Nutrition and health status assessment of community-residing elderly in New York City: a pilot study

The Relationship of Food Insecurity to Nutritional Risk in Independent Living Older Adults

Understanding the factors that augment optimal health during aging is critical as the US older adult population is increasing. Most research about food insecurity, nutritional risk, and perceived health among older adults are in urban areas or congregate living facilities. Thus, the purpose of this project was to study the relationships among these factors, plus activities of daily living, in community-dwelling older adults in a medium-sized city. Using a qualitative-quantitative study design, a cross-sectional survey was completed by 167 low-income senior apartment residents. Food insecurity in this group was higher than the national and state rate, yet nutrition assistance programs were underutilized and participants under 75 years were more food insecure than their older counterparts. Food insecure residents were at greater nutritional risk, had poorer self-reported health status, were more likely to be depressed, and had a less independent function, including limitations on the ability to shop for and prepare food. The study area is desirable to retirees due to lower cost of living; however, access to services, such as grocery stores, public transportation, and health care providers is limited. This research indicates the need for increased outreach, nutrition assistance, and support services to ensure healthy aging in these regions.

Effect of seasonal changes on nutritional status and biochemical parameters in Turkish older adults

BACKGROUND/OBJECTIVES

Available data suggest that seasonal changes may influence the nutritional status and overall health of elderly individuals. Therefore, this study was conducted to investigate the effects of seasonal changes and related factors on energy and nutrient intake of older adults.

SUBJECTS/METHODS

Individuals aged 65 years or over were prospectively enrolled in this single-center study (male: 11, female: 20). Data were collected between May 2013 and February 2014 during winter, spring, summer and autumn. Food consumption and biochemical parameters were taken during each season to assess the seasonal nutrition status of the elderly. Upon analysis of biochemical parameters (retinol, vitamin D and vitamin C), an high-performance liquid chromatography device was utilized whereas an Immulite 2000 device was utilized during analysis of serum folic acid and parathyroid hormone.

RESULTS

Fruit, fat, egg and bread consumption varied seasonally in males and females (P < 0.05). During winter, daily energy intake was found to be greater than in other seasons in males (557 kcal) and females (330 kcal) (P < 0.05). Additionally, carbohydrates, vegetable protein, n-3 fatty acid and sodium intake increased in winter, while the n-6/n-3 ratio increased in summer among males (P < 0.05). Dietary fiber and sodium intake in winter, vitamin C, iron and zinc intake in spring, and cholesterol, retinol, vitamin D and niacin intake in autumn were found to be higher in females when compared to other seasons (P < 0.05). Serum parathyroid hormone level was higher in winter, and vitamin D level was higher in autumn in both genders (P < 0.05). In males, blood folic acid level was higher in winter, while vitamin C level was higher in females, and there was no seasonal variation in retinol concentration (P < 0.05).

CONCLUSION

Food consumption and biochemical parameters showed significant seasonal variations in older adults. It is not clear if nutrition plans in older adults will benefit from consideration of seasonal changes in eating habits.

Use of Telephone-Administered Survey for Identifying Nutritional Risk Indicators Among Community-Living Older Adults in Rural Areas

The ability of Elderly Nutrition Programs, especially in rural areas, to address increasing needs for disparate program services is linked to determining which older people are most likely to be at nutritional risk and what constitutes the potential risk. The purpose of this study is to characterize nutritional risk factors in a probability sample of rural elders (n = 152) through telephone interviews using a 67-question modified version of the Nutrition Screening Initiative's Level I and II screens. Participants reported high levels of unintentional weight loss, medication use, multiple health conditions, and depression. This study demonstrates that comprehensive information on general health, eating habits, living environment, and functional status can be collected from rural elders by telephone. Because much of the reported nutritional risk in this sample occurs in residents living in areas not receiving nutrition services, expanded nutritional risk data can be used to anticipate need for programs and services in areas not presently served.

A nutritional status survey of older adults in long-term care in the Yazd province of Iran

It is important to assess the nutritional status of older adults because of its role in ensuring health and quality of life and its association with functional status. The purpose of this study was to evaluate the nutritional status of an older adult population living in long-term care institutions in the Yazd province of Iran. Fifty elderly subjects were randomly selected from each of two long-term care institutions in Yazd. A 3-day food intake survey was conducted using the direct weighing method and anthropometric measurements for calculating body mass index (BMI) were also collected. Of the participants, 54% of women and 41% of men had a BMI less than 19.9 kg/m(2). The mean intakes of energy, protein, vitamins A and C, riboflavin, and niacin as well as the minerals calcium, phosphorus, and iron, were significantly less than Dietary Reference Intakes (DRIs) for both genders. Thiamin intake was more than adequate in both women and men. In our study, the majority of elderly subjects displayed a poor reported nutritional intake according to the DRIs. Our findings support the development of national nutrition plans for older adults living in long-term care institutions as an important necessity.

Older adults in the rural South are not meeting healthful eating guidelines

OBJECTIVE

To evaluate diet quality of rural older adults using national dietary guidelines and the Healthy Eating Index (HEI).

DESIGN

Five to six 24-hour recalls were conducted at monthly intervals over a 6-month period, using the Nutrition Coordinating Center food grouping system to calculate intake.

SUBJECTS

Included in this cross-sectional study were 63 females and 59 males aged 65 to 93 years residing in two rural North Carolina counties; one third of each sex group was African American, Native American, or white. Inclusion criteria included age>65 years, education<or=12 years, and low income.

ANALYSES

HEI scores were computed from the average of the recalls, and compared using one-way analysis of variance. Multiple regression modeling was utilized to evaluate effects of demographic and self-reported health variables on HEI score.

RESULTS

Most study participants did not meet minimum Food Guide Pyramid recommended servings of grains, fruits, vegetables, and dairy. They exceeded recommendations for discretionary calorie servings (median=3.3 and 5.3 for females and males, respectively). Using the HEI, 24% had poor diets, 75% needed improvement, and only 1% had good diets. Of the participants with an eighth-grade education or less, men had a mean HEI score 9.6 units lower than women.

CONCLUSION

These rural adults are not meeting recommended nutrition guidelines, and most are consuming diets considered poor or needing improvement. Health care providers should recognize barriers that put these older adults at risk for poor nutrition and should be prepared to initiate referrals to community resources. Nutrition counseling should include strategies to increase whole grain, fruit, vegetable, and reduced-fat dairy consumption with the ultimate goal of improving dietary intake to prevent declines in functional status and independence associated with aging.

Factors associated with Oklahoma Older Americans Act Nutrition Program participants ability to shop, cook, and feed themselves

Oklahoma Older Americans Act Nutrition Program participants' (n = 859) ability to shop, cook, and feed themselves was evaluated using factor analysis and logistic regression. Congregate participants who reported they were not able to shop, cook, and feed themselves had significantly lower "mobility," "financial management," and "financial security" factor scores; home-delivered participants had significantly lower "mobility," "living arrangement" and "financial security," and higher "social interaction" factor scores. For congregate meal participants the factors "mobility" and "financial management" and for home-delivered meal participants, the factors "mobility" and "social interaction" were significantly associated with reported ability to shop, cook, and feed themselves.

Cognitive function in healthy older European adults: the ZENITH study

OBJECTIVE

Baseline data are reported from a study of the effects of zinc supplementation on cognitive function in older adults as assessed by the CANTAB computerised test battery.

DESIGN

This is a multicentre prospective intervention study employing a randomised double-blind design.

SETTING

European community-based study.

PARTICIPANTS

There are 387 healthy adults aged 55-87 y from centres in France, Italy and Northern Ireland.

INTERVENTIONS

Measures of visual memory, working memory and attention were obtained at baseline (prior to supplementation).

RESULTS

Younger adults (<70 y) performed significantly better than older adults (>70 y) on all tests, with minimal differences between centres. In addition, men outperformed women on tests of spatial span, pattern recognition memory and reaction times, although these gender differences varied somewhat between centres.

CONCLUSIONS

The results are generally consistent with previous age- and gender-related effects on cognitive functioning.

Nutrition Risk and Associated Factors in Congregate Meal Participants in Northern Florida

Nutrition is a key for extending quality of life of the elderly. Factors associated with nutritional risk in elders were identified with a modified nutrition screen initiative checklist. High, moderate and low nutritional risk was seen in 31, 46 and 23%, respectively, of 324 elders in six congregate meal sites in northern Florida. High nutritional risk was associated with urban residency, females, being African American, self-reported poor health and irregular visits to medical/health professionals. African American females living in urban areas with limited access to health care are most vulnerable.

Differences in Preferences of Entrees by Elderly Congregate Meal Participants According to Age, Gender, Ethnicity and Education and a Factor Analysis Approach to Group Entrée Preferences

Congregate meal participants (n = 381), ages 60-100, provided preference ratings of 43 entrees utilizing a modified Food Rating Scale (FACT). Differences in preferences of entrees associated with age, gender, ethnicity and educational level were analyzed using X2 analysis. Factor analysis was used to group entrees which were associated according to preferences. Both males and females agreed with the top five preferred entrees. For other entrees, females had a higher acceptance level. Both age groups preferred the same top five entrees; for other entrees, the younger group was more accepting of these. Few differences were noted among the various ethnic groups (91% white and 7% African-American). Education level of respondents had a varying association with entree preference, depending upon the specific entree.

Nutritional and health consequences are associated with food insecurity among U.S. elderly persons

The purpose of this study was to examine the consequences associated with food insecurity for the nutritional and health status of the elderly in the United STATES: The data analyzed were from the Third National Health and Nutrition Examination Survey (1988-1994) and the Nutrition Survey of the Elderly in New York State (1994). Multiple logistic and linear regression analyses were used to assess the extent to which food-insecure elderly were likely to have lower nutrient intake, skinfold thickness, self-reported health status and higher nutritional risk. Regardless of food insecurity status, older people consumed less than the recommended dietary allowance for eight nutrients. Food-insecure elderly persons had significantly lower intakes of energy, protein, carbohydrate, saturated fat, niacin, riboflavin, vitamins B-6 and B-12, magnesium, iron and zinc, as well as lower skinfold thickness. In addition, food-insecure elderly persons were 2.33 (95% confidence interval: 1.73-3.14) times more likely to report fair/poor health status and had higher nutritional risk. These results indicate that food-insecure elderly persons have poorer dietary intake, nutritional status and health status than do food-secure elderly persons. It is necessary to ensure the nutritional well-being of all elderly persons who are at nutritional and health risk, including those who are food insecure and have even poorer nutritional and health status than those who are food secure.

Understanding needs is important for assessing the impact of food assistance program participation on nutritional and health status in U.S. elderly persons

This study aimed to assess the impact of food assistance programs on nutritional and health status of nutritionally needy elderly persons. Two cross-sectional and one longitudinal data sets were used: Third National Health and Nutrition Examination Survey (1988-94), Nutrition Survey of the Elderly in New York State (1994) and Longitudinal Study of Aging (1984-1990). Multiple logistic and linear regression analyses were used to examine whether food assistance participants among food insecure elderly (i.e., those whose needs for food assistance programs are met) have better nutrient intake, skinfold thickness and self-reported health status and less nutritional risk, hospitalization and mortality than nonparticipants (i.e., those whose needs are unmet) and whether the benefit is larger than that among food secure elderly persons. Across three data sets, food insecure elderly persons had poorer nutritional and health status than food secure elderly persons. Contrary to the hypotheses, among food insecure elderly persons, food assistance participants had similar or poorer nutrient intakes, skinfold thickness, nutritional risk, self-reported health status, hospitalization and mortality than nonparticipants. Food secure participants had similar nutritional and health status as food secure nonparticipants. Lack of information on the dynamic nature and changes in needs with program participation in the three data sets likely did not allow accurate estimation of the impact of food assistance participation. Different study designs, as well as theory and knowledge of needs that clarifies need status and its change within each older individual across an appropriate time interval, are necessary to accurately assess impacts of food assistance programs.