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Yamamoto M, Nozoe M, Ikeji R, Seike H, Yoshida Y, Shomoto K. Anorexia assessment using the Simplified Nutritional Appetite Questionnaire and its association with activities of daily living in patients with stroke. Nutrition 2024; 117:112238. [PMID: 37924625 DOI: 10.1016/j.nut.2023.112238] [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: 04/29/2023] [Revised: 09/12/2023] [Accepted: 09/21/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVE This study aimed to validate the assessment of anorexia in patients with acute stroke using the Simplified Nutritional Appetite Questionnaire. METHODS This cross-sectional observational study assessed appetite using the Simplified Nutritional Appetite Questionnaire in patients with acute stroke at discharge from an acute care hospital. Additionally, the relationship between the Simplified Nutritional Appetite Questionnaire and Mini Nutritional Assessment, Mini Nutritional Assessment - Short Form scores, skeletal muscle mass, muscle strength, and activities of daily living measured using the Functional Independence Measures for the motor domain was investigated. A multiple regression analysis was conducted with the Functional Independence Measure for the motor domain as the dependent variable and the Simplified Nutritional Appetite Questionnaire and other confounding factors as explanatory variables to evaluate the association between the Simplified Nutritional Appetite Questionnaire and functional outcomes. RESULTS Among the 234 patients with stroke analyzed in this study, the median Simplified Nutritional Appetite Questionnaire score was 15 (IQR = 13-16) points. The Simplified Nutritional Appetite Questionnaire score significantly correlated with weight change, Functional Independence Measure for the motor domain, nutritional assessment index, and energy and protein intake. However, no significant differences in body mass index, muscle mass, or muscle strength were observed. In the multiple regression analysis adjusted for confounders, the Simplified Nutritional Appetite Questionnaire score (β = 0.106; P = 0.007) was independently associated with the Functional Independence Measure for the motor domain (adjusted R2 = 0.662). CONCLUSIONS This study's results found a significant correlation between Simplified Nutritional Appetite Questionnaire scores and nutritional status as well as an independent association with functional outcomes in patients with stroke. These findings suggest that the Simplified Nutritional Appetite Questionnaire can be a valuable tool for evaluating anorexia in this patient population.
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Affiliation(s)
- Miho Yamamoto
- Department of Rehabilitation Medicine, Nishiyamato Rehabilitation Hospital, Nara, Japan; Graduate School of Health Sciences, Kio University, Nara, Japan
| | - Masafumi Nozoe
- Department of Physical Therapy, Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan.
| | - Rio Ikeji
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan
| | - Haruka Seike
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan
| | - Yosuke Yoshida
- Department of Rehabilitation, Nara Prefecture Seiwa Medical Center, Sango, Japan
| | - Koji Shomoto
- Graduate School of Health Sciences, Kio University, Nara, Japan
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Qiu Y, Li G, Zheng L, Liu W, Li X, Wang X, Chen L. Relationship Between Cognitive Frailty and Mortality in Older Adults: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2023; 24:1637-1644.e8. [PMID: 37660724 DOI: 10.1016/j.jamda.2023.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE To synthesize the pooled mortality risk estimate and determine whether cognitive frailty is a predictor of mortality. DESIGN A systematic review and meta-analysis. SETTING AND PARTICIPANTS The participants were community-dwelling older adults aged ≥60 years. METHODS PubMed, Web of Science, Embase, CINAHL, and the Cochrane Library databases were systematically searched. Two researchers independently screened potentially eligible literature, evaluated the quality of the included studies, and then extracted the data. We used STATA, version 15.0 to perform the all data. RESULTS Nineteen studies were included. The association between cognitive frailty and a higher risk of death was statistically significant [hazard ratio (HR), 2.01; 95% CI, 1.84-2.19; P < .001]. The outcomes indicated that cognitive frailty was a critical risk factor for predicting mortality (OR, 4.82; 95% CI, 1.59-14.57; P < .01). Based on different models of cognitive frailty, the results of subgroup analyses revealed that the risk of mortality was the highest in the Frail + mild cognitive impairment group (HR, 2.35; 95% CI, 2.05-2.70; P < .001). The subgroup analyses by region demonstrated that mortality risk was lowest in the European group (HR, 1.63; 95% CI, 1.4-1.87; P < .001). CONCLUSIONS AND IMPLICATIONS This study quantitatively portrays the pooled mortality risk estimate of cognitive frailty. The results suggest that in older adults, cognitive frailty can be a predictor of mortality. The findings could alert health care providers to pay more attention to cognitive frailty.
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Affiliation(s)
- Yiming Qiu
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Guichen Li
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Lufang Zheng
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Wei Liu
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Xin Li
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Xinxin Wang
- The First Hospital of Jilin University, Changchun, Jilin, China.
| | - Li Chen
- School of Nursing, Jilin University, Changchun, Jilin, China; Department of Pharmacology, College of Basic Medical Sciences, Jilin University, Changchun, Jilin, China.
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Lysophospholipids and branched chain amino acids are associated with aging: a metabolomics-based study of Chinese adults. Eur J Med Res 2023; 28:58. [PMID: 36732870 PMCID: PMC9893616 DOI: 10.1186/s40001-023-01021-w] [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: 10/21/2022] [Accepted: 01/17/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Aging is an inevitable process associated with impairments in multiple organ systems, which increases the risk of comorbidity and disability, and reduces the health-span. Metabolomics is a powerful tool in aging research, which can reflect the characteristics of aging at the level of terminal metabolism, and may contribute to the exploration of aging mechanisms and the formulation of anti-aging strategies. METHODS To identify possible biomarkers and pathways associated with aging using untargeted metabolomics methods, we performed liquid chromatography-mass spectrometry (LC-MS)-based untargeted metabolomics profiling on serum samples from 32 older adults and 32 sex-matched young controls. RESULTS Metabolite profiling could distinguish the two groups. Among the 349 metabolites identified, 80-including lysophospholipids whose levels gradually decline-are possible candidate aging biomarkers. Valine, leucine and isoleucine degradation and biosynthesis were important pathways in aging, with reduced levels of L-isoleucine (r = - 0.30, p = 0.017) and L-leucine (r = - 0.32, p = 0.010) observed in older adults. CONCLUSIONS We preliminarily revealed the metabolite changes associated with aging in Chinese adults. Decreases in mitochondrial membrane-related lysophospholipids and dysfunction of branched-chain amino acid metabolism were determined to be the characteristics and promising research targets for aging.
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Thomsen TK, Pedersen JL, Sloth B, Damsgaard EM, Rud CL, Hvas CL. Nutritional risk screening in a Danish university hospital is insufficient and may underestimate nutritional risk: A cross-sectional study. J Hum Nutr Diet 2023; 36:108-115. [PMID: 35509207 PMCID: PMC10084170 DOI: 10.1111/jhn.13025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 04/15/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Disease-related-malnutrition predicts poor clinical outcomes in elderly patients, and screening is pivotal for identifying patients at nutritional risk. The present study aimed to investigate nutrition screening rates in electronic patient records and validate the scores given. A secondary aim was to investigate whether the proportion of patients at risk differed between patients where screening was documented and those where no screening was documented. METHODS This cross-sectional observational study was conducted in a Danish university hospital during November 2020. Patients aged 65 years or more admitted to a medical department were included. The Nutrition Risk Screening 2002 (NRS-2002) tool was used to identify patients at nutritional risk, both in routine clinical care, where data were collected retrospectively, and during a validation process in a random patient sample, where data were collected prospectively. RESULTS In total, 817 patients were admitted for more than 24 h. Of these, an NRS-2002 score was documented in 294 (36%), among whom 177 (60%) were at nutritional risk. In 146 patients where no score was documented, 88 (60%) were at risk. Validation was possible in 91 patients where a record-based score and a validated score were documented. The specificity of the record-based score was 100%, whereas the sensitivity was 75%, indicating that routine screening underestimated nutritional risk (p < 0.001, proportion difference 19%; 95% confidence interval = 10%-28%). CONCLUSIONS Electronic documentation does not solve issues about compliance with nutritional risk screening. In patients where screening was not documented, the occurrence of nutritional risk was similar, indicating that omission of screening is not related to the score.
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Affiliation(s)
| | | | - Bente Sloth
- Department of Nutrition, Aarhus University Hospital, Aarhus N, Denmark
| | | | - Charlotte Lock Rud
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus N, Denmark
| | - Christian Lodberg Hvas
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus N, Denmark
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Tuo J, Deng R, Tao M, Xu Z, Peng Y, Linghu Y, Huang S, Yu C. Cultural factors and senior tourism: Evidence from the Chinese context. Front Psychol 2022; 13:1030059. [PMID: 36507043 PMCID: PMC9731214 DOI: 10.3389/fpsyg.2022.1030059] [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: 08/28/2022] [Accepted: 10/10/2022] [Indexed: 11/25/2022] Open
Abstract
Recently, numerous studies have focused on tourism among the older population. Of them, most reported on status analysis, tourism motivation, and tourism model, to name a few; however, there was a lack of comprehensive synthesis and analysis of the motivation, influencing factors, policy impact, and other factors of older tourism. Thus, this study conducted various keyword searches among both English and Chinese publications. We found that older population's tourism is affected by various factors, such as travel expense, physical condition, the length and distance of a trip, and cultural influence. The results provide a reference for the development and implementation of tourism among the older population.
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Affiliation(s)
- Jinmei Tuo
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, China,Department of Neurology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Renli Deng
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Ming Tao
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Zucai Xu
- Department of Neurology, Affiliated Hospital of Zunyi Medical University, Zunyi, China,The Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University, Zunyi, China
| | - Yan Peng
- Department of Neurology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yushuang Linghu
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Shiming Huang
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, China,*Correspondence: Shiming Huang,
| | - Changyin Yu
- Department of Neurology, Affiliated Hospital of Zunyi Medical University, Zunyi, China,The Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University, Zunyi, China,Changyin Yu,
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Medici F, Rizzo S, Buwenge M, Arcelli A, Ferioli M, Macchia G, Deodato F, Cilla S, De Iaco P, Perrone AM, Strolin S, Strigari L, Ravegnini G, Bazzocchi A, Morganti AG. Everything You Always Wanted to Know about Sarcopenia but Were Afraid to Ask: A Quick Guide for Radiation Oncologists (Impact of Sarcopenia in Radiotherapy: The AFRAID Project). Curr Oncol 2022; 29:8513-8528. [PMID: 36354731 PMCID: PMC9689889 DOI: 10.3390/curroncol29110671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/21/2022] [Accepted: 11/05/2022] [Indexed: 11/10/2022] Open
Abstract
Sarcopenia (SP) is a syndrome characterized by age-associated loss of skeletal muscle mass and function. SP worsens both acute and late radiation-induced toxicity, prognosis, and quality of life. Myosteatosis is a pathological infiltration of muscle tissue by adipose tissue which often precedes SP and has a proven correlation with prognosis in cancer patients. Sarcopenic obesity is considered a "hidden form" of SP (due to large fat mass) and is independently related to higher mortality and worse complications after surgery and systemic treatments with worse prognostic impact compared to SP alone. The evaluation of SP is commonly based on CT images at the level of the middle of the third lumbar vertebra. On this scan, all muscle structures are contoured and then the outlined surface area is calculated. Several studies reported a negative impact of SP on overall survival in patients undergoing RT for tumors of the head and neck, esophagus, rectum, pancreas, cervix, and lung. Furthermore, several appetite-reducing side effects of RT, along with more complex radiation-induced mechanisms, can lead to SP through, but not limited to, reduced nutrition. In particular, in pediatric patients, total body irradiation was associated with the onset of SP and other changes in body composition leading to an increased risk of cardiometabolic morbidity in surviving adults. Finally, some preliminary studies showed the possibility of effectively treating SP and preventing the worsening of SP during RT. Future studies should be able to provide information on how to prevent and manage SP before, during, or after RT, in both adult and pediatric patients.
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Affiliation(s)
- Federica Medici
- Department of Experimental, Radiation Oncology, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum University of Bologna, Via Albertoni 15, 40138 Bologna, Italy
- Correspondence: ; Tel.: +39-051-214-3564
| | - Stefania Rizzo
- Service of Radiology, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), 6900 Lugano, Switzerland
| | - Milly Buwenge
- Department of Experimental, Radiation Oncology, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum University of Bologna, Via Albertoni 15, 40138 Bologna, Italy
| | - Alessandra Arcelli
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Martina Ferioli
- Department of Experimental, Radiation Oncology, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum University of Bologna, Via Albertoni 15, 40138 Bologna, Italy
| | - Gabriella Macchia
- Radiation Oncology Unit, Gemelli Molise Hospital-Università Cattolica del Sacro Cuore, 86100 Campobasso, Italy
| | - Francesco Deodato
- Radiation Oncology Unit, Gemelli Molise Hospital-Università Cattolica del Sacro Cuore, 86100 Campobasso, Italy
| | - Savino Cilla
- Medical Physics Unit, Gemelli Molise Hospital-Università Cattolica del Sacro Cuore, 86100 Campobasso, Italy
| | - Pierandrea De Iaco
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy
| | - Anna Myriam Perrone
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy
| | - Silvia Strolin
- Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Lidia Strigari
- Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Gloria Ravegnini
- Department of Pharmacy and Biotechnology, University of Bologna, 40126 Bologna, Italy
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Alessio G. Morganti
- Department of Experimental, Radiation Oncology, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum University of Bologna, Via Albertoni 15, 40138 Bologna, Italy
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
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Middleton G, Patterson KA, Muir-Cochrane E, Velardo S, McCorry F, Coveney J. The Health and Well-being Impacts of Community Shared Meal Programs for Older Populations: A Scoping Review. Innov Aging 2022; 6:igac068. [PMID: 36588625 PMCID: PMC9795837 DOI: 10.1093/geroni/igac068] [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: 08/09/2022] [Indexed: 12/29/2022] Open
Abstract
Background and Objectives There are social and economic benefits to supporting individuals to live independently for as long as possible. Structured shared meal programs provide opportunities for older individuals to connect in their communities and likely impact their health and well-being. Research in this area has not been summarized in recent years. This scoping review was undertaken to explore the impact shared meal programs may have for older community-dwelling adults. Research Design and Methods Nine databases were systematically searched in 2020, and 5,996 unique studies were identified. Two independent reviewers screened titles, abstracts, and full text for inclusion. Reference lists of included papers were hand searched, and the search was updated in 2021. Eighteen studies were included in the final review. Results Studies were published between 1980 and 2021 and most were published in the United States. Most studies were cross-sectional, two adopted a qualitative design, one a cohort design. Significant associations were reported between shared meal programs and improved dietary intake; however, minimal improvements were reported for physical health measures. The programs had a positive impact on attendees' social networks and perceived well-being. Discussion and Implications Structured shared meal programs show promise in supporting the health and well-being of older adults in the community. They provide additional nutrition, opportunities for social connection, and are perceived to contribute to perceived well-being. More investigation is required to understand how these programs work to facilitate health and well-being, and how they can best be used to improve health outcomes for older populations.
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Affiliation(s)
- Georgia Middleton
- Address correspondence to: Georgia Middleton, BNutDiet (Hons), PhD, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Campus, GPO Box 2100, Adelaide, SA 5001, Australia. E-mail:
| | - Karen A Patterson
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Eimear Muir-Cochrane
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Stefania Velardo
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Fidelma McCorry
- Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - John Coveney
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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Leucine Supplementation in Middle-Aged Male Mice Improved Aging-Induced Vascular Remodeling and Dysfunction via Activating the Sirt1-Foxo1 Axis. Nutrients 2022; 14:nu14183856. [PMID: 36145233 PMCID: PMC9505861 DOI: 10.3390/nu14183856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/14/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022] Open
Abstract
Vascular aging is associated with metabolic remodeling, and most studies focused on fatty acid and glucose metabolism. Based on our metabolomic data, leucine was significantly reduced in the aortas of aged mice. Whether leucine supplementation can reverse aging-induced vascular remodeling remains unknown. To investigate the effectiveness of leucine, male mice at 15 or 18 months were supplemented with leucine (1.5%) for 3 months. All the aged mice, with or without leucine, were sacrificed at 21 months. Blood pressure and vascular relaxation were measured. H&E, Masson’s trichrome, and Elastica van Gieson staining were used to assess aortic morphology. Vascular inflammation, reactive oxidative stress (ROS), and vascular smooth muscle cell (VSMC) phenotype were also measured in mouse aortas. Compared with the 21-month-old mice without leucine, leucine supplementation from 15 months significantly improved vascular relaxation, maintained the contractile phenotype of VSMCs, and repressed vascular inflammation and ROS levels. These benefits were not observed in the mice supplemented with leucine starting from 18 months, which was likely due to the reduction in leucine transporters Slc3a2 or Slc7a5 at 18 months. Furthermore, we found benefits from leucine via activating the Sirt1-induced Foxo1 deacetylation. Our findings indicated that leucine supplementation in middle-aged mice improved aging-induced vascular remodeling and dysfunction.
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Zukeran MS, Valentini Neto J, Romanini CV, Mingardi SVB, Cipolli GC, Aprahamian I, Lima Ribeiro SM. The association between appetite loss, frailty, and psychosocial factors in community-dwelling older adults adults. Clin Nutr ESPEN 2022; 47:194-198. [DOI: 10.1016/j.clnesp.2021.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 10/15/2021] [Accepted: 12/18/2021] [Indexed: 02/08/2023]
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Yu Z, Ling L. Determinants of nutritional status and outcome in adults with RCSE: a retrospective cohort study. BMC Neurol 2021; 21:344. [PMID: 34496796 PMCID: PMC8424937 DOI: 10.1186/s12883-021-02373-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 08/30/2021] [Indexed: 02/08/2023] Open
Abstract
Background This study aimed to investigate the association between nutritional characteristics in patients with refractory convulsive status epilepticus. Methods We retrospectively enrolled 73 patients with refractory convulsive status epilepticus over 18 years of age at the West China Hospital between January 2017 and May 2019. All patients met the 2016 International League Against Epilepsy diagnostic criteria for refractory convulsive status epilepticus. A logistic regression model was used to evaluate the association between malnutrition and refractory convulsive status epilepticus. Results Of the 73 patients with refractory convulsive status epilepticus, 33 (45.21 %) suffered from malnutrition during hospitalization, and duration of hospitalization in days (OR = 1.251; 95 % CI,–1.067–1.384; P = 0.007), nasal feeding (OR = 22.623; 95 % CI: 1.091-286.899; P = 0.013), and malnutrition on admission (OR = 30.760; 95 % CI: 1.064–89.797; P = 0.046) were significantly associated with malnutrition in patients with refractory convulsive status epilepticus. Conclusions Malnutrition is a common complication during hospitalization in patients with refractory convulsive status epilepticus. The duration of hospitalization (days), nasal feeding, and malnutrition at admission are associated with malnutrition in patients with refractory convulsive status epilepticus. Further longitudinal studies are needed to identify the relationship between refractory convulsive status epilepticus and adverse outcomes.
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Affiliation(s)
- Zhang Yu
- Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane 37 #, 610041, Chengdu, Sichuan, China.,Department of Neurology, Chengdu Shangjin Nanfu Hospital, Shang Jin Road 253#, 610000, Chengdu, Sichuan, China
| | - Liu Ling
- Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane 37 #, 610041, Chengdu, Sichuan, China.
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Olofsson JK. Olfaction and Aging: A Review of the Current State of Research and Future Directions. Iperception 2021; 12:20416695211020331. [PMID: 34249327 PMCID: PMC8239976 DOI: 10.1177/20416695211020331] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 04/21/2021] [Indexed: 11/16/2022] Open
Abstract
Olfaction, the sense of smell, is characterized by a notable age-dependency such that aging individuals are more likely to have poor olfactory abilities. These impairments are considered to be mostly irreversible and as having potentially profound effects on quality of life and food behavior, as well as constituting warning signs of mortality, cognitive dysfunction, and dementia. Here, we review the current state of research on aging and olfaction, focusing on five topics which we regard to be of particular relevance for the field: nutrition and health, cognition and dementia, mortality, environment and genetics, and training-based enhancement. Under each of these headlines, we provide a state-of-the-art overview and discuss gaps in our knowledge which might be filled by further research. Understanding how olfactory abilities are diminished in aging, and how they may be alleviated or recovered, involves a set of challenging tasks for researchers in the years to come.
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Affiliation(s)
- Jonas K. Olofsson
- Gösta Ekman Laboratory, Stockholm University, Stockholm, Sweden; Department of Psychology, Stockholm University, Stockholm, Sweden
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12
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Toriumi S, Kabutoya T, Hoshide S, Kario K. Different age-related impacts of lean and obesity on cardiovascular prognosis in Japanese patients with cardiovascular risks: The J-HOP (Japan Morning Surge-Home Blood Pressure) Study. J Clin Hypertens (Greenwich) 2021; 23:382-388. [PMID: 33389806 PMCID: PMC8029821 DOI: 10.1111/jch.14161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/07/2020] [Accepted: 12/17/2020] [Indexed: 11/28/2022]
Abstract
The relationship between lean and cardiovascular events has been shown to vary with age, but the relationship between age‐related lean and cardiovascular events in Asia has not been established. We divided patients enrolled in the J‐HOP (Japan Morning Surge‐Home Blood Pressure) study with one or more cardiovascular disease risks into three groups based on their body mass index (BMI): lean (BMI < 21), normal‐weight (21 ≤ BMI <27), and obese (BMI ≥ 27). We stratified the risk of cardiovascular events of lean and obesity compared to normal weight into the patients < 65 years old and those aged ≥ 65 years. A total of 286 cardiovascular disease events were observed during the follow‐up period (73 ± 46 months). Regarding the relationship between BMI and cardiovascular disease risk, both lean and obesity were independent prognostic factors: lean: hazard ratio (HR) 1.43, 95% confidence interval (CI): 1.02‐2.01, p = .040; obesity: HR 1.55, 95%CI: 1.13‐2.12, p = .006. In patients < 65 years old, the risk of cardiovascular disease of the lean patients was lower than that of the normal‐weight patients (HR 0.39, 95%CI: 0.12‐1.29, p = .124) and the risk of obesity patients was significantly higher (HR 1.77, 95%CI: 1.08‐2.92, p = .024). In the patients aged ≥ 65 years, lean was a significant independent factor of cardiovascular events compared to normal‐weight (lean: HR 1.70, 95%CI: 1.18‐2.47, p = .005). In conclusion, lean was an independent predictor of cardiovascular events in patients aged ≥ 65 years.
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Affiliation(s)
- Shinichi Toriumi
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
| | - Tomoyuki Kabutoya
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
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Prevalence of and Factors Associated With Sarcopenia Among Older Adults With Knee Osteoarthritis. TOPICS IN GERIATRIC REHABILITATION 2021. [DOI: 10.1097/tgr.0000000000000301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Le Couteur DG, Solon-Biet SM, Cogger VC, Ribeiro R, de Cabo R, Raubenheimer D, Cooney GJ, Simpson SJ. Branched chain amino acids, aging and age-related health. Ageing Res Rev 2020; 64:101198. [PMID: 33132154 DOI: 10.1016/j.arr.2020.101198] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/04/2020] [Accepted: 10/16/2020] [Indexed: 02/08/2023]
Abstract
Branched chain amino acids (BCAA: leucine, valine, isoleucine) have key physiological roles in the regulation of protein synthesis, metabolism, food intake and aging. Many studies report apparently inconsistent conclusions about the relationships between blood levels of BCAAs or dietary manipulation of BCAAs with age-related changes in body composition, sarcopenia, obesity, insulin and glucose metabolism, and aging biology itself. These divergent results can be resolved by consideration of the role of BCAAs as signalling molecules and the bidirectional mechanistic relationship between BCAAs and some aging phenotypes. The effects of BCAAs are also influenced by the background nutritional composition such as macronutrient ratios and imbalance with other amino acids. Understanding the interaction between BCAAs and other components of the diet may provide new opportunities for influencing age-related outcomes through manipulation of dietary BCAAs together with titration of macronutrient ratios and other amino acids.
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15
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Low E, Kellett J, Bacon R, Naumovski N. Food Habits of Older Australians Living Alone in the Australian Capital Territory. Geriatrics (Basel) 2020; 5:geriatrics5030055. [PMID: 32962146 PMCID: PMC7555807 DOI: 10.3390/geriatrics5030055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/11/2020] [Accepted: 09/15/2020] [Indexed: 12/05/2022] Open
Abstract
The link between adequate nutrition and quality of life for older persons is well established. With the proportion of older adults increasing, policy regarding support and care for the ageing has shifted emphasis to keeping older adults in their homes for as long as possible. Risk of malnutrition is an issue of importance for this population and, while this risk is well researched within the hospital setting, it is still relatively under-researched within the community-dwelling elderly, particularly with respect to the lived experience. This qualitative study (underpinned by interpretative phenomenology philosophy) explores how the lived experiences of community-dwelling older people living in one-person households in the Australian Capital Territory (ACT) influences dietary patterns, food choices and perceptions about food availability. Using purposeful and snowballing sampling, older people (65 years and over) living alone in the community participated in focus group discussions triangulated with their family/carers. Data were thematically analysed using a previously established approach. Participants (n = 22) were interviewed in three focus groups. Three themes were identified: active and meaningful community connectedness; eating well and behaviours to promote dietary resilience. Of these, community connectedness was pivotal in driving food patterns and choices and was a central component influencing behaviours to eating well and maintaining dietary resilience.
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Affiliation(s)
- Elizabeth Low
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Bruce ACT 2617, Australia; (J.K.); (R.B.); (N.N.)
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce ACT 2617, Australia
- Correspondence:
| | - Jane Kellett
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Bruce ACT 2617, Australia; (J.K.); (R.B.); (N.N.)
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce ACT 2617, Australia
| | - Rachel Bacon
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Bruce ACT 2617, Australia; (J.K.); (R.B.); (N.N.)
| | - Nenad Naumovski
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Bruce ACT 2617, Australia; (J.K.); (R.B.); (N.N.)
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce ACT 2617, Australia
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17676 Athens, Greece
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16
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Evaluation of pressure ulcer risk in hospitalized patients after metabolic surgery. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.799157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Αntoniadou M, Varzakas T. Breaking the vicious circle of diet, malnutrition and oral health for the independent elderly. Crit Rev Food Sci Nutr 2020; 61:3233-3255. [PMID: 32686465 DOI: 10.1080/10408398.2020.1793729] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Aging impairs senses, mastication, oral status and function, causing nutritional needs and diet insufficiencies. The present needs of independent older adults suggest that health research and oral health care should shift from reductionist disease management to integral and personal treatment plans, including lifestyle, psychological, nutritional and oral health coaching approaches. Dentists and other medical professionals that work in the field of gerodontology should be educated on the macro and micronutrient needs of the elderly and incorporate certain nutritional plans early in the life of their patients with their approval and cooperation, in order to postpone tooth loss and masticatory impairment. Old recipes such as the Mediterranean diet should be kept as a base for all the elderly and be enriched in a customized interpersonal way from the dentist as well as the medical professional according to the specific needs of one's oral and general health status. In this nonsystematic review paper, the basic aspects of the vicious cycle of nutrition and oral health status are discussed and suggestions of major nutrients' influence and needs for independent elders are reported. Based on the scientific data collected, suggestions are made for the food industry for better quality and dosage of foods for this category of individuals. Such strategies can be a whole new area of interest for the food industry in order to obtain better quality of food packaging for the independent OA with accepted texture, odor, colors, macronutrients and micronutrients' consistency and in specific portions.
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Affiliation(s)
- Maria Αntoniadou
- Dental School, National and Kapodistrian University of Athens, Greece
| | - Theodoros Varzakas
- Dept. Food Science and Technology, University of the Peloponnese, Kalamata, Greece
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18
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Pedersen JL, Pederen PU, Damsgaard EM. Patient-Reported Fatigue Is Associated with Poor Energy Intake and Readmission to Hospital. Health (London) 2020. [DOI: 10.4236/health.2020.123021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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19
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Malnutrition and related risk factors in older adults from different health-care settings: an enable study. Public Health Nutr 2019; 23:446-456. [PMID: 31453792 PMCID: PMC7025158 DOI: 10.1017/s1368980019002271] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Objective: The origin of malnutrition in older age is multifactorial and risk factors may vary according to health and living situation. The present study aimed to identify setting-specific risk profiles of malnutrition in older adults and to investigate the association of the number of individual risk factors with malnutrition. Design: Data of four cross-sectional studies were harmonized and uniformly analysed. Malnutrition was defined as BMI < 20 kg/m2 and/or weight loss of >3 kg in the previous 3–6 months. Associations between factors of six domains (demographics, health, mental function, physical function, dietary intake-related problems, dietary behaviour), the number of individual risk factors and malnutrition were analysed using logistic regression. Setting: Community (CD), geriatric day hospital (GDH), home care (HC), nursing home (NH). Participants: CD older adults (n 1073), GDH patients (n 180), HC receivers (n 335) and NH residents (n 197), all ≥65 years. Results: Malnutrition prevalence was lower in CD (11 %) than in the other settings (16–19 %). In the CD sample, poor appetite, difficulties with eating, respiratory and gastrointestinal diseases were associated with malnutrition; in GDH patients, poor appetite and respiratory diseases; in HC receivers, younger age, poor appetite and nausea; and in NH residents, older age and mobility limitations. In all settings the likelihood of malnutrition increased with the number of potential individual risk factors. Conclusions: The study indicates a varying relevance of certain risk factors of malnutrition in different settings. However, the relationship of the number of individual risk factors with malnutrition in all settings implies comprehensive approaches to identify persons at risk of malnutrition early.
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20
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Panza F, Lozupone M, Solfrizzi V, Sardone R, Dibello V, Di Lena L, D'Urso F, Stallone R, Petruzzi M, Giannelli G, Quaranta N, Bellomo A, Greco A, Daniele A, Seripa D, Logroscino G. Different Cognitive Frailty Models and Health- and Cognitive-related Outcomes in Older Age: From Epidemiology to Prevention. J Alzheimers Dis 2019; 62:993-1012. [PMID: 29562543 PMCID: PMC5870024 DOI: 10.3233/jad-170963] [Citation(s) in RCA: 194] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Frailty, a critical intermediate status of the aging process that is at increased risk for negative health-related events, includes physical, cognitive, and psychosocial domains or phenotypes. Cognitive frailty is a condition recently defined by operationalized criteria describing coexisting physical frailty and mild cognitive impairment (MCI), with two proposed subtypes: potentially reversible cognitive frailty (physical frailty/MCI) and reversible cognitive frailty (physical frailty/pre-MCI subjective cognitive decline). In the present article, we reviewed the framework for the definition, different models, and the current epidemiology of cognitive frailty, also describing neurobiological mechanisms, and exploring the possible prevention of the cognitive frailty progression. Several studies suggested a relevant heterogeneity with prevalence estimates ranging 1.0–22.0% (10.7–22.0% in clinical-based settings and 1.0–4.4% in population-based settings). Cross-sectional and longitudinal population-based studies showed that different cognitive frailty models may be associated with increased risk of functional disability, worsened quality of life, hospitalization, mortality, incidence of dementia, vascular dementia, and neurocognitive disorders. The operationalization of clinical constructs based on cognitive impairment related to physical causes (physical frailty, motor function decline, or other physical factors) appears to be interesting for dementia secondary prevention given the increased risk for progression to dementia of these clinical entities. Multidomain interventions have the potential to be effective in preventing cognitive frailty. In the near future, we need to establish more reliable clinical and research criteria, using different operational definitions for frailty and cognitive impairment, and useful clinical, biological, and imaging markers to implement intervention programs targeted to improve frailty, so preventing also late-life cognitive disorders.
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Affiliation(s)
- Francesco Panza
- Department of Medical Sciences, Geriatric Unit and Laboratory of Gerontology and Geriatrics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy.,Department of Basic Medicine, Neurodegenerative Disease Unit, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
| | - Madia Lozupone
- Department of Basic Medicine, Neurodegenerative Disease Unit, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Vincenzo Solfrizzi
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari "Aldo Moro", Bari, Italy
| | - Rodolfo Sardone
- National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte Bari, Italy
| | - Vittorio Dibello
- Interdisciplinary Department of Medicine (DIM), Section of Dentistry, University of Bari Aldo Moro, Bari, Italy
| | - Luca Di Lena
- National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte Bari, Italy
| | - Francesca D'Urso
- Department of Clinical and Experimental Medicine, Psychiatric Unit, University of Foggia, Foggia, Italy
| | - Roberta Stallone
- Department of Basic Medicine, Neurodegenerative Disease Unit, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine (DIM), Section of Dentistry, University of Bari Aldo Moro, Bari, Italy
| | - Gianluigi Giannelli
- National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte Bari, Italy
| | | | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, Psychiatric Unit, University of Foggia, Foggia, Italy
| | - Antonio Greco
- Department of Medical Sciences, Geriatric Unit and Laboratory of Gerontology and Geriatrics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
| | - Davide Seripa
- Department of Medical Sciences, Geriatric Unit and Laboratory of Gerontology and Geriatrics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Giancarlo Logroscino
- Department of Basic Medicine, Neurodegenerative Disease Unit, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
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21
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Brooks JM, Petersen CL, Titus AJ, Umucu E, Chiu C, Bartels SJ, Batsis JA. Varying Levels of Food Insecurity Associated with Clinically Relevant Depressive Symptoms in U.S. Adults Aged 60 Years and Over: Results from the 2005-2014 National Health and Nutrition Survey. J Nutr Gerontol Geriatr 2019; 38:218-230. [PMID: 31074705 DOI: 10.1080/21551197.2019.1611520] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Food insecurity refers to restricted or uncertain access to and ineffective utilization of nutritious and safe foods. Although food insecurity is linked to poorer physical health consequences among older adults, national estimates are not well known on food insecurity and depression. Using the 2005-2014 National Health and Nutrition Examination Survey, this study examines the associations between varying food insecurity levels and clinically relevant depressive symptoms (defined by PHQ-9 ≥ 10) among adults ≥60 years old (n = 7969). Rates of clinically relevant depressive symptoms in marginal, low, and very low food security were 12.3, 16.3, and 25.2%, respectively. Marginal, low, and very low food security were significantly associated with clinically relevant depressive symptoms: odds ratio (OR) = 1.12 (95% confidence intervals [CI] 1.07-1.18), OR = 1.07 (95% CI 1.03-1.12), and OR = 1.24 (95% CI 1.16-1.32), respectively. Given the intersection of food insecurity and depression, geriatric health professionals should work to improve health and nutrition programs for older adults at risk for or experiencing both public health concerns.
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Affiliation(s)
- Jessica M Brooks
- a Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College , Lebanon , NH , USA.,b Department of Rehabilitation and Health Services, University of North Texas , Denton , TX , USA
| | - Curtis L Petersen
- c The Dartmouth Institute for Health Policy and Clinical Practice at Dartmouth College , Lebanon , NH , USA.,d Department of Epidemiology, Geisel School of Medicine at Dartmouth College , Lebanon , NH , USA
| | - Alexander J Titus
- d Department of Epidemiology, Geisel School of Medicine at Dartmouth College , Lebanon , NH , USA.,e Program in Quantitative Biomedical Sciences, Dartmouth College , Lebanon , NH , USA
| | - Emre Umucu
- f Department of Rehabilitation Sciences, University of Texas at El Paso , El Paso , TX , USA
| | - Chungyi Chiu
- g Department of Kinesiology and Community Health, The University of Illinois at Urbana-Champaign , Champaign , IL , USA
| | - Stephen J Bartels
- a Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College , Lebanon , NH , USA.,c The Dartmouth Institute for Health Policy and Clinical Practice at Dartmouth College , Lebanon , NH , USA
| | - John A Batsis
- c The Dartmouth Institute for Health Policy and Clinical Practice at Dartmouth College , Lebanon , NH , USA.,h Department of Medicine, Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth , Lebanon , NH , USA.,i Centers for Health and Aging , Lebanon , NH , USA
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22
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Assessment and Treatment of the Anorexia of Aging: A Systematic Review. Nutrients 2019; 11:nu11010144. [PMID: 30641897 PMCID: PMC6356473 DOI: 10.3390/nu11010144] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 01/04/2019] [Accepted: 01/07/2019] [Indexed: 12/30/2022] Open
Abstract
(1) Background: Appetite loss in older people, the ‘Anorexia of Aging’ (AA), is common, associated with under-nutrition, sarcopenia, and frailty and yet receives little attention. This review had two aims: describe interventions for AA and their effectiveness, and identify the methods of appetite assessment. (2) Methods: Study inclusion: participants aged ≥65, intervention for AA, and appetite assessment, any design, and comparator. Exclusion: studies on specific health cohorts. Searches in four databases with hand searching of references and citing works. Two researchers independently assessed eligibility and quality. (3) Results: Authors screened 8729 titles, 46 full texts. Eighteen articles were included describing nine intervention types: education (n = 1), exercise (n = 1), flavor enhancement (n = 2), increased meal variety (n = 1), mealtime assistance (n = 1), fortified food (n = 1), oral nutritional supplement (ONS) (n = 8), amino acids (n = 1), and medication (n = 2). Three studies evaluated combinations: education + exercise, ONS + exercise, and ONS + medication. Five intervention types exhibited favorable effects on appetite but in single datasets or not replicated. Appetite was assessed predominantly by Likert (n = 9), or visual analogue scales (n = 7). (4) Conclusions: A variety of interventions and methods of appetite assessments were used. There was a lack of clarity about whether AA or undernutrition was the intervention target. AA is important for future research but needs standardized assessment so that effectiveness of a range of interventions can be fully explored.
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Abstract
The anorexia of aging affects approximately a quarter of older people and is a major contributor to the development of under-nutrition and many other adverse health outcomes in older people. Despite the high prevalence, the anorexia of aging is frequently overlooked by clinicians and, of even more concern, it is commonly accepted as inevitable and a part of 'normal' aging. Early identification of risk coupled with efforts to mitigate these risks through appropriate interventions might stem the deleterious consequences of the anorexia of aging. This review aims to provide an update on the current knowledge base whilst making some practical suggestions that may be of use in clinical practice. Interventions such as exercise and good nutrition remain the preferred treatment while pharmacological options, whilst they continue to be trialed, are not currently recommended for routine clinical use.
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Affiliation(s)
- A D Jadczak
- Agathe Daria Jadczak, University of Adelaide, South Australia, Australia,
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24
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Yannakoulia M, Mamalaki E, Anastasiou CA, Mourtzi N, Lambrinoudaki I, Scarmeas N. Eating habits and behaviors of older people: Where are we now and where should we go? Maturitas 2018; 114:14-21. [DOI: 10.1016/j.maturitas.2018.05.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/02/2018] [Accepted: 05/08/2018] [Indexed: 12/28/2022]
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25
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Saghaleini SH, Dehghan K, Shadvar K, Sanaie S, Mahmoodpoor A, Ostadi Z. Pressure Ulcer and Nutrition. Indian J Crit Care Med 2018; 22:283-289. [PMID: 29743767 PMCID: PMC5930532 DOI: 10.4103/ijccm.ijccm_277_17] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Pressure ulcers can diminish global life quality, contribute to rapid mortality in some patients and pose a significant cost to health-care organizations. Accordingly, their prevention and management are highly important. Nutritional deprivation and insufficient dietary intake are the key risk factors for the development of pressure ulcers and impaired wound healing. Unplanned weight loss is a major risk factor for malnutrition and pressure ulcer development. Suboptimal nutrition interferes with the function of the immune system, collagen synthesis, and tensile strength. No laboratory test can exactly define an individual's nutritional status. Although serum albumin, prealbumin, transferrin, and retinol-binding protein as well as anthropometric measures such as height, weight, and body mass index and the other laboratory values may be suitable to establish the overall prognosis, still they might not well represent the nutritional status. Although the ideal nutrient intake to encourage wound healing is unknown, increased needs for energy, protein, zinc, and Vitamins A, C, and E and also amino acids such as arginine and glutamine have been documented. Hydration plays a vital role in the preservation and repair of skin integrity. Dehydration disturbs cell metabolism and wound healing. Adequate fluid intake is necessary to support the blood flow to wounded tissues and to prevent additional breakdown of the skin. The main aim of the present article is to review the current evidence related to hydration and nutrition for bedsore prevention and management in adults.
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Affiliation(s)
- Seied Hadi Saghaleini
- Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kasra Dehghan
- Department of Anesthesiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Kamran Shadvar
- Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sarvin Sanaie
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ata Mahmoodpoor
- Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zohreh Ostadi
- Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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26
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Padilla Colón CJ, Molina-Vicenty IL, Frontera-Rodríguez M, García-Ferré A, Rivera BP, Cintrón-Vélez G, Frontera-Rodríguez S. Muscle and Bone Mass Loss in the Elderly Population: Advances in diagnosis and treatment. JOURNAL OF BIOMEDICINE (SYDNEY, NSW) 2018; 3:40-49. [PMID: 30505650 PMCID: PMC6261527 DOI: 10.7150/jbm.23390] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Aging is the result of different functional changes leading to a substantial reduction of all human capabilities. A variety of anatomical and physiological changes occur with advancing age. These changes are more evident in the elderly population. There are various methods to measure muscle and bone mass loss, but the dual X-ray absorptiometry (DXA) is considered one of the most efficient. The elderly population (65 years and older) has been increasing throughout the years. Loss of muscle mass (sarcopenia) and loss bone mass (osteopenia or osteoporosis) with advancing age, when untreated, represent a major public health problem for the elderly population and may result in loss of independence in later life. Untreated age-related sarcopenia and osteopenia/osteoporosis increase the risk for falls and fractures, making older individuals more susceptible to the development of mobility limitations or severe disabilities that ultimately affect their capacity for independence. In this review, we will discuss the muscle and bone mass loss in the elderly population and advances in diagnosis and treatment.
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Affiliation(s)
- Carlos J. Padilla Colón
- Department of Education, Physical Education and Health Programs, San Juan, PR, USA
- Research and Development Service (151), VA Caribbean Healthcare System, San Juan PR, USA
| | - Irma L. Molina-Vicenty
- Research and Development Service (151), VA Caribbean Healthcare System, San Juan PR, USA
- Department of Biology, University of Puerto Rico, Rio Piedras Campus, San Juan, PR, USA
- Department of Radiological Sciences, University of Puerto Rico, Medical Sciences Campus, San Juan, PR, USA
| | - María Frontera-Rodríguez
- Research and Development Service (151), VA Caribbean Healthcare System, San Juan PR, USA
- Department of Biology, University of Puerto Rico, Rio Piedras Campus, San Juan, PR, USA
| | - Alejandra García-Ferré
- Research and Development Service (151), VA Caribbean Healthcare System, San Juan PR, USA
- Department of Biology, University of Puerto Rico, Rio Piedras Campus, San Juan, PR, USA
| | | | - Gerardo Cintrón-Vélez
- Research and Development Service (151), VA Caribbean Healthcare System, San Juan PR, USA
- Department of Biology, University of Puerto Rico, Rio Piedras Campus, San Juan, PR, USA
| | - Sebastián Frontera-Rodríguez
- Research and Development Service (151), VA Caribbean Healthcare System, San Juan PR, USA
- Department of Biology, University of Puerto Rico, Rio Piedras Campus, San Juan, PR, USA
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27
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Jensen MEJ, Pedersen JL, Gregersen M. A Dietician’s Bedside Supervision in a Geriatric Ward Is Effective. Health (London) 2018. [DOI: 10.4236/health.2018.109094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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28
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Abstract
Older people often experience loss of appetite and/or decreased food intake that, unavoidably, impact energy metabolism and overall health status. The association of age-related nutritional deficits with several adverse outcomes has led to the recognition of a geriatric condition referred to as "anorexia of aging." Anorexia is an independent predictor of morbidity and mortality both in the community and across clinical settings. Multidimensional interventions within personalized care plans currently represent the most effective option to ensure the provision of adequate amounts of food, limit weight loss, and prevent adverse health outcomes in older adults.
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Affiliation(s)
- Francesco Landi
- Department of Geriatrics, Neurosciences and Orthopedics, Center for Geriatric Medicine (CEMI), Institute of Internal Medicine and Geriatrics, Catholic University of the Sacred Heart, L.go F. Vito 8, Rome 00168, Italy.
| | - Anna Picca
- Department of Geriatrics, Neurosciences and Orthopedics, Center for Geriatric Medicine (CEMI), Institute of Internal Medicine and Geriatrics, Catholic University of the Sacred Heart, L.go F. Vito 8, Rome 00168, Italy
| | - Riccardo Calvani
- Department of Geriatrics, Neurosciences and Orthopedics, Center for Geriatric Medicine (CEMI), Institute of Internal Medicine and Geriatrics, Catholic University of the Sacred Heart, L.go F. Vito 8, Rome 00168, Italy
| | - Emanuele Marzetti
- Department of Geriatrics, Neurosciences and Orthopedics, Center for Geriatric Medicine (CEMI), Institute of Internal Medicine and Geriatrics, Catholic University of the Sacred Heart, L.go F. Vito 8, Rome 00168, Italy
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29
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Burger C, Kiesswetter E, Gietl A, Pfannes U, Arens-Azevedo U, Sieber CC, Volkert D. Size Matters! Differences in Nutritional Care between Small, Medium and Large Nursing Homes in Germany. J Nutr Health Aging 2017; 21:464-472. [PMID: 28346574 DOI: 10.1007/s12603-016-0767-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The aim of this study is to comprehensively describe nutritional care in German nursing homes (NHs) and to examine if nutritional care differs between small, medium and large NHs. DESIGN Nationwide cross-sectional postal survey. SETTING Nursing homes. PARTICIPANTS 541 NHs across Germany. MEASUREMENTS Information on structural NH characteristics and nutritional care (food provision and menu planning, nursing care, and management and quality assurance) was collected by means of a questionnaire addressed to the management of a random sample of German NHs. NHs were grouped by size as small (≤ 50 beds), medium (50 - 100 beds) or large (> 100 beds) institutions. Frequencies were used to describe nutritional care, and Chi2-test to identify differences in nutritional care by NH size. RESULTS Aspects in the domain of food provision and menu planning regarding food variety and choice were widely implemented in German NHs (77 - 100 %). Best results were achieved in the domain of nursing care, where all aspects were implemented in at least 68 % of the NHs. Aspects regarding management and quality assurance, especially those concerning staffing, i.e. the availability of an interface manager (14 %), an interdisciplinary nutrition team (12 %) and a dietician (42 %), were only rarely implemented. Differences by NH size were found between small and medium or large NHs. On the one hand, small NHs stated more often to consider individual capabilities of the residents with texture-modified food (81 % vs. 60 %, p<0.05) and produce more often hot meals at ward level on a regular base (46 % vs. 32 %, p<0.05) than large NHs. On the other hand, several aspects regarding food provision and menu planning, and management and quality assurance were significantly more often implemented in larger than smaller NHs. CONCLUSION Whereas kitchen and nursing-related aspects of nutritional care seem to be widely implemented in German NHs, management and quality assurance demands are often not met. The differences found by NH size support the hypothesis that the number of residents living in a NH has an impact on how nutritional care is performed.
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Affiliation(s)
- C Burger
- D. Volkert, Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany,
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Lindegaard Pedersen J, Pedersen PU, Damsgaard EM. Nutritional Follow-Up after Discharge Prevents Readmission to Hospital - A Randomized Clinical Trial. J Nutr Health Aging 2017; 21:75-82. [PMID: 27999853 DOI: 10.1007/s12603-016-0745-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To compare the effects of two individualized nutritional follow-up intervention strategies (home visit or telephone consultation) with no follow-up, with regard to acute readmissions to hospital at two points in time, 30 and 90 days after discharge from hospital. DESIGN Randomized clinical trial with two intervention groups and one control group, and monitoring on readmission at 30 and 90 days after discharge. SETTING Intervention in the participants' homes after discharge from hospital. PARTICIPANTS Inclusion: Malnourished geriatric patients and patients at risk of malnutrition (MNA<24), aged 75 years and older, living at home and alone. Exclusion: Nursing home residents and patients with terminal illnesses or cognitive impairment. Randomization: Upon discharge, the patients were stratified according to nutritional status (MNA), and assigned to one of three groups: 'home visit', 'telephone', or 'control' group. INTERVENTION Individualized nutritional counselling of the patient and the patient's daily home carer by a clinical dietician one, two, and four weeks after discharge from hospital. The counselling was either in-person at the patient's homes, or over the telephone. All patients received a diet plan on discharge. The control group received standard care, but no follow-up after discharge. MEASUREMENTS Information on readmissions to hospital and mortality at 30 and 90 days after discharge was obtained from electronic patient records. Intention-to-treat (ITT) and per-protocol (PP) analyses were carried out. RESULTS Two-hundred and eight participants were randomized, 73 to home visits, 68 to the telephone consultation group, and 67 to the control group. The mean age of the participants was 86.1 years. Home visit participants had a lower risk of readmission to hospital compared to control participants at 30 days after discharge (HR=0.4; 95% CI: 0.2-0.9, p=0.03) and 90 days after discharge (HR=0.4; 95% CI: 0.2-0.8, p<0.01). No significant difference was detected between the telephone consultation group and the control group, at either 30 days (HR=0.6, 95% CI: 0.3-1.3, p=0.18) or 90 days after discharge (HR=0.7, 95% CI: 0.4-1.3, p=0.23). The PP analysis revealed that the risk of readmission was significantly lower in the home visit group compared to the control group and the telephone consultation group compared to the control group, and this was evident at 30 days as well as at 90 days after discharge. CONCLUSION An individualized nutritional follow-up performed as home visits seems to reduce readmission to hospital 30 and 90 days after discharge. Intervention by telephone consultations may also prevent readmission, but only among participants who receive the full intervention.
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Affiliation(s)
- J Lindegaard Pedersen
- Jette Lindegaard Pedersen, Clinical research nurse, Aarhus University Hospital, Geriatrics, P.P. Oerumsgade 11, Aarhus, 8000, Denmark, 0045 40256721,
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Jung SE, Bishop AJ, Kim M, Hermann J, Kim G, Lawrence J. Does Depressive Affect Mediate the Relationship between Self-Care Capacity and Nutritional Status Among Rural Older Adults? : A Structural Equation Modeling Approach. J Nutr Gerontol Geriatr 2017; 36:63-74. [PMID: 28207371 DOI: 10.1080/21551197.2017.1281785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study examined the relationships of self-care capacity and depressive affect on nutritional status and whether depressive affect mediated the relationship of self-care capacity on nutritional status. A convenience sample of 171 rural community-dwelling older adults, 65 years and above, participated. Structural equation modeling (SEM) was conducted to test a mediation model. The hypothesized SEM model was supported with adequate fit (χ2 (1) = 1.87, p = 0.17; CFI = 0.94; RMSEA = 0.07; SRMR = 0.03). SEM analysis revealed a significant positive direct effect of self-care capacity on nutritional status (γ = 0.14, p = 0.042). Significant negative direct effects were observed for self-care capacity on depressive affect (γ = -0.15, p = 0.027) and for depressive affect on nutritional status (β = -0.27, p < 0.01). Depressive affect was also observed to partially mediate the relationship of self-care capacity on nutrition status (γ = 0.04, p = 0.046). Findings highlight the importance of emotional well-being on rural older adults' nutritional status, particularly those with decreased ability to engage in self-care practices.
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Affiliation(s)
- Seung Eun Jung
- a Department of Human Nutrition and Hospitality Management , The University of Alabama , Tuscaloosa , Alabama , USA
| | - Alex J Bishop
- b Department of Human Development and Family Science , Oklahoma State University , Stillwater , Oklahoma , USA
| | - Minjung Kim
- c Department of Psychology , The University of Alabama , Tuscaloosa , Alabama , USA
| | - Janice Hermann
- d Department of Nutritional Sciences , Oklahoma State University , Stillwater , Oklahoma , USA
| | - Giyeon Kim
- e Alabama Research Institute on Aging (ARIA) , The University of Alabama , Tuscaloosa , Alabama , USA
| | - Jeannine Lawrence
- a Department of Human Nutrition and Hospitality Management , The University of Alabama , Tuscaloosa , Alabama , USA
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André B, Canhão H, Espnes GA, Ferreira Rodrigues AM, Gregorio MJ, Nguyen C, Sousa R, Grønning K. Is there an association between food patterns and life satisfaction among Norway's inhabitants ages 65 years and older? Appetite 2016; 110:108-115. [PMID: 27988367 DOI: 10.1016/j.appet.2016.12.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 12/08/2016] [Accepted: 12/13/2016] [Indexed: 01/07/2023]
Abstract
The lack of information regarding older adults' health and lifestyles makes it difficult to design suitable interventions for people at risk of developing unhealth lifestyles. Therefore, there is a need to increase knowledge about older adults' food patterns and quality of life. Our aim was to determine associations among food patterns, anxiety, depression, and life satisfaction in Norwegian inhabitants ages 65+. The Nord-Trøndelag Health Study (The HUNT Study) is a large, population-based cohort study that includes data for 125 000 Norwegian participants. The cohort used for this study is wave three of the study, consisting of 11 619 participants age 65 and over. Cluster analysis was used to categorize the participants based on similarities in food consumption; two clusters were identified based on similarities regarding food consumption among participants. Significant differences between the clusters were found, as participants in the healthy food-patterns cluster had higher life satisfaction and lower anxiety and depression than those in the unhealthy food-patterns cluster. The associations among food patterns, anxiety, depression, and life satisfaction among older adults show the need for increased focus on interactions among food patterns, food consumption, and life satisfaction among the elderly in order to explore how society can influence these patterns.
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Affiliation(s)
- Beate André
- Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Norway; NTNU Center for Health Promotion Research, Norway.
| | - Helena Canhão
- CEDOC, NOVA Medical School, University Nova de Lisbon, Lisbon, Portugal; Portuguese Society of Rheumatology, Portugal
| | - Geir A Espnes
- Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Norway; NTNU Center for Health Promotion Research, Norway
| | | | | | - Camilla Nguyen
- Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Norway; NTNU Center for Health Promotion Research, Norway
| | - Rute Sousa
- CEDOC, NOVA Medical School, University Nova de Lisbon, Lisbon, Portugal; Portuguese Society of Rheumatology, Portugal
| | - Kjersti Grønning
- Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Norway; NTNU Center for Health Promotion Research, Norway
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Sturtzel B, Elmadfa I, Ohrenberger G. The energy intake through regular nontherapeutic meals provision in long-term care: impact on nutritional status and related Geriatric Nutritional Risk Index. SPRINGERPLUS 2016; 5:136. [PMID: 26933634 PMCID: PMC4761357 DOI: 10.1186/s40064-016-1763-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 02/12/2016] [Indexed: 11/10/2022]
Abstract
To investigate how the energy intake of institutionalized long-term-care patients through the regular nontherapeutic meals provision is associated with the nutritional status and the Geriatric Nutritional Risk Index (GNRI). A 9 month longitudinal, observational study. Long-term-care Hospital. 66 long-term-care patients with multiple medical conditions and solely oral food-intake. 47 (71 %) patients, predominantly women (n = 39/47), with a mean age of 83.04 (±9.58) years completed study time and 19 (29 %) deceased. At week 1 and week 36 of observation time energy intake was measured by means of three-days-weighing-records. Body composition was assessed with bioelectrical impedance analysis. Serum albumin, body weight and body height were taken from the medical report. Albumin content, body weight and height were used to calculate the Geriatric Nutritional Risk Index: GNRI = [1.489 × albumin (g/L)] + [41.7 × (weight/ideal body weight)]. Energy intake was significantly below 24 kcal/kg body weight per day. The GNRI of the deceased patients was significantly (p = 0.002) lower than the GNRI of the completers. During observation time energy-intake p < 0.001, body fat (p = 0.001) and phase angle (PA) of bio impedance measurement (p = 0.018) and likewise the GNRI (p = 0.021) of the completers decreased significantly. At the beginning and at the end of observation time energy intake correlated significantly with PA (p = 0.028/p < 0.001) and GNRI (p = 0.436/p = 0.004). Also GNRI and PA correlated significantly at the beginning (p = 0.001) and at the end (p < 0.001) of observation time. The energy intake through non therapeutic meals provision was too low for sustaining the nutritional status and likewise the GNRI. The malnourishment and the nutrition related clinical risk of the geriatric patients aggrevated during observation time.
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Westergren A, Edfors E, Norberg E, Stubbendorff A, Hedin G, Wetterstrand M, Hagell P. Short-term effects of a computer-based nutritional nursing training program for inpatient hospital care. J Eval Clin Pract 2016; 22:799-807. [PMID: 27133949 DOI: 10.1111/jep.12545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 03/23/2016] [Accepted: 03/23/2016] [Indexed: 12/19/2022]
Abstract
RATIONALE This study aimed to explore whether a computer-based training in eating and nutrition for hospital nursing staff can influence the precision in nutritional treatment and care. METHOD A pre-intervention and post-intervention study was conducted with a cross-sectional design at each time point. The settings were one intervention (IH) and two control hospitals (CH1 and CH2). Hospital inpatients >18 years old at baseline (2012; n = 409) and follow-up (2014; n = 456) were included. The computer-based training was implemented during a period of 3 months in the IH with 297 (84%) participating registered nurses and nurse assistants. Nutritional risk was screened for using the Minimal Eating Observation and Nutrition Form. Nutritional treatment and care was recorded using a standardized protocol RESULTS In the IH, there was an increase in the share of patients at UN risk that received energy-dense food (+16.7%) and dietician consultations (+17.3%) between baseline and follow-up, while fewer received feeding assistance (-16.2%). There was an increase in the share of patients at UN risk that received energy-dense food (+19.5%), a decrease in oral nutritional supplements (-30.5%) and food-registrations (-30.6%) in CH1, whereas there were no changes in CH2. 'Overtreatment' (providing nutritional treatment to those not at UN risk) was significantly higher in CH2 (52.7%) than in CH1 (14.3%) and in the IH (25.2%) at follow-up. CONCLUSION The computer-based training seemed to increase the probability for patients at UN risk in the IH to receive nutritional treatment without increasing overtreatment.
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Affiliation(s)
- Albert Westergren
- The PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden.
| | - Ellinor Edfors
- The PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden
| | | | | | - Gita Hedin
- The PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden
| | | | - Peter Hagell
- The PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden
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Roy M, Gaudreau P, Payette H. A scoping review of anorexia of aging correlates and their relevance to population health interventions. Appetite 2016; 105:688-99. [DOI: 10.1016/j.appet.2016.06.037] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 06/27/2016] [Accepted: 06/28/2016] [Indexed: 12/21/2022]
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Anorexia of Aging: Risk Factors, Consequences, and Potential Treatments. Nutrients 2016; 8:69. [PMID: 26828516 PMCID: PMC4772033 DOI: 10.3390/nu8020069] [Citation(s) in RCA: 213] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 01/20/2016] [Indexed: 11/21/2022] Open
Abstract
Older people frequently fail to ingest adequate amount of food to meet their essential energy and nutrient requirements. Anorexia of aging, defined by decrease in appetite and/or food intake in old age, is a major contributing factor to under-nutrition and adverse health outcomes in the geriatric population. This disorder is indeed highly prevalent and is recognized as an independent predictor of morbidity and mortality in different clinical settings. Even though anorexia is not an unavoidable consequence of aging, advancing age often promotes its development through various mechanisms. Age-related changes in life-style, disease conditions, as well as social and environmental factors have the potential to directly affect dietary behaviors and nutritional status. In spite of their importance, problems related to food intake and, more generally, nutritional status are seldom attended to in clinical practice. While this may be the result of an “ageist” approach, it should be acknowledged that simple interventions, such as oral nutritional supplementation or modified diets, could meaningfully improve the health status and quality of life of older persons.
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Pedersen JL, Pedersen PU, Damsgaard EM. Early Nutritional Follow-Up after Discharge Prevents Deterioration of ADL Functions in Malnourished, Independent, Geriatric Patients Who Live Alone - A Randomized Clinical Trial. J Nutr Health Aging 2016; 20:845-853. [PMID: 27709234 DOI: 10.1007/s12603-015-0629-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To compare the effects of two nutritional follow-up interventions with regard to preventing short-term deterioration in ADL, and to compare their effects on physical function, emotional health, and health-related quality of life. DESIGN Randomized clinical trial with two intervention groups and one control group, and a follow-up period of eight weeks. SETTING Intervention in the participants' homes after discharge from hospital. PARTICIPANTS Inclusion: Malnourished geriatric patients and patients at risk of malnutrition (MNA<24), aged 75 years and older, living at home and alone. Exclusion: Nursing home residents and patients with terminal illnesses or cognitive impairment. Randomization: At discharge, the patients were assigned to one of three groups: 'home visit', 'telephone consultation', or 'control' group. INTERVENTION Individually tailored nutritional counselling of the patient and the patient's daily home carer by a clinical dietician one, two, and four weeks after discharge from hospital. The counselling was either in-person at the patients' homes, or by telephone. The control group received no follow-up after discharge. MEASUREMENTS Primary outcome: Change in ADL (Barthel-100 score) at discharge and eight weeks later. SECONDARY OUTCOMES Change in physical performance (handgrip strength, 30-sec. chair stand test, CAS), quality of life and depression measurements (SF-36, Depression List, Geriatric Depression Score), and Avlund mobility-tiredness score (Mob-T). RESULTS Two-hundred and eight participants were randomized, 73 to home visits and 68 to telephone consultations. The control group comprised 67 patients. The mean age of the participants was 86.1 years. At eight weeks after discharge, 157 completed the follow-up (home visit 52, telephone consultation 51, and control group 54). The mean age of these patients was 85.8 years. More patients in the home visit group improved or maintained their ADL (96%), compared to the telephone (75%) and control groups (72%), p<0.01. No difference was detected among the groups with regard to physical measurements, health-related quality of life, and emotional health. CONCLUSION Early nutritional follow-up after discharge, performed as home visits, prevents deterioration of ADL in malnourished, independent, geriatric patients who live alone and thereby preserves their independence.
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Affiliation(s)
- J L Pedersen
- Jette Lindegaard Pedersen, Department of Geriatrics, Aarhus University Hospital, P.P. Oerumsgade 11, 8000 Aarhus C, Denmark,
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Perkisas S, Vandewoude M. Where frailty meets diabetes. Diabetes Metab Res Rev 2016; 32 Suppl 1:261-7. [PMID: 26453435 DOI: 10.1002/dmrr.2743] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 07/13/2015] [Accepted: 10/06/2015] [Indexed: 12/11/2022]
Abstract
Diabetes is a chronic illness that has an effect on multiple organ systems. Frailty is a state of increased vulnerability to stressors and a limited capacity to maintain homeostasis. It is a multidimensional concept and a dynamic condition that can improve or worsen over time. Frailty is either physical or psychological or a combination of these two components. Sarcopenia, which is the age-related loss of skeletal muscle mass and strength, is the main attributor to the physical form of frailty. Although the pathophysiology of diabetes is commonly focused on impaired insulin secretion, overload of gluconeogenesis and insulin resistance, newer insights broaden this etiologic horizon. Immunologic factors that create a chronic state of low-grade inflammation--'inflammaging'--have an influence on both the ageing process and diabetes. Persons with diabetes mellitus already tend to have an accelerated ageing process that places them at greater risk for developing frailty at an earlier age. The development of frailty--and sarcopenia--is multifactorial and includes nutritional, physical and hormonal elements; these elements are interlinked with those of diabetes. A lower muscle mass will lead to poorer glycaemic control through lower muscle glucose uptake. This leads to higher insulin secretion and insulin resistance, which is the stepping stone for diabetes itself.
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Affiliation(s)
- Stany Perkisas
- Department of Geriatrics, University of Antwerp, Antwerp, Belgium
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Wysokiński A, Sobów T, Kłoszewska I, Kostka T. Mechanisms of the anorexia of aging-a review. AGE (DORDRECHT, NETHERLANDS) 2015; 37:9821. [PMID: 26232135 PMCID: PMC5005824 DOI: 10.1007/s11357-015-9821-x] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 07/22/2015] [Indexed: 05/05/2023]
Abstract
Many, even healthy, older people fail to adequately regulate food intake and experience loss of weight. Aging-associated changes in the regulation of appetite and the lack of hunger have been termed as the anorexia of aging. The etiology of the anorexia of aging is multi-factorial and includes a combination of physiological changes associated with aging (decline in smell and taste, reduced central and peripheral drive to eat, delayed gastric emptying), pathological conditions (depression, dementia, somatic diseases, medications and iatrogenic interventions, oral-health status), and social factors (poverty, loneliness). However, exact mechanisms of the anorexia of aging remain to be elucidated. Many neurobiological mechanisms may be secondary to age-related changes in body composition and not associated with anorexia per se. Therefore, further studies on pathophysiological mechanisms of the anorexia of aging should employ accurate measurement of body fat and lean mass. The anorexia of aging is associated with protein-energy malnutrition, sarcopenia, frailty, functional deterioration, morbidity, and mortality. Since this symptom can lead to dramatic consequences, early identification and effective interventions are needed. One of the most important goals in the geriatric care is to optimize nutritional status of the elderly.
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Affiliation(s)
- Adam Wysokiński
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Czechosłowacka 8/10, 92-216, Łódź, Poland,
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Westergren A, Khalaf A, Hagell P. A Swedish version of the SCREEN II for malnutrition assessment among community-dwelling elderly. Scand J Public Health 2015; 43:667-71. [DOI: 10.1177/1403494815575339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2015] [Indexed: 11/16/2022]
Abstract
Background: The Seniors in the Community: Risk Evaluation for Eating and Nutrition II (SCREEN II) Questionnaire assesses nutritional risk among elderly people living at home. Our aim was to produce a Swedish language version of the SCREEN II and to examine response patterns, data completeness and the relationship between malnutrition and general health. Methods: The SCREEN II was translated into Swedish using dual panel methodology, and then followed up with field test interviews of 24 seniors (median age, 83 years). We used the survey data ( n = 565) to assess item and score distribution, missing responses, and the relationship to the subject’s general and nutritional health. Results: The Swedish SCREEN II was considered easy to understand, respond to, and relevant ( n = 21; 88% of subjects found it so in all three respects) and its median completion time was 5 minutes. The level of survey item data completeness was 94–99%, and 82% of surveys had computable total scores. Of those subjects with completed forms, 35% had no nutritional risk; 35% had moderate risk; and 30% were at high risk. The malnutrition risk increased with poorer perceived health. Conclusions: Our study results are similar to those using previous SCREEN II versions, indicating that the scale adaptation was successful and providing initial support for use of the Swedish SCREEN II Questionnaire.
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Affiliation(s)
- Albert Westergren
- PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden
| | - Atika Khalaf
- PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden
| | - Peter Hagell
- PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden
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Krzymińska-Siemaszko R, Mossakowska M, Skalska A, Klich-Rączka A, Tobis S, Szybalska A, Cylkowska-Nowak M, Olszanecka-Glinianowicz M, Chudek J, Wieczorowska-Tobis K. Social and economic correlates of malnutrition in Polish elderly population: the results of PolSenior study. J Nutr Health Aging 2015; 19:397-402. [PMID: 25809803 DOI: 10.1007/s12603-014-0572-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the prevalence of malnutrition in Polish elderly population and analyse its social and economic correlates based on the data from the PolSenior project, the first large-scale study of a representative group of Polish seniors. DESIGN A cross-sectional population-based study. SETTING All territorial provinces in Poland. PARTICIPANTS 4482 community-dwelling respondents aged 65 years or above (women: n=2142, age=79.0±8.4 years; men: n=2340, age= 78.3±8.6 years). MEASUREMENTS The nutritional status of participants was assessed through the Mini Nutritional Assessment Short Form (the revised MNA-SF). Out of social and economic correlates we evaluated age, sex, level of education, marital status, place of residence, living conditions and economic status. Economic status of the respondents was determined on the basis of questions on how well they could manage their own budgets. Those who could afford only the cheapest food or clothes were considered the group of self-reported poverty. RESULTS Frequency of malnutrition in the PolSenior population accounted for 7.5% (in 5.0% men and 9.0% women; p<0.001). The risk of malnutrition was present in 38.9% (33.3% men and 42.4% women; p<0.001). In our study female sex, older age, unmarried status, living in a rural area and self-reported poverty were independent correlates of malnutrition. CONCLUSIONS Our data showed high prevalence of malnutrition and the risk of its development among the community-dwelling elderly people in Poland. Screening with MNA-SF should focus in particular on unmarried, poorly educated individuals, in late old age, living in rural areas and self-reporting a poor financial state, especially women.
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Affiliation(s)
- R Krzymińska-Siemaszko
- Roma Krzymińska-Siemaszko, Department of Palliative Medicine, Poznan University of Medical Sciences, os. Rusa 25a, Poznan, Poland, Phone/fax: +48 618738303, e-mail:
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Westergren A, Hagell P, Sjödahl Hammarlund C. Malnutrition and risk of falling among elderly without home-help service--a cross sectional study. J Nutr Health Aging 2014; 18:905-11. [PMID: 25470807 DOI: 10.1007/s12603-014-0469-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES The aim of this study was to explore the frequency of malnutrition risk and associated risk of falling, social and mental factors among elderly without home-help service. The aim was also to explore factors associated with risk of falling. DESIGN A cross-sectional design was used. SETTING Elderly persons own homes. PARTICIPANTS Data were collected during preventive home visits to 565 elderly (age range 73-90 years) without home-help service. Those with complete SCREEN II forms were included in the study (n = 465). MEASUREMENTS MEASUREMENTS included rating scales regarding malnutrition risk (SCREEN II) and risk of falling (Downton). In addition, single-items: general health, satisfaction with life, tiredness, low-spiritedness, worries/anxiety and sleeping were used. RESULTS According to the SCREEN II, 35% of the sample had no malnutrition risk, 35% had moderate risk and 30% had high malnutrition risk. In an ordinal regression analysis, increased malnutrition risk was associated with being a woman living alone (OR 4.63), male living alone (OR 6.23), lower age (OR 0.86), poorer general health (OR 2.03-5.01), often/always feeling tired (OR 2.38), and an increased risk of falling (OR 1.21). In a linear regression analysis, risk of falling was associated with higher age (B 0.020), not shopping independently (B 0.162), and low meat consumption (B 0.138). CONCLUSION There are complex associations between malnutrition risk and the gender-cohabitation interaction, age, general health, tiredness, and risk of falling. In clinical practice comprehensive assessments to identify those at risk of malnutrition including associated factors are needed. These have to be followed by individual nutritional interventions using a holistic perspective which may also contribute to reducing the risk of falling.
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Affiliation(s)
- A Westergren
- Albert Westergren, School of Health and Society, Kristianstad University, SE-291 88 Kristianstad, Sweden, E-mail: ,Phone: +46 44 208550. Mobile: +46 705-329131
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Prevalence, incidence, and clinical impact of sarcopenia: facts, numbers, and epidemiology-update 2014. J Cachexia Sarcopenia Muscle 2014; 5:253-9. [PMID: 25425503 PMCID: PMC4248415 DOI: 10.1007/s13539-014-0161-y] [Citation(s) in RCA: 400] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 09/01/2014] [Indexed: 12/25/2022] Open
Abstract
Sarcopenia is now defined as a decline in walking speed or grip strength associated with low muscle mass. Sarcopenia leads to loss of mobility and function, falls, and mortality. Sarcopenia is a major cause of frailty, but either condition can occur without the other being present. Sarcopenia is present in about 5 to 10 % of persons over 65 years of age. It has multiple causes including disease, decreased caloric intake, poor blood flow to muscle, mitochondrial dysfunction, a decline in anabolic hormones, and an increase in proinflammatory cytokines. Basic therapy includes resistance exercise and protein and vitamin D supplementation. There is now a simple screening test available for sarcopenia-SARC-F. All persons 60 years and older should be screened for sarcopenia and treated when appropriate.
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Messinger-Rapport BJ, Gammack JK, Little MO, Morley JE. Clinical Update on Nursing Home Medicine: 2014. J Am Med Dir Assoc 2014; 15:786-801. [DOI: 10.1016/j.jamda.2014.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 09/02/2014] [Indexed: 12/18/2022]
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Huang YC, Wahlqvist ML, Lee MS. Appetite predicts mortality in free-living older adults in association with dietary diversity. A NAHSIT cohort study. Appetite 2014; 83:89-96. [PMID: 25131903 DOI: 10.1016/j.appet.2014.08.017] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 08/05/2014] [Accepted: 08/11/2014] [Indexed: 10/24/2022]
Abstract
This study aimed to assess the predictive ability of appetite for mortality among representative free-living Taiwanese older adults. A total of 1856 participants aged 65 years or over from the Elderly Nutrition and Health Survey during 1999-2000 completed an appetite question in a larger questionnaire. Personal information was obtained by face-to-face interview at baseline, together with a 24-hour dietary recall and simplified food frequency questionnaire which provided a dietary diversity score and food intake frequency. Survivorship was ascertained from the Death Registry until December 31, 2008. Participants with a poor appetite had lower dietary diversity scores (DDS) and intake frequencies of meat, fish and sea food, egg, vegetable and fruit intake, along with lower energy, protein, vitamin B-1, niacin, iron and phosphate intakes. Those who had fair and poor appetites had a higher risk of all-cause mortality compared to those with good appetite, with hazard ratios (HR) (95% confidence interval, CI) of 1.28 (1.03-1.58) and 2.27 (1.71-3.02), respectively. After adjustment for confounders, the HRs (95% CI) were 1.05 (0.83-1.33) and 1.50 (1.03-2.18), respectively. With further adjustment for DDS or general health these HRs became non-significant. The joint HR (95% CI) for "DDS ≤ 4 and poor appetite" was 1.77 (1.04-3.00) compared to "DDS > 4 and good appetite" as referent. Poor appetite is associated with lower food and nutrient intakes and an independent risk for mortality in older Taiwanese. In conclusion, appetite is separate, mediated by general health and modulated by dietary quality in its predictive capacity for mortality.
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Affiliation(s)
- Yi-Chen Huang
- Graduate Institute of Life Sciences, National Defense Medical Center, 161 Minchuan East Road, Sec 6, Taipei 114, Taiwan
| | - Mark L Wahlqvist
- Institute of Population Health Sciences, National Health Research Institutes, No 35, Keyan Road, Zhunan Town, Miaoli County 35053, Taiwan; National Defense Medical Center, School of Public Health, 161 Minchuan East Road, Sec. 6, Taipei 114, Taiwan; Monash Asia Institute, Monash University, 5th Floor, H Building, 900 Dandenong Road, Caulfield East, Melbourne, Vic. 3145, Australia
| | - Meei-Shyuan Lee
- Graduate Institute of Life Sciences, National Defense Medical Center, 161 Minchuan East Road, Sec 6, Taipei 114, Taiwan; National Defense Medical Center, School of Public Health, 161 Minchuan East Road, Sec. 6, Taipei 114, Taiwan; Monash Asia Institute, Monash University, 5th Floor, H Building, 900 Dandenong Road, Caulfield East, Melbourne, Vic. 3145, Australia.
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Cho J, Yusuf R, Kook S, Attar E, Lee D, Park B, Cheng T, Scadden DT, Lee BC. Purinergic P2Y₁₄ receptor modulates stress-induced hematopoietic stem/progenitor cell senescence. J Clin Invest 2014; 124:3159-71. [PMID: 24937426 DOI: 10.1172/jci61636] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 04/29/2014] [Indexed: 11/17/2022] Open
Abstract
Purinergic receptors of the P2Y family are G protein-coupled surface receptors that respond to extracellular nucleotides and can mediate responses to local cell damage. P2Y-dependent signaling contributes to thrombotic and/or inflammatory consequences of tissue injury by altering platelet and endothelial activation and immune cell phagocytosis. Here, we have demonstrated that P2Y14 modifies cell senescence and cell death in response to tissue stress, thereby enabling preservation of hematopoietic stem/progenitor cell function. In mice, P2Y14 deficiency had no demonstrable effect under homeostatic conditions; however, radiation stress, aging, sequential exposure to chemotherapy, and serial bone marrow transplantation increased senescence in animals lacking P2Y14. Enhanced senescence coincided with increased ROS, elevated p16(INK4a) expression, and hypophosphorylated Rb and was inhibited by treatment with a ROS scavenger or inhibition of p38/MAPK and JNK. Treatment of WT cells with pertussis toxin recapitulated the P2Y14 phenotype, suggesting that P2Y14 mediates antisenescence effects through Gi/o protein-dependent pathways. Primitive hematopoietic cells lacking P2Y14 were compromised in their ability to restore hematopoiesis in irradiated mice. Together, these data indicate that P2Y14 on stem/progenitor cells of the hematopoietic system inhibits cell senescence by monitoring and responding to the extracellular manifestations of tissue stress and suggest that P2Y14-mediated responses prevent the premature decline of regenerative capacity after injury.
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Sanford A, Morley JE. Are the New Guidelines for Cholesterol and Hypertension Age Friendly? J Am Med Dir Assoc 2014; 15:373-5. [DOI: 10.1016/j.jamda.2014.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 04/02/2014] [Indexed: 01/08/2023]
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