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Cederholm T, Bosaeus I. Malnutrition in Adults. N Engl J Med 2024; 391:155-165. [PMID: 38986059 DOI: 10.1056/nejmra2212159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Affiliation(s)
- Tommy Cederholm
- From Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala (T.C.), Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm (T.C.), Theme Inflammation and Aging, Medical Unit Aging, Karolinska University Hospital, Stockholm (T.C.), and the Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, and the Clinical Nutrition Unit, Sahlgrenska University Hospital, Gothenburg (I.B.) - all in Sweden
| | - Ingvar Bosaeus
- From Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala (T.C.), Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm (T.C.), Theme Inflammation and Aging, Medical Unit Aging, Karolinska University Hospital, Stockholm (T.C.), and the Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, and the Clinical Nutrition Unit, Sahlgrenska University Hospital, Gothenburg (I.B.) - all in Sweden
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Singhal S, Wang Y, Qin Z, Peterson DR, Dunne RF, Culakova E, Hopkins JO, Melnyk N, Onitilo A, Targia V, Mohile S, Loh KP. Nutritional impairment, psychological health and quality of life among older adults with advanced cancer: A secondary analysis of a randomized clinical trial. Cancer Med 2024; 13:e7348. [PMID: 38898664 PMCID: PMC11187162 DOI: 10.1002/cam4.7348] [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: 01/25/2024] [Revised: 05/09/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Nutritional impairment is associated with treatment toxicity and worse overall survival in patients with cancer. We aimed to (1) evaluate the association of nutritional impairment with psychological health and quality of life (QOL) and (2) examine which measures of nutrition had the strongest association with psychological health and QOL among older adults receiving cancer treatment with palliative intent. METHODS This secondary analysis was performed on baseline data from a nationwide cluster randomized clinical trial (ClinicalTrials.gov identifier: NCT02107443; PI: Mohile). Adults age ≥70 with advanced cancer and ≥1 geriatric assessment (GA) impairment were enrolled from 2014 to 2017. In line with geriatric oncology standards, we defined nutritional impairment as Mini Nutritional Assessment Short Form (MNA-SF) ≤11, body mass index (BMI) <21 kg/m2, or >10% involuntary weight loss in the past 6 months. We conducted multivariable linear regressions to evaluate the association of nutritional impairment with each measure of psychological health and QOL: Geriatric Depression Scale (GDS-15, range 0-15), Generalized Anxiety Disorder-7 (GAD-7, range 0-21), NCCN Distress Thermometer (NCCN DT, range 0-10), and Functional Assessment of Cancer Therapy-General (FACT-G, range 0-108). Analyses were adjusted for patient demographics, clinical characteristics, and GA. RESULTS Among 541 patients, the mean age was 77 (range 70-96) and 60% had nutritional impairment. Mean baseline scores: GDS-15 3.1 (SD 2.7), GAD-7 2.9 (SD 4.0), NCCN DT 2.9 (SD 2.7), and FACT-G 80 (SD 15). In the adjusted model, compared to those with no nutritional impairment, older adults with nutritional impairment had greater depression (β = 0.79, 95% CI 0.36-1.23) and anxiety severity (β = 0.86, 95% CI 0.19-1.53), and worse QOL (β = -6.31, 95% CI -8.62 to -4.00). Of the measures of nutrition, MNA-SF ≤11 demonstrated the strongest associations with depression, anxiety, distress, and QOL. CONCLUSION Nutritional impairment is associated with impaired psychological health and worse QOL. Clinicians should use the MNA-SF to screen older adults for nutritional impairment and offer tailored supportive interventions.
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Affiliation(s)
- Surbhi Singhal
- Division of Hematology/Oncology, Department of MedicineUniversity of California DavisSacramentoCaliforniaUSA
| | - Ying Wang
- Department of Public Health SciencesUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - Zhaoyang Qin
- Department of Biostatistics and Computational BiologyUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - Derick R. Peterson
- Department of Biostatistics and Computational BiologyUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - Richard F. Dunne
- Division of Hematology and OncologyJames P. Wilmot Cancer Institute, University of Rochester Medical CenterRochesterNew YorkUSA
| | - Eva Culakova
- Department of Surgery, Supportive Care in Cancer UnitUniversity of RochesterRochesterNew YorkUSA
| | - Judith O. Hopkins
- Novant Health Cancer Institute/Southeast Clinical Oncology Research ConsortiumWinston‐SalemNorth CarolinaUSA
| | - Natalia Melnyk
- Delaware/Christiana Care NCI Community Oncology Research Program (NCORP)NewarkDelawareUSA
| | | | - Valerie Targia
- Stakeholders for the Care and Research of Oncology Elders (SCOREBoard) Advisory CommitteeDuarteUSA
| | - Supriya Mohile
- Division of Hematology and OncologyJames P. Wilmot Cancer Institute, University of Rochester Medical CenterRochesterNew YorkUSA
| | - Kah Poh Loh
- Division of Hematology and OncologyJames P. Wilmot Cancer Institute, University of Rochester Medical CenterRochesterNew YorkUSA
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Pareja Sierra T, Hünicken Torrez FL, Pablos Hernández MC, López Velasco R, Ortés Gómez R, Cervera Díaz MDC, Hormigo Sánchez AI, Perdomo Ramírez B, Mora Fernández J, Jiménez Mola S, Rodriguez Piñera MA, Condorhuaman Alvarado PY, Sanchez Juan C, Ramos Clemente JI, Veses Martín S, Rodríguez Manzano I, González-Colaço Harmand M, Camprubí Robles M, Martín Aguilar A, Saez Lopez P. A Prospective, Observational Study of the Effect of a High-Calorie, High-Protein Oral Nutritional Supplement with HMB in an Old and Malnourished or at-Risk-of-Malnutrition Population with Hip Fractures: A FracNut Study. Nutrients 2024; 16:1223. [PMID: 38674912 PMCID: PMC11053940 DOI: 10.3390/nu16081223] [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: 03/14/2024] [Revised: 04/12/2024] [Accepted: 04/13/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Hip fractures are prevalent among older people, often leading to reduced mobility, muscle loss, and bone density decline. Malnutrition exacerbates the prognosis post surgery. This study aimed to evaluate the impact of a 12-week regimen of a high-calorie, high-protein oral supplement with β-hydroxy-β-methylbutyrate (HC-HP-HMB-ONS) on nutritional status, daily activities, and compliance in malnourished or at-risk older patients with hip fractures receiving standard care. SUBJECTS AND METHODS A total of 270 subjects ≥75 years of age, residing at home or in nursing homes, malnourished or at risk of malnutrition, and post hip fracture surgery, received HC-HP-HMB-ONS for 12 weeks. Various scales and questionnaires assessed outcomes. RESULTS During the 12 weeks of follow-up, 82.8% consumed ≥75% of HC-HP-HMB-ONS. By week 12, 62.4% gained or maintained weight (+0.3 kg), 29.2% achieved normal nutritional status (mean MNA score +2.8), and 46.8% improved nutritional status. Biochemical parameters improved significantly. Subjects reported good tolerability (mean score 8.5/10), with 87.1% of healthcare providers concurring. CONCLUSIONS The administration of HC-HP-HMB-ONS markedly enhanced nutritional status and biochemical parameters in older hip-fracture patients, with high compliance and tolerability. Both patients and healthcare professionals expressed satisfaction with HC-HP-HMB-ONS.
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Affiliation(s)
- Teresa Pareja Sierra
- Department of Geriatrics, University Hospital of Guadalajara, 19002 Guadalajara, Spain;
| | | | | | - Rosario López Velasco
- Department of Geriatrics, University Hospital Nuestra Señora de Valme, 41014 Sevilla, Spain
| | - Raquel Ortés Gómez
- Department of Geriatrics, University Hospital San Pedro de Alcántara, 10003 Cáceres, Spain
| | | | | | - Beatriz Perdomo Ramírez
- Department of Geriatrics, University Hospital Fundación Alcorcón, 28922 Alcorcón, Spain (P.S.L.)
| | - Jesús Mora Fernández
- Department of Geriatrics, Instituto de Investigación del Hospital Clínico San Carlos (IdISSC), Universidad Complutense, 28040 Madrid, Spain
| | - Sonia Jiménez Mola
- Department of Geriatrics, Complejo Asistencial Universitario de León, 24008 León, Spain
| | | | | | - Carlos Sanchez Juan
- Department of Endocrinology and Nutrition, Hospital General University of Valencia, 46014 València, Spain
| | | | - Silvia Veses Martín
- Departament of Endocrinology, Doctor Peset University Hospital, 46017 València, Spain
| | - Ingrid Rodríguez Manzano
- Departament of Geriatrics, University Hospital Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain
| | | | | | | | - Pilar Saez Lopez
- Department of Geriatrics, University Hospital Fundación Alcorcón, 28922 Alcorcón, Spain (P.S.L.)
- La Paz Hospital Research Institute (IdiPAZ), 28029 Madrid, Spain
- Head Coordinator of the Spanish National Hip Fracture Registry, Madrid, Spain
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Fatmah F. Effectiveness of mangrove sword bean food bar addressed to older people of landslide disaster victims. Front Nutr 2024; 11:1291580. [PMID: 38650640 PMCID: PMC11034437 DOI: 10.3389/fnut.2024.1291580] [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: 09/09/2023] [Accepted: 03/26/2024] [Indexed: 04/25/2024] Open
Abstract
Background Older people require extra attention due to their reduced ability to prepare for disasters, as they adequately possess distinct needs. These groups necessitate uncomplicated, readily consumable, and palatable food options that fulfill their micronutrient needs. The objective of this research was to assess the effects of a snack bar enriched with api-api mangrove (Avicennia marina) and sword bean (Canavalia ensiformis) on the body weight and Body Mass Index (BMI) of older people individuals afflicted by a landslide event. Methods A non-randomized pre-post-intervention study was undertaken, involving 31 senior participants. The intervention group consisted of 15 seniors who were provided with a mangrove sword bean snack bar, while the control group comprised 16 seniors who received a sword bean food bar during 15 days. All study participants received education on maintaining a balanced diet for older people individuals. The data analysis involved using univariate and bivariate analyses, explicitly applying the independent t-test and dependent t-test. Results In the hedonic evaluation, the mangrove sword bean food bar had superior average attributes in terms of scent, flavor, texture, and color compared to the sword bean food bar. The consumption of snack bars made from mangrove sword beans resulted in a significant rise in weight (0.2 kg), energy intake (240.8 kcal), protein content (5.8 g), carbohydrate content (40.06 g), and fat content (4.4 g). Carbohydrate can significantly increase weight in the treatment subjects. Furthermore, the provision of comprehensive nutrition education has the potential to enhance the post-study knowledge score, as seen by the observed increase of 40.6. A significant disparity was observed between the mean carbohydrate consumption and understanding of balanced nutrition among the intervention and control groups. Conclusion Api-api mangrove sword bean snack bars have been identified as a viable and efficient substitute for emergency food provisions, particularly in disaster-stricken communities. These food bars have demonstrated a significant capacity to contribute to the weight gain of individuals within such groups, thus addressing the nutritional needs of impacted populations in the aftermath of natural calamities. Subsequent investigations may include employing pregnant women as participants to explore the issue above. Clinical Trial Registration Clinicaltrials.gov, identifier: NCT05897892.
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Affiliation(s)
- Fatmah Fatmah
- Disaster Management Study Program, School of Environmental Science Universitas Indonesia, Jakarta, Indonesia
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Calcaterra L, Abellan van Kan G, Steinmeyer Z, Angioni D, Proietti M, Sourdet S. Sarcopenia and poor nutritional status in older adults. Clin Nutr 2024; 43:701-707. [PMID: 38320461 DOI: 10.1016/j.clnu.2024.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND & AIMS The association between sarcopenia and malnutrition has been poorly studied in the older population. The purpose of this study is to address the association between sarcopenia, according to different validated definitions, and nutritional status in a large population of community-dwelling older adults. METHODS Observational, cross-sectional study of the Geriatric Frailty Clinic (GFC) for Assessment of Frailty and Prevention of Disability, held by the "Gérontopôle" of the Toulouse University Hospital. Patients aged above 65 years who benefitted from a Dual X-ray Densitometry (DXA) during their assessment at the GFC from June 5th 2013 to January 28th 2020 were included. Sarcopenia was defined according to proposed validated definitions. The Mini Nutritional Assessment (MNA) was used to stratify nutritional status, and identify patients with a poor nutritional status (at risk of malnutrition or malnourished, MNA <24). Multiple logistic regression analyses were performed between MNA and each sarcopenia definition adjusted for confounders. RESULTS Among the 938 patients with DXA data, a total of 809 (86.2 %) subjects were included in the analysis (mean age 81.8 ± 6.9 years, 527 females (65.1 %)). Prevalence of sarcopenia ranged from 12.6 % to 44.9 %, according to various definitions. Overall 244 (30.2 %) of the patients had a poor nutritional status (MNA-score <24), Baumgartner and Newman definitions of sarcopenia were both associated with low MNA-scores (OR = 4.69, CI 3.15-6.98 and OR = 2.30, CI 1.55-3.14, respectively), EWGSOP2 "confirmed sarcopenia" definition was also associated with low MNA-scores (OR = 3.68, CI 2.30-5.89), as well as for the lean mass definition according EWGSOP2 cut-off (OR 5.22 CI 3.52-7.73). Both FNIH and EWGSOP2 "probable sarcopenia" definitions were not associated with the risk of malnutrition. CONCLUSIONS In this study, the prevalence of sarcopenia ranged from 12.6 to 44.9 % according to various definitions. A score of MNA under 24, was associated with almost all of the sarcopenia definitions. This study reinforces the concept that malnutrition and sarcopenia are strictly related. When facing malnutrition in daily clinical practice, body composition should be assessed and the proposed nutritional intervention should be tailored by these results in order to prevent the onset of late-life disability.
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Affiliation(s)
- L Calcaterra
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France; Division of Subacute Care, IRCCS, Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - G Abellan van Kan
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France.
| | - Z Steinmeyer
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France
| | - D Angioni
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France
| | - M Proietti
- Division of Subacute Care, IRCCS, Istituti Clinici Scientifici Maugeri, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - S Sourdet
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France
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Ruiz-Rosso R, Moreno-Cámara S, Gutiérrez-Sánchez B, da-Silva-Domingues H, Del-Pino-Casado R, Palomino-Moral PÁ. Factors Influencing Nutritional Status in Hospitalized Individuals Aged 70 and Above. Nutrients 2024; 16:645. [PMID: 38474773 PMCID: PMC10934742 DOI: 10.3390/nu16050645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 02/20/2024] [Accepted: 02/24/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Older adults are vulnerable to malnutrition due to physical, psychological, and social factors. Malnutrition, a prevalent and modifiable issue in this population, is associated with an elevated risk of adverse clinical outcomes. The purpose of the study is to assess the nutritional status of older adult individuals admitted to a general hospital and examine its correlation with socio-health and demographic variables. METHODS The study included 239 individuals aged 70 and above, employing a cross-sectional descriptive observational approach with a convenience sampling method. Sociodemographic information was gathered, and variables such as cognitive impairment, functional capacity, comorbidities, medication consumption, and nutritional status were evaluated. Statistical analysis involved descriptive calculations, bivariate analysis, and multivariate analysis, utilizing binary logistic regression. RESULTS Approximately half of the sample were at risk of malnutrition, with a more notable prevalence among women. Factors such as age (OR = 1.04), cognitive impairment (OR = 1.06), functional dependence (OR = 0.96), and comorbidities (OR = 1.08) were linked to an elevated risk of malnutrition. In our regression model, age, cognitive impairment, and drug consumption emerged as significant predictors of malnutrition risk. CONCLUSIONS Individuals aged 70 and above have a notably high prevalence of malnutrition risk, particularly among those experiencing functional dependence and cognitive impairment. In our sample, cognitive impairment in older adults, coupled with above-median drug consumption, emerges as the primary predictor for malnutrition risk.
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Affiliation(s)
| | | | | | - Henrique da-Silva-Domingues
- Department of Nursing, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (R.R.-R.); (S.M.-C.); (B.G.-S.); (R.D.-P.-C.); (P.Á.P.-M.)
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Tesfaye BT, Yizengaw MA, Birhanu TE, Bosho DD. Nutritional status of hospitalized elderly patients in Ethiopia: a cross-sectional study of an important yet neglected problem in clinical practice. Front Nutr 2024; 10:1227840. [PMID: 38260070 PMCID: PMC10800825 DOI: 10.3389/fnut.2023.1227840] [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: 05/23/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
Background Malnutrition is a common geriatric syndrome affecting approximately half of the older population with a more pronounced occurrence rate in those hospitalized. It affects the physiology, and results in poor humanistic and clinical outcomes. In Africa, particularly in Ethiopia, albeit multiple studies are available on malnutrition in non-hospitalized older population, similar studies in inpatient settings are scarce. Therefore, this study was conducted with the intention to quantify the prevalence of malnutrition in older patients on inpatient admission and determine its associated factors. Methods A total of 157 older inpatients aged 60 years and above were included in the present study. The data collection format was developed after an in-depth review of relevant literatures. The full Mini-Nutritional Assessment (MNA) tool was employed to assess the nutritional status on admission. Data completeness was checked thoroughly. Descriptive statistics and logistic regression analysis were conducted using STATA 15.0. The area under the receiver operating characteristic curve (ROC), Hosmer-Lemeshow test, and classification table were computed to evaluate the final model goodness-of-fit. Results Of the total study subjects, 81% were malnourished (MNA score <17) and 17% were at risk for malnutrition (MNA score of 17.5-23.5). However, upon review of the patients' medical charts, malnutrition diagnosis was recorded in only two patients. Rural residence (AOR = 2.823, 95%CI: 1.088, 7.324), self-reported financial dependence for expenses (AOR = 4.733, 95%CI: 1.011, 22.162), and partial dependence in functional autonomy on admission (AOR = 3.689, 95%CI: 1.190, 11.433) significantly increased the risk of malnutrition. The area under the ROC curve (0.754) and the Hosmer-Lemeshow test (p = 0.7564) indicated that the final model reasonably fits the data. The model`s sensitivity is 96.85%. Conclusion In the present study, an alarmingly high prevalence of malnutrition was identified older inpatients. The problem went undiagnosed in a similar percentage of patients. Several available literatures indicate the presence of an association between nutritional status and patient outcomes, thus strict nutritional screening at inpatient admission and intervention are recommended with special emphasis for those from rural areas, with financial dependence, and with functional impairment on admission.
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Affiliation(s)
- Behailu Terefe Tesfaye
- Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Mengist Awoke Yizengaw
- Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tesema Etefa Birhanu
- Human Anatomy Unit, Department of Biomedical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Dula Dessalegn Bosho
- Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
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Ward NA, Reid-McCann R, Brennan L, Cardwell CR, de Groot C, Maggi S, McCaffrey N, McGuinness B, McKinley MC, Noale M, O'Neill RF, Prinelli F, Sergi G, Trevisan C, Volkert D, Woodside JV, McEvoy CT. Effects of PROtein enriched MEDiterranean Diet and EXercise on nutritional status and cognition in adults at risk of undernutrition and cognitive decline: the PROMED-EX Randomised Controlled Trial. BMJ Open 2023; 13:e070689. [PMID: 37880167 PMCID: PMC10603411 DOI: 10.1136/bmjopen-2022-070689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 08/31/2023] [Indexed: 10/27/2023] Open
Abstract
INTRODUCTION Undernutrition leading to unplanned weight loss is common in older age and has been linked to increased dementia risk in later life. Weight loss can precede dementia by a decade or more, providing a unique opportunity for early intervention to correct undernutrition and potentially prevent or delay cognitive impairment. The combined effects of diet and exercise on undernutrition have not yet been evaluated. The objective of this trial is to determine the effect of a protein-enriched Mediterranean diet, with and without exercise, on nutritional status and cognitive performance in older adults at risk of undernutrition and cognitive decline. METHODS One hundred and five participants aged 60 years and over at risk of undernutrition and with subjective cognitive decline will be recruited to participate in a 6-month, single-blind, parallel-group randomised controlled trial. Participants will be block randomised into one of three groups: group 1-PROMED-EX (diet+exercise), group 2-PROMED (diet only) and group 3-standard care (control). The primary outcome is nutritional status measured using the Mini Nutritional Assessment. Secondary outcomes include cognitive function, nutritional intake, body composition, physical function and quality of life. Mechanistic pathways for potential diet and exercise-induced change in nutritional status and cognition will be explored by measuring inflammatory, metabolic, nutritional and metabolomic biomarkers. ETHICS AND DISSEMINATION The study is approved by the UK Office for Research Ethics Committee (ref: 21/NW/0215). Written informed consent will be obtained from participants prior to recruitment. Research results will be disseminated to the public via meetings and media and the scientific community through conference presentations and publication in academic journals. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT05166564).
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Affiliation(s)
- Nicola Ann Ward
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | | - Lorraine Brennan
- School of Agriculture and Food Science, Institute of Food and Health and Conway Institute, University College Dublin, Dublin, Ireland
| | | | - Cpgm de Groot
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Stefania Maggi
- Neuroscience Institute, Aging Branch, National Research Council, Padua, Italy
| | - Noel McCaffrey
- ExWell Medical, Irish Wheelchair Association, Dublin, Ireland
| | | | | | - Marianna Noale
- Neuroscience Institute, Aging Branch, National Research Council, Padua, Italy
| | - Roisin F O'Neill
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Federica Prinelli
- Institute for Biomedical Technologies, Epidemiology Unit, National Research Council, Segrate, Italy
| | - Giuseppe Sergi
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Caterina Trevisan
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Dorothee Volkert
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Nuremberg, Germany
| | - Jayne V Woodside
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Claire T McEvoy
- Centre for Public Health, Queen's University Belfast, Belfast, UK
- Global Brain Health Institute, Trinity College Dublin, Ireland & University of California, San Francisco, California, USA
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Arensberg MB, Gahche J, Clapes R, Kerr KW, Merkel J, Dwyer JT. Research is still limited on nutrition and quality of life among older adults. Front Med (Lausanne) 2023; 10:1225689. [PMID: 37780557 PMCID: PMC10536330 DOI: 10.3389/fmed.2023.1225689] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/25/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Globally, the number of older adults is growing exponentially. Yet, while living longer, people are not necessarily healthier. Nutrition can positively impact healthy aging and quality of life (QoL). Two decades ago, nutrition and diet were rarely viewed as key QoL domains, were not part of QoL screening, and QoL studies frequently used unvalidated tools. It is unclear how the nutrition and QoL research area may have since evolved. Methods A scoping review was conducted in Pubmed of research with community-living older adults (aged ≥65) from developed economies that included 1 of 29 common, valid QoL instruments, nutrition indices, and was published between 1/2000-12/2022. The review followed published methodology guidance and used the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow diagram to document identified studies and record number of included/excluded studies (based on scoping review's pre-specified criteria). Results Of 258 studies identified initially, 37 fully met scoping review inclusion criteria; only 2 were QoL studies, 30 focused on nutrition, 3 on measurement tool validation/testing, and 2 were other study types. Most studies (n = 32) were among populations outside of North America; majority were conducted in Europe (n = 22) where the EuroQol 5 Dimension (Eq5D) was used in >1/2 the studies. Of 5 North American studies, the 36-Item Short Form Survey (SF-36) was most frequently used (n = 4). Myriad nutrition indices described various aspects of eating, dietary intake, and nutrition status, making comparability between studies difficult. Studies included several different nutrition questionnaires; Mini Nutritional Assessment (MNA) (n = 8) or Mini Nutritional Assessment Short Form (MNA-SF) (n = 5) were used most frequently. The most frequent anthropometric measure reported was Body Mass Index (BMI) (n = 28). Nutrition-related biochemical indices were reported infrequently (n = 8). Discussion The paucity of studies over the last two decades suggests research on nutrition and QoL among community-living older adults remains underdeveloped. Valid QoL instruments and nutrition indices are now available. To ensure greater comparability among studies it is important to develop consensus on core indices of QoL and particularly nutrition. Greater agreement on these indices will advance further research to support healthy aging and improve QoL for community-dwelling older adults.
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Affiliation(s)
| | - Jaime Gahche
- Office of Dietary Supplements, National Institutes of Health, Bethesda, MD, United States
| | - Raquel Clapes
- Abbott Nutrition Division of Abbott, Granada University Science Park, Granada, Spain
| | - Kirk W. Kerr
- Abbott Nutrition Division of Abbott, Columbus, OH, United States
| | - Joyce Merkel
- Office of Dietary Supplements, National Institutes of Health, Bethesda, MD, United States
| | - Johanna T. Dwyer
- Office of Dietary Supplements, National Institutes of Health, Bethesda, MD, United States
- School of Medicine and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
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Duran S, Çakar H, Çağlar N, Dağaşan S. The Effects of Nutrition Education on the Handgrip Strength and Nutrition Status of Elderly Patients on Hemodialysis. TOP CLIN NUTR 2023. [DOI: 10.1097/tin.0000000000000312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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Salvesi C, Silvi S, Fiorini D, Alessandroni L, Sagratini G, Palermo FA, De Leone R, Egidi N, Cifani C, Micioni Di Bonaventura MV, Amedei A, Niccolai E, Scocchera F, Mannucci F, Valeriani V, Malavasi M, Servili S, Casula A, Cresci A, Corradetti I, Coman MM, Verdenelli MC. Six-Month Synbio ® Administration Affects Nutritional and Inflammatory Parameters of Older Adults Included in the PROBIOSENIOR Project. Microorganisms 2023; 11:microorganisms11030801. [PMID: 36985374 PMCID: PMC10053431 DOI: 10.3390/microorganisms11030801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/16/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
The physiological changes associated with ageing contribute to the incidence of diseases, morbidity, and mortality. For modern society, it is essential to find solutions to improve elderly people's health and quality of life. Among promising strategies, the PROBIOSENIOR project proposed a daily six-month supplementation with new probiotic functional foods and nutraceuticals. The aim of this work was to evaluate the modulating effects of the probiotic diet on inflammatory markers and nutritional status. Ninety-seven elderly volunteers were randomly assigned to either a placebo-diet group or a probiotic-diet group (SYNBIO®). Faeces, urine, and blood samples were collected before and after the supplementation to determine serum cytokines, biogenic amines, and inflammation markers. Comparing the results obtained before and after the intervention, probiotic supplementations significantly decreased the TNF-α circulating levels and significantly increased those of IGF-1. Biogenic-amine levels showed high variability, with significant variation only for histamine that decreased after the probiotic supplementation. The supplementation influenced the serum concentration of some crucial cytokines (IL-6, IL-8, and MIP-1α) that significantly decreased in the probiotic group. In addition, the Mini Nutritional Assessment questionnaire revealed that the probiotic-supplemented group had a significant improvement in nutritional status. In conclusion, the PROBIOSENIOR project demonstrated how SYNBIO® supplementation may positively influence some nutritional and inflammatory parameters in the elderly.
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Affiliation(s)
- Chiara Salvesi
- Scuola di Bioscienze e Medicina Veterinaria, University of Camerino, 62032 Camerino, Italy
| | - Stefania Silvi
- Scuola di Bioscienze e Medicina Veterinaria, University of Camerino, 62032 Camerino, Italy
| | - Dennis Fiorini
- Scuola di Scienze e Tecnologie, University of Camerino, 62032 Camerino, Italy
| | - Laura Alessandroni
- Scuola di Scienze del Farmaco e dei Prodotti della Salute, University of Camerino, 62032 Camerino, Italy
| | - Gianni Sagratini
- Scuola di Scienze del Farmaco e dei Prodotti della Salute, University of Camerino, 62032 Camerino, Italy
| | | | - Renato De Leone
- Scuola di Scienze e Tecnologie, University of Camerino, 62032 Camerino, Italy
| | - Nadaniela Egidi
- Scuola di Scienze e Tecnologie, University of Camerino, 62032 Camerino, Italy
| | - Carlo Cifani
- Scuola di Scienze del Farmaco e dei Prodotti della Salute, University of Camerino, 62032 Camerino, Italy
| | | | - Amedeo Amedei
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Elena Niccolai
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | | | | | - Valerio Valeriani
- Ambito Territoriale Sociale 16-17-18 Marche Region, 62032 Camerino, Italy
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12
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Shin HR, Kim YS, Park YK, Koo SK, Son WH, Han JW, Son EH, Kang HJ, Choi KH, Han JS, Lee HS, Lim HS. Nutritional Status and Frailty Improvement through Senior-Friendly Diet among Community-Dwelling Older Adults in South Korea. Nutrients 2023; 15:nu15061381. [PMID: 36986111 PMCID: PMC10051771 DOI: 10.3390/nu15061381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 03/15/2023] Open
Abstract
Considering that Korea’s aging population is rapidly increasing, health serves as an indicator of older adults’ quality of life, and dietary life directly affects their health. For health maintenance and improvement, preventive healthcare measures including safe food selection and nutritional supply are needed. This study aimed to evaluate the effect of senior-friendly diet on nutrition and health status improvement in older adults receiving community care. A total of 180 older adults were analyzed, with 154 and 26 in the senior-friendly diet intervention group and the general diet group, respectively. Surveys, blood tests, and frailty evaluations were conducted before and after the study. After 5 months of intervention, the blood status, nutrient intake, and frailty level were evaluated. The participants’ mean age was 82.7 years, and 89.4% of them were living alone. In both groups, energy, protein, vitamin A, vitamin D, vitamin C, calcium, and magnesium intake were insufficient initially but generally improved after the intervention. Especially in the intervention group, energy, protein, vitamin D, vitamin C, and folic acid intake significantly increased. The frailty level also slightly improved, and the malnutrition rate was reduced. Even after the passage of time, the improvement effect size significantly differed between the groups. Therefore, resolving and supporting meals corresponding to the physiological needs of the older adults has a great impact on improving their quality of life, and such special consideration is a reasonable way to respond to a super-aged society.
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Affiliation(s)
- Hye-Ri Shin
- Department of Gerontology, AgeTech-Service Convergence Major, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Republic of Korea; (H.-R.S.); (Y.-S.K.)
| | - Young-Sun Kim
- Department of Gerontology, AgeTech-Service Convergence Major, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Republic of Korea; (H.-R.S.); (Y.-S.K.)
| | - Yoo-Kyung Park
- Department of Medical Nutrition, AgeTech-Service Convergence Major, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Republic of Korea; (Y.-K.P.)
| | - Seul-Ki Koo
- Department of Gerontology, AgeTech-Service Convergence Major, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Republic of Korea; (H.-R.S.); (Y.-S.K.)
| | - Woo-Hyun Son
- Department of Gerontology, AgeTech-Service Convergence Major, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Republic of Korea; (H.-R.S.); (Y.-S.K.)
| | - Jae-Won Han
- Department of Gerontology, AgeTech-Service Convergence Major, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Republic of Korea; (H.-R.S.); (Y.-S.K.)
| | - Eun-Ha Son
- Department of Gerontology, AgeTech-Service Convergence Major, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Republic of Korea; (H.-R.S.); (Y.-S.K.)
| | - Hae-Jin Kang
- Department of Medical Nutrition, AgeTech-Service Convergence Major, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Republic of Korea; (Y.-K.P.)
| | - Kyeong-Hee Choi
- The Food Industry Promotional Agency of Korea, Iksan 54576, Republic of Korea
| | - Jin-Soo Han
- The Food Industry Promotional Agency of Korea, Iksan 54576, Republic of Korea
| | - Hyun-Sun Lee
- The Food Industry Promotional Agency of Korea, Iksan 54576, Republic of Korea
| | - Hee-Sook Lim
- Department of Gerontology, AgeTech-Service Convergence Major, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Republic of Korea; (H.-R.S.); (Y.-S.K.)
- Correspondence: ; Tel.: +82-31-201-2936
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13
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Kananen L, Eriksdotter M, Boström A, Kivipelto M, Annetorp M, Metzner C, Bäck Jerlardtz V, Engström M, Johnson P, Lundberg L, Åkesson E, Sühl Öberg C, Hägg S, Religa D, Jylhävä J, Cederholm T. Body mass index and Mini Nutritional Assessment-Short Form as predictors of in-geriatric hospital mortality in older adults with COVID-19. Clin Nutr 2022; 41:2973-2979. [PMID: 34389208 PMCID: PMC8318666 DOI: 10.1016/j.clnu.2021.07.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/06/2021] [Accepted: 07/20/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND & AIMS Overweight and obesity have been consistently reported to carry an increased risk for poorer outcomes in coronavirus disease 2019 (COVID-19) in adults. Existing reports mainly focus on in-hospital and intensive care unit mortality in patient cohorts usually not representative of the population with the highest mortality, i.e. the very old and frail patients. Accordingly, little is known about the risk patterns related to body mass and nutrition in very old patients. Our aim was to assess the relationship between body mass index (BMI), nutritional status and in-geriatric hospital mortality among geriatric patients treated for COVID-19. As a reference, the analyses were performed also in patients treated for other diagnoses than COVID-19. METHODS We analyzed up to 10,031 geriatric patients with a median age of 83 years of which 1409 (14%) were hospitalized for COVID-19 and 8622 (86%) for other diagnoses in seven geriatric hospitals in the Stockholm region, Sweden during March 2020-January 2021. Data were available in electronic hospital records. The associations between 1) BMI and 2) nutritional status, assessed using the Mini-Nutritional Assessment - Short Form (MNA-SF) scale, and short-term in-geriatric hospital mortality were analyzed using logistic regression. RESULTS After adjusting for age, sex, comorbidity, polypharmacy, frailty and the wave of the pandemic (first vs. second), underweight defined as BMI<18.5 increased the risk of in-hospital mortality in COVID-19 patients (odds ratio [OR] = 2.30; confidence interval [CI] = 1.17-4.31). Overweight and obesity were not associated with in-hospital mortality. Malnutrition; i.e. MNA-SF 0-7 points, increased the risk of in-hospital mortality in patients treated for COVID-19 (OR = 2.03; CI = 1.16-3.68) and other causes (OR = 6.01; CI = 2.73-15.91). CONCLUSIONS Our results indicate that obesity is not a risk factor for very old patients with COVID-19, but emphasize the role of underweight and malnutrition for in-hospital mortality in geriatric patients with COVID-19.
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Affiliation(s)
- L. Kananen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Faculty of Social Sciences (Health Sciences), Gerontology Research Center, Tampere University, Tampere, Finland,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland,Corresponding author. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - M. Eriksdotter
- Division Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden,Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - A.M. Boström
- Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden,Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden,Research and Development Unit, Stockholms Sjukhem, Stockholm, Sweden
| | - M. Kivipelto
- Division Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden,Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden,Research and Development Unit, Stockholms Sjukhem, Stockholm, Sweden
| | - M. Annetorp
- Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - C. Metzner
- Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - V. Bäck Jerlardtz
- Department of Geriatric Medicine, Jakobsbergsgeriatriken, Stockholm, Sweden
| | - M. Engström
- Department of Geriatric Medicine, Sabbatsbergsgeriatriken, Stockholm, Sweden
| | - P. Johnson
- Department of Geriatric Medicine, Capio Geriatrik Nacka AB, Nacka, Sweden
| | - L.G. Lundberg
- Department of Geriatric Medicine, Dalengeriatriken Aleris Närsjukvård AB, Stockholm, Sweden
| | - E. Åkesson
- Research and Development Unit, Stockholms Sjukhem, Stockholm, Sweden
| | - C. Sühl Öberg
- Department of Geriatric Medicine, Handengeriatriken, Aleris Närsjukvård AB, Stockholm, Sweden
| | - S. Hägg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - D. Religa
- Division Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden,Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - J. Jylhävä
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Faculty of Social Sciences (Health Sciences), Gerontology Research Center, Tampere University, Tampere, Finland
| | - T. Cederholm
- Division Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden,Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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14
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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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15
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Dawed A, Mekonnen TC, Genetu M, Tadesse SE, Dewau R, Muche A, Zerga AA, Ayele FY, Gill TK. Comparing the validity of anthropometric measurements in identifying malnutrition status of older age people in Borena district, North Central Ethiopia: a cross_sectional study. BMC Geriatr 2022; 22:776. [PMID: 36192694 PMCID: PMC9528122 DOI: 10.1186/s12877-022-03467-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
Background Malnutrition among older age people is becoming significantly higher in spite of improvements in the health care system. Life expectancy of Ethiopian elders is increasing; but reliable and valid tools for screening and diagnosis of malnutrition in this subgroup are limited. This study aimed to assess the validity of anthropometric measurements: Mid Upper Arm Circumference (MUAC), Body Mass Index (BMI), and Calf Circumference (CC) in detecting malnutrition status of older age people in Ethiopia. Methods A community based cross-sectional study was conducted in Borena District from January to March, 2020. A total of 421 participants aged were systematically included in the study. To test reliability and validity of the measurements,Cronbach’s α coefficient and Pearson’s correlations were used, respectively. The full Mini-Nutritional Assessment (MNA) tool was used to diagnosis malnutrition. Overall accuracy, sensitivity and specificity of BMI, MUAC and CC were estimated using Receiver Operating Characteristic curves. The Youden Index was used to determine the best cut-off point. Results The reliability of BMI, MUAC and CC by Cronbach’s alpha was found 0.847. Significant positive correlations between MNA, BMI(r = 0.56, p < 0.01); MNA, MUAC(r = 0.43, p < 0.01; and MNA, CC(r = 0.52, p < 0.01) revealed. The area under the curve (AUC) of BMI, MUAC and CC were found: 0.98(95% CI, 0.96–0.99, p < 0.001), 0.94(95% CI, 0.89–0.98, p < 0.001) and 0.96(95% CI, 0.94–0.98, p < 0.001) indicating the overall accuracy respectively. The sensitivity and specificity of BMI, MUAC and CC using established cut off points were found: 90%, 96%; 78%, 94% and 84%, 95% respectively. However, using the Youden index the best cut-off point, the sensitivity and specificity of MUAC and CC were 88%, 86%; 92% and 89% respectively and adjusted for age and sex. Conclusions The current study demonstrated that BMI was a reliable and valid method to identify the malnutrition status of older age people. A MUAC value of 19 cm and CC of 30 cm were simple and efficient cut-off points for the determination of malnutrition in the older age people. A future study is needed to validate the validity of BMI, MUAC and CC against biochemical tests as gold standard. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03467-9.
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Affiliation(s)
- Abdu Dawed
- Dessie Comprehensive Specialized Hospital, Dessie, North Eastern, Ethiopia
| | - Tefera Chane Mekonnen
- Human Nutrition and Dietetics Department, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
| | - Muluken Genetu
- Department of Health Service Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Sisay Eshete Tadesse
- Human Nutrition and Dietetics Department, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Reta Dewau
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Amare Muche
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Aregash Abebayehu Zerga
- Human Nutrition and Dietetics Department, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Fanos Yeshanew Ayele
- Human Nutrition and Dietetics Department, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Tiffany K Gill
- Adelaide Medical School, Faculty of Health and Medical Sciences, the University of Adelaide, Adelaide, South Australia, Australia
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16
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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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17
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Nutritional intake and malnutrition in institutionalised and non-institutionalised older adults. Br J Nutr 2022; 128:921-931. [PMID: 34583786 DOI: 10.1017/s0007114521003925] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Malnutrition (synonym: undernutrition) is prevalent among older adults, which may be partly related to changes in dietary intake, but evidence on the link between malnutrition and diet is scarce. The aims of this study were to estimate the association between energy/nutrients intake and malnutrition, and to characterise nutritional inadequacy in institutionalised and non-institutionalised older adults. A national survey was conducted including a Portuguese representative sample of nursing home (NH) residents (n 563) and community-dwellers (n 837) aged ≥ 65 years. Data included socio-demographic characteristics, self-reported health, loneliness feelings, nutritional status (Mini Nutritional Assessment®) and dietary intake (two non-consecutive 24-h recalls). A higher energy intake was associated with lower odds of malnutrition risk (being 'at risk of malnutrition' or 'malnourished') in both settings, but only significant among NH residents after adjusting for confounders (NH: OR = 0·66, 95 % CI 0·50, 0·86; community: OR = 0·64, 95 % CI 0·37, 1·10). The intake of carbohydrates, fat, fibre, vitamin C, Na, K and Mg was inversely associated with malnutrition risk in NH residents, and protein, fat, vitamin B6, folates, Na, K, Ca and Mg intake in community-dwellers. After additional adjustment for total energy, only Na and Mg intake of community-dwellers remained significantly associated. The prevalence of inadequate nutrient intake was generally higher for the malnutrition risk group, which was particularly evident among community-dwellers. The effect of dietary intake on nutritional status seems more dependent on total energy and carbohydrates intake in institutionalised elders, whereas among community-dwellers protein and some micronutrients appear to have a greater impact.
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18
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Tavassoli N, de Souto Barreto P, Berbon C, Mathieu C, de Kerimel J, Lafont C, Takeda C, Carrie I, Piau A, Jouffrey T, Andrieu S, Nourhashemi F, Beard JR, Soto Martin ME, Vellas B. Implementation of the WHO integrated care for older people (ICOPE) programme in clinical practice: a prospective study. THE LANCET. HEALTHY LONGEVITY 2022; 3:e394-e404. [PMID: 36098317 DOI: 10.1016/s2666-7568(22)00097-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/04/2022] [Accepted: 04/06/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The INSPIRE integrated care for older people (ICOPE)-CARE programme is a public health programme implementing the ICOPE health-care pathway in clinical practice. The primary objective of this study was to describe the large-scale implementation and feasibility of the INSPIRE ICOPE-CARE guidelines in clinical practice. The secondary aims were to describe the characteristics of patients who were identified as positive for abnormalities in intrinsic capacity (ie, locomotion, cognition, psychology, vitality, hearing, and vision) during step 1, and to describe the prevalence of these positive screenings. METHODS In this prospective study, we evaluated a real-life population of users of primary care services in the Occitania region (France). Participants who were aged 60 years and older and lived in a community were eligible for inclusion in our study. Individuals aged ≥60 years were screened (step 1) by health-care providers or through self-assessments using digital tools (the ICOPE MONITOR app and the ICOPEBOT conversational robot). Our implementation strategy involved raising awareness among health-care professionals about the WHO ICOPE programme, training professionals in the ICOPE-CARE guidelines, and developing a digital infrastructure (ie, digital tools, a database, and a remote ICOPE monitoring platform). The feasibility of implementing the INSPIRE ICOPE-CARE guidelines was determined by the anticipated inclusion of ≥10 000 participants, and having a follow-up rate of over 50%. FINDINGS Between Jan 1, 2020, and November 18, 2021, 10 903 older people (mean age 76·0, SD 10·5 years; 6627 [60·8%] of whom were women) had a baseline step 1 screening done, and 5185 (70·4%) of 7367 eligible participants had a 6-month follow-up of step 1 screening. 10 285 (94·3%) participants had a positive intrinsic capacity result during screening at baseline. 958 (9·3%) participants were evaluated with step 2 (in-depth assessments). Positive intrinsic capacity was confirmed in 865 (90·3%) participants. Most recommendations in step 3 (care plan) were related to locomotion, vitality, and cognition. INTERPRETATION The high number of participants included in our study, as well as the high rates of follow-up, provides evidence to suggest that the large-scale implementation of ICOPE in clinical practice is feasible. The very high prevalence of positive screening for impaired intrinsic capacity during step 1, as well as the high rates of confirmed deficits in intrinsic capacity during step 2, suggest that the INSPIRE ICOPE-CARE programme is able to target individuals who are at increased risk for functional loss and disability. FUNDING Occitania Regional Health Agency, Region Occitanie and Pyrénées-Méditerranée, European Regional Development Fund, and The Interreg Program V-A Spain-France-Andorra.
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Affiliation(s)
- Neda Tavassoli
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France.
| | - Philipe de Souto Barreto
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France; Maintain Aging Research team, Centre d'Epidémiologie et de Recherche en santé des POPulations, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
| | - Caroline Berbon
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France
| | - Celine Mathieu
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France
| | - Justine de Kerimel
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France
| | - Christine Lafont
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France
| | - Catherine Takeda
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France
| | - Isabelle Carrie
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France
| | - Antoine Piau
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France; Maintain Aging Research team, Centre d'Epidémiologie et de Recherche en santé des POPulations, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
| | - Tania Jouffrey
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France
| | - Sandrine Andrieu
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France; Maintain Aging Research team, Centre d'Epidémiologie et de Recherche en santé des POPulations, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France; Clinical Epidemiology and Public Health Department, Toulouse University Hospital, Toulouse, France
| | - Fatemeh Nourhashemi
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France; Maintain Aging Research team, Centre d'Epidémiologie et de Recherche en santé des POPulations, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
| | - John R Beard
- Australian Research Council Centre of Excellence in Population Ageing Research, University of New South Wales, Sydney, NSW, Australia
| | - Maria Eugenia Soto Martin
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France; Maintain Aging Research team, Centre d'Epidémiologie et de Recherche en santé des POPulations, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
| | - Bruno Vellas
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France; Maintain Aging Research team, Centre d'Epidémiologie et de Recherche en santé des POPulations, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
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Nutritional Assessment of Greek Liver Cirrhosis Patients: Mini Nutritional Assessment Predicts Mortality. Healthcare (Basel) 2022; 10:healthcare10050859. [PMID: 35627995 PMCID: PMC9140559 DOI: 10.3390/healthcare10050859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 02/04/2023] Open
Abstract
Malnutrition is highly prevalent in liver cirrhosis (LC). It increases as the severity of the disease progresses and it is related to poor survival. The objectives of the study were the nutritional assessment of Greek LC patients, using various nutritional assessment and screening tools, and the comparison of their predictive value for mortality. In total, 137 (77 male) consecutive LC patients (median age: 67 years) were assessed with subjective global assessment (SGA) and mini nutritional assessment (MNA) questionnaires, anthropometrics, handgrip strength (HGS) tests, and bioelectric impedance analysis (BIA), in comparison to a control group of 148 healthy people. Disease severity was assessed using the model for end-stage liver disease (MELD) scores. Patients were followed up for a median of 19 months. Survival curves were calculated using the Kaplan–Meier method. In total, 60% and 43% of patients were of adequate nutritional status by SGA and MNA, respectively, which was confirmed by most anthropometric measurements. MNA and SGA scores correlated significantly with anthropometrics and BIA-derived parameters. Besides the MELD score, mid-arm circumference (MAC), triceps skinfold (TSF), BIA’s phase angle (Pha), and MNA predicted mortality in cirrhotic patients. The nutritional assessment demonstrated an unexpectedly high prevalence of well-nourished LC patients. MNA was a strong predictor of mortality.
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20
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Recognising undernutrition in a community hospital: the nursing judgement is insufficient. Eur J Clin Nutr 2022; 76:1611-1614. [PMID: 35444266 PMCID: PMC9019789 DOI: 10.1038/s41430-022-01145-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/03/2022] [Accepted: 04/06/2022] [Indexed: 12/01/2022]
Abstract
Introduction Standardised nutritional screening methods improve the rate of recognising older patients with undernutrition, which is strongly encouraged in hospitals and residential settings. Therefore, our study compared the rates of identifying undernutrition before and after introducing the Mini Nutritional Assessment (MNA®) in a community hospital. Methods This was a single-centre, retrospective, observational before–after study. Participants were subjects aged 65 years or older, admitted to a community hospital from May 2018 to December 2020. The nursing assessment at admission included the MNA® from January 2020. The prevalence of undernutrition gathered by nursing diagnoses from 2018 to 2019 was compared with data obtained using the MNA® in 2020. Then, a confirmatory analysis was conducted to compare the prevalence of undernutrition in 2020 when both nursing diagnoses and the MNA® were used. Results We analysed data of approximately 316 patients (238 before and 78 after introducing the MNA®). Overall, results showed that 47.1% (n = 149) of the patients were undernourished. As observed, the prevalence of undernutrition was 38.6% (n = 92) in 2018–2019 and 73.1% (n = 57) in 2020 (p < 0.001). In 2020, however, 38.5% of patients (n = 30) were identified as undernourished using the MNA® but not using nursing diagnoses. Therefore, the correlation between these two methods was poor (Pearson’s correlation 0.169, p = 0.14). Conclusion Identifying elderly patients with undernutrition significantly increased after introducing the MNA®. Undernutrition is a common condition that should be systematically screened using a validated tool to activate personalised nutritional interventions promptly.
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21
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Das S. Cognitive frailty among community-dwelling rural elderly population of West Bengal in India. Asian J Psychiatr 2022; 70:103025. [PMID: 35189474 DOI: 10.1016/j.ajp.2022.103025] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/06/2022] [Accepted: 02/11/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVES There has been growing interest in the links between physical frailty and cognitive impairment: both can increase the risk of emerging life-threatening health problems and are currently prominent within the global geriatric health agenda. A recent consensus proposes the idea of 'cognitive frailty' defined by the presence of both physical frailty and cognitive impairment in the absence of dementia. Present study is intended to determine the prevalence of cognitive frailty and its associated factors. METHODS Cross-sectional survey was conducted among the rural community-dwelling elderly population of West Bengal, India (n = 510), without diagnosed dementia at baseline. An Interview-based questionnaire was administered to obtain information on sociodemographic, physical and psychosocial characteristics. Study participants were categorized as non-cognitive impairment (NCI) and cognitive impairment (CI) by Bangla Adaptation of Mini-Mental State Exam (BMSE ≤ 25) scale, as non-physical frailty (NPF) and physical frailty (PF) using Modified Fried Frailty Phenotype (FP ≥ 3) scale, as robust (NPF + NCI), pre-cognitive frailty (NPF + CI or PF + NCI) and cognitive frailty (PF + CI). RESULTS The overall prevalence of cognitive frailty was 21.8%. In multinomial regression analysis, final model indicated that increasing age, being woman, out-of-wedlock, poor education and non-working sociodemographic status had significant association with cognitive frailty. Poor nutritional status, low health-related quality of life and depression are also prone among the cognitively frail participants. CONCLUSIONS Present study allows us to understand complementary relationships between sociodemographic, physical, psychosocial characteristics and cognitive frailty. There is a dire need for multidimensional approach for providing appropriate and comprehensive geriatric health care for developing countries like India.
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Affiliation(s)
- Sayani Das
- Biological Anthropology Unit, Indian Statistical Institute, Kolkata, India.
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22
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Advances in knowledge of screening practices and their use in clinical practice to prevent malnutrition. Proc Nutr Soc 2022; 81:41-48. [DOI: 10.1017/s0029665121003670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Malnutrition is common among older adults and is associated with a progressive decline in overall health and increased mortality. With a rapidly ageing population, the detection, prevention and management of malnutrition require urgent attention within health service planning and delivery. Routine screening for malnutrition among older adults in community settings, which addresses aetiological as well as phenotypic factors, is considered an important step for prevention and early intervention. The aim of this review is to summarise current malnutrition screening literature and highlight research that seeks to understand and address community-based approaches to malnutrition screening and management. Key healthcare professionals (HCPs) that encounter community-dwelling older adults include general practitioners (GPs), community-based nurses, community pharmacists and a range of other health and social care professionals including dietitians, physiotherapists, speech and language therapists, and occupational therapists. The key barriers to implementing screening in primary care include lack of knowledge about malnutrition among non-dietetic HCPs, lack of resources allocated to managing malnutrition, lack of access to dietetic services, and poor GP knowledge about oral nutritional supplement prescribing. In addition, older adults have poor insight into the clinical condition and the associated negative health implications. Investment in education among HCPs and public awareness is required, as well as accompanying resources to successfully implement malnutrition screening programmes for community-dwelling older adults.
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23
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Frailty but not sarcopenia nor malnutrition increases the risk of developing COVID-19 in older community-dwelling adults. Aging Clin Exp Res 2022; 34:223-234. [PMID: 34689315 PMCID: PMC8541803 DOI: 10.1007/s40520-021-01991-z] [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: 07/16/2021] [Accepted: 09/25/2021] [Indexed: 12/12/2022]
Abstract
Background The identification of coronavirus disease 2019 (COVID-19) risk factors is requested to implement prevention strategies. Aim To explore the associations between the COVID-19 incidence and malnutrition, sarcopenia, and frailty, identified as potential risk factors in previous cross-sectional studies. Methods Malnutrition, sarcopenia, and frailty were assessed at the last available follow-up from the Sarcopenia and Physical Impairments with Advancing Age (SarcoPhAge) cohort (i.e., the fifth year that ended in 2019) according to the Mini-Nutritional Assessment short-form, the European Working Group on Sarcopenia in Older People (EWGSOP2), and the Fried criteria, respectively. Information regarding the COVID-19 was gathered by phone calls interviews in April 2021 to measure its self-declared incidence. Adjusted Cox regressions and Kaplan–Meier curves were performed. Results The present study included 241 participants [median age 75.6 (73.0–80.6) years, 63.1% women]. Among them, 27 participants (11.2%) developed the non-fatal Covid-19. No significant increased risks of COVID-19 were observed in patients with malnutrition [adjusted HR 1.14 (0.26–5.07)] and sarcopenia [adjusted HR 1.25 (0.35–4.42)]. Nevertheless, the incidence of COVID-19 was significantly higher in frail (44.4%) than in robust participants (8.5%) [Adjusted HR 7.01 (2.69–18.25)], which was confirmed by the Kaplan–Meier curves (p < 0.001). Among the frailty syndrome components, a low physical activity level was the only one significantly associated with an increased risk of COVID-19 [adjusted HR 5.18 (1.37–19.54)]. Conclusion Despite some limitations in the methodology of this study (i.e., limited sample size, COVID-19 incidence self-reported and not assessed systematically using objective measurements) requiring careful consideration, an increased risk to develop COVID-19 was observed in the presence of the frailty syndrome. Further investigations are needed to elaborate on our findings. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-01991-z.
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Lengelé L, Locquet M, Moutschen M, Beaudart C, Kaux JF, Gillain S, Reginster JY, Bruyère O. Frailty but not sarcopenia nor malnutrition increases the risk of developing COVID-19 in older community-dwelling adults. Aging Clin Exp Res 2022. [PMID: 34689315 DOI: 10.1007/s40520-021-01991-z[publishedonlinefirst:2021/10/25]] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND The identification of coronavirus disease 2019 (COVID-19) risk factors is requested to implement prevention strategies. AIM To explore the associations between the COVID-19 incidence and malnutrition, sarcopenia, and frailty, identified as potential risk factors in previous cross-sectional studies. METHODS Malnutrition, sarcopenia, and frailty were assessed at the last available follow-up from the Sarcopenia and Physical Impairments with Advancing Age (SarcoPhAge) cohort (i.e., the fifth year that ended in 2019) according to the Mini-Nutritional Assessment short-form, the European Working Group on Sarcopenia in Older People (EWGSOP2), and the Fried criteria, respectively. Information regarding the COVID-19 was gathered by phone calls interviews in April 2021 to measure its self-declared incidence. Adjusted Cox regressions and Kaplan-Meier curves were performed. RESULTS The present study included 241 participants [median age 75.6 (73.0-80.6) years, 63.1% women]. Among them, 27 participants (11.2%) developed the non-fatal Covid-19. No significant increased risks of COVID-19 were observed in patients with malnutrition [adjusted HR 1.14 (0.26-5.07)] and sarcopenia [adjusted HR 1.25 (0.35-4.42)]. Nevertheless, the incidence of COVID-19 was significantly higher in frail (44.4%) than in robust participants (8.5%) [Adjusted HR 7.01 (2.69-18.25)], which was confirmed by the Kaplan-Meier curves (p < 0.001). Among the frailty syndrome components, a low physical activity level was the only one significantly associated with an increased risk of COVID-19 [adjusted HR 5.18 (1.37-19.54)]. CONCLUSION Despite some limitations in the methodology of this study (i.e., limited sample size, COVID-19 incidence self-reported and not assessed systematically using objective measurements) requiring careful consideration, an increased risk to develop COVID-19 was observed in the presence of the frailty syndrome. Further investigations are needed to elaborate on our findings.
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Affiliation(s)
- Laetitia Lengelé
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium.
| | - Médéa Locquet
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium
| | - Michel Moutschen
- Department of Infectious Diseases and General Internal Medicine, CHU Sart-Tilman, University of Liège, 4000, Liège, Belgium
| | - Charlotte Beaudart
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium
- Physical, Rehabilitation Medicine and Sports Traumatology, SportS2, University Hospital of Liège, 4000, Liège, Belgium
| | - Jean-François Kaux
- Physical, Rehabilitation Medicine and Sports Traumatology, SportS2, University Hospital of Liège, 4000, Liège, Belgium
- Department of Sport Rehabilitation Sciences, University of Liège, 4000, Liège, Belgium
| | - Sophie Gillain
- Geriatrics Department, University Hospital of Liège, Liège, Belgium
| | - Jean-Yves Reginster
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium
- Physical, Rehabilitation Medicine and Sports Traumatology, SportS2, University Hospital of Liège, 4000, Liège, Belgium
- Department of Sport Rehabilitation Sciences, University of Liège, 4000, Liège, Belgium
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Del Brutto OH, Rumbea DA, Mera RM, Recalde BY, Sedler MJ. Social Determinants of Health (Social Risk) and Nutritional Status Among Community-Dwelling Older Adults Living in a Rural Setting: The Atahualpa Project. J Prim Care Community Health 2022; 13:21501319221087866. [PMID: 35352591 PMCID: PMC8972921 DOI: 10.1177/21501319221087866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: Several studies have attempted to clarify the role of social determinants of health (SDH) on nutritional status of older adults, but results are inconsistent due to differences in SDH assessments at different levels of population development. In this study, we assessed this association in community-dwelling older adults living in rural Ecuador. Methods: SDH were measured by the Gijon’s Social-Familial Evaluation Scale (SFES) and nutritional status by the Mini Nutritional Assessment (MNA®). Multivariate logistic regression models were fitted to assess the association between SDH components and nutritional status. Locally weighted scatterplot smoothing (LOWESS) and a generalized linear model were used to evaluate the potential non-linearity of the association between the Gijon’s SFES and MNA® scores. Results: A total of 295 individuals (mean age: 72.1 ± 7.6 years; 58% women) were enrolled. There was an inverse association between the total Gijon’s SFES and nutritional status (OR: 0.75; 95% C.I.: 0.65-0.86; P < .001). Three of five components of the Gijon’s SFES (family situation, social relationships, and support networks) were inversely associated with nutritional status in multivariate logistic regression models. A LOWESS plot, together with a generalized linear model, showed an inverse linear relationship between the continuous Gijon’s SFES and MNA® scores. One standard deviation of increase in the continuous Gijon’s SFES score (2.39 points) decreased the MNA® score by 0.78 points. Conclusion: Study results show a significant inverse association between high social risk and a good nutritional status. Components of the Gijon’s SFES measuring social isolation are responsible for this association.
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Affiliation(s)
- Oscar H Del Brutto
- Universidad Espíritu Santo-Ecuador, Samborondón, Ecuador.,Hospital-Clínica Kennedy, Samborondón, Ecuador
| | | | - Robertino M Mera
- Biostatistics/Epidemiology, Freenome, Inc., South San Francisco, CA, USA
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26
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Burman M, Hörnsten C, Öhlin J, Olofsson B, Nordström P, Gustafson Y. Prevalence of Obesity and Malnutrition in Four Cohorts of Very Old Adults, 2000-2017. J Nutr Health Aging 2022; 26:706-713. [PMID: 35842761 DOI: 10.1007/s12603-022-1820-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Investigate trends in the prevalence of obesity and malnutrition among very old adults (age ≥ 85 years) between 2000 and 2017. DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS A study with data from the Umeå 85+/Gerontological regional database population-based cohort study of very old adults in northern Sweden. Every 5 years from 2000-2002 to 2015-2017, comprehensive assessments of participants were performed during home visits (N=1602). Body mass index (BMI) classified participants as underweight (<18.5 kg/m2), normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obese (≥30.0 kg/m2). Mini Nutritional Assessment (MNA) scores classified participants as malnourished (0 to <17), at risk of malnutrition (17-23.5), and having good nutritional status (24-30). Prevalence and trends were examined using analysis of variance and chi-squared tests, including subgroup analyses of nursing home residents. RESULTS Between 2000-2002 and 2015-2017, the mean BMI increased from 24.8± 4.7 to 26.0± 4.7 kg/m2. The prevalence of obesity and underweight were 13.4% and 7.6%, respectively, in 2000-2002 and 18.3% and 3.0%, respectively, in 2015-2017. The mean MNA score increased between 2000-2002 and 2010-2012 (from 23.2± 4.7 to 24.2± 3.6), and had decreased (to 23.3± 4.2) by 2015-2017. The prevalence of malnutrition was 12.2%, 5.1%, and 8.7% in 2000-2002, 2010-2012, and 2015-2017, respectively. Subgroup analyses revealed similar BMI and MNA score patterns among nursing home residents. CONCLUSIONS Among very old adults, the mean BMI and prevalence of obesity seemed to increase between 2000-2002 and 2015-2017. Meanwhile, the nutritional status (according to MNA scores) seemed to improve between 2000-2002 and 2010-2012, it declined by 2015-2017.
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Affiliation(s)
- M Burman
- Maria Burman, Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, SE-901 87, Umeå, Sweden, E-mail address:
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27
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Thet D, Siritientong T, Sangarlangkarn A, Lwin HMS, Phonphithak S, Apornpong T, Avihingsanon A. Deterioration of Nutritional Status and Its Negative Association with Depression Among Older HIV-Infected Asian Population: A Four-Year Longitudinal Study. AIDS Res Hum Retroviruses 2021; 38:592-600. [PMID: 34541868 DOI: 10.1089/aid.2021.0087] [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: 11/12/2022] Open
Abstract
There is limited evidence about the long-term changes in nutritional status among the elderly people living with human immunodeficiency virus (PLWH). We aimed to investigate the changes in nutritional status and related factors over 4 years in the elderly PLWH. The longitudinal study was conducted prospectively among 250 PLWH, 50 years of age and older, receiving antiretroviral therapy (ART). The Mini Nutritional Assessment (MNA) and Thai Depression Scale (TDS) to assess nutritional status and depression, respectively, were performed at the outpatient clinic both at baseline and 4-year follow-up. Majority were male (60.8%) with median age of 58 years. The median CD4 was 612.5 cells/mm3 and 98% had HIV RNA <50 copies/mL. Median duration of ART was 20 years. Median body mass index was 23.1 kg/m2. The most common ART were rilpivirine (45.2%) and dolutegravir (18.8%). Fifty-one patients (20.4%) deteriorated in nutritional status and mean MNA scores declined (25.8 vs. 24.8, p < .001) at follow-up period. In multivariate analysis, high TDS scores (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.17-1.52), polypharmacy (OR, 1.35; 95% CI, 1.10-1.65), and high-density lipoprotein cholesterol (HDL-C) levels (OR, 1.04; 95% CI, 1.01-1.07) were associated factors of deterioration in nutritional status. In this 4-year longitudinal follow-up, 20% of the aging PLWH have deterioration of nutritional status. High TDS scores (depression), polypharmacy, and high HDL-C were significantly associated with declining nutritional status. Our findings highlight the importance of screening and monitoring nutritional and depression status in routine HIV treatment and care for geriatric HIV-infected population.
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Affiliation(s)
- Daylia Thet
- Department of Food and Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Tippawan Siritientong
- Department of Food and Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Burn and Wound Care, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Aroonsiri Sangarlangkarn
- Division of General Internal Medicine, Temple University Hospital, Philadelphia, Pennsylvania, USA
| | - Hay Mar Su Lwin
- HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | | | | | - Anchalee Avihingsanon
- HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
- Tuberculosis Research Unit, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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28
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Griffin A, McGarry S, Moloney C, Galvin R. Diagnostic accuracy of the Mini Nutritional Assessment – Short Form to identify malnutrition among older adults: protocol for a systematic review and meta-analysis. HRB Open Res 2021. [DOI: 10.12688/hrbopenres.13358.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Malnutrition has many associated physiological and psychological consequences for older adults that can result in reduced quality of life, poor disease outcomes and more frequent and longer hospital stays. Early recognition of malnutrition allows for timely intervention and treatment. There are several screening tools for nutrition risk. The most common one for malnutrition developed and validated for older adults is the short-form of the Mini Nutritional Assessment (MNA-SF). It can be completed in just a few minutes and applied in all health care settings. This systematic review and meta-analysis serves to synthesise the totality of evidence regarding the diagnostic accuracy of the MNA-SF tool compared with the full-form of the Mini Nutritional Assessment (MNA-FF) in older adults for the diagnosis of malnutrition in healthcare settings. Systematic searches of five bibliographical databases will be performed and will include the Pubmed, EMBASE, Cochrane Library, CINAHL and Web of Science to identify all studies that validate the MNA-SF for malnutrition among older adults in healthcare settings. Risk of bias will be assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pre-specified MNA-SF scores will be used to identify patients’ risk of malnutrition. Using data from 2x2 tables, studies will be pooled to generate summary estimates of sensitivity and specificity using a bivariate random effects model. The findings of this systematic review of diagnostic accuracy will provide evidence for healthcare professionals to make informed decisions regarding the optimum use of the MNA-SF as a nutrition risk screening tool to identify malnutrition among older people. Registration details: Prospero registration number CRD42019131847
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Karim KMR, Tasnim T, Shams SD, Zaher MA, Mamun S. Mini Nutritional Assessment and physical function of older people in residential aged care facility, Bangladesh. Nutr Health 2021; 28:443-452. [PMID: 34250851 DOI: 10.1177/02601060211030119] [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: 11/16/2022]
Abstract
BACKGROUND Malnutrition may decrease physical function and exacerbate health conditions and thus have a negative effect on health-related quality of life of older people. AIM The study was aimed at evaluating the extent of malnutrition, physical function and other associated risk factors for the older persons (>65 years) living in the residential aged care facilities in Bangladesh. METHODS A cross-sectional study was performed with a sample of 200 older people in various residential aged care facilities in Dhaka, Bangladesh. Nutritional status was evaluated using the Mini Nutritional Assessment. A structured questionnaire was used to assess the socioeconomic condition, dietary diversity, functional ability and other related risk factors for malnutrition. RESULTS According to the Mini Nutritional Assessment, 33.5% of participants living in residential aged care facilities were malnourished and 52.5% were at risk of malnutrition. Dietary diversity score differs significantly (p<0.001) among malnourished (3.78 ± 0.45), at risk of malnutrition (4.46 ± 0.98) and well-nourished (4.75 ± 1.11) groups. Twenty-five percent of the study participants reported limitations in mobility and 26.5% reported limitations in activities of daily living. Females were more vulnerable in terms of malnutrition and physical function than males. Mini Nutritional Assessment score is significantly correlated (p<0.05) with several risk factors for malnutrition such as body mass index, education level, meal, protein consumption, dietary diversity score, weight loss, reduced food intake, mobility and activities of daily living of the older people. CONCLUSIONS The study reaffirms that a high rate of malnutrition and risk of malnutrition is prevalent among aged care residents, who need special attention and may benefit from individualized nutrition interventions.
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Affiliation(s)
| | - Tasmia Tasnim
- Department of Nutrition and Food Engineering, 130058Daffodil International University, Bangladesh
| | - Sabrin Deeba Shams
- Institute of Nutrition and Food Science, 95324University of Dhaka, Bangladesh
| | | | - Sumaiya Mamun
- Institute of Nutrition and Food Science, 95324University of Dhaka, Bangladesh
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Lengelé L, Bruyère O, Beaudart C, Reginster JY, Locquet M. Malnutrition, assessed by the Global Leadership Initiative on Malnutrition (GLIM) criteria but not by the mini nutritional assessment (MNA), predicts the incidence of sarcopenia over a 5-year in the SarcoPhAge cohort. Aging Clin Exp Res 2021; 33:1507-1517. [PMID: 33991331 DOI: 10.1007/s40520-021-01880-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/03/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND The capacity of malnutrition screening to predict the onset of sarcopenia is unknown. AIM Our first objective is to explore the association between the screening of malnutrition and the incidence of sarcopenia and then, to assess the added value of the diagnosis of malnutrition to predict sarcopenia over a 5-year follow-up. METHODS Malnutrition was screened at baseline according to the MNA short-form (MNA-SF) and long-form (MNA-LF) and was diagnosed by the GLIM definition. Sarcopenia was defined using the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria. Kaplan-Meier analysis and adjusted Cox regression were performed to explore the association between nutritional status and the incidence of sarcopenia. RESULTS A total of 418 participants were analyzed (median age 71.7 years (67.7 - 76.8), 60% women) for our first objective. Among them, 64 (15.3%) became sarcopenic during the follow-up period. In the adjusted model, the incidence of sarcopenia was nonsignificantly associated with the risk of malnutrition for both forms of the MNA (MNA-SF: HR of 1.68 (95% CI 0.95 - 2.99); MNA-LF: HR of 1.67 (95% CI 0.86 - 3.26)). However, among the 337 participants for which a GLIM assessment was possible and in which 46 participants became sarcopenic, malnourished subjects had a higher risk than well-nourished participants of developing sarcopenia after 5 years, with an adjusted HR of 3.19 (95% CI 1.56 - 6.50). CONCLUSION A full diagnosis of malnutrition seems more useful than a simple malnutrition screening to predict the incidence of sarcopenia over 5 years.
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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.
| | - 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
- Department of Sport Rehabilitation Sciences, University of Liège, 4000, Liège, Belgium
- Physical, Rehabilitation Medicine and Sports Traumatology, University Hospital of Liège, SportS2, 4000, Liège, Belgium
| | - 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
| | - 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
- 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
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Fatmah F, Utomo SW, Lestari F. Broccoli-Soybean-Mangrove Food Bar as an Emergency Food for Older People during Natural Disaster. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3686. [PMID: 33916157 PMCID: PMC8037724 DOI: 10.3390/ijerph18073686] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/26/2021] [Accepted: 03/28/2021] [Indexed: 11/17/2022]
Abstract
Older people risk poor nutritional status during natural disasters due to low intakes of energy, carbohydrates, protein, and fat. A food bar is a form of emergency food product that contains carbohydrate and protein, and is practical for disaster situations. The study aimed to investigate the effect of a broccoli-soybean-mangrove food bar on older people's weight following natural disasters. A quasi-experimental pre-post intervention study was designed using 33 subjects at the treatment group of various nutritional status types of older people during two weeks with balanced nutrition education over two weeks. Bivariate analysis with a paired t-test used to test whether weight, macronutrient intakes, and balanced nutrition knowledge were significantly different before and after the study. The study showed broccoli-soybean-mangrove food bar consumption resulted in a significantly increased weight of 0.2 kg, energy (291.9 kcal), protein (6.1 g), carbohydrate (31.1 g), dan fat (15.6 g) intakes. Balanced nutrition education of older people could also substantially increase knowledge of older people regarding nutrition (11.8 points). The proportion of malnourished subjects who gained weight was more remarkable than normal subjects in the first and second weeks of the intervention. However, the proportion of normal nutritional status subjects having increased macronutrients intakes was higher than the malnourished subjects. These findings recommend broccoli-soybean-mangrove food bar consumption to significantly improve weight and macronutrients intakes in older people following a natural disaster. It is necessary to make the broccoli-soybean-mangrove food bar more available, accessible, and affordable to all people in emergencies, mainly for older people.
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Affiliation(s)
- Fatmah Fatmah
- Disaster Management Study Program, School of Environmental Science, Universitas Indonesia, Jakarta 10430, DKI Jakarta Province, Indonesia
| | - Suyud Warno Utomo
- Department of Environmental Health, Faculty of Public Health, Universitas Indonesia, Depok 16424, West Java Province, Indonesia;
| | - Fatma Lestari
- Department of Occupational Health and Safety, Faculty of Public Health, Universitas Indonesia, Depok 16424, West Java Province, Indonesia;
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ANNES MLF, TABAJARA FB, ROSA RDD, MATTIELLO R, ALVES ALS, SCHWANKE CHA. Agreement of body weight of older adults measured on digital chair scale and mechanical platform scale. REV NUTR 2021. [DOI: 10.1590/1678-9865202134e200203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Objective The aim of the study was to evaluate the agreement between the weight of older adults measured on a chair scale and a platform scale. Methods This is a cross-sectional study. We evaluated 131 older adults (?60 years old), walk-in patients, admitted to a university hospital. Weight was measured on a digital chair scale model MS5811 (Charder® brand) and after on a mechanical platform scale (Filizola® brand). For the agreement analysis, the intraclass correlation coefficient and the Bland-Altman plot were used. Results Most of the sample consisted of males individuals (57.3%; n= 75). The average age was 70.47±7.59 years (60-96 years old). Measured by both methods, weight showed normal distribution. The average weight measured was 67.99±14.03 kg on the chair scale and 68.04±14.02 kg on the platform scale. The intraclass correlation coefficient of weight measured by the two methods was 1.00 (IC95%=1.00-1.00; p<0.001). In the Bland-Altman plot, the mean bias for the weight measured on the chair scale and the platform scale was 0.049 (IC95%=-0.011 to 0.110; p=0.1084). Conclusions The agreement between the weight measured on a chair scale and on a platform scale was almost excellent. Thus, the chair scale can be used as an alternative method of measuring weight, especially in the older adults with postural instability, mobility restrictions or immobility syndrome.
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Affiliation(s)
| | | | | | - Rita MATTIELLO
- Pontifícia Universidade Católica do Rio Grande do Sul, Brasil
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