-sectional study was conducted between June and August 2016 on 500 elderly. RESULTS Higher somatic (Beta = 0.259) and cognitive anxiety (Beta = 0.508), increased age (Beta = 0.174) were significantly associated with higher depression, whereas having a secondary (Beta = -4.006) and a university (Beta = -6.829) levels of education compared to illiteracy, living home (Beta = -2.557) compared to living in a nursing home and male gender (Beta = -1.280) were significantly associated with lower depression. Increased BMI (Beta = 0.056), a married (Beta = 0.687) and a widowed (Beta = 1.022) status compared to a single status were associated with a better nutritional status, whereas an increased somatic anxiety (Beta = -0.061), secondary (Beta = -0.79) and university (Beta = -1.196) educational levels compared to illiteracy were significantly associated with a worse nutritional status. Increased cognitive (Beta = 1.160) and affective (Beta = 0.788) anxiety and age (Beta = 0.191) were associated with higher stress, whereas a primary (Beta = -6.991), secondary (Beta = -11.812) and university (Beta = -13.927) educational levels, male gender (Beta = -2.015) were significantly associated with lower stress compared to females. A significantly higher mean depression score was found in patients living in nursing homes compared to those living at home (13.74 vs. 11.18). No difference was found between the two groups concerning the nutritional status and stress score. CONCLUSION Living in nursing homes was associated with more malnutrition and depression. An increased awareness of the personnel working in nursing homes and family members of these older adults can help improve their psychological status.
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Affiliation(s)
- Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon; INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.
| | - Marie-Claude Daher
- Ecole Supérieure des Affaires, Beirut, Lebanon; Ecole des Hautes Etudes en Sante Publique, Rennes, France
| | - Rabih Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Dory Hachem
- Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Nelly Kheir
- Faculty of Pedagogy, Université de la Sainte Famille, Batroun, Lebanon
| | - Pascale Salameh
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon; Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; Faculty of Medicine, Lebanese University, Beirut, Lebanon
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Fávaro-Moreira NC, Krausch-Hofmann S, Matthys C, Vereecken C, Vanhauwaert E, Declercq A, Bekkering GE, Duyck J. Risk Factors for Malnutrition in Older Adults: A Systematic Review of the Literature Based on Longitudinal Data. Adv Nutr 2016; 7:507-22. [PMID: 27184278 PMCID: PMC4863272 DOI: 10.3945/an.115.011254] [Citation(s) in RCA: 332] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
The present systematic review critically examines the available scientific literature on risk factors for malnutrition in the older population (aged ≥65 y). A systematic search was conducted in MEDLINE, reviewing reference lists from 2000 until March 2015. The 2499 papers identified were subjected to inclusion criteria that evaluated the study quality according to items from validated guidelines. Only papers that provided information on a variable's effect on the development of malnutrition, which requires longitudinal data, were included. A total of 6 longitudinal studies met the inclusion criteria and were included in the systematic review. These studies reported the following significant risk factors for malnutrition: age (OR: 1.038; P = 0.045), frailty in institutionalized persons (β: 0.22; P = 0.036), excessive polypharmacy (β: -0.62; P = 0.001), general health decline including physical function (OR: 1.793; P = 0.008), Parkinson disease (OR: 2.450; P = 0.047), constipation (OR: 2.490; P = 0.015), poor (OR: 3.30; P value not given) or moderate (β: -0.27; P = 0.016) self-reported health status, cognitive decline (OR: 1.844; P = 0.001), dementia (OR: 2.139; P = 0.001), eating dependencies (OR: 2.257; P = 0.001), loss of interest in life (β: -0.58; P = 0.017), poor appetite (β: -1.52; P = 0.000), basal oral dysphagia (OR: 2.72; P = 0.010), signs of impaired efficacy of swallowing (OR: 2.73; P = 0.015), and institutionalization (β: -1.89; P < 0.001). These risk factors for malnutrition in older adults may be considered by health care professionals when developing new integrated assessment instruments to identify older adults' risk of malnutrition and to support the development of preventive and treatment strategies.
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Affiliation(s)
| | | | - Christophe Matthys
- Department of Clinical and Experimental Medicine,,Clinical Nutrition Unit, Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - Carine Vereecken
- University College Leuven-Limburg, Knowledge and Information Center FOOD, Leuven, Belgium; and
| | - Erika Vanhauwaert
- Department of Clinical and Experimental Medicine,,University College Leuven-Limburg, Knowledge and Information Center FOOD, Leuven, Belgium; and
| | | | | | - Joke Duyck
- Population Studies in Oral Health, Department of Oral Health Sciences, BIOMAT Research Cluster, Department of Oral Health Sciences, Katholieke Universiteit Leuven, Leuven, Belgium;
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Health determinants of nutritional status in community-dwelling older population: the VERISAÚDE study. Public Health Nutr 2016; 19:2220-8. [PMID: 26975221 DOI: 10.1017/s1368980016000434] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Malnutrition is a common and relevant syndrome in elderly people due to its influence on quality of life. The main aim of the present study was to identify health determinants of malnutrition or risk of malnutrition. DESIGN Cross-sectional study collecting information on sociodemographic and health factors (co-morbidity, cognitive or affective problems, prescription medication use, frailty status, self-rated health) as determinants of nutritional status, assessed by the short form of the Mini Nutritional Assessment. SETTING Forty-three senior centres from Galicia (north-western Spain) participated to recruit participants. SUBJECTS A representative community-dwelling sample of 749 elderly people aged ≥65 years. RESULTS Of the total participants, 14·3 % were malnourished/at risk of malnutrition. Presence of overweight or obesity, depressive symptoms, polypharmacy (use of five or more prescription medications), presence of pre-frailty or frailty status and poor self-rated health showed the strongest relationship to malnutrition/risk of malnutrition. This model predicted 86·0 % of the cases correctly. The best determinants for women were polypharmacy and poor self-rated health, reaching 82·8 % of cases of malnourishment/risk of malnutrition predicted correctly. In men, the main determinants were overweight or obesity, depressive symptomatology and polypharmacy, with 89·8 % of cases of malnourishmen/risk of malnutrition predicted correctly. CONCLUSIONS Screening for nutritional status and its determinant factors should be included as part of comprehensive assessments to ensure an early screening of malnutrition and to propose possible intervention strategies that would be important for both elderly people and the health-care system.
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Bartoszek A, Domżał-Drzewicka R, Kachaniuk H, Kocka K, Muzyczka K. The state of nutrition and the self-assessment of symptoms of depression in the group of seniors living in the countryside of Lublin province - preliminary report. PRZEGLAD GASTROENTEROLOGICZNY 2015; 10:208-14. [PMID: 26759627 PMCID: PMC4697030 DOI: 10.5114/pg.2015.49476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 12/22/2014] [Accepted: 01/07/2015] [Indexed: 01/16/2023]
Abstract
INTRODUCTION The incidence of malnutrition increases together with the number of chronic diseases and medications taken daily. There are also other factors causing changes in the nutrition of the elderly, raising the risk of undernourishment. Such factors include difficulties with daily shopping, meal preparation and other everyday activities, hindering access to food with proper quantitative and qualitative properties. The nutritional state of the elderly is influenced not only by somatic disorders, but also by mental disorders such as depression. AIM To define the relationship between the nutritional state of the elderly living in their home environment and the incidence of depression. MATERIAL AND METHODS The described sample consisted of 116 (100%) elderly persons living in the Lubelskie Voivodeship, using the services carried out within primary healthcare. The nutritional state of the elderly was assessed with the use of the full version of the Mini Nutritional Assessment (MNA) questionnaire. In order to determine the intensity of depression symptoms, the Geriatric Depression Scale (GDS) (the 15-item version by Yesavage) was applied. RESULTS During analysis of the impact of depression on malnutrition risk, a correlation with a high statistical significance level was found. Malnutrition was significantly more often identified in people in whom the GDS scale revealed severe depression (p = 0.00002). The risk of depression has a substantial impact on nutritional state. The nutritional state of the elderly deteriorates together with the increase of the risk of depression. CONCLUSIONS In over 48% of respondents, including those living with their families, an intensification of depression symptoms was found.
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Affiliation(s)
- Agnieszka Bartoszek
- Chair of Oncology and Environmental Health, Faculty of Nursing and Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Renata Domżał-Drzewicka
- Chair of Oncology and Environmental Health, Faculty of Nursing and Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Hanna Kachaniuk
- Chair of Oncology and Environmental Health, Faculty of Nursing and Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Katarzyna Kocka
- Chair of Oncology and Environmental Health, Faculty of Nursing and Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Katarzyna Muzyczka
- Chair of Oncology and Environmental Health, Faculty of Nursing and Health Sciences, Medical University of Lublin, Lublin, Poland
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Fonad E, Robins Wahlin TB, Rydholm Hedman AM. Associations between falls and general health, nutrition, dental health and medication use in Swedish home-dwelling people aged 75 years and over. HEALTH & SOCIAL CARE IN THE COMMUNITY 2015; 23:594-604. [PMID: 25676026 DOI: 10.1111/hsc.12182] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/15/2014] [Indexed: 06/04/2023]
Abstract
The vast majority of elderly people in Sweden live in private homes in their communities for as long as possible. Poor health and a high risk of falls are very common among this group. This cross-sectional study investigates the association between falls and general health, appetite, dental health, and the use of multiple medications among home-dwelling men and women aged ≥ 75 years. Data were collected between October 2008 and March 2009 using a postal questionnaire. A total of 1243 people participated in the questionnaire survey (74% response rate), of which 1193 were included in the analysis. The majority of participants were women (n = 738, 62%). Falls in the previous 12-month period were reported by 434 (36%) participants. Most fallers (n = 276, 64%) were women. The majority of the fallers lived in a flat (n = 250, 58%). Poor health (aOR: 1.61; CI: 1.34-1.95), poor dental health (aOR: 1.22; CI: 1.07-1.39) and the use of four or more types of medication daily (aOR: 1.13; CI: 1.03-1.25) were significantly associated with falls in all participants. Poor dental health was found irrespectively of living in a flat (aOR: 1.23; CI: 1.04-1.46) or living in a house (aOR: 1.28; CI: 1.02-1.61), and both were significantly associated with falls. The use of more than four different types of medication daily (aOR: 1.25; CI: 1.11-1.41) was associated with falls for those living in a flat. The results highlight that falls are associated with poor general health, poor dental health and the use of four or more types of medication daily. Health professionals should provide health promotion education and investigate dental health and risk factors for oral disease. Likewise, medical and clinical practices of physicians and community care nurses should include assessing the risk of falling, and treatment that predisposes falls.
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Affiliation(s)
- Edit Fonad
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Tarja-Brita Robins Wahlin
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Discipline of Psychiatry, The University of Queensland School of Medicine, Brisbane, Queensland, Australia
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Doumit JH, Nasser RN, Hanna DR. Nutritional and health status among nursing home residents in Lebanon: comparison across gender in a national cross sectional study. BMC Public Health 2014; 14:629. [PMID: 24950594 PMCID: PMC4075932 DOI: 10.1186/1471-2458-14-629] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 06/11/2014] [Indexed: 11/19/2022] Open
Abstract
Background This study described the differences between elderly men and women living in Lebanese long-term care nursing homes on socio-economic, health and nutritional status. Methods This study used a cross-sectional design. Field researchers obtained data from 221 residents; 148 (67%) women and 73 (33%) men, living in 36 nursing homes. Data on health conditions; nutritional, psychological, and functional status; socio-demographic characteristics, as well as social relations were collected. The analysis used both chi-square and t-test tests. Results The majority of elderly had low socio-economic and poor health status. In comparison to men, women were significantly less educated, had lower occupational status, had no partner, relied financially on their children and relatives, and enjoyed better social relations and health behaviours. Furthermore, the prevalence of both; malnutrition, and at risk of malnutrition, were at 3.2% and 27.6% respectively. There was no statistically significant difference between women and men on Mini Nutritional Assessment, Activities of Daily Living, Geriatric Depression Scale, Body Mass Index, and chronic diseases. While women reported “good” health status compared to men, they continued to have higher prevalence of diseases and chronic pain. Conclusions This study explored the socio-demographic, health, and nutritional status of elderly residing in Lebanese nursing homes and compared these characteristics across gender. The results indicated the need of health support and institutional interventions for elderly women residents.
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Affiliation(s)
- Jacqueline H Doumit
- Nursing and Health Sciences Department, Notre Dame University-Louaize, Zouk Mosbeh, Lebanon.
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Boulos C, Salameh P, Barberger-Gateau P. Factors associated with poor nutritional status among community dwelling Lebanese elderly subjects living in rural areas: results of the AMEL study. J Nutr Health Aging 2014; 18:487-94. [PMID: 24886735 DOI: 10.1007/s12603-014-0463-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES This study aimed to assess the nutritional status, measured by MNA, and its association with socio-demographic indicators and health related characteristics of a representative sample of community dwelling elderly subjects. DESIGN Cross-sectional study. SETTING Community dwelling elderly individuals living in rural communities in Lebanon. PARTICIPANTS 1200 elderly individuals aged 65 years or more. MEASUREMENTS Socio-demographic indicators and health related characteristics were recorded during a standardized interview. Nutritional status was assessed through Mini Nutritional Assessment (MNA). The 5-item GDS score and the WHO-5-A score were used to assess mood, whereas Mini Mental Status (MMS) was applied to evaluate cognitive status. RESULTS The prevalence of malnutrition and risk of malnutrition was 8.0% respective 29.1% of the study sample. Malnutrition was significantly more frequent in elderly subjects aged more than 85 years, in females, widowed and illiterate people. Moreover, participants who reported lower financial status were more often malnourished or at risk of malnutrition. Regarding health status, poor nutritional status was more common among those reporting more than three chronic diseases, taking more than three drugs daily, suffering from chronic pain and those who had worse oral health status. Also, depressive disorders and cognitive dysfunction were significantly related to malnutrition. After multivariate analysis following variables remained independently associated to malnutrition: living in the governorate of Nabatieh (ORa 2.30, 95% CI 1.35 -3.93), reporting higher income (ORa 0.77, 95% CI 0.61-0.97), higher number of comorbidities (ORa 1.22, 95% CI 1.12-1.32), chronic pain (ORa 1.72, 95% CI 1.24-2.39), and depressive disorders (ORa 1.66, 95% CI 1.47-1.88). On the other hand, better cognitive functioning was strongly associated with decreased nutritional risk (ORa 0.27, 95%CI 0.17-0.43). CONCLUSION Our results highlighted the close relationship between health status and malnutrition. The identification of potential predictive factors may allow better prevention and management of malnutrition in elderly people.
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Affiliation(s)
- C Boulos
- Christa Boulos, Department of Nutrition, Faculty of Pharmacy, Saint Joseph University, Beirut, Lebanon,
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Takeuchi K, Aida J, Ito K, Furuta M, Yamashita Y, Osaka K. Nutritional status and dysphagia risk among community-dwelling frail older adults. J Nutr Health Aging 2014; 18:352-7. [PMID: 24676314 DOI: 10.1007/s12603-014-0025-3] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Although the presence of dysphagia is a key determinant of nutritional status among older adults, few studies have focused on the association between malnutrition and dysphagia risk in community-dwelling frail older adults. This study estimated the prevalence of malnutrition and quantified the association between malnutrition and dysphagia risk among community-dwelling older Japanese adults requiring long-term care. DESIGN Cross-sectional study. SETTING This study was conducted with the cooperation of the Japan Dental Association and local dental associations in all 47 prefectures from January to February 2012. PARTICIPANTS Individuals aged ≥65 years capable of oral nutrient intake who were living at home and receiving home dental care and treatment. MEASUREMENTS Individual demographic characteristics and factors associated with health loss-related functional decline were obtained through interviews by home-visit dentists and self-administered questionnaires. Nutritional status and dysphagia risk were evaluated using the Mini Nutritional Assessment Short Form and the Dysphagia Risk Assessment for the Community-dwelling Elderly. RESULTS Among 874 respondents (345 men and 529 women), 24.6% were malnourished, 67.4% were at risk of malnutrition, and 8.0% were well nourished. Dysphagia risk was related to an increased likelihood of malnutrition at an old age, even after adjusting for covariates (PR = 1.30, 95% CI = 1.01-1.67). CONCLUSION Malnutrition is highly prevalent among community-dwelling frail older adults, and dysphagia risk is independently associated with malnutrition. Dysphagia may be an important predictor of malnutrition progression in aged populations.
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Affiliation(s)
- K Takeuchi
- K. Takeuchi, Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken 812-8582, Japan, +81-92-642-6353, FAX: +81-92-642-6354,
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El Zoghbi M, Boulos C, Amal AH, Saleh N, Awada S, Rachidi S, Bawab W, Salameh P. Association between cognitive function and nutritional status in elderly: A cross-sectional study in three institutions of Beirut—Lebanon. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.gmhc.2013.04.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Droogsma E, van Asselt DZB, Schölzel-Dorenbos CJM, van Steijn JHM, van Walderveen PE, van der Hooft CS. Nutritional status of community-dwelling elderly with newly diagnosed Alzheimer's disease: prevalence of malnutrition and the relation of various factors to nutritional status. J Nutr Health Aging 2013; 17:606-10. [PMID: 23933871 DOI: 10.1007/s12603-013-0032-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To determine the prevalence of malnutrition and its relation to various factors in community-dwelling elderly with newly diagnosed Alzheimer's disease (AD). DESIGN Retrospective cross-sectional study. SETTING Memory clinic in a rural part of the Netherlands. PARTICIPANTS 312 Community-dwelling AD patients, aged 65 years or older, were included. MEASUREMENTS At the time the diagnosis AD was made, socio-demographic characteristics and data on nutritional status (Mini Nutritional Assessment (MNA)), cognitive function (Mini Mental State Examination (MMSE), Cambridge Cognitive Examination (Camcog)), functional status (Interview for Deterioration in Daily Living Activities in Dementia (IDDD), Barthel Index (BI)) and behaviour (Revised Memory and Behaviour Problems Checklist (RMBPC)) were assessed. Characteristics of well-nourished patients (MNA score >23.5) were compared to characteristics of patients at risk of malnutrition (MNA score 17-23.5). Linear regression analysis was performed to assess the effect of various factors on nutritional status. RESULTS The prevalence of malnutrition was 0% and 14.1% was at risk of malnutrition. AD patients at risk of malnutrition were more impaired in basic and complex daily functioning than well-nourished AD patients (median IDDD score 41.5 [25th -75th percentile 38.8-48.0] versus median IDDD score 40.0 [25th -75th percentile 37.0-43.0], p = 0.028). The degree of impairment in basic and complex daily functioning (IDDD) was independently related to nutritional status (MNA) (p = 0.001, B = -0.062). CONCLUSION One in seven community-dwelling elderly with newly diagnosed AD is at risk of malnutrition. The degree of impairment in daily functioning is independently related to nutritional status. Therefore, assessment of the nutritional status should be included in the comprehensive assessment of AD patients. The relation between daily functioning, nutritional status and AD warrants further investigation.
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Affiliation(s)
- E Droogsma
- Geriatric Medicine, Medical Centre Leeuwarden, Po Box 888 Leeuwarden 8901 BR, The Netherlands
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Boulos C, Salameh P, Barberger-Gateau P. The AMEL study, a cross sectional population-based survey on aging and malnutrition in 1200 elderly Lebanese living in rural settings: protocol and sample characteristics. BMC Public Health 2013; 13:573. [PMID: 23758758 PMCID: PMC3701550 DOI: 10.1186/1471-2458-13-573] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 06/05/2013] [Indexed: 11/26/2022] Open
Abstract
Background Lebanon is faced with a particular challenge because of large socioeconomic inequality and accelerated demographic transition. Rural residents seem more vulnerable because of limited access to transport, health and social services. No information is available regarding health, nutrition and living conditions of this specific population. The purpose of the AMEL (Aging and Malnutrition in Elderly Lebanese) study is to assess the nutritional status of community dwelling elderly people, aged 65 years and above, living in a rural settings in Lebanon, in line of socioeconomic factors, health and living conditions. The present paper will describe the gender specific characteristics of the study population. Methods AMEL is a cross-sectional population based study conducted between April 2011 and April 2012 including 1200 elderly individuals living in the 24 rural Caza (districts) of Lebanon. People aged greater than or equal to 65 y were randomly selected through multistage cluster sampling. Subjects were interviewed at their homes by trained interviewers. The questionnaire included the following measures: socio-demographic factors, nutritional status (Mini Nutritional Assessment, MNA), health related characteristics, functional ability, cognitive status, mood and social network. Results The sample included 591 men (49.3%) and 609 women (50.8%). Mean age was 75.32 years and similar between genders. Malnutrition (MNA < 17) and risk of malnutrition (MNA between 17 and 23.5) were present in 8.0% (95%CI 4.9%-11.1%) and 29.1% (95%CI 24.0%-34.2%) respectively of the participants, and more frequent in women (9.1% and 35.3% respectively). Regarding socio-demographic status, among women the level of illiteracy and poor income was significantly higher than in men. Moreover, chronic diseases, poor self perceived health, frailty, functional disability, depressive symptoms and cognitive impairment were particularly high and significantly more frequent in women than in men. Conclusion The present study provides unique information about nutritional status, health and living conditions of community dwelling rural residents of Lebanon. These findings may alert policy makers to plan appropriate intervention in order to improve the quality of life and increase successful aging.
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Affiliation(s)
- Christa Boulos
- Department of Nutrition, Faculty of Pharmacy, Saint Joseph University, Beirut, Lebanon.
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