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Boucaud-Maitre D, Simo-Tabue N, Mounsamy L, Rambhojan C, Letchimy L, Rinaldo L, Dartigues JF, Amieva H, Dramé M, Tabué-Teguo M. Malnutrition and its determinants among older adults living in foster families in Guadeloupe (French West Indies). A cross-sectional study. PLoS One 2024; 19:e0304998. [PMID: 38905295 PMCID: PMC11192354 DOI: 10.1371/journal.pone.0304998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/22/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Foster families may represent an alternative model for dependent older adults in many countries where nursing homes are insufficiently developed. This study aimed to assess the prevalence of malnutrition and its determinants in older adults living in foster families in Guadeloupe (French West Indies). METHODS This cross-sectional study was gathered from the KASAF (Karukera Study of Ageing in Foster families) study (n = 107, 41M/66F, Mdn 81.8 years). Nutritional status was assessed with the Mini Nutritional Assessment Short-Form (MNA-SF). Clinical characteristics and scores on geriatric scales (Mini-Mental State Examination (MMSE), Activities of Daily Living (ADL), Short Physical Performance Battery (SPPB), Center for Epidemiologic Studies- Depression (CESD) and Questionnaire Quality of Life Alzheimer's Disease (QoL-AD)) were extracted. Bivariate analysis and logistic models adjusted for age and gender were performed to test the association of nutritional status with socio-demographic variables and geriatric scales. RESULTS Thirty (28.0%) older adults were malnourished (MNA-SF score ≤7). In bivariate analysis, malnutrition was associated with an increased prevalence of cardiovascular diseases (46.7% versus 19.5%, p = 0.004), the presence of hemiplegia (30.0% versus 6.5%, p = 0.003), a poorer cognitive status (MMSE score 4.7 ± 7.1versus 9.7 ± 10.7; p = 0.031), higher risk of depression (CESD score 27.3 ± 23.0 versus 13.5 ± 14.4; p = 0.035) and dependency (ADL score 1.9 ± 1.9 versus 2.3 ± 2.1; p<0.001). Malnutrition was also associated with lower caregivers'rating of QoL (QoL-AD score 21.8 ± 6.4 versus 26.0 ± 5.7; p = 0.001) but not by older adult's rating (24.1 ± 11.2 versus 28.3 ± 7.7; p = 0.156). Similar associations were observed in logistic models adjusted for age and gender. CONCLUSION Malnutrition was common among foster families for older adults. Special attention towards the prevention and treatment of malnutrition in older adults from cardiovascular diseases, cognitive impairment, dependency and depression is necessary in this model of dependency support.
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Affiliation(s)
- Denis Boucaud-Maitre
- Centre Hospitalier Le Vinatier, Bron, France
- Equipe EPICLIV, Université des Antilles, Fort-de-France, Martinique
- Centre Hospitalo-Universitaire de Guadeloupe, Pointe-à-Pitre, Guadeloupe
| | - Nadine Simo-Tabue
- Centre Hospitalo-Universitaire de Martinique, Fort-de-France, Martinique
| | - Ludwig Mounsamy
- Centre Hospitalo-Universitaire de Guadeloupe, Pointe-à-Pitre, Guadeloupe
| | | | - Laurys Letchimy
- Centre Hospitalo-Universitaire de Martinique, Fort-de-France, Martinique
| | - Leila Rinaldo
- Centre Hospitalo-Universitaire de Guadeloupe, Pointe-à-Pitre, Guadeloupe
| | | | - Hélène Amieva
- Inserm U1219 Bordeaux Population Health Center, University of Bordeaux, Bordeaux, France
| | - Moustapha Dramé
- Equipe EPICLIV, Université des Antilles, Fort-de-France, Martinique
- Centre Hospitalo-Universitaire de Martinique, Fort-de-France, Martinique
| | - Maturin Tabué-Teguo
- Equipe EPICLIV, Université des Antilles, Fort-de-France, Martinique
- Centre Hospitalo-Universitaire de Martinique, Fort-de-France, Martinique
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Kunvik S, Kanninen JC, Holm A, Suominen MH, Kautiainen H, Puustinen J. Nutritional Status and Health-Related Quality of Life among Home-Dwelling Older Adults Aged 75 Years: The PORI75 Study. Nutrients 2024; 16:1713. [PMID: 38892646 PMCID: PMC11174355 DOI: 10.3390/nu16111713] [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: 04/26/2024] [Revised: 05/24/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024] Open
Abstract
Malnutrition in older people has been considered as a health concern associated with a range of implications for health and functional ability. However, evidence of nutrition and health-related quality of life (HRQoL) among older people is limited. The aim of this study was to study the associations between nutritional status and HRQoL among home-dwelling older adults aged 75 years. In this cross-sectional study, we studied 75-year-old home-dwelling residents who participated in PORI75 preventive health screenings in 2020 and completed the full Mini Nutritional Assessment (MNA). The participants' HRQoL was measured using the 15D instrument. Altogether, 462 participants (60% women) were included. Of these, 11% had decreased nutritional status (MNA score < 24); 12.7% were women and 8.6% were men, with no difference between the sexes (p = 0.17). A relationship was found between HRQoL and the MNA: a decreased MNA score was associated with decreased HRQoL (p < 0.001, r = 0.45, 95% CI: 0.38 to 0.53). All 15 HRQoL dimensions (except hearing) were associated with the MNA score. Among the men, the association was stronger compared to the women, especially when the MNA score was <24, indicating decreased nutritional status. In conclusion, impaired nutritional status seems to be associated with impaired HRQoL among 75-year-old people living at home, especially among men.
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Affiliation(s)
- Susanna Kunvik
- Faculty of Health and Welfare, Satakunta University of Applied Sciences, 28100 Pori, Finland
| | - Jonna-Carita Kanninen
- Faculty of Technology, Satakunta University of Applied Sciences, 28100 Pori, Finland
| | - Anu Holm
- Faculty of Technology, Satakunta University of Applied Sciences, 28100 Pori, Finland
- Faculty of Medicine, University of Turku, 20014 Turku, Finland
| | - Merja H. Suominen
- Department of General Practice and Primary Health Care, Helsinki University Central Hospital, University of Helsinki, 00290 Helsinki, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, Helsinki University Central Hospital, University of Helsinki, 00290 Helsinki, Finland
| | - Juha Puustinen
- Unit of Neurology, Satasairaala Central Hospital, Satakunta Wellbeing County, 28500 Pori, Finland
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Alotaibi R, Aladel A, Alshammari SA, Abulmeaty MMA, Alhamdan AA. Association of Nutritional Status and Diet Diversity with Skeletal Muscle Strength and Quality of Life among Older Arab Adults: A Cross-Sectional Study. Nutrients 2023; 15:4382. [PMID: 37892457 PMCID: PMC10609555 DOI: 10.3390/nu15204382] [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: 09/09/2023] [Revised: 10/01/2023] [Accepted: 10/14/2023] [Indexed: 10/29/2023] Open
Abstract
There is little research evaluating skeletal muscle strength, nutritional status, and quality of life in older Arab adults. This study examined the association of nutritional status with skeletal muscle strength and quality of life among older adults living in Saudi Arabia. A cross-sectional study was conducted among older adults (n = 166 older adults; 57.8% females) who visited primary outpatient clinics at King Khalid University Hospital in Riyadh City. Sociodemographic data, Mini Nutritional Assessment short-form (MNA-SF), diet variety score (DVS), and health-related quality of life (HR-QoL) were assessed. Furthermore, handgrip strength (HGS) and knee extension strength (KES) were measured to evaluate skeletal muscle strength. Malnourishment and risk of malnutrition were found in 16.9% of our sample. Nutritional status was significantly associated with muscle strength and HR-QoL (p < 0.05). The well-nourished group had higher HGS, KES, and total HR-QoL scores compared to the at risk of malnutrition or malnourished group. Moreover, there was a moderate positive correlation between MNA-SF and total HR-QoL scores (r = 0.40). The percentage of individuals in the well-nourished group categorized with a high or moderate DVS was significantly higher than those at risk of malnutrition or are malnourished; however, DVS was not associated with muscle strength and HR-QoL. The MNA-SF score had a significant positive correlation with HGS (r = 0.30) and KES (r = 0.23). An increase in the MNA-SF score was significantly associated with higher odds of being moderate/high (HGS and HR-QoL) in the crude and adjusted models. In conclusion, maintaining adequate nutritional status is beneficial for preserving skeletal muscle strength and promoting better HR-QoL among older individuals. Therefore, applications of appropriate nutritional and muscle strength assessments in geriatric care institutions are recommended.
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Affiliation(s)
- Rahaf Alotaibi
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (R.A.); (A.A.); (M.M.A.A.)
| | - Alanoud Aladel
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (R.A.); (A.A.); (M.M.A.A.)
| | - Sulaiman A. Alshammari
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia;
| | - Mahmoud M. A. Abulmeaty
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (R.A.); (A.A.); (M.M.A.A.)
| | - Adel A. Alhamdan
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (R.A.); (A.A.); (M.M.A.A.)
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Perry E, Walton K, Lambert K. Prevalence of Malnutrition in People with Dementia in Long-Term Care: A Systematic Review and Meta-Analysis. Nutrients 2023; 15:2927. [PMID: 37447253 DOI: 10.3390/nu15132927] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/25/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Dementia is a common syndrome in older people. Dementia alters eating behaviors, hunger and thirst cues, swallow function, ability to self-feed, and recognition and interest in food. There is significant variation in the reported prevalence of malnutrition among older people who live in long-term care. The aim was to conduct a systematic literature review and meta-analysis of the prevalence of malnutrition in those with dementia living in long-term care using a validated nutrition assessment tool. Scopus, Web of Science, CINAHL, and Medline were searched. A random effects model was used to determine the prevalence and risk of malnutrition. Data were retrieved from 24 studies. Most of the studies were from Europe or South Asia. The prevalence of malnutrition ranged from 6.8 to 75.6%, and the risk of malnutrition was 36.5-90.4%. The pooled prevalence of malnutrition in those with dementia in long-term care was 26.98% (95% CI 22.0-32.26, p < 0.0001, I2 = 94.12%). The pooled prevalence of the risk of malnutrition in those with dementia was 57.43% (95% CI 49.39-65.28, p < 0.0001, I2 = 97.38%). Malnutrition is widespread in those with dementia living in long-term care. Further research exploring malnutrition in other industrialized countries using validated assessment tools is required.
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Affiliation(s)
- Emma Perry
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Karen Walton
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Kelly Lambert
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
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Boström AM, Cederholm T, Faxén-Irving G, Franzén E, Grönstedt H, Seiger Å, Vikström S, Wimo A. Factors Associated with Health-Related Quality of Life in Older Persons Residing in Nursing Homes. J Multidiscip Healthc 2022; 15:2615-2622. [PMID: 36388631 PMCID: PMC9664909 DOI: 10.2147/jmdh.s381332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/04/2022] [Indexed: 10/31/2023] Open
Abstract
PURPOSE Health-related quality of life (HRQoL) is an important patient-related outcome for the assessment of interventions and treatments in older people. Understanding underlying mechanisms for HRQoL is crucial for improving care, rehabilitation and symptom relief. This study examined the associations between HRQoL and frailty, sarcopenia, dependence of ADL, physical function and nutritional status in older nursing home (NH) residents. PATIENTS AND METHODS This is a cross-sectional study employing baseline data from the Older Person's Exercise and Nutrition (OPEN) study. Residents ≥75 years and able to stand up from seated position, residing in eight nursing homes in Sweden, were recruited. The EuroQoL 5-dimension Questionnaire (EQ-5D-5L, 0-1) was used to assess HRQoL. For exposure, the FRAIL and SARC-F questionnaires, Bergs Balance Scale, Functional Independence Measure (FIM), and Mini Nutritional Assessment-Short Form (MNA-SF) were used, including chair-stand test, walking speed and some biochemical markers. Descriptive and inferential statistics including linear regression models were applied. RESULTS Data from 113 residents (59% women, mean age 85 years) revealed a mean EQ-5D index of 0.76. After relevant adjustments, factors associated with low HRQoL were sarcopenia (p<0.001), cognitive function (p<0.001), dependence in ADL (p=0.002), low plasma-albumin (p=0.002) and impaired nutritional status (p=0.038). CONCLUSION This study displays evidence that modifiable conditions like sarcopenia and malnutrition are related to HRQoL in older NH residents. Such findings indicate a potential for physical exercise, including muscle training, and improved nutritional routines, including protein supplementation, to enhance nursing home care. Future studies, in larger NH populations, on exercise and nutrition for effects on HRQoL are needed.
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Affiliation(s)
- Anne-Marie Boström
- Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Medical Unit Aging, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm and R&D Unit, Stockholms Sjukhem, Stockholm, Sweden
| | - Tommy Cederholm
- Medical Unit Aging, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Division of Clinical Geriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm and Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Gerd Faxén-Irving
- Division of Clinical Geriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden
| | - Erika Franzén
- Division of Physiotherapy, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Medical Unit Occupational Therapy and Physiotherapy, Theme Women’s Health and Allied Health Professionals, Karolinska University Hospital, Stockholm and Stockholms Sjukhem R&D Unit, Stockholm, Sweden
| | - Helena Grönstedt
- Medical Unit Occupational therapy and Physiotherapy, Women´s Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Åke Seiger
- Division of Clinical Geriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden
| | - Sofia Vikström
- Division of Occupational Therapy, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden
| | - Anders Wimo
- Division of Neurogeriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden
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Solsona Fernández S, Caverni Muñoz A, Labari Sanz G, Monterde Hernandez B, Martínez Marco MA, Mesa Lampré P. Preliminary Evidence on the Effectiveness of a Multidisciplinary Nutritional Support for Older People with Femur Fracture at an Orthogeriatric Unit in Spain. J Nutr Gerontol Geriatr 2022; 41:270-293. [PMID: 36503421 DOI: 10.1080/21551197.2022.2153959] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
To describe the nutritional and functional changes that occurred in older patients with a femur fracture following a dietary intervention and oral nutritional support implemented at an orthogeriatric unit in Aragon, Spain. Open-label, prospective study. Patients were consecutively recruited and arranged into three groups based on their CONtrolling NUTritional (CONUT®) score and nutritional needs. Nutritional status was assessed while in hospital, and at 45-, 100- and 180-days post-hospital discharge. One hundred and sixty-nine patients [mean age: 86 years (SD ± 5.48)] were recruited (July 2017 to January 2020). At admission, 53.3% were at risk of malnutrition; 26.6% were malnourished; 20.1% were well-nourished. Variable proportions of malnourished patients at admission were well-nourished 45-, 100-, and 180-days post-discharge. CONUT® and Barthel index correlations showed that as nutritional status enhanced, patients gained functionality. Dietary interventions and nutritional support may help restoring the nutritional and functional status of older patients with a femur fracture.
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Affiliation(s)
| | | | - G Labari Sanz
- Nursing Liaison Service, Nuestra Señora de Gracia Hospital, Zaragoza, Spain
| | - B Monterde Hernandez
- Dietetics and Clinical Nutrition Service, Nuestra Señora de Gracia Hospital, Zaragoza, Spain
| | - M A Martínez Marco
- Orthogeriatric Unit, Nursing Department, Nuestra Señora de Gracia Hospital, Zaragoza, Spain
| | - P Mesa Lampré
- Geriatric Department, Nuestra Señora de Gracia Hospital, Zaragoza, Spain
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7
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Oura R, Mäntylä P, Saarela R, Hiltunen K. Oral hypofunction and association with need for daily assistance among older adults in long-term care. J Oral Rehabil 2022; 49:823-830. [PMID: 35620888 PMCID: PMC9546329 DOI: 10.1111/joor.13345] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/24/2022] [Accepted: 05/19/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Oral hypofunction (OHF) is related to occlusal status and bite force. It has specific symptoms and varying degrees of severity. OBJECTIVES OHF was determined with five signs. The relationships between OHF and need for assistance in oral hygiene, moving, eating, and occlusal status in older adults living in long-term care (LTC) were examined. METHODS A comprehensive clinical oral examination was conducted on 393 residents who lived in LTC in Helsinki, Finland. The five signs to determine OHF were mouth dryness, visible food residue on oral or denture surfaces, ability to keep the mouth open during examination, clearness of speech, and diet of pureed or soft food. Score points of 0-2 were given for each sign and the sum was categorized as mild, moderate, or severe OHF. Participants were divided into three groups accordingly, and occlusal status was determined based on contact units. In addition, nurses collected background information on number of medications and level of cognition. Need for assistance was based on oral hygiene, moving, and eating. RESULTS Of participants (n=319), 21% showed severe and 41% moderate OHF. Occlusal status differences between the OHF groups were significant. OHF severity associated linearly with increased severity of cognitive impairment and increased need for assistance in oral hygiene, eating, and moving. CONCLUSIONS OHF score based on the five signs can be used to determine OHF severity. OHF was common and associated with occlusal status, cognitive impairment, and need for assistance in oral hygiene, moving, and eating in older adults living in LTC.
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Affiliation(s)
- Riki Oura
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Päivi Mäntylä
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland; Kuopio University Hospital, Oral and Maxillofacial Diseases, Kuopio, Finland
| | - Riitta Saarela
- Department of Social Services and Health Care, Oral Health Care, City of Helsinki, Helsinki, Finland
| | - Kaija Hiltunen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
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BAYRAK M, ÖZPOLAT G. Impact of quality of life on nutritional risk and malnutrition: a cross-sectional study in elderly patients. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.983161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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9
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Lee YC, Chiu EC. Nutritional status as a predictor of comprehensive activities of daily living function and quality of life in patients with stroke. NeuroRehabilitation 2021; 48:337-343. [PMID: 33814468 DOI: 10.3233/nre-201540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Nutritional status could affect functional capacity and reduce quality of life in patients with stroke. Although the associations between nutritional status, basic activities of daily living (BADL)/Instrumental ADL, and quality of life (QOL) in older people have been identified, the relationships have not yet been examined in patients with stroke, using the full Mini Nutritional Assessment (MNA) or MNA-short form (MNA-SF). OBJECTIVE This study aimed to examine the relationship between nutritional status (using full MNA and MNA-SF), comprehensive ADL function, and QOL in patients with stroke. METHODS Eighty-two patients with ischemic stroke participated in this cross-sectional design study. Each participant was assessed with the full MNA, MNA-SF, comprehensive ADL function (including Barthel Index and Frenchay Activities Index), and WHO Quality of Life Questionnaire (WHOQOL-BREF) once. RESULTS The MNA-SF was only significantly correlated with the comprehensive ADL function (rho = 0.27, p = 0.013), whereas, the full MNA was found to be significantly correlated with the comprehensive ADL function and WHOQOL-BREF (rho = 0.24, p = 0.029 and rho = 0.30, p = 0.005, respectively). The MNA-SF was a significant predictor of comprehensive ADL function, accounting for 44% of the variance. The full MNA was the only significant predictor of the WHOQOL-BREF, explaining 17% of the variance. CONCLUSIONS This study has revealed a relationship between nutritional status, comprehensive ADL function, and QOL among patients with stroke. Patients with stroke with better nutritional status had higher ADL function as well as better QOL. The MNA-SF was useful in predicting comprehensive ADL, whereas, the full MNA could be used to predict QOL. Knowledge and evidence of the association and predictive power of the MNA-SF and full MNA could guide clinicians to choose tools for assessing the nutritional status of patients with stroke more effectively.
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Affiliation(s)
- Ya-Chen Lee
- Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - En-Chi Chiu
- Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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Lengelé L, Bruyère O, Beaudart C, Reginster JY, Locquet M. Impact of Malnutrition Status on Muscle Parameter Changes over a 5-Year Follow-Up of Community-Dwelling Older Adults from the SarcoPhAge Cohort. Nutrients 2021; 13:nu13020407. [PMID: 33525324 PMCID: PMC7910934 DOI: 10.3390/nu13020407] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 02/07/2023] Open
Abstract
This study aimed to assess the impact of malnutrition on the 5-year evolution of physical performance, muscle mass and muscle strength in participants from the SarcoPhAge cohort, consisting of community-dwelling older adults. The malnutrition status was assessed at baseline (T0) according to the “Global Leadership Initiatives on Malnutrition” (GLIM) criteria, and the muscle parameters were evaluated both at T0 and after five years of follow-up (T5). Lean mass, muscle strength and physical performance were assessed using dual X-ray absorptiometry, handgrip dynamometry, the short physical performance battery test and the timed up and go test, respectively. Differences in muscle outcomes according to nutritional status were tested using Student’s t-test. The association between malnutrition and the relative 5-year change in the muscle parameters was tested using multiple linear regressions adjusted for several covariates. A total of 411 participants (mean age of 72.3 ± 6.1 years, 56% women) were included. Of them, 96 individuals (23%) were diagnosed with malnutrition at baseline. Their muscle parameters were significantly lower than those of the well-nourished patients both at baseline and after five years of follow-up (all p-values < 0.05), except for muscle strength in women at T5, which was not significantly lower in the presence of malnutrition. However, the 5-year changes in muscle parameters of malnourished individuals were not significantly different than those of well-nourished individuals (all p-values > 0.05).
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Affiliation(s)
- Laetitia Lengelé
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (L.L.); (C.B.); (J.-Y.R.); (M.L.)
| | - Olivier Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (L.L.); (C.B.); (J.-Y.R.); (M.L.)
- Department of Sport Rehabilitation Sciences, University of Liège, 4000 Liège, Belgium
- Physical, Rehabilitation Medicine and Sports Traumatology, SportS2, University Hospital of Liège, 4000 Liège, Belgium
- Correspondence: ; Tel.: +32-43-66-3230
| | - Charlotte Beaudart
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (L.L.); (C.B.); (J.-Y.R.); (M.L.)
| | - Jean-Yves Reginster
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (L.L.); (C.B.); (J.-Y.R.); (M.L.)
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Médéa Locquet
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (L.L.); (C.B.); (J.-Y.R.); (M.L.)
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Ojala AK, Sintonen H, Roine RP, Strandberg TE, Schalin-Jäntti C. Impaired breathing, sleeping, vitality, and depression, and negative impact of L-T4 treatment characterize health-related quality of life in older people with stable CVD. Aging Clin Exp Res 2020; 32:2041-2047. [PMID: 32277433 PMCID: PMC7532955 DOI: 10.1007/s40520-020-01537-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/20/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) and thyroid dysfunction are common in older people, but little is known about how they affect health-related quality of life (HRQoL). METHODS We assessed HRQoL with the 15D instrument in 329 home-dwelling patients aged ≥ 75 years with stable CVD and compared the results to those of an age- and gender-matched general population (n = 103). We also studied the impact of age, BMI, number of medications, thyroid-stimulating hormone (TSH) concentration, levothyroxine (L-T4) substitution and Mini-Mental State Examination (MMSE) on HRQoL. RESULTS Overall HRQoL was impaired in older people with stable CVD (mean 15D score 0.777 vs 0.801, p = 0.001), and also on single dimensions of breathing, sleeping, discomfort and symptoms, distress, vitality (all p < 0.001), and depression (p = 0.016) compared to the age- and gender-matched general population. Furthermore, in the patients, L-T4 substitution associated with impaired sleeping (p = 0.018) and sexual activity (p = 0.030). Moreover, MMSE points, number of medications used, age (all p < 0.001) and BMI (p = 0.009) predicted impaired HRQoL. CONCLUSIONS Older people with stable CVD are characterized by impaired HRQoL compared to age- and gender-matched controls. We demonstrate that this is the consequence of impaired breathing, sleeping, discomfort and symptoms, distress, vitality, and depression. L-T4 substitution has a negative impact on HRQoL in old patients with stable CVD. MMSE score, number of medications, age and BMI predict worse HRQoL.
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Affiliation(s)
- Anna K Ojala
- Endocrinology, Abdominal Center, Helsinki University Hospital and University of Helsinki, P.O. Box 340, 00290, Helsinki, Finland
| | - Harri Sintonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Risto P Roine
- Group Administration, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Timo E Strandberg
- University of Helsinki, and Helsinki University Hospital, Helsinki, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Camilla Schalin-Jäntti
- Endocrinology, Abdominal Center, Helsinki University Hospital and University of Helsinki, P.O. Box 340, 00290, Helsinki, Finland.
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Salminen KS, Suominen MH, Kautiainen H, Pitkälä KH. Associations between Nutritional Status, Frailty and Health-Related Quality of Life among Older Long-Term Care Residents in Helsinki. J Nutr Health Aging 2020; 24:319-324. [PMID: 32115614 PMCID: PMC7064461 DOI: 10.1007/s12603-019-1320-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 11/05/2019] [Indexed: 01/03/2023]
Abstract
OBJECTIVES The aim of this study was to examine how nutritional status modifies the association between frailty and health-related quality of life (HRQoL) among older nursing home residents. We also investigated how residents' energy intake is linked to frailty score. DESIGN AND PARTICIPANTS A total of 486 older (> 65 years of age) nursing home residents living in Helsinki, Finland were included to this cross-sectional study. METHODS We collected data on the residents' background information, HRQoL by 15D, nutritional status by Mini Nutritional Assessment (MNA), frailty status (Fried's phenotype criteria; pre-frail: 1-2 criteria and frail: 3-5) and energy intake (one- or two-day food records). RESULTS The frail residents were more often malnourished and had lower HRQoL than those in the prefrail group. Energy and protein intakes were significantly lower among frail women than prefrail women. Energy intake was linearly associated with frailty points. When residents in the frail and prefrail groups were divided according to their nutritional status, both nutritional status and frailty were associated with HRQoL, but there was no interaction. CONCLUSIONS Both nutritional status and frailty were associated with HRQoL, and lower energy intake indicated a higher frailty score. An adequate energy intake may promote residents' HRQoL and prevent frailty in long-term care.
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Affiliation(s)
- K S Salminen
- K.S. Salminen, Department of General Practice and Primary Health Care, University of Helsinki, Finland. POB 20, FIN-00014 University of Helsinki, Finland.
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Saarela RK, Hiltunen K, Mäntylä P, Pitkälä KH. Changes in Institutionalized Older People's Dentition Status in Helsinki, 2003‐2017. J Am Geriatr Soc 2019; 68:221-223. [DOI: 10.1111/jgs.16230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 08/22/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Riitta K.T. Saarela
- City of Helsinki, Department of Social Services and Health CareOral Health Care Helsinki Finland
| | - Kaija Hiltunen
- Department of Oral and Maxillofacial Diseases, Faculty of MedicineUniversity of Helsinki Helsinki Finland
| | - Päivi Mäntylä
- Department of Oral and Maxillofacial Diseases, Faculty of MedicineUniversity of Helsinki Helsinki Finland
- Institute of Dentistry, University of Eastern Finland Kuopio Finland
- Kuopio University Hospital, Oral and Maxillofacial Diseases Kuopio Finland
| | - Kaisu H. Pitkälä
- Department of General Practice and Primary Health CareUniversity of Helsinki Helsinki Finland
- Helsinki University Hospital, Unit of Primary Health Care Helsinki Finland
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Severity of both neuropsychiatric symptoms and dementia is associated with quality of life in nursing home residents. Eur Geriatr Med 2019; 10:793-800. [PMID: 34652697 DOI: 10.1007/s41999-019-00213-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 06/12/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The primary focus in long-term care is to maintain quality of life. The aim of this study was to investigate the association of severity of neuropsychiatric symptoms (NPS) and health-related quality of life (HRQoL) and their interaction with dementia severity among institutionalized older people with dementia. METHODS 352 long-term care residents aged 65 years or over with dementia participated in this cross-sectional study. NPS were measured with Neuropsychiatric Inventory (NPI). HRQoL was measured with 15D. Dementia severity was measured with Clinical Dementia Rating (CDR). RESULTS The severity of NPS was significantly associated with better HRQoL in 15D. Residents with severe dementia (CDR 3) had worse HRQoL than residents with mild-moderate dementia (CDR < 3). There was a significant interaction between NPI and CDR (p = 0.037 for NPI, p < 0.001 for CDR, p < 0.001 for interaction). HRQoL correlated positively with all NPS subgroups in residents with severe dementia, but in residents with mild-moderate dementia, no significant correlation existed. In severe dementia, higher NPI correlated positively with such dimensions of 15D as mobility, vision, eating, speech, excretion, usual activities, mental functions, and vitality, whereas in residents with mild-moderate dementia only with mobility. In mild-moderate dementia, NPI correlated negatively with depression, distress and vitality. CONCLUSION Dementia severity and NPS burden are important determining factors of HRQoL in long-term care. NPS have a distinct impact on HRQoL at different stages of dementia. In severe dementia, higher NPS and better HRQoL indicate better functioning and higher vitality.
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Energy Intake and Severity of Dementia Are Both Associated with Health-Related Quality of Life among Older Long-Term Care Residents. Nutrients 2019; 11:nu11102261. [PMID: 31546994 PMCID: PMC6835645 DOI: 10.3390/nu11102261] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 09/17/2019] [Accepted: 09/18/2019] [Indexed: 01/01/2023] Open
Abstract
Our aim was to investigate how energy intake modifies the association of the stage of dementia with health related quality of life (HRQoL) among institutionalized older people. A cross-sectional sample of 538 older long-term care residents with dementia in Helsinki, Finland were assessed with HRQoL (15D), energy intake (from one to two days), and the stage of dementia by the clinical dementia rating (CDR) scale. The energy intakes were standardized by z-scores to include both men and women in the same analyses. Severity of dementia was associated with HRQoL (15D index in CDR 0.5–1: 0.65 (0.11), CDR 2: 0.60 (0.10), CDR 3: 0.52 (0.10)). When the three groups of dementia severity were divided according to their energy intake quartiles, there was an association between the HRQoL and the stage of dementia (p < 0.001) and energy intake (p = 0.013); however, no interaction was observed (p = 0.30). While partial correlation analysis showed that energy intake correlated with HRQoL among residents with very mild/mild or moderate dementia, this was not observed among those with severe dementia. In moderate dementia, the dimensions of mobility and usual activities correlated significantly with higher energy intake. Both energy intake and severity of dementia are associated with HRQoL.
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