Nutrition and dementia

Reactive oxygen species for therapeutic application: Role of piezoelectric materials

This perspective article emphasizes the significant role of reactive oxygen species (ROS) in in vivo remedial therapy of various diseases and complications, capitalizing on their potential reactivity. Among the various influencers, herein, piezoelectric materials driven ROS generation activity is primarily considered. Intrinsic non-centrosymmetry of piezoelectric materials makes them suitable for distinct dipole formation in the presence of external mechanical stimuli. Such characteristics prompt the positioning of opposite charged carriers to execute associated redox transformations that effectively participate to generate ROS in the aqueous media of the cell cytoplasm, organelles and nucleus. The immense reactivity of piezoelectric material driven ROS is fostered to terminate cellular toxicity or curtail tumor cell growth, due to their higher specificity. This perspective considers the conjugated performance of piezoelectric materials and ultrasound which can remotely generate electrical charges that promote ROS production for therapeutic application. In particular, a substantial synopsis is provided for the remedial activity of numerous piezocatalytic materials in tumor cell apoptosis, antibacterial treatment, dental care and neurological disorders. Subsequently, the report precisely demonstrates the methods involving various spectrophotometric approaches for the analysis of the ROS. Finally, the key challenges of piezoelectric material-based therapy are discussed and systematic future progress is outlined.

Food Skills of People with a Chronic Mental Illness: The Need for Intervention

This study quantified the food skills of people with a mental illness living in hospital-based care and the community using the Functional Needs Assessment — Nutritional Management Program (Dombrowski 1990). There were clear and marked food skills deficits among people living in hospital-based care. There were no significant differences between the food skills of male and female participants. The deficits that were identified may place patients at nutritional risk if they are moved into community accommodation without appropriate support mechanisms for the provision of food. Recommendations are made for intervention through the implementation of food skills training and incidental learning.

Dementia and its relationship with food

This article provides an overview of dementia and how it relates to nutrition. It examines the evidence for food and nutrition preventing, causing and treating dementia. The article highlights how malnutrition can affect the individual with dementia. The remainder of the article provides an in-depth, focused discussion on the difficulties people may experience in the community in relation to food and eating and the impact this has on family caregivers, with recommendations for achieving optimum nutrition.

Relationship between dietary patterns and cognitive function in a community-dwelling population in Japan

The purpose of this study was to clarify the association between dietary patterns and cognitive function in a community-dwelling population in Japan. A total of 388 volunteers (60 years and older) who participated in the Iwaki Health Promotion Project 2011 were recruited. Diet was assessed with a validated, self-administered brief-type diet history questionnaire. Dietary patterns were extracted from 52 predefined food groups by principal component analysis. The Mini-Mental State Examination was also used to measure global cognitive status. Three dietary patterns were identified as follows: "Healthy," "Noodle," and "Alcohol and accompaniment." Compared with the low tertile of the "Alcohol and accompaniment" pattern, only the middle tertile was independently related to an increased risk of poor cognitive function. In conclusions, present study failed to substantiate dose-dependent associations between dietary patterns and the risk of poor cognitive function. Further studies with longitudinal observations are warranted.

Anthropometric Indices and Their Correlates in Cognitively-Intact and Elderly Canadians with Dementia

Les mesures anthropométriques reflètent l'état nutritionnel. Cette recherche a examiné les données provenant de Canadien(ne)s âgé(e)s ayant participé à la première phase de l'Étude sur la santé et le vieillissement au Canada (CSHA-1). Le poids et la taille furent mesurés chez 1 464 personnes vivant dans la communauté et 963 individus en institution. Les sujets institutionnalisés avaient un poids corporel inférieur à ceux vivant en communauté (59,1 ± 13,8 kg. vs. 65,1 ± 14,1 kg.); ils étaient plus petits (160,4 ± 10.1 cm vs. 162,6 ± 10 cm), et leur IMC étaient plus bas (23,3 ± 5,0 vs. 24,6 ± 4,5) (p< .001). Les valeurs anthropométriques furent plus basses chez les femmes, et diminuaient progressivement avec l'âge. Les Québécois avaient une taille plus petite et un poids corporel inférieur à ceux des Canadiens vivant ailleurs. Les mesures anthropométriques ont diminué suivant le diagnostic cognitif, en allant de normal, à «deficit cognitif sans démence» (CIND), à dément; les participants atteints de la démence de type Alzheimer avaient les poids corporels les plus bas. Les facteurs associés au poids corporel étaient différents parmi les participants vivant dans la communauté et en institution.

L-methylfolate in the Therapeutic Management of Major Depressive Disorder

Optimal levels of the bioactive folate are necessary for maintaining proper brain and body functioning. Folate deprivation and impaired folate metabolism are clinically associated with defects in the developing nervous system. Numerous studies implicate a deficiency of bioactive folate with an increased risk of major depressive disorder and other neuropsychiatric disorders. Bioactive forms of folate, particularly L-methylfolate, have been found to augment the therapeutic efficacy of antidepressants in patients with major depressive disorder, who fail to adequately respond to standard therapies. The antidepressant action of L-methylfolate appears to improve treatment outcomes most effectively when administered as an adjuvant to traditional antidepressants. This new understanding of the role of folates in major depressive disorder and other mood disorders offers opportunities to improve treatment outcomes.

The declaration of nutrition, health, and intelligence for the child-to-be

The Declaration of Nutrition, Health, and Intelligence for the Child-to-be is an urgent cry from the unborn child for a life-span of nutrients for physical and mental wellness. It is a proclamation of paramount importance for everyone involved in child development: parents, health professionals, teachers, government agencies, all producers of food--and children, so they may learn how to feed themselves well. The Declaration of Olympia on Nutrition and Fitness, 1996, came from a group pf nutritional scientists and medical doctors to commemorate the Olympic Games' 100th anniversary. They based it on the health principles of Hippocrates: genetics, the age of the individual, the powers of various foods, and exercise. Following today's vast wealth of nutritional research and expressing it with my teaching experience, I have revitalized the Declaration of Olympia by writing from the heart of the little learner and the hope of the child-to-be. The nutrients implicated in healthy reproduction and lifelong health include B vitamins, particularly B1, B6, folate, B1312 antioxidants, particularly vitamins C and E: minerals such as iron, zinc, magnesium, selenium, iodine, and copper; and essential fatty acids, particularly DHA. These nutrients also lower the risk of neural tube defects: autism, dyslexia, Down's syndrome: childhood cancers, obesity, and defective fetal cell membranes associated with maternal diabetes. Our metabolism is hugely influenced also by activity and by affection. Today's foods are often processed beyond the cells' recognition and can result in neurological and physical morbidity and mortality. A diet of unprocessed free-range animals and seafood: legumes, deep-colored vegetables and fruits: nuts, seeds, and whole grains, germ and bran, reinstates nutritional potency.

Nutrition and cognitive impairment in the elderly

As the number of older people is growing rapidly worldwide and the fact that elderly people are also apparently living longer, dementia, the most common cause of cognitive impairment is getting to be a greater public health problem. Nutrition plays a role in the ageing process, but there is still a lack of knowledge about nutrition-related risk factors in cognitive impairment. Research in this area has been intensive during the last decade, and results indicate that subclinical deficiency in essential nutrients (antioxidants such as vitamins C, E and beta-carotene, vitamin B(12), vitamin B(6), folate) and nutrition-related disorders, as hypercholesterolaemia, hypertriacylglycerolaemia, hypertension, and diabetes could be some of the nutrition-related risk factors, which can be present for a long time before cognitive impairment becomes evident. Large-scale clinical trials in high-risk populations are needed to determine whether lowering blood homocysteine levels reduces the risk of cognitive impairment and may delay the clinical onset of dementia and perhaps of Alzheimer's disease. A curative treatment of cognitive impairment, especially Alzheimer's disease, is currently impossible. Actual drug therapy, if started early enough, may slow down the progression of the disease. Longitudinal studies are required in order to establish the possible link of nutrient intake--nutritional status with cognitive impairment, and if it is possible, in fact, to inhibit or delay the onset of dementia.

Treatment of protein-energy malnutrition in chronic nonmalignant disorders

Protein-energy malnutrition (PEM) is common in connection with chronic disease and is associated with increased morbidity and mortality. Because the risk of PEM is related to the degree of illness, the causal connections between malnutrition and a poorer prognosis are complex. It cannot automatically be inferred that nutritional support will improve the clinical course of patients with wasting disorders. We reviewed studies of the treatment of PEM in cases of chronic obstructive pulmonary disease, chronic heart failure, stroke, dementia, rehabilitation after hip fracture, chronic renal failure, rheumatoid arthritis, and multiple disorders in the elderly. Several methodologic problems are associated with nutrition treatment studies in chronically ill patients. These problems include no generally accepted definition of PEM, uncertain patient compliance with supplementation, and a wide range of outcome variables. Avail-able treatment studies indicate that dietary supplements, either alone or in combination with hormonal treatment, may have positive effects when given to patients with manifest PEM or to patients at risk of developing PEM. In chronic obstructive pulmonary disease, nutritional treatment may improve respiratory function. Nutritional therapy of elderly women after hip fractures may speed up the rehabilitation process. When administered to elderly patients with multiple disorders, diet therapy may improve functional capacity. The data regarding nutritional treatment of the conditions mentioned above is still inconclusive. There is still a great need for randomized controlled long-term studies of the effects of defined nutritional intervention programs in chronically ill and frail elderly with a focus on determining clinically relevant outcomes.

Do nutrition indicators predict death in elderly Canadians with cognitive impairment?

This study describes the independent association between nutritional risk and death in older adults diagnosed with cognitive impairment. Canadian Study of Health and Aging participants who completed a clinical exam and were diagnosed with cognitive impairment and had complete data for regression analyses were included (n = 735). Nutritional risk was defined as the presence of at least one abnormal nutrition indicator identified during the clinical exam (history of weight loss, abnormal serum albumin, poor appetite, body mass index < 20). Other covariates believed to influence mortality were modelled with nutritional risk using logistic regression. There were 373 deaths during the five-year follow-up period in this sample. Nutritional risk was found to independently increase the likelihood of death (OR = 1.6, 95% CI 1.1, 2.2) in these older adults suffering from cognitive impairment. Further work is required to determine if interventions can improve nutritional status and quality of life of these older adults.

Factors associated with cognitive impairment among older Italian inpatients. Gruppo Italiano di Farmacovigilanza nell'Anziano (G.I.F.A.)

OBJECTIVE

To examine the association of cognitive impairment with educational, demographic, and nutritional variables in older hospitalized people.

DESIGN

Survey of older patients admitted consecutively to a hospital during two 2-month periods in 1993.

SETTING

Patients admitted for general medical care at 35 hospitals participating in the GIFA study throughout Italy.

PARTICIPANTS

A total of 3628 patients aged 65 or older were studied.

MEASUREMENTS

The Hodkinson Abbreviated Mental Test (HAMT) was used as a screening method to assess the patients' basic cognitive function. Multiple logistic regression was used to examine the association between cognitive impairment and demographic, educational or nutritional variables.

RESULTS

Twenty-nine percent of older inpatients were classified as having cognitive impairment, with similar distribution of HAMT score found in both genders. Educational attainment has a highly significant inverse relationship with cognitive impairment (highest education: OR 0.32; 95% CI 0.20-0.52). Moreover, cognitive impairment decreased with increasing body mass index (3rd tertile: OR 0.69; 95% CI: 0.51-0.93), cholesterol serum level (highest values: OR 0.59; 95% CI 0.37-0.93), circulating lymphocytes (highest values: OR 0.55; 95% CI 0.45-0.69), and serum albumin (highest values: OR 0.60; 95% CI 0.47-0.76), with a gradient of influence for each variable.

CONCLUSIONS

Educational attainment affects cognitive function in older inpatients. The strong association between cognitive impairment and nutritional variables suggests that every effort to improve nutritional status is needed in approaching cognitive impairment in older patients.

Chronic dementia. Challenges in feeding a patient

1. For the SDAT/MID patient, the nurse must determine food preferences and ability to eat, meet nutritional needs, and have a basic understanding of what techniques might assist professional and family caregivers with appropriate feeding techniques. 2. Ensuring adequate nutrition requires a multidisciplinary approach. Nurses must collaborate with dietitians and other health care professionals regarding food selection, feeding techniques, and environmental management that maximize nutritional outcomes. 3. There is a need for continuing research into nutritional needs and dietary interventions for dementia patients in all stages of illness and in all settings.

Influence of smoking on folate intake and blood folate concentrations in a group of elderly Spanish men

OBJECTIVE

To investigate the relationship between smoking habits and folate status in a group of elderly Spanish men.

DESIGN

We studied folate intake, serum and erythrocyte folate concentrations, hematological and biochemical data in 72 elderly males (comparing 24 smokers data with 44 nonsmokers ones).

RESULTS

Percentage deficiencies for folate intake, serum and erythrocyte levels were higher in smokers. Serum folate levels were significantly higher in nonsmokers. Smokers had higher mean corpuscular volume than did nonsmokers.

CONCLUSIONS

Smoking could be harmful to the intake and folate status. For smokers who will not give up the habit, improved dietary intake or a folate supplement is advisable.

Malnutrition in institutionalized elderly: how and why?

OBJECTIVE

To determine the prevalence of undernutrition and overnutrition in long-term care elderly patients and the functional, behavioral, environmental, nutritional, and medical variables associated with this prevalence.

DESIGN

Cross-sectional, observational.

SETTING

Long-term care hospital in Canada.

SUBJECTS

Two hundred elderly patients (n = 166 male), average age 78.5 years.

MEASUREMENTS

Assessment of nutritional status and presence of specific behavioral, medical, environmental, and functional characteristics known to impact on nutritional status. Nutritional status was determined by weight, % weight loss, BMI, skinfolds, arm circumference, area measurements, and % body fat. Multiple regression analyses were performed to identify the factors associated specifically with undernutrition and overnutrition in this population.

RESULTS

Severe undernutrition was present in 18% (n = 36) and severe overnutrition in 10% (n = 20). Mild/moderate undernutrition was present in 27.5% (n = 55) and mild/moderate overnutrition in 18% (n = 36). Overnutrition was positively associated with primary diagnosis and number of medications and negatively associated with poor appetite, number of feeding impairments, protein intake, and mental state. Undernutrition was positively associated with dysphagia, slow eating, low protein intake, poor appetite, presence of a feeding tube, and age and negatively associated with primary diagnosis.

CONCLUSIONS

Undernutrition exists at a level that is high (45.5%) but not unusual for this type of institutional setting. Behavioral, environmental, and disease-related factors greatly influence nutritional status. Undernutrition appears to be affected by nutritional factors more than overnutrition. Efforts should be directed toward influencing some of these factors to decrease undernutrition in the institutionalized elderly.