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Ruiz-Rosso R, Moreno-Cámara S, Gutiérrez-Sánchez B, da-Silva-Domingues H, Del-Pino-Casado R, Palomino-Moral PÁ. Factors Influencing Nutritional Status in Hospitalized Individuals Aged 70 and Above. Nutrients 2024; 16:645. [PMID: 38474773 PMCID: PMC10934742 DOI: 10.3390/nu16050645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 02/20/2024] [Accepted: 02/24/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Older adults are vulnerable to malnutrition due to physical, psychological, and social factors. Malnutrition, a prevalent and modifiable issue in this population, is associated with an elevated risk of adverse clinical outcomes. The purpose of the study is to assess the nutritional status of older adult individuals admitted to a general hospital and examine its correlation with socio-health and demographic variables. METHODS The study included 239 individuals aged 70 and above, employing a cross-sectional descriptive observational approach with a convenience sampling method. Sociodemographic information was gathered, and variables such as cognitive impairment, functional capacity, comorbidities, medication consumption, and nutritional status were evaluated. Statistical analysis involved descriptive calculations, bivariate analysis, and multivariate analysis, utilizing binary logistic regression. RESULTS Approximately half of the sample were at risk of malnutrition, with a more notable prevalence among women. Factors such as age (OR = 1.04), cognitive impairment (OR = 1.06), functional dependence (OR = 0.96), and comorbidities (OR = 1.08) were linked to an elevated risk of malnutrition. In our regression model, age, cognitive impairment, and drug consumption emerged as significant predictors of malnutrition risk. CONCLUSIONS Individuals aged 70 and above have a notably high prevalence of malnutrition risk, particularly among those experiencing functional dependence and cognitive impairment. In our sample, cognitive impairment in older adults, coupled with above-median drug consumption, emerges as the primary predictor for malnutrition risk.
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Affiliation(s)
| | | | | | - Henrique da-Silva-Domingues
- Department of Nursing, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (R.R.-R.); (S.M.-C.); (B.G.-S.); (R.D.-P.-C.); (P.Á.P.-M.)
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Brech GC, da Silva VC, Alonso AC, Machado-Lima A, da Silva DF, Micillo GP, Bastos MF, de Aquino RDC. Quality of life and socio-demographic factors associated with nutritional risk in Brazilian community-dwelling individuals aged 80 and over: cluster analysis and ensemble methods. Front Nutr 2024; 10:1183058. [PMID: 38235441 PMCID: PMC10792032 DOI: 10.3389/fnut.2023.1183058] [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: 03/09/2023] [Accepted: 10/26/2023] [Indexed: 01/19/2024] Open
Abstract
Introduction The aim of the present study was to use cluster analysis and ensemble methods to evaluate the association between quality of life, socio-demographic factors to predict nutritional risk in community-dwelling Brazilians aged 80 and over. Methods This cross-sectional study included 104 individuals, both sexes, from different community locations. Firstly, the participants answered the sociodemographic questionnaire, and were sampled for anthropometric data. Subsequently, the Mini-Mental State Examination (MMSE) was applied, and Mini Nutritional Assessment Questionnaire (MAN) was used to evaluate their nutritional status. Finally, quality of life (QoL) was assessed by a brief version of World Health Organizations' Quality of Life (WHOQOL-BREF) questionnaire and its older adults' version (WHOQOL-OLD). Results The K-means algorithm was used to identify clusters of individuals regarding quality-of-life characteristics. In addition, Random Forest (RF) and eXtreme Gradient Boosting (XGBoost) algorithms were used to predict nutritional risk. Four major clusters were derived. Although there was a higher proportion of individuals aged 80 and over with nutritional risk in cluster 2 and a lower proportion in cluster 3, there was no statistically significant association. Cluster 1 showed the highest scores for psychological, social, and environmental domains, while cluster 4 exhibited the worst scores for the social and environmental domains of WHOQOL-BREF and for autonomy, past, present, and future activities, and intimacy of WHOQOL-OLD. Conclusion Handgrip, household income, and MMSE were the most important predictors of nutritional. On the other hand, sex, self-reported health, and number of teeth showed the lowest levels of influence in the construction of models to evaluate nutritional risk. Taken together, there was no association between clusters based on quality-of-life domains and nutritional risk, however, predictive models can be used as a complementary tool to evaluate nutritional risk in individuals aged 80 and over.
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Affiliation(s)
- Guilherme Carlos Brech
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Vanderlei Carneiro da Silva
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Angelica Castilho Alonso
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Adriana Machado-Lima
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
| | - Daiane Fuga da Silva
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
| | | | - Marta Ferreira Bastos
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
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Cano-García L, Redondo-Rodríguez R, Manrique-Arija S, Domínguez-Quesada C, Crisóstomo Vacas J, Armenteros-Ortiz P, Ruiz-Vilchez D, Martín-Martín JM, García-Studer A, Ortiz-Márquez F, Mena-Vázquez N, Fernández-Nebro A. Prevalence of Malnutrition and Associated Factors in Older Patients with Rheumatoid Arthritis: A Cross-Sectional Study. Nutrients 2023; 15:3500. [PMID: 37630691 PMCID: PMC10460011 DOI: 10.3390/nu15163500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/03/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
OBJECTIVE To describe the frequency of malnutrition in older patients with rheumatoid arthritis (RA) and investigate associated risk factors. METHODS This multicenter, cross-sectional study included participants aged ≥65 years who met the 2010 ACR/EULAR criteria for RA. Nutritional status was assessed using the Mini Nutritional Assessment Short Form (MNA-SF) and based on variables, such as albumin level, the Geriatric Nutritional Risk Index (GNRI), and vitamin D. Data were also collected on epidemiological variables, inflammatory disease activity, quality of life, physical function, and frailty. Multivariate models were used to study factors associated with nutritional status. RESULTS The study population comprised 76 RA patients aged ≥65 years, of whom 68.4% had a normal nutritional status, and 31.5% had an impaired nutritional status: 28.9% were at risk of malnutrition, and 2.6% were malnourished. Additionally, 10% had albumin levels <3.8 g/L. Patients with impaired nutritional status had poorer quality of life and physical function. The factors associated with compromised nutritional status (OR [95% CI]) were age (1.0 [1.0-1.1]; p = 0.035), DAS28-ESR (1.8 [1.0-3.2]; p = 0.024), and EuroQoL-5D-5L (0.9 [0.9-0.9]; p = 0.040). Furthermore, the GNRI was associated with the MNA score (0.06 [0.0-0.1]; p = 0.014). CONCLUSIONS Approximately one-third of older patients with RA have impaired nutritional status. Older age, higher inflammatory disease activity, and decreased quality of life are associated with impaired nutritional status. The MNA and GNRI are valuable tools for assessing the nutritional status of patients with RA.
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Affiliation(s)
- Laura Cano-García
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Málaga, Spain; (L.C.-G.); (R.R.-R.); (S.M.-A.); (A.G.-S.); (F.O.-M.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
| | - Rocío Redondo-Rodríguez
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Málaga, Spain; (L.C.-G.); (R.R.-R.); (S.M.-A.); (A.G.-S.); (F.O.-M.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
- Departamento de Medicina, Universidad de Málaga, 29010 Málaga, Spain
| | - Sara Manrique-Arija
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Málaga, Spain; (L.C.-G.); (R.R.-R.); (S.M.-A.); (A.G.-S.); (F.O.-M.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
- Departamento de Medicina, Universidad de Málaga, 29010 Málaga, Spain
| | | | - Juan Crisóstomo Vacas
- UGC de Reumatología, Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain; (J.C.V.); (P.A.-O.); (D.R.-V.)
| | - Pedro Armenteros-Ortiz
- UGC de Reumatología, Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain; (J.C.V.); (P.A.-O.); (D.R.-V.)
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain
| | - Desiree Ruiz-Vilchez
- UGC de Reumatología, Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain; (J.C.V.); (P.A.-O.); (D.R.-V.)
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain
| | - José María Martín-Martín
- UGC de Reumatología, Hospital Universitario Nuestra Señora de la Candelaria, 38010 Santa Cruz de Tenerife, Spain;
| | - Aimara García-Studer
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Málaga, Spain; (L.C.-G.); (R.R.-R.); (S.M.-A.); (A.G.-S.); (F.O.-M.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
| | - Fernando Ortiz-Márquez
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Málaga, Spain; (L.C.-G.); (R.R.-R.); (S.M.-A.); (A.G.-S.); (F.O.-M.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
| | - Natalia Mena-Vázquez
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Málaga, Spain; (L.C.-G.); (R.R.-R.); (S.M.-A.); (A.G.-S.); (F.O.-M.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
| | - Antonio Fernández-Nebro
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Málaga, Spain; (L.C.-G.); (R.R.-R.); (S.M.-A.); (A.G.-S.); (F.O.-M.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
- Departamento de Medicina, Universidad de Málaga, 29010 Málaga, Spain
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Fernández-Garza LE, Coindreau-Frías F, Botello-González L, Ramos-Bacco M, Barrera-Saldaña HA. Factors Associated with Malnutrition Risk in Residents of Long-Term Care Facilities in Mexico. J Nutr Gerontol Geriatr 2023; 42:91-101. [PMID: 37738390 DOI: 10.1080/21551197.2023.2259348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
OBJECTIVE To investigate factors associated with the nutritional status in institutionalized Mexican older adults. MATERIAL AND METHODS In this cross-sectional study of residents in three long-term care facilities (LTCFs) in Monterrey, Mexico, a medical history, Mini-Mental State Examination, Barthel index, and geriatric depression scale, and Mini Nutritional Assessment (MNA) were performed. Risk of malnutrition and malnutrition status were defined as MNA 17-23.5 and <17, respectively. RESULTS Residents (n = 280) had a median age of 85 years and 72.1% were female. A total of 116 (41.4%) were at risk of malnutrition and 35 (12.5%) were malnourished. Having malnutrition or being at risk of malnutrition was associated with age (OR = 1.048), functional dependence (OR = 8.376), body mass index (BMI) <22 (OR = 7.518), cognitive impairment (OR = 2.210), urinary incontinence (OR = 2.397), previous stroke (OR = 2.870), Parkinson's disease (OR = 5.193), use of calcium channel blockers (OR = 3.706), and use of atypical antipsychotics (OR = 2.277). Having benign prostatic hyperplasia (OR = 0.067) or the use of angiotensin II receptor blockers (OR = 0.038) were related to being well-nourished. CONCLUSIONS In a population of residents of three LTCFs in Mexico, we found a high prevalence of malnutrition or being at risk of malnutrition. This underscores the need to implement guidelines for the prompt identification of this condition and further explanation of the factors identified as possibly related to malnutrition.
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Affiliation(s)
- Luis E Fernández-Garza
- National Laboratory of Specialized Services of Research, Development, and Innovation for Chemical and Biotechnological Drugs (LANSEIDI), CONACyT at Innbiogem, Monterrey, Nuevo León, Mexico
- Internal Medicine Department, Mexican Institute of Social Security, Monterrey, Nuevo León, Mexico
| | | | | | | | - Hugo A Barrera-Saldaña
- National Laboratory of Specialized Services of Research, Development, and Innovation for Chemical and Biotechnological Drugs (LANSEIDI), CONACyT at Innbiogem, Monterrey, Nuevo León, Mexico
- Schools of Medicine & of Biological Sciences, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, Mexico
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Saucedo Figueredo MC, Morilla-Herrera JC, Kaknani Uttumchandani S, Durá Pérez E, San Alberto Giraldos M, Nava Del Val MA, Hierrezuelo Martín MJ, Gómez Borrego AB, García Irazusta M, Gálvez González M, Miguel Morales-Asencio J. Longitudinal assessment of the eating pattern of people with dementia and its association with problems for feeding and malnutrition: a prospective follow-up study protocol. BMJ Open 2023; 13:e068790. [PMID: 37230516 DOI: 10.1136/bmjopen-2022-068790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION Dementia conditions the patient's nutrition from the beginning and vice versa. Generating difficulties for feeding (FEDIF) will influence its evolution. There are currently few nutritional longitudinal studies in people with dementia. Most focus on problems already established. The Edinburgh Feeding Evaluation in Dementia (EdFED) Scale identifies FEDIF of patients with dementia by studying their behaviours while eating or being fed. It also indicates areas of potential clinical interventions. METHODS AND ANALYSIS Prospective multicentre observational study carried out in nursing homes, Alzheimer's day care centres and primary healthcare centres. The study population will be dyads composed by the patient (diagnosed of dementia, over 65 years of age and who have feeding difficulties) and their family caregiver. Sociodemographic variables and nutritional status (body mass index, Mini Nutritional Assessment, blood test and calf and arm circumference) will be assessed. The Spanish version of the EdFED Scale will be completed and the presence of nursing diagnoses related to feeding behaviours will be collected. Follow-up will take place for 18 months. ETHICS AND DISSEMINATION All data will be carried out respecting European legislation 2016/679 in data protection, and the Spanish 'Organic Law 3/2018 of December 2005'. The clinical data will be kept segregated and encrypted. The informed consent has been obtained. The research has been authorised by the Costa del Sol Health Care District on 27 February 2020 and the Ethics Committee on 2 March 2021. It has obtained funding from the Junta de Andalucía on 15 February 2021. Findings of the study will be presented at provincial, national and international conferences and published in peer-reviewed journals.
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Affiliation(s)
- María Carmen Saucedo Figueredo
- Primary Health Care Costa del Sol District, Los Boliches Health Care Centre, Andalucia Health Service (SAS), Fuengirola, Andalucia, Spain
- IR Group C-13 "Chronicity, Dependency, Care and Health Services", Biomedical Research Institute of Malaga (IBIMA), Malaga, Andalucia, Spain
| | - Juan Carlos Morilla-Herrera
- IR Group C-13 "Chronicity, Dependency, Care and Health Services", Biomedical Research Institute of Malaga (IBIMA), Malaga, Andalucia, Spain
- Residences Unit, Malaga and Valle del Guadalhorce Primary Health Care District, Andalucia Health Service (SAS), Malaga, Andalucia, Spain
| | - Shakira Kaknani Uttumchandani
- IR Group C-13 "Chronicity, Dependency, Care and Health Services", Biomedical Research Institute of Malaga (IBIMA), Malaga, Andalucia, Spain
- Nursing Department, University of Malaga, Health Science Faculty, Malaga, Andalucia, Spain
| | - Elena Durá Pérez
- Andalusian Public Foundation for Research in Biomedicine and Health of Malaga, FIMABIS, Malaga, Andalucia, Spain
| | - Mercedes San Alberto Giraldos
- Primary Health Care Costa del Sol District, La Lobilla Health Care Center, Andalucia Health Service (SAS), Estepona (Málaga), Andalucia, Spain
| | - Maria Antonia Nava Del Val
- Primary Health Care Costa del Sol District, Las Albarizas Health Care Center, Andalucia Health Service (SAS), Marbella, Andalucia, Spain
| | - María Jesús Hierrezuelo Martín
- Primary Health Care Costa del Sol District, Las Lagunas Health Care Center, Servicio Andaluz de Salud, Mijas Costa, Andalucia, Spain
| | - Ana Belén Gómez Borrego
- Community Mental Health Unit, Virgen de la Victoria University Hospital, Servicio Andaluz de Salud, Estepona, Andalucia, Spain
| | - Manuela García Irazusta
- Primary Health Care Costa del Sol District, Fuengirola Oeste Health Care Center, Servicio Andaluz de Salud, Marbella, Andalucia, Spain
| | - María Gálvez González
- Primary Health Care Costa del Sol District, La Carihuela Health Care Center, Servicio Andaluz de Salud, Benalmadena, Andalucia, Spain
| | - Jose Miguel Morales-Asencio
- IR Group C-13 "Chronicity, Dependency, Care and Health Services", Biomedical Research Institute of Malaga (IBIMA), Malaga, Andalucia, Spain
- Nursing Department, University of Malaga, Málaga, Andalucia, Spain
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Kazemian S, Tavolinejad H, Rashedi S, Yarahmadi P, Farrokhpour H, Kolte D. Meta-Analysis on the Association Between Nutritional Status and Outcomes After Transcatheter Aortic Valve Implantation. Am J Cardiol 2023; 186:109-116. [PMID: 36328831 DOI: 10.1016/j.amjcard.2022.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/20/2022] [Accepted: 10/06/2022] [Indexed: 11/05/2022]
Abstract
Malnutrition is a common co-morbidity among candidates for transcatheter aortic valve implantation (TAVI). This study aimed to investigate the association between nutritional status determined by objective nutritional indices and outcomes of patients who underwent TAVI. We systematically searched PubMed, Embase, Web of Science, Scopus, and Cochrane Library from inception until April 18, 2022 to identify studies examining the association of preprocedural nutritional status with post-TAVI outcomes. Malnutrition was defined by objective nutritional indices-controlling nutritional index, nutritional risk index, geriatric nutritional risk index (GNRI), and prognostic nutritional index (PNI). The primary end point was 1-year all-cause mortality. The review included 13 observational studies and 6,785 patients who underwent TAVI. Malnutrition was associated with a higher risk of 1-year all-cause mortality, as defined by either the controlling nutritional index (hazard ratio [HR] 2.70, 95% confidence interval [CI] 1.21 to 6.03, p = 0.015), GNRI (HR 1.79, 95% CI 1.09 to 2.93, p = 0.021), or PNI (HR 1.17, 95% CI 1.11 to 1.23, p <0.001). In the meta-analysis of adjusted results, lower GNRI was independently associated with higher 1-year mortality (HR 1.70, 95% CI 1.16 to 2.50, p = 0.006). Lower GNRI was associated with increased risk of acute kidney injury (relative risk [RR] 2.21, 95% CI 1.63 to 2.99, p <0.001) and 1-year cardiovascular mortality (RR 2.50, 95% CI 1.66 to 3.78, p <0.001). Lower PNI was associated with a higher risk of major vascular complications (RR 2.99, 95% CI 1.38 to 6.51, p = 0.006). In conclusion, baseline malnutrition, as assessed by objective indices, is associated with worse outcomes after TAVI. Future studies should focus on the value of nutritional assessment and interventions to improve nutritional status in patients who underwent TAVI.
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Affiliation(s)
- Sina Kazemian
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Tavolinejad
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Rashedi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Pourya Yarahmadi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Farrokhpour
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Dhaval Kolte
- Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
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Totland TH, Krogh HW, Smedshaug GB, Tornes RA, Bye A, Paur I. Harmonization and standardization of malnutrition screening for all adults - A systematic review initiated by the Norwegian Directorate of Health. Clin Nutr ESPEN 2022; 52:32-49. [PMID: 36513471 DOI: 10.1016/j.clnesp.2022.09.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 09/05/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND & AIMS The Norwegian Directorate of Health has identified a need to harmonize and standardize the malnutrition screening practice in Norwegian hospitals and primary health care settings, in order to provide a seamless communication of malnutrition screening along the patient pathway. Our aim was to perform a systematic review of the validity and reliability of screening tools used to identify risk of malnutrition across health care settings, diagnoses or conditions and adult age groups, as a first step towards a national recommendation of one screening tool. METHODS A systematic literature search for articles evaluating validity, agreement, and reliability of malnutrition screening tools, published up to August 2020, was conducted in: MEDLINE, Embase, APA PsycInfo, Cinahl, Cochrane Databases, Web of Science, Epistemonikos, SveMed+, and Norart. The systematic review was registered in PROSPERO (CRD42022300558). For critical appraisal of each included article, the Quality Criteria Checklist by The Academy of Nutrition and Dietetics was used. RESULTS The review identified 105 articles that fulfilled the inclusion and exclusion criteria. The most frequently validated tools were Mini Nutritional Assessment short form (MNA), Malnutrition Universal Screening Tool (MUST), Malnutrition Screening Tool (MST), and Nutritional Risk Screening 2002 (NRS-2002). MNA, MST and NRS-2002 displayed overall moderate validity, and MUST low validity. All four tools displayed low agreement. MST and MUST were validated across health care settings and age groups. In general, data on reliability was limited. CONCLUSIONS The screening tools MST and NRS-2002 displayed moderate validity for the identification of malnutrition in adults, of which MST is validated across health care settings. In addition, MNA has moderate validity for the identification of malnutrition in adults 65 years or older.
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Affiliation(s)
- Torunn Holm Totland
- Department of Non-Communicable Diseases, Division of Prevention and Public Health, Norwegian Directorate of Health, Oslo, Norway; Department of Physical Health and Ageing, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.
| | - Henriette Walaas Krogh
- Department of Non-Communicable Diseases, Division of Prevention and Public Health, Norwegian Directorate of Health, Oslo, Norway
| | - Guro Berge Smedshaug
- Department of Non-Communicable Diseases, Division of Prevention and Public Health, Norwegian Directorate of Health, Oslo, Norway
| | | | - Asta Bye
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway; European Palliative Care Research Centre (PRC), Dept. of Oncology, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingvild Paur
- Department of Non-Communicable Diseases, Division of Prevention and Public Health, Norwegian Directorate of Health, Oslo, Norway; Norwegian Advisory Unit on Disease-related Undernutrition, Oslo University Hospital, Oslo, Norway; Dept. of Clinical Services, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
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Moradell A, Fernández-García ÁI, Navarrete-Villanueva D, Pérez-Gómez J, Gesteiro E, Ara Royo I, Casajús JA, Gómez-Cabello A, Vicente-Rodríguez G. Does nutritional status influence the effects of a multicomponent exercise programme on body composition and physical fitness in older adults with limited physical function? Eur J Sport Sci 2022:1-10. [PMID: 35816744 DOI: 10.1080/17461391.2022.2092426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Physical exercise effects and ageing on fitness may be influenced by nutritional status. This study investigates the effects of a 6-month multicomponent exercise training (MCT) on nutritional status and evaluates if this type of exercise could affect differently body composition and physical fitness depending on the nutritional status of older adults with decreased functional capacity. Ninety-three participants (80.4 ± 6.0 y) were divided into control (n = 45) and intervention (n = 48) groups. The intervention consisted of a 6-month multicomponent training. Comparisons between changes in body composition and fitness during the 6-months were performed between individuals at risk of malnutrition and those well-nourished, according to the Mini Nutritional Assessment. Model mixed-effect analyses were used to investigate differences after the 6 months of MCT between groups. Well-nourished participants compared with those at risk of malnutrition had higher: arm (13.4 ± 3.5 vs 14.3 ± 33.6 repetitions) and leg strength (9.0 ± 3.0 vs 11.1 ± 3.3 repetitions), maximum walking speed (31.6 ± 13.1 vs 23.7 ± 6.3s), agility (11.9 ± 5.8 vs 8.3 ± 2.1s), and aerobic capacity (31.6 ± 13.1 vs 23.7 ± 6.3 m), at baseline. After the training, those without risk of malnutrition in CON decreased their nutritional status (-1.7 + 0.7 points). Those well-nourished that performed the intervention decreased total fat mass (-1.0 ± 0.3 kg) and body fat percentage (-1.2 ± 0.4%). Both groups of training improved similarly in all tests, except for balance, in which the well-nourished showed improvements of 6.3 ± 1.9s. These results underline the usefulness of MCT in improving physical fitness regardless of nutritional status and preventing nutritional status detriment in well-nourished older adults, who are fitter and benefit more, in terms of body composition.Trial registration: ClinicalTrials.gov identifier: NCT03831841.Highlights Multicomponent exercise programme seems to be effective in delaying detriments in the nutritional status of well-nourished people.Well-nourished older people obtain more benefits in body composition from the multicomponent exercise than those at risk of malnutrition, decreasing adiposity.The positive effect of multicomponent exercise was observed in physical fitness independently of nutritional status.
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Affiliation(s)
- Ana Moradell
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Agrifood Research and Technology Centre of Aragón -IA2-, CITA-Universidad de Zaragoza, Zaragoza, Spain.,Exercise and Health in Special Population Spanish Research Net (EXERNET), Spain.,Department of Physiatry and Nursing, Faculty of Health and Sport Science FCSD, University of Zaragoza, Zaragoza, Spain
| | - Ángel I Fernández-García
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Agrifood Research and Technology Centre of Aragón -IA2-, CITA-Universidad de Zaragoza, Zaragoza, Spain.,Exercise and Health in Special Population Spanish Research Net (EXERNET), Spain.,Department of Physiatry and Nursing, Faculty of Health and Sport Science FCSD, University of Zaragoza, Zaragoza, Spain
| | - David Navarrete-Villanueva
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Agrifood Research and Technology Centre of Aragón -IA2-, CITA-Universidad de Zaragoza, Zaragoza, Spain.,Exercise and Health in Special Population Spanish Research Net (EXERNET), Spain.,Department of Physiatry and Nursing, Faculty of Health, University of Zaragoza, Zaragoza, Spain
| | - Jorge Pérez-Gómez
- Exercise and Health in Special Population Spanish Research Net (EXERNET), Spain.,HEME Research Group, University of Extremadura, Cáceres, Spain
| | - Eva Gesteiro
- Exercise and Health in Special Population Spanish Research Net (EXERNET), Spain.,ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences-INEF, Polytechnic University of Madrid, Madrid, Spain
| | - Ignacio Ara Royo
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.,Biomedical Research Net in Physiopatology, Obesity and Nutricition (CIBERObn) Madrid, Spain
| | - Jose Antonio Casajús
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Agrifood Research and Technology Centre of Aragón -IA2-, CITA-Universidad de Zaragoza, Zaragoza, Spain.,Exercise and Health in Special Population Spanish Research Net (EXERNET), Spain.,Department of Physiatry and Nursing, Faculty of Health, University of Zaragoza, Zaragoza, Spain.,Biomedical Research Net in Physiopatology, Obesity and Nutricition (CIBERObn) Madrid, Spain
| | - Alba Gómez-Cabello
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Agrifood Research and Technology Centre of Aragón -IA2-, CITA-Universidad de Zaragoza, Zaragoza, Spain.,Exercise and Health in Special Population Spanish Research Net (EXERNET), Spain.,Department of Physiatry and Nursing, Faculty of Health and Sport Science FCSD, University of Zaragoza, Zaragoza, Spain.,Biomedical Research Net in Physiopatology, Obesity and Nutricition (CIBERObn) Madrid, Spain.,Defense University Center, Zaragoza, Spain
| | - Germán Vicente-Rodríguez
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Agrifood Research and Technology Centre of Aragón -IA2-, CITA-Universidad de Zaragoza, Zaragoza, Spain.,Exercise and Health in Special Population Spanish Research Net (EXERNET), Spain.,Department of Physiatry and Nursing, Faculty of Health and Sport Science FCSD, University of Zaragoza, Zaragoza, Spain.,Biomedical Research Net in Physiopatology, Obesity and Nutricition (CIBERObn) Madrid, Spain
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Hu Y, Yang H, Zhou Y, Liu X, Zou C, Ji S, Liang T. Prediction of all-cause mortality with malnutrition assessed by nutritional screening and assessment tools in patients with heart failure:a systematic review. Nutr Metab Cardiovasc Dis 2022; 32:1361-1374. [PMID: 35346547 DOI: 10.1016/j.numecd.2022.03.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/16/2022] [Accepted: 03/07/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS In the absence of a gold standard or scientific consensus regarding the nutritional evaluation of heart failure (HF) patients, this study aimed to summarize and systematically evaluate the prognostic value of nutritional screening and assessment tools used for all-cause mortality in HF patients. METHODS AND RESULTS Relevant studies were retrieved from major databases (PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang Data, and China Biology Medicine disc (CMB)) and searched from the earliest available date until July 2021. If three or more studies used the same tool, meta-analysis using RevMan 5.3 was performed. This systematic review was registered at PROSPERO (number CRD42021275575). A total of 36 articles involving 25,141 HF patients were included for qualitative analysis and 31 studies for quantitative analysis. Meta-analysis of these studies indicated, poor nutritional status evaluated by using 5 nutritional screening tools (Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI), Controlling Nutritional Status Score (CONUT), Nutritional Risk Index (NRI), and Short Form Mini Nutritional Assessment (MNA-SF)) or 2 nutritional assessment tools (the Mini Nutritional Assessment (MNA) and Generated Subjective Global Assessment (SGA)) predicted all-cause mortality in HF patients. Of all tools analyzed, MNA had the maximum HR for mortality [HR = 2.62, 95%CI 1.11-6.20, P = 0.03] and MNA-SF [HR = 1.94, 95%CI 1.40-2.70, P<0.001] was the best nutritional screening tools. CONCLUSION Poor nutritional status predicted all-cause mortality in HF patients. MNA may be the best nutritional assessment tool, and MNA-SF is most recommended for HF patient nutritional screening. The application value of MNA, especially in patients with reduced left ventricular ejection fraction (LVEF), needs to be further confirmed. The clinical application value of Mini-Nutrition Assessment Special for Heart Failure (MNA-HF) and Global Leadership Initiative on Malnutrition (GLIM) in HF patients needs to be confirmed.
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Affiliation(s)
- Yule Hu
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, NO.9 Dong Dan San Tiao, 100730, Beijing, China
| | - Haojie Yang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, NO.9 Dong Dan San Tiao, 100730, Beijing, China
| | - Yanjun Zhou
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, NO.9 Dong Dan San Tiao, 100730, Beijing, China
| | - Xin Liu
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, NO.9 Dong Dan San Tiao, 100730, Beijing, China
| | - Changhong Zou
- Heart Failure Care Unit, Heart Failure Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100045, Beijing, China
| | - Shiming Ji
- Heart Failure Care Unit, Heart Failure Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100045, Beijing, China
| | - Tao Liang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, NO.9 Dong Dan San Tiao, 100730, Beijing, China.
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10
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Razon AH, Haque M, Ahmed M, Ahmad T. Assessment of dietary habits, nutritional status and common health complications of older people living in rural areas of Bangladesh. Heliyon 2022; 8:e08947. [PMID: 35243069 PMCID: PMC8857427 DOI: 10.1016/j.heliyon.2022.e08947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/09/2021] [Accepted: 02/09/2022] [Indexed: 11/26/2022] Open
Abstract
Background Old age is one of the vulnerable and prone stages in terms of health status. So this study aimed to assess the nutritional status and common health complications of older people. Methods Simplified Nutritional Appetite Questionnaire (SNAQ), Anthropometric measurements, Diet History Method, and Mini Nutritional Assessment (MNA) tools were used to measure the nutritional status. Data were analyzed by using Statistical Package for Social Science (SPSS) version 16. Results Out of the total 320 elderly participants the mean ± SD value for the age of male and female was 67.25 ± 6.5 and 67.32 ± 7.7 years respectively. According to BMI classification, it was noticed that with advancing age the percentage of underweight was also increased such as for 60–75 years old age group the underweight percentage was 30.0% where for 76 to 85 and >85 years old age group the underweight percentage was 45.0% and 60.0% respectively. According to the MNA score, 97 elderly respondents were malnourished and a total of 172 respondents had SNAQ scores below 14. This study found a statistically significant (P < 0.05) correlations among various health complications with nutritional status according to MNA score. In addition 56.6% (OR = 1.24, 95% CI = .799–1.939), 63.8% (OR = 1.18, 95% CI = .745–1.857) and 64.7% (OR = 1.14, 95% CI = .720–1.804) respondents had diabetes mellitus, hypertension and cardiovascular disease respectively. The risk of musculoskeletal pain (OR = 1.073, 95% CI = .684–1.681), bedsore (OR = 1.884, 95% CI = .903–3.934) and decreased sense of thirst (OR = 1.278, 95% CI = .821–1.991) were higher among females than males. A little number of the elderly used to take milk, meat, and fish daily. Conclusion During this cross-sectional study, significant correlations among nutritional changes with health complications were determined. To prevent malnutrition among the elderly a proper health policy as well as periodical nutritional screening should be conducted.
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Nutritional status assessment in Alzheimer disease and its influence on disease progression. NEUROLOGÍA (ENGLISH EDITION) 2021; 37:735-747. [PMID: 34657824 DOI: 10.1016/j.nrleng.2019.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 11/04/2019] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Nutritional deficiencies are frequent in Alzheimer disease (AD), even in early stages. Nutritional impairment (NI) may be associated with faster disease progression. The objective of this study was to describe the frequency of NI and the associated risk factors at the time of diagnosis and to analyse its influence on subsequent progression. METHODS We performed a prospective, multicentre, observational study of patients recently diagnosed with prodromal AD (pAD) or dementia due to AD (ADd). Two clinical assessments were conducted over a period of 18 months. The Mini Nutritional Assessment test (MNA; score range, 0-30; cut-off point for NI, < 24) was used to estimate nutritional status. Progression was defined as an increase of ≥ 3 points on the Clinical Dementia Rating-sum of boxes test. RESULTS The sample included 50 patients with pAD (mean [standard deviation] age, 76.1 [5.3] years; 68% women), and 127 with ADd (80 [5.9] years; 72.4% women). A total of 141 (79.7%) completed both evaluations. The prevalence of NI was 28.2% (24% for pAD, 29.9% for ADd; P = .43), with the majority (92%) at risk of malnutrition. NI was associated with female sex (odds ratio [OR]: 4.2; 95% confidence interval [CI]: 1.7-10.5; P < .001) and greater behavioural involvement (OR: 5.8; 95% CI: 2.6-12.7; P < .001). A larger proportion of patients with progression was observed among those with NI than among those with normal nutritional status (50% vs 28.7%, P < .05; ADd: 53.6% vs 31.8%, P < .05; pAD: 41.7% vs 22.9%, P = .21). Greater cognitive impairment (OR: 2.1; 95% CI: 1.03-4.4; P < .05) and NI (OR: 2.4; 95% CI: 1.1-5.1; P < .05) were independent risk factors for disease progression. CONCLUSIONS NI is highly prevalent in patients with AD. Assessing nutritional status at the time of diagnosis may enable identification of patients at greater risk of disease progression.
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Chen B, Liu W, Chen Y, She Q, Li M, Zhao H, Zhao W, Peng Z, Wu J. Effect of Poor Nutritional Status and Comorbidities on the Occurrence and Outcome of Pneumonia in Elderly Adults. Front Med (Lausanne) 2021; 8:719530. [PMID: 34712677 PMCID: PMC8547609 DOI: 10.3389/fmed.2021.719530] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/16/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Malnutrition and comorbidity are two common geriatric syndromes. The pathology of pneumonia is multifactorial, making its diagnosis and management a great challenge. Hospital-acquired pneumonia (HAP) and community-acquired pneumonia (CAP) are two main types of pneumonia. However, the effect of geriatric syndromes on pneumonia and its prognosis have not been clearly explored. Methods: We collected the relevant electronic data of inpatients aged over 65 years and diagnosed with pneumonia in the Geriatrics Department Building of the First Affiliated Hospital with Nanjing Medical University between December 2018 and December 2019, and further divided them into HAP group and CAP group. The correlations of age, age-adjusted Charlson Comorbidity Index (aCCI), basic diseases and nutritional indexes (i.e., albumin, electrolyte, hemoglobin) with pneumonia and prognosis were analyzed. We analyzed the associations between infection prognosis/infection level and age, nutritional status, aCCI and underlying diseases, using linear regression model. The box plot was applied to present infection outcome, and the nomogram was built for predicting infection outcomes. We utilized the heat map to show the associations between nutritional status and infection level/outcome in all infected patients, HAP, and CAP. Results: The final study comprised samples of 669 pneumonia patients divided into HAP group (n = 517) and CAP group (n = 152). In all patients, the infection outcome was negatively correlated with age (P = 0.013). The level of albumin was negatively correlated with infection prognosis in all patients (P = 0.03), and negatively correlated with neutrophil count and CRP (P = 0.008, P < 0.001). ACCI was positively correlated with CRP (P = 0.003). The prognosis was negatively associated with age and albumin level. In the patients with basic dementia/Alzheimer's disease and chronic obstructive pulmonary disease/asthma, the prognosis was worse. Conclusion: There was a correlation between poor nutritional status-related indexes and inflammatory indexes. A poor nutritional status might predict a high risk of pneumonia in elderly adults. Advanced age and comorbidities were risk factors for the occurrence and poor prognosis of pneumonia. Therefore, comorbidities should be well-treated in the elderly with pneumonia.
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Affiliation(s)
- Bo Chen
- Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Wen Liu
- Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Yanbing Chen
- First Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Quan She
- Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Min Li
- Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - HongYe Zhao
- Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
- Department of General Practice, The First People's Hospital of Lianyungang, Lianyungang Clinical College of Nanjing Medical University, Lianyungang, China
| | - Weihong Zhao
- Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Zhihang Peng
- Department of Epidemiology and Health Statistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jianqing Wu
- Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
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Mozo-Alonso F, Novalbos-Ruiz JP, Duran-Alonso JC, Rodríguez-Martin A. Nutritional Status of Non-Institutionalized Adults Aged over 65. Study of Weight and Health in Older Adults (PYSMA). Nutrients 2021; 13:1561. [PMID: 34066337 PMCID: PMC8148168 DOI: 10.3390/nu13051561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND A significant increase in the prevalence of malnourishment, obesity, and sarcopenic obesity has been observed in developed countries over the last few decades. In Spain, this especially happens in populations over 65 who are not institutionalized. Differences in lifestyle, medication, and economic capacity partially explain this increase. OBJECTIVE To study the nutritional status of a population of 65 year-olds and subjects who are not institutionalized, in the Cádiz region (Spain). METHODS Observational, transversal study carried out on 2621 subjects who are 65 years old and over, with a direct weight and height measurement, in 150 pharmacy offices from 44 locations. A mobile application was designed for homogeneous data collection in all the pharmacy offices. The data required from all subjects was gender, age, postal code, social security contribution regime, if the patient lives alone, type of food consumed as the main meals, level of physical activity, polypharmacy, weight, and height. RESULTS The prevalence of overweight and obesity amounts to 82.2% of the population (43.2% overweight and 39% obese). We found an inverse relationship between the prevalence of overweight and obesity with carrying out physical activity and having full dinners. CONCLUSION We identify the need to reinforce the messages to the elderly aimed at maintaining adequate physical activity and assessing the quality and quantity of dinners, as well as reducing, as much as possible, the treatments that may lead to weight gain.
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Affiliation(s)
- Felipe Mozo-Alonso
- Colegio Oficial Farmacéuticos de Cádiz, Calle Isabel la Católica, 22. Cádiz, 11004 Cádiz, Spain;
| | | | - Juan C. Duran-Alonso
- Hospital Juan Grande, Glorieta Félix Rdguez, de la Fuente, Jerez de la Frontera, 11408 Cádiz, Spain;
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Yang S, Wang S, Wang L, Liu G, Tai P, Kou F, Jia W, Han K, Liu M, He Y. Dietary behaviors and patterns of centenarians in Hainan: A cross-sectional study. Nutrition 2021; 89:111228. [PMID: 33848822 DOI: 10.1016/j.nut.2021.111228] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 01/29/2021] [Accepted: 03/01/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVES The aim of this study was to understand the diet-related behaviors of Hainan centenarians and to analyze dietary factors that affect their nutritional status. METHODS Data were collected from the China Hainan Centenarian Cohort Study, a full sample survey including questionnaires, physical examinations, and physiologic indices of the centenarian population. The study included 1002 centenarians. The diet-related behaviors were assessed using the food frequency questionnaire; nutritional status was determined according to the Mini Nutritional Assessment - short form scale scores. We used logistic regression models to analyze the main dietary risk factors of malnutrition. RESULTS Of all the centenarians, 94.6% maintained regular meals, 80.4% had three meals a day, 53.4% ate each meal until 80% full, 88.7% ate vegetables daily, and 70% drank one to two cups of water daily. Centenarians ate rice-based staple foods; eggs, dairy, legumes, nuts, and poultry were not popular. The main sources of meat were red meat and seafood. None liked fried food, and 19.3% preferred sweet flavors. People with normal nutritional status accounted for 12.3% of the population, whereas those with malnutrition comprised 20.8%. Dietary factors that affected nutritional status included three meals a day (odds ratio [OR], 0.366; 95% confidence interval [CI], 0.173-0.778), tea drinking (OR, 0.236; 95% CI, 0.087-0.641), and the frequency of poultry (OR, 0.261; 95% CI, 0.088-0.771), seafood (OR, 0.247; 95% CI, 0.110-0.554), nuts (OR, 0.381; 95% CI, 0.150-0.965), and pastry (OR, 0.219; 95% CI, 0.080-0.600) consumption. CONCLUSION This was the first study on the dietary behaviors and nutritional status of centenarians using survey data. We highlighted the factors affecting nutritional status and provided scientific support for dietary strategies that may improve the nutritional status of the elderly population.
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Affiliation(s)
- Shanshan Yang
- Department of Disease Prevention and Control, The 1st Medical Center, Chinese PLA General Hospital, Beijing, China; Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, the 2nd Clinical Center, Chinese PLA General Hospital, Beijing, China
| | - Shengshu Wang
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, the 2nd Clinical Center, Chinese PLA General Hospital, Beijing, China
| | - Lili Wang
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, Beijing, China; National Clinical Research Center for Otolaryngologic Diseases, Chinese PLA General Hospital, Beijing, China
| | - Guangdong Liu
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, the 2nd Clinical Center, Chinese PLA General Hospital, Beijing, China
| | - Penggang Tai
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, the 2nd Clinical Center, Chinese PLA General Hospital, Beijing, China
| | - Fuyin Kou
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, the 2nd Clinical Center, Chinese PLA General Hospital, Beijing, China
| | - Wangping Jia
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, the 2nd Clinical Center, Chinese PLA General Hospital, Beijing, China
| | - Ke Han
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, the 2nd Clinical Center, Chinese PLA General Hospital, Beijing, China
| | - Miao Liu
- Department of Statistics and Epidemiology, Graduate school, Chinese PLA General Hospital, Beijing, China
| | - Yao He
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, the 2nd Clinical Center, Chinese PLA General Hospital, Beijing, China.
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Guigoz Y, Vellas B. Nutritional Assessment in Older Adults : MNA® 25 years of a Screening Tool and a Reference Standard for Care and Research; What Next? J Nutr Health Aging 2021; 25:528-583. [PMID: 33786572 DOI: 10.1007/s12603-021-1601-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A tool to assess nutritional status in older persons was really needed. It took 5 years to design the MNA® (Mini Nutrition Assessment) tool, complete the first validations studies both in Europe and in the U.S. and to publish it. After the full MNA®, the MNA® short form and the self-MNA® have been validated. As well as Chinese and other national MNA® forms. Now more than 2000 clinical research have used the MNA® all over the world from community care to hospital. At least 22 Expert groups included the MNA® in new clinical practice guidelines, national or international registries. The MNA® is presently included in almost all geriatric and nutrition textbook and part of the teaching program for medicine and other health care professional worldwide. The urgent need is to target the frail older adults more likely to have weight loss and poor appetite and to prevent frailty and weight loss in the robust. We present in this paper the review of 25 years of clinical research and practice using the MNA® worldwide.
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Affiliation(s)
- Y Guigoz
- Yves Guigoz, Chemin du Raidillon, CH-1066 Epalinges, Switzerland.
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Abate T, Mengistu B, Atnafu A, Derso T. Malnutrition and its determinants among older adults people in Addis Ababa, Ethiopia. BMC Geriatr 2020; 20:498. [PMID: 33228557 PMCID: PMC7684921 DOI: 10.1186/s12877-020-01917-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 11/17/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND In Ethiopia, malnutrition among older adults is under detected and, neglected area because the entire problem related with aging considered as fate of aging. Also, older adults are often omitted from public health research. Literatures are scarce in Ethiopia; there is limited information in the current study area among older adults using Min Nutritional Assessment (MNA). Therefore, this paper investigated the prevalence of malnutrition and its predictors among older adults people aged 65 years or above in Addis Ababa, Ethiopia. METHODS A community-based cross-sectional study was employed from January 1 to march 30, 2020 in Addis Ababa. Nutritional status of the older adults was measured by using Min nutritional assessment (MNA). Data from 662 older adults were collected through face to face interviews using a structured questionnaire. Bivariable and multivariable logistic regression analysis was done to identify factors associated with malnutrition. RESULT The prevalence of malnutrition among older adults was found to be 26.6%[95% Confidence interval (CI):22.8, 30.1]. Depression [Adjusted Odds Ratio (AOR) = 7.57 95%CI: 5.01, 11.45], being poor [AOR = 1.95 95% CI: 1.166, 3.25], occupation; daily laborer and guard [AOR = 2.78 95% CI: 1.12, 7.17] and being old old [AOR = 2.62 95% CI: 1.62, 4.25] were significantly associated with the higher odds of malnutrition. CONCLUSION This study illustrated that considerably high proportion of older adults were malnourished in Addis Ababa. Socio-economic characteristics and depression were significantly associated with malnutrition. Therefore, nutritional and social support activities are essential for older adults, particularly of those who are socio-economically disadvantaged and advanced age. In addition, regular nutritional screening and management as well as behavioral interventions should be strengthened as a pillar component of therapeutic interventions. Specific nutritional requirements, at later stages of life is changing, and with the population aged over 65 years increasing in low-income countries like Ethiopia, the research in this field is likely to increase further.
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Affiliation(s)
- Tadele Abate
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Berhanu Mengistu
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asmamaw Atnafu
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Terefe Derso
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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Liu G, Yang S, Liu W, Wang S, Tai P, Kou F, Jia W, Han K, Liu M, He Y. Canonical Correlation Analysis on the Association Between Sleep Quality and Nutritional Status Among Centenarians in Hainan. Front Public Health 2020; 8:585207. [PMID: 33330327 PMCID: PMC7716598 DOI: 10.3389/fpubh.2020.585207] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/09/2020] [Indexed: 01/08/2023] Open
Abstract
Objective: To analyze the correlation between nutritional status and sleep quality among centenarians. Methods: A total of 1,002 centenarians in Hainan were included in the full sample survey. The Mini Nutritional Assessment-Short Form (MNA-SF) was used for nutritional risk assessment and the Pittsburgh Sleep Quality Index Scale (PSQI) was used for evaluating sleep quality. Canonical correlation analysis was conducted to analyze their correlation. Results: Two statistically significant (p < 0.05) canonical coefficients were found, with the first canonical correlation coefficient having a value of 0.247, eigenvalue of 0.065, and contribution rate of 89.0%. The linear combination of nutrition variable V1, mainly determined by MNA1 (appetite loss), MNA5 (dementia/depression), and MNA2 (weight loss), indicates an association with sleep quality; the linear combination of sleep quality W1, mainly determined by PSQI1 (subjective sleep quality), PSQI7 (daytime dysfunction), and PSQI2 (sleep latency), indicates an association with nutritional status. Appetite loss, dementia/depression, and weight loss have negative correlations with subjective sleep quality and daytime dysfunction. Conclusion: Among centenarians, the relationship between nutritional status and sleep quality is bidirectional. Furthermore, appetite loss, dementia/depression, weight loss, subjective sleep quality, and daytime dysfunction are the main relevant factors.
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Affiliation(s)
- Guangdong Liu
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Institute of Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Shanshan Yang
- Department of Disease Prevention and Control, The 1st Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Wei Liu
- Hospital Management Institute, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Shengshu Wang
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Institute of Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Penggang Tai
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Institute of Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Fuyin Kou
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Institute of Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Wangping Jia
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Institute of Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Ke Han
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Institute of Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Miao Liu
- Department of Statistics and Epidemiology, Graduate School, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yao He
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Institute of Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China
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Doi S, Ashikaga K, Kida K, Watanabe M, Yoneyama K, Suzuki N, Kuwata S, Kaihara T, Koga M, Okuyama K, Kamijima R, Tanabe Y, Takeichi N, Watanabe S, Izumo M, Ishibashi Y, Akashi YJ. Prognostic value of Mini Nutritional Assessment-Short Form with aortic valve stenosis following transcatheter aortic valve implantation. ESC Heart Fail 2020; 7:4024-4031. [PMID: 32909396 PMCID: PMC7754760 DOI: 10.1002/ehf2.13007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/25/2020] [Accepted: 08/27/2020] [Indexed: 01/30/2023] Open
Abstract
Aims Older adults at risk for malnutrition are known to have a high mortality rate. This study aimed to investigate whether the Mini Nutritional Assessment—Short Form (MNA‐SF) could predict midterm mortality in patients undergoing transcatheter aortic valve implantation (TAVI). Methods and results We applied the MNA‐SF in 288 patients who had undergone TAVI from January 2016 to June 2019 at the St. Marianna University School of Medicine hospital. Using the MNA‐SF cut‐off value to indicate the risk of malnutrition, patients were divided into two groups, namely, those with an MNA‐SF score ≤11 (impaired MNA‐SF group) and those with an MNA‐SF score ≥12 (maintained MNA‐SF group). We used this value to investigate the association between the MNA‐SF and all‐cause mortality. Overall, 188 (65%) and 100 (35%) patients comprised the impaired MNA‐SF and maintained MNA‐SF groups, respectively, and 41 patients died after TAVI (mean follow‐up duration, 458 ± 315 days). Kaplan–Meier analyses showed that patients in the impaired MNA‐SF group had a significantly higher incidence of all‐cause mortality (hazard ratio 2.67; 95% confidence interval 1.29–6.21; P = 0.01). Multivariate Cox regression analyses showed that the MNA‐SF score was an independent predictor of all‐cause mortality after adjusting for the Society of Thoracic Surgeons risk score, Katz Index, and brain natriuretic peptide test results (hazard ratio 1.14; 95% confidence interval 1.01–1.28; P = 0.04). Conclusions The MNA‐SF was useful to screen for the risk of malnutrition in patients with TAVI and in predicting midterm prognoses in patients undergoing TAVI and could predict patient mortality after the procedure.
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Affiliation(s)
- Shunichi Doi
- Division of Cardiology, Department of Internal MedicineSt. Marianna University School of Medicine2‐16‐1 Sugao, Miyamae‐kuKawasakiKanagawa216‐8511Japan
| | - Kohei Ashikaga
- Division of Cardiology, Department of Internal MedicineSt. Marianna University School of Medicine2‐16‐1 Sugao, Miyamae‐kuKawasakiKanagawa216‐8511Japan
| | - Keisuke Kida
- Department of PharmacologySt. Marianna University School of MedicineKawasakiJapan
| | - Mika Watanabe
- Division of Cardiology, Department of Internal MedicineSt. Marianna University School of Medicine2‐16‐1 Sugao, Miyamae‐kuKawasakiKanagawa216‐8511Japan
| | - Kihei Yoneyama
- Division of Cardiology, Department of Internal MedicineSt. Marianna University School of Medicine2‐16‐1 Sugao, Miyamae‐kuKawasakiKanagawa216‐8511Japan
| | - Norio Suzuki
- Division of Cardiology, Department of Internal MedicineSt. Marianna University School of Medicine2‐16‐1 Sugao, Miyamae‐kuKawasakiKanagawa216‐8511Japan
| | - Shingo Kuwata
- Division of Cardiology, Department of Internal MedicineSt. Marianna University School of Medicine2‐16‐1 Sugao, Miyamae‐kuKawasakiKanagawa216‐8511Japan
| | - Toshiki Kaihara
- Division of Cardiology, Department of Internal MedicineSt. Marianna University School of Medicine2‐16‐1 Sugao, Miyamae‐kuKawasakiKanagawa216‐8511Japan
| | - Masashi Koga
- Division of Cardiology, Department of Internal MedicineSt. Marianna University School of Medicine2‐16‐1 Sugao, Miyamae‐kuKawasakiKanagawa216‐8511Japan
| | - Kazuaki Okuyama
- Division of Cardiology, Department of Internal MedicineSt. Marianna University School of Medicine2‐16‐1 Sugao, Miyamae‐kuKawasakiKanagawa216‐8511Japan
| | - Ryo Kamijima
- Division of Cardiology, Department of Internal MedicineSt. Marianna University School of Medicine2‐16‐1 Sugao, Miyamae‐kuKawasakiKanagawa216‐8511Japan
| | - Yasuhiro Tanabe
- Division of Cardiology, Department of Internal MedicineSt. Marianna University School of Medicine2‐16‐1 Sugao, Miyamae‐kuKawasakiKanagawa216‐8511Japan
| | - Naoya Takeichi
- Rehabilitation CenterSt. Marianna University School of Medicine HospitalKawasakiJapan
| | - Satoshi Watanabe
- Rehabilitation CenterSt. Marianna University School of Medicine HospitalKawasakiJapan
| | - Masaki Izumo
- Division of Cardiology, Department of Internal MedicineSt. Marianna University School of Medicine2‐16‐1 Sugao, Miyamae‐kuKawasakiKanagawa216‐8511Japan
| | - Yuki Ishibashi
- Division of Cardiology, Department of Internal MedicineSt. Marianna University School of Medicine2‐16‐1 Sugao, Miyamae‐kuKawasakiKanagawa216‐8511Japan
| | - Yoshihiro J. Akashi
- Division of Cardiology, Department of Internal MedicineSt. Marianna University School of Medicine2‐16‐1 Sugao, Miyamae‐kuKawasakiKanagawa216‐8511Japan
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Badrasawi M, Jarradat A, Khodour Z, Lahaleh R, Irshaied A. Sarcopenia prevalence and its correlations with age-related disorders among community-dwelling Palestinian older adults. JOURNAL OF GERONTOLOGY AND GERIATRICS 2020. [DOI: 10.36150/2499-6564-377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Asamane EA, Greig CA, Thompson JL. The association between nutrient intake, nutritional status and physical function of community-dwelling ethnically diverse older adults. BMC Nutr 2020; 6:36. [PMID: 32864152 PMCID: PMC7447572 DOI: 10.1186/s40795-020-00363-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 07/20/2020] [Indexed: 01/06/2023] Open
Abstract
Background There are limited longitudinal data regarding nutrient intake, nutritional status and physical function in community-dwelling ethnically diverse older adults. This study explored these variables and their relationship at baseline (n = 100) and 8-months' follow-up (n = 81) among community-dwelling ethnically diverse older adults (≥60 years) in Birmingham, United Kingdom. Methods Multiple-pass 24-h dietary recalls and the Mini Nutritional Assessment-Short Form assessed nutritional intake and status, respectively. Short Physical Performance Battery (SPPB) and handgrip strength measured physical function. Linear and multinomial regressions were used to predict relationships between physical function, nutritional status and nutrient intake. Results Complete data were collected at baseline (n = 100) and 8-months' follow-up (n = 81). Mean (SD) age was 70 (8.1) years (60% male), with 62% being obese. Statistically significant decreases in intakes of vitamin B6, vitamin B1, iron, folate, and magnesium occurred over time. Daily intake of all micronutrients except vitamin B12, phosphorus and manganese were below the Recommended Nutrient Intakes (RNI). SPPB (Z = -4.01, p < 0.001) and nutritional status (Z = -2.37, p = 0.018) declined over time. Higher SPPB scores at baseline (OR = 0.54 95% CI 0.35, 0.81) were associated with a slower decline in nutritional status. Conclusion The observed declines and inadequate nutrient intakes in the absence of weight loss in just 8 months may pose serious challenges to healthy ageing, identifying an urgent need to re-evaluate and tailor appropriate dietary advice for this population. Additionally, the associations of nutrition and physical function observed in this study serves as an essential resource to design and implement community/faith-based interventions targeting early screening of nutritional status and physical function to ensure most older adults are assessed and treated accordingly.
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Affiliation(s)
- Evans A Asamane
- School of Sports, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.,School Primary, Community and Social Care, Keele University, Keele, UK
| | - Carolyn A Greig
- School of Sports, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.,MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
| | - Janice L Thompson
- School of Sports, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
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Asamane EA, Greig CA, Thompson JL. Social networks and their influences on nutrient intake, nutritional status and physical function in community-dwelling ethnically diverse older adults: a mixed-methods longitudinal study. BMC Public Health 2020; 20:1011. [PMID: 32590967 PMCID: PMC7318427 DOI: 10.1186/s12889-020-09153-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 06/19/2020] [Indexed: 11/17/2022] Open
Abstract
Background The United Kingdom population is ageing and becoming increasingly diverse; thus, it is vital to develop and implement interventions supporting this population shift. Social networks (SN) significantly impact health outcomes in later life, however relatively little is known about SN of community-dwelling ethnically diverse older adults. This study aimed to: 1) profile SN and changes in SN in this population over 8 months; 2) examine associations between SN, dietary intake, nutritional status, and physical function. Methods SN were assessed using the Wenger Practitioner Assessment of Network Type. Energy and nutrient intakes were measured using multiple-pass 24-h recalls. The Mini Nutritional Assessment-Short Form (MNA-SF) assessed nutritional status. Physical function was measured using the Short Physical Performance Battery (SPPB) and handgrip strength. Data were collected at baseline and 8-months. Correlation and regression analyses examined relationships between SN, physical function, nutrient intake and nutritional status. Semi-structured interviews were conducted at baseline (n = 92) and follow-up (n = 81) to identify potential influences of SN. Interviews were transcribed verbatim and analysed using directed content analysis. Results Quantitative data were obtained from 100 participants at baseline and 81 at follow-up. Mean (SD) age was 70.8 (8.1) years (59% male), comprising African/Caribbean (60%), South Asian (34%), and other ethnicities (6%). Five SN typologies were identified under two broad areas: integrated-SN consisting of locally integrated (44%) and wider community (8%); and non-integrated-SN consisting of family dependent (25%), local self-contained (17%), and private restricted (6%). At follow-up, 37% remained in non-integrated networks, 19% transitioned to non-integrated networks, 11% transitioned to, and 33% remained in, integrated networks. Participants within integrated networks at baseline had higher SPPB scores at follow-up. Compared to the private restricted, local self-contained SN significantly predicted zinc, riboflavin and vitamin B6 intakes. Participants remaining in, or transitioning to, non-integrated networks had low MNA-SF scores. Qualitative findings indicate that participants with reductions in SN perceived it as causing poorer physical function and eating behaviours. Conclusion In the present study, integrated SN were associated with higher physical function and nutritional status at 8-month’s follow-up. These results can inform the design of interventions to improve social networks, physical function and healthy nutrition within this population.
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Affiliation(s)
- Evans A Asamane
- School of Sports, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK. .,School of Primary, Community and Social Care, Keele University, Keele, UK.
| | - Carolyn A Greig
- School of Sports, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.,NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Janice L Thompson
- School of Sports, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
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Fatyga P, Pac A, Fedyk-Łukasik M, Grodzicki T, Skalska A. The relationship between malnutrition risk and inflammatory biomarkers in outpatient geriatric population. Eur Geriatr Med 2020; 11:383-391. [PMID: 32297262 PMCID: PMC7280354 DOI: 10.1007/s41999-020-00303-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 02/19/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Malnutrition is an underestimated, but significant problem among older persons. It is described as a consequence of genetic and environmental factors, lack of physical activity, and co-morbidities. However, a key role of a geriatrician is to further explore the multidimensional complexity of this issue. The aim of this study was to identify the relationship between nutritional status and different factors, particularly focusing on inflammatory biomarkers. METHODS Nutritional status was assessed using Mini-Nutritional-Assessment with a score below 24 (out of 30) defined as malnutrition. Different serum biomarkers of inflammation were measured, such as High-Sensitivity-C-Reactive-Protein (hsCRP), Interleukin-6 (IL-6), Interleukin-8 (IL-8), Interleukin-18(IL-18), osteoprotegerin(OPG), and Soluble-Receptor-For-TNF-alfa(sTNFRII). Medical history, mental status (Mini-Mental-State-Examination, Geriatric-Depression-Scale) and activities of daily living (using Instrumental-Activities-of-Daily-Living-Scale) were used in the evaluation. The relationship between nutritional status and the factors listed was assessed. RESULTS The mean age of 76 examined persons (40.8% female) from the outpatient clinic was 71 years. Malnutrition risk was recognized in 29%. The following factors significant in univariate regression were used in stepwise regression analysis: age, sex, mental status (MMSE, GDS), valve disease, number of diseases, IADL. Stepwise regression revealed that the risk of malnutrition was increased by the presence of valve disease, number of diseases, and female sex. Factors that increased the risk of malnutrition were: logsTNFRII (OR = 3.09; 95% CI 1.07-8.96), IL-8 (OR = 1.09; 95% CI 1.00-1.18), and OPG (OR = 1.27; 95% CI 1.02-1.57). Risk of malnutrition was negatively associated with Il-18(OR = 0.995; 95% CI 0.991-0.999). CONCLUSIONS Chronic inflammation and immunologic process are likely contributors to the complex etiopathogenesis of malnutrition in older persons.
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Affiliation(s)
- Paulina Fatyga
- Department of Toxicology and Environmental Diseases, Jagiellonian University Medical College, Kraków, Poland
- University Hospital, Kraków, Poland
| | - Agnieszka Pac
- Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Małgorzata Fedyk-Łukasik
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, 2 Jakubowskiego Str., 30-688, Kraków, Poland
- University Hospital, Kraków, Poland
| | - Tomasz Grodzicki
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, 2 Jakubowskiego Str., 30-688, Kraków, Poland
- University Hospital, Kraków, Poland
| | - Anna Skalska
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, 2 Jakubowskiego Str., 30-688, Kraków, Poland.
- University Hospital, Kraków, Poland.
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Skipper A, Coltman A, Tomesko J, Charney P, Porcari J, Piemonte TA, Handu D, Cheng FW. Adult Malnutrition (Undernutrition) Screening: An Evidence Analysis Center Systematic Review. J Acad Nutr Diet 2020; 120:669-708. [DOI: 10.1016/j.jand.2019.09.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Indexed: 01/09/2023]
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Muñoz Díaz B, Martínez de la Iglesia J, Molina Recio G, Aguado Taberné C, Redondo Sánchez J, Arias Blanco MC, Romero Saldaña M. [Nutritional status and associated factors in ambulatory elderly patients]. Aten Primaria 2020; 52:240-249. [PMID: 30665707 PMCID: PMC7118571 DOI: 10.1016/j.aprim.2018.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 11/16/2018] [Accepted: 12/04/2018] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE To analyze the nutritional status (NS) of patients older than 65 years and establish their relationship with sociodemographic and health variables. DESIGN Cross-sectional observational study in patients older than 65 years. LOCATION 3 health centers. PARTICIPANTS 255 patients: ambulatory (AP), in domiciliary care (DP) or institutionalized (IP). They completed the study 243 (response rate 95.3%). MAIN MEASUREMENTS The Chang method was applied to determine the NS. Sociodemographic, anthropometric variables, dependence, mood, cognitive and analytical parameters were collected. Associations were analyzed applying chi-square and analysis of variance. The prevalence ratio (PR) for malnutrition was calculated. A multivariate model was applied (binary logistic regression). Significance was considered for p<0.05. RESULTS The average age was 81.3 years (SD=7.4) and 72.0% were women. 48.9% were AP, 26.8% DP and 24.2% IP. 29.6% (95% CI: 23.9-35.8) presented malnutrition. Greater malnutrition was established in relation to living in a residence or requiring home help (PR=5.3), age over 85 (PR=4.9), presenting a moderate or higher dependency for basic activities of daily living (PR=3.9) and instrumental (PR=3.3), need help for mobility (PR=2.9) and present moderate/severe cognitive impairment (PR=2.1). The determinants of malnutrition in the multivariate model were older than 85 years old and being IP or DP. CONCLUSIONS Emphasis should be placed on evaluating NS in patients older than 85 years of age who live in a residence or require home care, since they are the groups at greatest risk of malnutrition.
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Affiliation(s)
- Belén Muñoz Díaz
- Atención Primaria, Unidad de Gestión Clínica Villaviciosa, Córdoba, España
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Raposeiras-Roubín S, Abu-Assi E, Paz RC, Rosselló X, Barreiro Pardal C, Piñón Esteban M, Pascual CR, García Comesaña J, González-Carrero López A, Caneiro-Queija B, Cespón-Fernández M, Muñoz-Pousa I, Domínguez-Erquicia P, Domínguez-Rodríguez LM, Carpintero A, García E, Ibáñez B, Iñíguez-Romo A. Impact of malnutrition in the embolic–haemorrhagic trade-off of elderly patients with atrial fibrillation. Europace 2020; 22:878-887. [DOI: 10.1093/europace/euaa017] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 01/29/2020] [Indexed: 12/15/2022] Open
Abstract
Abstract
Aims
Nutrition is an important determinant of health above the age of 80 years. Malnutrition in the elderly is often underdiagnosed. The aim of this study was to report the prevalence and prognostic value of malnutrition in patients ≥80 years old with atrial fibrillation (AF) with and without anticoagulant therapy.
Methods and results
We assessed the nutritional status of 4724 octogenarian patients with diagnoses of AF in a single centre from Spain between 2014 and 2017 with the CONUT score. Malnutrition was confirmed in 2036 patients (43.1%). Anticoagulation prescription was more frequent in patients with good nutrition than in those malnourished (79.5% vs. 71.7%, P < 0.001). The impact of malnutrition on mortality was evaluated by Cox regression, whereas its association with ischaemic stroke and major bleeding was studied through competing risk analysis. After multivariate adjusting, malnutrition was associated with mortality [hazard ratio (HR) 1.36, 95% confidence interval (CI) 1.24–1.49], stroke [sub-distribution HR (sHR) 1.37, 95% CI 1.10–1.69], and major bleeding (sHR 1.29, 95% CI 1.02–1.64). In anticoagulated patients, the embolic–haemorrhagic trade-off event was virtually neutral for those who had normal nutritional status [average daily rates (ADRs) for stroke and bleeding: 4.70 and 4.69 per 100 000 patients/day, respectively; difference = +0.01 per 100 000 patients/day; P = 0.99] and negative for those with malnutrition (ADR for stroke and bleeding: 5.38 and 7.61 per 100 000 patients/day, respectively; difference = −2.23 per 100 000 patients/day; P = 0.07).
Conclusion
Malnutrition is very common in octogenarian patients with AF, being a clinical predictor for poor prognosis. For anticoagulated patients, malnutrition was associated with a negative embolic–haemorrhagic balance.
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Affiliation(s)
- Sergio Raposeiras-Roubín
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Estrada Clara Campoamor, 341, 36212 Vigo, Spain
| | - Emad Abu-Assi
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Estrada Clara Campoamor, 341, 36212 Vigo, Spain
| | - Rafael Cobas Paz
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Estrada Clara Campoamor, 341, 36212 Vigo, Spain
| | - Xavier Rosselló
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
| | | | - Miguel Piñón Esteban
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Estrada Clara Campoamor, 341, 36212 Vigo, Spain
| | - Carlos Rodriguez Pascual
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Estrada Clara Campoamor, 341, 36212 Vigo, Spain
| | - Julio García Comesaña
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Estrada Clara Campoamor, 341, 36212 Vigo, Spain
| | | | - Berenice Caneiro-Queija
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Estrada Clara Campoamor, 341, 36212 Vigo, Spain
| | - María Cespón-Fernández
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Estrada Clara Campoamor, 341, 36212 Vigo, Spain
| | - Isabel Muñoz-Pousa
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Estrada Clara Campoamor, 341, 36212 Vigo, Spain
| | - Pablo Domínguez-Erquicia
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Estrada Clara Campoamor, 341, 36212 Vigo, Spain
| | | | - Alberto Carpintero
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Estrada Clara Campoamor, 341, 36212 Vigo, Spain
| | - Enrique García
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Estrada Clara Campoamor, 341, 36212 Vigo, Spain
| | - Borja Ibáñez
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
| | - Andrés Iñíguez-Romo
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Estrada Clara Campoamor, 341, 36212 Vigo, Spain
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Izquierdo Delgado E, Gutiérrez Ríos R, Andrés Calvo M, Repiso Gento I, Castrillo Sanz A, Rodríguez Herrero R, Rodríguez Sanz MF, Tola-Arribas MA. Nutritional status assessment in Alzheimer disease and its influence on disease progression. Neurologia 2020; 37:S0213-4853(19)30148-3. [PMID: 31980283 DOI: 10.1016/j.nrl.2019.11.005] [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: 06/15/2019] [Revised: 08/20/2019] [Accepted: 11/04/2019] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Nutritional deficiencies are frequent in Alzheimer disease (AD), even in early stages. Nutritional impairment (NI) may be associated with faster disease progression. The objective of this study was to describe the frequency of NI and the associated risk factors at the time of diagnosis and to analyse its influence on subsequent progression. METHODS We performed a prospective, multicentre, observational study of patients recently diagnosed with prodromal AD (pAD) or dementia due to AD (ADd). Two clinical assessments were conducted over a period of 18months. The Mini Nutritional Assessment test (MNA; score range, 0-30; cut-off point for NI, <24) was used to estimate nutritional status. Progression was defined as an increase of ≥3points on the Clinical Dementia Rating-sum of boxes test. RESULTS The sample included 50 patients with pAD (mean [standard deviation] age, 76.1 [5.3] years; 68% women), and 127 with ADd (80 [5.9] years; 72.4% women). A total of 141 (79.7%) completed both evaluations. The prevalence of NI was 28.2% (24% for pAD, 29.9% for ADd; P=.43), with the majority (92%) at risk of malnutrition. NI was associated with female sex (odds ratio [OR]: 4.2; 95% confidence interval [CI]: 1.7-10.5; P<.001) and greater behavioural involvement (OR: 5.8; 95%CI: 2.6-12.7; P<.001). A larger proportion of patients with progression was observed among those with NI than among those with normal nutritional status (50% vs 28.7%, P<.05; ADd: 53.6% vs 31.8%, P<.05; pAD: 41.7% vs 22.9%, P=.21). Greater cognitive impairment (OR: 2.1; 95%CI: 1.03-4.4; P<.05) and NI (OR: 2.4; 95%CI: 1.1-5.1; P<.05) were independent risk factors for disease progression. CONCLUSIONS NI is highly prevalent in patients with AD. Assessing nutritional status at the time of diagnosis may enable identification of patients at greater risk of disease progression.
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Affiliation(s)
- E Izquierdo Delgado
- Servicio de Medicina Interna, Hospital Universitario Río Hortega, Valladolid, España
| | - R Gutiérrez Ríos
- Sección de Neurología, Complejo Asistencial de Segovia, Segovia, España
| | - M Andrés Calvo
- Servicio de Medicina Interna, Hospital Universitario Río Hortega, Valladolid, España
| | - I Repiso Gento
- Medicina de Familia, Área Sanitaria Valladolid Oeste, Valladolid, España
| | - A Castrillo Sanz
- Sección de Neurología, Complejo Asistencial de Segovia, Segovia, España
| | | | | | - M A Tola-Arribas
- Sección de Neurología, Hospital Universitario Río Hortega, Valladolid, España.
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Khoddam H, Eshkevarlaji S, Nomali M, Modanloo M, Keshtkar AA. Prevalence of Malnutrition Among Elderly People in Iran: Protocol for a Systematic Review and Meta-Analysis. JMIR Res Protoc 2019; 8:e15334. [PMID: 31582361 PMCID: PMC6880236 DOI: 10.2196/15334] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/07/2019] [Accepted: 08/13/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Malnutrition occurs following a decrease or an imbalance in the absorption of energy, protein, vitamins, and minerals because of numerous factors. Thus, it has serious and life-threatening consequences. To plan for this issue, we need information on the burden of this problem. OBJECTIVE The aim of this study is to determine the prevalence of malnutrition among elderly people in Iran. METHODS For the purpose of this study, papers, including original articles, theses, and conference proceedings on the prevalence of malnutrition among people aged 60 years and above, and have been published in national and international journals until September 2018 will be included without any language limitation. The following keywords along with their synonyms in Persian will be used in the literature search: malnutrition, elderly, and Iran. At first, the screening process will be conducted based on our inclusion and exclusion criteria. Then, the full text of the remaining articles will be read carefully, and eligible articles will be selected according to the objectives of the study. Next, the methodological quality of the selected papers will be reviewed, and the required information will be extracted from those with acceptable quality. Finally, a meta-analysis will be performed using the Stata software (version 14) when optimum criteria are met. It should be noted that all stages of screening, selection, quality assessment of primary studies, and data extraction will be performed by two reviewers independently. RESULTS This review is ongoing and will be completed at the end of 2019. CONCLUSIONS This review aims to provide comprehensive evidence about the prevalence of malnutrition among elderly people in Iran. This can help Iranian health managers and policy makers make informed decisions for preventing malnutrition and promoting the health status of elderly people. TRIAL REGISTRATION PROSPERO CRD42018115358; https://tinyurl.com/y28su47m. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/15334.
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Affiliation(s)
- Homeira Khoddam
- Nursing Research Center, Golestan University of Medical Sciences, Gorgan, Islamic Republic of Iran
| | - Sepideh Eshkevarlaji
- School of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Islamic Republic of Iran
| | - Mahin Nomali
- Department of Epidemiology & Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Mahnaz Modanloo
- Nursing Research Center, Golestan University of Medical Sciences, Gorgan, Islamic Republic of Iran
| | - Abbas Ali Keshtkar
- Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
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Fanelli Kuczmarski M, Stave Shupe E, Pohlig RT, Rawal R, Zonderman AB, Evans MK. A Longitudinal Assessment of Diet Quality and Risks Associated with Malnutrition in Socioeconomic and Racially Diverse Adults. Nutrients 2019; 11:nu11092046. [PMID: 31480661 PMCID: PMC6770204 DOI: 10.3390/nu11092046] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 08/24/2019] [Accepted: 08/26/2019] [Indexed: 01/07/2023] Open
Abstract
Little is known about the effects of diet quality through adulthood and its association with malnutrition later in life. The first research objective was to evaluate diet quality assessed by Mean Adequacy Ratio (MAR) of United States African American and White adults (n = 2066), examined at baseline and two follow-up waves in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. The sample was split into cohorts by age at study baseline: Younger, <50, and older, ≥50 years. The second objective was to assess the association of MAR and risk for malnutrition in adults who were ≥60 years at wave 4 (n = 746). The Mini Nutritional Assessment was used to determine risk for malnutrition. At each of the three study waves, 17 micronutrients from two 24 h dietary recalls were used to calculate MAR. Over 13 years MAR changed minimally in the younger cohort as they aged from early to middle adulthood. In contrast, a statistically significant decline in MAR was observed for the older cohort between baseline (2004–2009) and wave 4 (2013–2017), with a greater degree of worsening at low energy levels. The risk for malnutrition was significantly associated with consuming a diet low in energy, lower protein as a percent of energy at baseline, as well as being food insecure, a current smoker, and having income <125% poverty. The risk for malnutrition was not associated with a change in protein intake in years prior to age 60, change in MAR scores across waves, MAR at wave 4, age, sex, race, or having hypertension or diabetes. These longitudinal study findings revealed that diet quality was not predictive of risk for malnutrition.
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Affiliation(s)
- Marie Fanelli Kuczmarski
- Department of Behavioral Health and Nutrition, University of Delaware, 206C McDowell Hall, Newark, DE 19716, USA.
| | - Emily Stave Shupe
- Department of Behavioral Health and Nutrition, University of Delaware, 206C McDowell Hall, Newark, DE 19716, USA
| | - Ryan T Pohlig
- College of Health Sciences, University of Delaware, STAR, Newark, DE 19716, USA
| | - Rita Rawal
- Department of Medical Laboratory Sciences, University of Delaware, 206C McDowell Hall, Newark, DE 19716, USA
| | - Alan B Zonderman
- National Institute on Aging, Laboratory of Epidemiology and Population Sciences, NIH, 251 Bayview Blvd, Baltimore, MD 21224, USA
| | - Michele K Evans
- National Institute on Aging, Laboratory of Epidemiology and Population Sciences, NIH, 251 Bayview Blvd, Baltimore, MD 21224, USA
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Validity of Nutritional Screening Tools for Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2019; 20:1351.e13-1351.e25. [PMID: 31409560 DOI: 10.1016/j.jamda.2019.06.024] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 04/23/2019] [Accepted: 06/24/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The aim of this systematic review was to summarize the validity of nutritional screening tools to detect the risk of malnutrition in community-dwelling older adults. DESIGN A systematic review and meta-analysis. The protocol for this systematic review was registered in the PROSPERO database (CRD42017072703). SETTING AND PARTICIPANTS A literature search was performed in PubMed, EMBASE, CINAHL, and Cochrane using the combined terms "malnutrition," "aged," "community-dwelling," and "screening." The time frame of the literature reviewed was from January 1, 2001, to May 18, 2018. Older community-dwellers were defined as follows: individuals with a mean/median age of >65 years who were community-dwellers or attended hospital outpatient clinics and day hospitals. All nutritional screening tools that were validated in community-dwelling older adults against a reference standard to detect the risk of malnutrition, or with malnutrition, were included. MEASURES Meta-analyses were performed on the diagnostic accuracy of identified nutritional screening tools validated against the Mini Nutritional Assessment-Long Form (MNA-LF). The symmetric hierarchical summary receiver operating characteristic models were used to estimate test performance. RESULTS Of 7713 articles, 35 articles were included in the systematic review, and 9 articles were included in the meta-analysis. Seventeen nutritional screening tools and 10 reference standards were identified. The meta-analyses showed average sensitivities and specificities of 0.95 (95% confidence interval [CI] 0.75-0.99) and 0.95 (95% CI 0.85-0.99) for the Mini Nutritional Assessment-Short Form (MNA-SF; cutoff point ≤11), 0.85 (95% CI 0.80-0.89) and 0.87 (95% CI 0.86-0.89) for the MNA-SF-V1 (MNA-SF using body mass index, cutoff point ≤11), 0.85 (95% CI 0.77-0.89) and 0.84 (95% CI 0.79-0.87) for the MNA-SF-V2 (MNA-SF using calf circumference instead of body mass, cutoff point ≤11), respectively, using MNA-LF as the reference standard. CONCLUSIONS AND IMPLICATIONS The MNA-SF, MNA-SF-V1, and MNA-SF-V2 showed good sensitivity and specificity to detect community-dwelling older adults at risk of malnutrition validated against the MNA-LF. Clinicians should consider the use of the cutoff point ≤11 on the MNA-SF, MNA-SF-V1, and MNA-SF-V2 to identify community-dwelling older adults at risk of malnutrition.
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Martín-Sánchez FJ, Cuesta Triana F, Rossello X, Pardo García R, Llopis García G, Caimari F, Vidán MT, Ruiz Artacho P, González Del Castillo J, Llorens P, Herrero P, Jacob J, Gil V, Fernández Pérez C, Gil P, Bueno H, Miró Ò, Matía Martín P, Rodríguez Adrada E, Santos MC, Salgado L, Brizzi BN, Docavo ML, Del Mar Suárez-Cadenas M, Xipell C, Sánchez C, Aguiló S, Gaytan JM, Jerez A, Pérez-Durá MJ, Berrocal Gil P, López-Grima ML, Valero A, Aguirre A, Pedragosa MÀ, Piñera P, LázaroAragues P, Sánchez Nicolás JA, Rizzi MA, Herrera Mateo S, Alquezar A, Roset A, Ferrer C, Llopis F, Álvarez Pérez JM, López Diez MP, Richard F, Fernández-Cañadas JM, Carratalá JM, Javaloyes P, Andueza JA, Sevillano Fernández JA, Romero R, Merlo Loranca M, Álvarez Rodríguez V, Lorca MT, Calderón L, Soy Ferrer E, Manuel Garrido J, Martín Mojarro E. Effect of risk of malnutrition on 30-day mortality among older patients with acute heart failure in Emergency Departments. Eur J Intern Med 2019; 65:69-77. [PMID: 31076345 DOI: 10.1016/j.ejim.2019.04.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 03/19/2019] [Accepted: 04/23/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Little is known about the prevalence and impact of risk of malnutrition on short-term mortality among seniors presenting with acute heart failure (AHF) in emergency setting. The objective was to determine the impact of risk of malnutrition on 30-day mortality risk among older patients who attended in Emergency Departments (EDs) for AHF. MATERIAL AND METHODS We performed a secondary analysis of the OAK-3 Registry including all consecutive patients ≥65 years attending in 16 Spanish EDs for AHF. Risk of malnutrition was defined by the Mini Nutritional Assessment Short Form (MNA-SF) < 12 points. Unadjusted and adjusted logistic regression models were used to assess the association between risk of malnutrition and 30-day mortality. RESULTS We included 749 patients (mean age: 85 (SD 6); 55.8% females). Risk of malnutrition was observed in 594 (79.3%) patients. The rate of 30-day mortality was 8.8%. After adjusting for MEESSI-AHF risk score clinical categories (model 1) and after adding all variables showing a significantly different distribution among groups (model 2), the risk of malnutrition was an independent factor associated with 30-day mortality (adjusted OR by model 1 = 3.4; 95%CI 1.2-9.7; p = .020 and adjusted OR by model 2 = 3.1; 95%CI 1.1-9.0; p = .033) compared to normal nutritional status. CONCLUSIONS The risk of malnutrition assessed by the MNA-SF is associated with 30-day mortality in older patients with AHF who were attended in EDs. Routine screening of risk of malnutrition may help emergency physicians in decision-making and establishing a care plan.
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Affiliation(s)
- Francisco Javier Martín-Sánchez
- Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.
| | - Federico Cuesta Triana
- Universidad Complutense de Madrid, Madrid, Spain; Department of Geriatric Medicine, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Xavier Rossello
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | | | - Guillermo Llopis García
- Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Francisca Caimari
- Department of Endocrinology, University College London, Hospitals NHS Foundation Trust, London, UK
| | - María Teresa Vidán
- Universidad Complutense de Madrid, Madrid, Spain; Department of Geriatric Medicine, Hospital General Universitario Gregorio Marañón, Instituto de Investigación IiSGM, Universidad Complutense de Madrid, Madrid, Spain
| | - Pedro Ruiz Artacho
- Department of Internal Medicine, Clínica Universitaria de Navarra, Madrid, Spain
| | - Juan González Del Castillo
- Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain
| | - Pere Llorens
- Emergency Department-UCE-UHD, Hospital General Universitario de Alicante, Alicante, Spain
| | - Pablo Herrero
- Emergency Department, Hospital Central de Asturias, Oviedo, Asturias, Spain
| | - Javier Jacob
- Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Víctor Gil
- Emergency Department, Hospital Clínic, Institut de Recerca Biomédica August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Cristina Fernández Pérez
- Universidad Complutense de Madrid, Madrid, Spain; Preventive Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Pedro Gil
- Universidad Complutense de Madrid, Madrid, Spain; Department of Geriatric Medicine, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Héctor Bueno
- Universidad Complutense de Madrid, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Cardiology, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Òscar Miró
- Emergency Department, Hospital Clínic, Institut de Recerca Biomédica August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Pilar Matía Martín
- Universidad Complutense de Madrid, Madrid, Spain; Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Alex Roset
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Carles Ferrer
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Ferrán Llopis
- Hospital Universitari de Bellvitge, Barcelona, Spain
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Wong MMH, So WKW, Choi KC, Cheung R, Chan HYL, Sit JWH, Ho B, Li F, Lee TY, Chair SY. Malnutrition risks and their associated factors among home-living older Chinese adults in Hong Kong: hidden problems in an affluent Chinese community. BMC Geriatr 2019; 19:138. [PMID: 31122189 PMCID: PMC6533669 DOI: 10.1186/s12877-019-1148-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 04/26/2019] [Indexed: 01/04/2023] Open
Abstract
Background Although China is undergoing rapid economic development, it is facing an ageing population. No data exists on malnutrition risks of older adults in an affluent Chinese society. The aim of this study is to examine these risks and identify their associated factors among home-living older Chinese adults in Hong Kong. Methods This is a cross-sectional study, to which home-living subjects aged 60 or above were recruited, between May and September 2017, from a non-governmental community organisation located in three different districts of Hong Kong. Nutritional status was assessed by the Mini Nutritional Assessment (MNA), and its associated factors examined included socio-demographic characteristics, lifestyle, health status and diet. Multivariable logistic regression analysis was performed to identify factors associated with malnutrition risks (MNA < 24). Results Six hundred thirteen subjects (mean age: 78.5 ± 7.4; 54.0% females) completed the survey. Nearly 30% (n = 179) were at risk of malnutrition. By multivariable logistic regression, subjects (1) whose vision was only fair or unclear, (2) with poor usual appetite and (3) with main meal skipping behaviour had significantly higher malnutrition risk (all p < 0.05). Conclusions In this affluent Chinese society, the malnutrition risk in older adults is close to the global average, which is a matter for much concern. Interventions are therefore warranted that target vulnerable groups with poor vision, appetite, and meal skipping behaviour. Trial registration Not applicable.
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Affiliation(s)
- Martin M H Wong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Winnie K W So
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China.
| | - Kai Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Regina Cheung
- The Neighbourhood Advice-Action Council, North Point, Hong Kong, China
| | - Helen Y L Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Janet W H Sit
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Brenda Ho
- The Neighbourhood Advice-Action Council, North Point, Hong Kong, China
| | - Francis Li
- The Neighbourhood Advice-Action Council, North Point, Hong Kong, China
| | - Tin Yan Lee
- The Neighbourhood Advice-Action Council, North Point, Hong Kong, China
| | - Sek Ying Chair
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
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Gamboa Moreno E, Mateo-Abad M, Ochoa de Retana García L, Vrotsou K, Del Campo Pena E, Sánchez Perez Á, Martínez Carazo C, Arbonies Ortiz JC, Rúa Portu MÁ, Piñera Elorriaga K, Zenarutzabeitia Pikatza A, Urquiza Bengoa MN, Méndez Sanpedro T, Oses Portu A, Aguirre Sorondo MB, Rotaeche Del Campo R. Efficacy of a self-management education programme on patients with type 2 diabetes in primary care: A randomised controlled trial. Prim Care Diabetes 2019; 13:122-133. [PMID: 30409669 DOI: 10.1016/j.pcd.2018.10.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 10/05/2018] [Indexed: 10/27/2022]
Abstract
AIM The purpose of this study was to assess the efficacy of the Spanish Diabetes Self-Management Program (SDSMP) versus usual care in adults with type 2 diabetes mellitus (T2DM) residing in a Spanish region. METHODS A two-year follow-up randomised controlled trial. The intervention consisted of 6 weekly structured peer-to-peer workshops. The primary outcome was change in HbA1c levels. Secondary outcomes included other clinical measures, quality of life, self-efficacy, life-style changes, medication and use of healthcare services. Mixed effect models were fitted. RESULTS n=297 patients were recruited in each study arm. Baseline HbA1c levels were comparable in both groups with an overall mean 7.1 (SD=1.2). The intervention did not significantly modify HbA1c, or other cardiovascular variables. Significant improvements were seen in self-efficacy, and in particularly its disease control component. Certain differences were also observed in the use of healthcare resources and medication consumption. High workshop participation and satisfaction rates were achieved. CONCLUSION HbA1c reductions are difficult to obtain in adequately controlled patients. On the other hand, raising awareness on one's disease can increase disease control self-efficacy. This finding, accompanied by reduced medication consumption and healthcare use rates, highlights that usual care would be benefited by incorporating certain SDSMP aspects. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT01642394.
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Affiliation(s)
- Estibaliz Gamboa Moreno
- Osakidetza, Active Patient Programme, Gros Health Centre, Avda Navarra 14, 20013 San Sebastián, Spain; Kronikgune-Research Centre on Chronicity, Torre del BEC, Ronda de Azkue, 1, 48902 Barakaldo, Bizkaia, Spain; Biodonostia Health Research Institute, Paseo Doctor Begiristain, 20014 San Sebastián, Spain.
| | - Maider Mateo-Abad
- Research Unit, Primary Care-Organization of Integrated Health Services of Gipuzkoa, Paseo Doctor Begiristain, 20014 San Sebastián, Spain; Kronikgune-Research Centre on Chronicity, Torre del BEC, Ronda de Azkue, 1, 48902 Barakaldo, Bizkaia, Spain; Biodonostia Health Research Institute, Paseo Doctor Begiristain, 20014 San Sebastián, Spain.
| | | | - Kalliopi Vrotsou
- Research Unit, Primary Care-Organization of Integrated Health Services of Gipuzkoa, Paseo Doctor Begiristain, 20014 San Sebastián, Spain; Kronikgune-Research Centre on Chronicity, Torre del BEC, Ronda de Azkue, 1, 48902 Barakaldo, Bizkaia, Spain; Biodonostia Health Research Institute, Paseo Doctor Begiristain, 20014 San Sebastián, Spain; REDISSEC-Health Services and Chronic Diseases Research Network, Spain.
| | - Emma Del Campo Pena
- Osakidetza, Donostialdea Integrated Health Organization, Ondarreta Health Centre, C/Zumalakarregi 24, 20008 San Sebastián, Spain.
| | - Álvaro Sánchez Perez
- Primary Care Research Unit of Bizkaia, C/ Luis Power 18 planta 4, 48014 Bilbao, Spain.
| | | | - Juan Carlos Arbonies Ortiz
- Osakidetza, Donostialdea Integrated Health Organization, Gros Health Centre, Avenida de Navarra 14, 20013 San Sebastián, Spain.
| | - M Ángeles Rúa Portu
- Osakidetza, Donostialdea Integrated Health Organization, Bidebieta Health Centre, Paseo Julio Urkijo s/n, 20016 Donostia, Spain.
| | - Koldo Piñera Elorriaga
- O + Berri, Basque Institute for Healthcare Innovation, Torre del BEC (Bilbao Exhibition Centre), Ronda de Azkue 1, 48902 Barakaldo, Bizkaia, Spain.
| | | | - Miren Nekane Urquiza Bengoa
- Osakidetza, Araba Integrated Health Organization, Olaguibel Health Centre, C/ Olaguibel 31, 01004 Vitoria-Gasteiz, Spain.
| | - Tomás Méndez Sanpedro
- Osakidetza, Ezkerraldea Enkarrterri Cruces Integrated Health Organization, Ortuella Health Centre, Avenida Minero s/n, 48530 Ortuella, Bizkaia, Spain.
| | - Ana Oses Portu
- Osakidetza, Bidasoa Integrated Health Organization, Hondarribia Health Centre, C/ Matxin de Arzu no 2, 20280 Hondarribia, Gipuzkoa, Spain.
| | - Miren Bakarne Aguirre Sorondo
- Research Unit, Primary Care-Organization of Integrated Health Services of Gipuzkoa, Paseo Doctor Begiristain, 20014 San Sebastián, Spain.
| | - Rafael Rotaeche Del Campo
- Osakidetza, Donostialdea Integrated Health Organization, Alza Health Centre, Paseo de Larratxo 95, 20017 San Sebastián, Spain; Kronikgune-Research Centre on Chronicity, Torre del BEC, Ronda de Azkue, 1, 48902 Barakaldo, Bizkaia, Spain; Biodonostia Health Research Institute, Paseo Doctor Begiristain, 20014 San Sebastián, Spain.
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Determinants of Self-Rated Health Perception in a Sample of a Physically Active Population: PLENUFAR VI Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102104. [PMID: 30257464 PMCID: PMC6210315 DOI: 10.3390/ijerph15102104] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 09/18/2018] [Accepted: 09/22/2018] [Indexed: 11/16/2022]
Abstract
The aim of this study was to investigate determinants of self-rated health (SRH) perception in Spanish adults. This cross-sectional study including data from 11,342 participants from the Spanish PLENUFAR VI study. SRH status was grouped in two categories ('good'/'poor') and the associations of socio-demographic characteristics, lifestyles, diet adequacy and chronic disease with SRH were assessed. After adjusting for relevant confounders, the risk ratios (RR) and (95% confidence intervals) for poor SRH were 1.05 (1.03⁻1.07) for each hour of increment of sitting, 1.56 (1.30⁻1.88) for short (≥5 h vs. 7⁻8 h) sleep duration, 0.63 (0.55⁻0.72) for vigorous (vs. light) physical activity, 0.61 (0.50⁻0.74) for adequate (vs. non-adequate) diet. Activities like jogging [RR for each unit of increment in the METs-h/day = 0.87 (0.82⁻0.92)], gymnastics [0.87 (0.81⁻0.93)], biking [0.91 (0.85⁻0.98)], and track and field [0.94 (0.89⁻0.98)], were associated with better health perception. Normally weight participants with any chronic disease had lower probability to report poor SRH than overweight/obese participants with any chronic disease. Frequent consumption of bread (>2 servings/day) was associated with a lower adjusted mean of health perception scale, while higher consumption of vegetables and fruit or fish were associated with higher values, concerning good SRH. We can conclude that normal-weight participants even suffering a chronic disease had lower probability to report poor health perception than participants with overweight/obesity and a chronic disease especially for hypertension and diabetes. Activities like jogging, gymnastics, biking, and track and field, and a higher consumption of fruits, vegetables and fish, were associated with better health rated perception.
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Jeruszka-Bielak M, Kollajtis-Dolowy A, Santoro A, Ostan R, Berendsen AAM, Jennings A, Meunier N, Marseglia A, Caumon E, Gillings R, de Groot LCPGM, Franceschi C, Hieke S, Pietruszka B. Are Nutrition-Related Knowledge and Attitudes Reflected in Lifestyle and Health Among Elderly People? A Study Across Five European Countries. Front Physiol 2018; 9:994. [PMID: 30108512 PMCID: PMC6079245 DOI: 10.3389/fphys.2018.00994] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 07/06/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Nutrition-related knowledge (NRK) and nutrition-related attitudes (NRAs) are necessary for dietary changes toward healthier dietary patterns. In turn, healthier dietary patterns can be beneficial in maintaining health of older adults. Therefore, the aim of this cross-sectional study was to investigate whether NRK and NRAs were associated with lifestyle and health features among older adults (65+ years) from five European countries (France, Italy, Poland, the Netherlands and United Kingdom). Methods: Within the European project NU-AGE, 1,144 healthy elderly volunteers (65–79 years) were randomly assigned to two groups: intervention (NU-AGE diet) or control. After 1-year of follow-up, both NRK and NRAs were assessed during exit interviews, in combination with a number of lifestyle and health variables (e.g., physical activity, smoking, alcohol use, BMI, self-assessed health status). Multivariable linear regression models were used in data analysis. Results: In the NU-AGE study sample, good NRK was associated with lower BMI and higher physical activity. More positive NRAs were related to lower BMI and self-reported very good or good appetite. Moreover, both NRK and NRAs were associated with some socio-economic determinants, like financial situation, age, education, living area (for NRK), and country (for NRAs). Participants in the intervention group showed a better NRK (β = 0.367 [95% CI: 0.117; 0.617], p = 0.004) and more positive NRAs (β = 0.838 [95% CI: 0.318; 1.358], p = 0.002) than those in the control group. Higher self-evaluated knowledge was also significantly related to more positive NRAs (p < 0.001). The most popular sources of nutrition information were food labels, books and magazines on health, the dietitian and the doctor's office, although their importance varied significantly among countries, and, to a lesser extent, between women and men and between intervention and control group. Conclusion: Higher NRK and NRA scores were associated with lower BMI and higher physical activity level. Therefore, a good nutrition-related knowledge and positive nutrition-related attitudes can strongly and positively influence the health status and quality of life among the older population. These results offer a great opportunity for policy makers to implement educational programs in order to counteract the epidemic of obesity and to improve the health span of European population.
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Affiliation(s)
- Marta Jeruszka-Bielak
- Department of Human Nutrition, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | - Anna Kollajtis-Dolowy
- Department of Human Nutrition, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | - Aurelia Santoro
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.,C.I.G. Interdepartmental Centre "L. Galvani", University of Bologna, Bologna, Italy
| | - Rita Ostan
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.,C.I.G. Interdepartmental Centre "L. Galvani", University of Bologna, Bologna, Italy
| | - Agnes A M Berendsen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Amy Jennings
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Nathalie Meunier
- Centre Hospitalier Universitaire de Clermont Ferrand, Clermont-Ferrand, France
| | - Anna Marseglia
- Care Sciences and Society, Department of Neurobiology, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Elodie Caumon
- Centre Hospitalier Universitaire de Clermont Ferrand, Clermont-Ferrand, France
| | - Rachel Gillings
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Lisette C P G M de Groot
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.,Institute of Neurological Sciences (IRCCS), Bologna, Italy
| | - Sophie Hieke
- European Food Information Council, Brussels, Belgium
| | - Barbara Pietruszka
- Department of Human Nutrition, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
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Rocaspana-García M, Blanco-Blanco J, Arias-Pastor A, Gea-Sánchez M, Piñol-Ripoll G. Study of community-living Alzheimer's patients' adherence to the Mediterranean diet and risks of malnutrition at different disease stages. PeerJ 2018; 6:e5150. [PMID: 30002978 PMCID: PMC6037138 DOI: 10.7717/peerj.5150] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 06/12/2018] [Indexed: 01/09/2023] Open
Abstract
Background Alzheimer’s disease (AD) is a neurodegenerative disease that is characterized by deficits in episodic memory. It is the most common form of dementia and affects 50–70% of patients with cognitive impairments over the age of 65. Elderly people are particularly susceptible to malnutrition and that risk is even higher in patients with AD. This study assessed the nutritional status of patients with AD at different stages of AD and explored how that status correlated with cognitive, functional and behavioural variables and caregiver overburden. The characteristics of the diet and the degree of adherence to the Mediterranean diet were also analysed. Methods This was a cross-sectional study that was representative of the general population and it was carried out in the Unit of Cognitive Disorders, Lleida, Spain. The participants were 111 subjects with AD who were aged 65 and over and still living at home. The subjects’ nutritional status was assessed using the Mini Nutritional Assessment (MNA) and Controlling Nutritional Status system. The monthly food intake was estimated using the short Food Frequency Questionnaire and adherence to the Mediterranean diet was evaluated using the Mediterranean Diet Score. The Mini Mental State Examination (MMSE), Global Deterioration Scale, Neuropsychiatric Inventory (NPI) and Zarit Burden Interview (ZBI) were also used. Results We found that 68% of the subjects presented with a risk of malnutrition and 19% were malnourished according to the MNA scale. Patients ate a higher quantity of meat and dairy products than recommended and fewer products from the remaining healthier food groups. Of the 111 subjects, 73% showed low adherence to the Mediterranean diet and 27% showed moderate adherence. There was a partial correlation between nutritional status and the MMSE when the data were adjusted for age and sex (r = 0, 318; p = 0.001) and inverse correlations were found for functional status (r = − 0.283; p = 0.004) and the NPI (r = − 0.409; p = 0.000) and ZBI scales (r = − 0.433; p = 0.000) when they were adjusted using the same variables. The ZBI scale (OR 1.08, 95% CI [1.01–1.15]) showed an increase in the risk of malnutrition in the multivariate analysis. Discussion Alterations in nutritional status were more common during the advanced stages of AD and were also associated with behavioural changes and caregiver overburden. Low adherence to traditional healthy diets in Mediterranean countries and food intake profiles should be considered when managing patients with AD. Other countries can use the results to examine diets in people with AD that are high in meat and dairy and low in healthy food groups like fruit and vegetables.
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Affiliation(s)
| | - Joan Blanco-Blanco
- GESEC Research Group, Faculty of Nursing and Physiotherapy, University of Lleida, Health Care Research Group (GRECS), Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | - Alfonso Arias-Pastor
- Unit of Cognitive Disorders, Santa Maria University Hospital, Clinical Neuroscience Research, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | - Montserrat Gea-Sánchez
- GESEC Research Group, Faculty of Nursing and Physiotherapy, University of Lleida, Health Care Research Group (GRECS), Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | - Gerard Piñol-Ripoll
- Unit of Cognitive Disorders, Santa Maria University Hospital, Clinical Neuroscience Research, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
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Mantzorou M, Vadikolias K, Pavlidou E, Serdari A, Vasios G, Tryfonos C, Giaginis C. Nutritional status is associated with the degree of cognitive impairment and depressive symptoms in a Greek elderly population. Nutr Neurosci 2018; 23:201-209. [PMID: 29914306 DOI: 10.1080/1028415x.2018.1486940] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Introduction: Cognitive impairment and malnutrition are two important public health issues in the elderly, which have been associated with their mental health.Aims: This study aims to evaluate the nutritional status of an elderly population in Greece, and its association with the grade of cognitive decline, anthropometric measures and psychological status.Materials and Methods: A total of 2092 elderly men and women were enrolled from seven Greek cities. Mini Nutritional Assessment (MNA), Mini Mental State Examination (MMSE) and Geriatric Depression Scale (GDS) questionnaires were used to assess the impact of nutritional status on cognitive abilities and psychological status of the participants.Results: Of the elderly, 35.0% were at risk of malnutrition and 11.3% were malnourished, while 34.4% of the participants had impaired cognitive function, and 32.3% showed depressive symptoms. Malnutrition was more frequently observed in participants presenting cognitive impairment, and depressive symptoms. In multiple regression analysis, nutritional status was independently associated with cognitive and psychological status.Conclusions: A high prevalence of malnutrition was recorded in this elderly population sample, which was directly associated with cognitive impairment and depression. Diagnostic tools such as MNA, MMSE, and GDS are strongly recommended to be applied as a routine clinical practice in the elderly to timely and effectively address these health problems.
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Affiliation(s)
- Maria Mantzorou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, Myrina, Lemnos, Greece
| | - Konstantinos Vadikolias
- Department of Neurology, School of Medicine, Democritus University of Thrace, Alexandroupoli, Greece
| | - Eleni Pavlidou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, Myrina, Lemnos, Greece
| | - Aspasia Serdari
- Department of Psychiatry and Child Psychiatry, Democritus University of Thrace, University Hospital of Alexandroupolis, Thrace, Greece
| | - Georgios Vasios
- Department of Food Science and Nutrition, School of Environment, University of Aegean, Myrina, Lemnos, Greece
| | - Christina Tryfonos
- Department of Food Science and Nutrition, School of Environment, University of Aegean, Myrina, Lemnos, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of Aegean, Myrina, Lemnos, Greece
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Maseda A, Diego-Diez C, Lorenzo-López L, López-López R, Regueiro-Folgueira L, Millán-Calenti JC. Quality of life, functional impairment and social factors as determinants of nutritional status in older adults: The VERISAÚDE study. Clin Nutr 2018; 37:993-999. [DOI: 10.1016/j.clnu.2017.04.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 03/21/2017] [Accepted: 04/07/2017] [Indexed: 11/28/2022]
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Yamaguchi K, Tohara H, Hara K, Nakane A, Kajisa E, Yoshimi K, Minakuchi S. Relationship of aging, skeletal muscle mass, and tooth loss with masseter muscle thickness. BMC Geriatr 2018. [PMID: 29519234 PMCID: PMC5844127 DOI: 10.1186/s12877-018-0753-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background Previous studies have reported a relationship between masseter muscle thickness and tooth loss or limb muscle thickness. However, it is not yet known whether masseter muscle thickness is related to appendicular skeletal muscle mass, and grip strength. The purpose of this study was to determine which of the two variables—tooth loss or appendicular skeletal muscle mass index—is more strongly related to masseter muscle thickness, and to identify a suitable indicator of decreasing masseter muscle thickness in healthy elderly individuals. Methods Grip strength, walking speed, body weight, skeletal muscle mass index, tooth loss, and masseter muscle thickness at rest and during contraction were determined in 97 community-dwelling elderly individuals aged ≥65 years (men: 44, women: 53). Masseter muscle thickness was chosen as the dependent variable, while age, skeletal muscle mass index, body weight, grip strength, and tooth loss were chosen as the independent variables. Multiple regression analysis was conducted using the stepwise regression method. Results In men, grip strength was the only independent predictor of masseter muscle thickness at rest. Tooth loss and grip strength were independent predictor of masseter muscle thickness during contraction. In women, tooth loss was the independent predictor of masseter muscle thickness both at rest and during contraction, while grip strength and body weight were the independent predictor of masseter muscle thickness at rest only. Conclusions We confirmed that in healthy elderly individuals, tooth loss has a stronger relationship with masseter muscle thickness than aging and skeletal muscle mass index do. Masseter muscle thickness in both elderly men and women is also associated with grip strength, suggesting that grip strength can be used as an indicator of masseter muscle thickness in this population.
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Affiliation(s)
- Kohei Yamaguchi
- Department of Gerodontology and Oral Rehabilitation, Tokyo Medical and Dental University, 1-5-45 yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Haruka Tohara
- Department of Gerodontology and Oral Rehabilitation, Tokyo Medical and Dental University, 1-5-45 yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Koji Hara
- Department of Gerodontology and Oral Rehabilitation, Tokyo Medical and Dental University, 1-5-45 yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Ayako Nakane
- Department of Gerodontology and Oral Rehabilitation, Tokyo Medical and Dental University, 1-5-45 yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Eriko Kajisa
- Department of Gerodontology and Oral Rehabilitation, Tokyo Medical and Dental University, 1-5-45 yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Kanako Yoshimi
- Department of Gerodontology and Oral Rehabilitation, Tokyo Medical and Dental University, 1-5-45 yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Tokyo Medical and Dental University, 1-5-45 yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
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The nutritional status of adult female patients with disabilities in Kuwait. J Taibah Univ Med Sci 2018; 13:238-246. [PMID: 31435330 PMCID: PMC6694908 DOI: 10.1016/j.jtumed.2018.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 01/09/2018] [Accepted: 01/14/2018] [Indexed: 11/26/2022] Open
Abstract
Objectives Adults with disabilities are at a higher risk of malnutrition than are their non-disabled counterparts owing to feeding problems and associated medical conditions. We evaluated the prevalence of malnutrition in a group of institutionalized women and investigated any feeding difficulties and nutrition-related medical problems. Methods This study used two versions of the Mini Nutritional Assessment-Short Form (MNA-SF) to screen malnutrition: the MNA-SF1 which uses the body mass index, and the MNA-SF2 which uses the calf circumference. Data were collected from 53 women with intellectual and physical disabilities in a cross-sectional survey of residents of the Kuwait Rehabilitation Centre. Results Of all participants, 63.5% were found to be overweight or obese, while 11.5% were underweight. Using the MNA-SF1, 57.7% were found to be at risk of malnourishment while 11.5% were malnourished. More patients were identified to be at risk of malnutrition or to be actually malnourished using the MNA-SF2 (59.6% and 23.1%, respectively). Reported feeding problems included difficulties in maintaining a sitting position, manipulating food on a plate, conveying food to the mouth, and in swallowing. The presence of infections worsened the prognoses of malnourished women regardless of their weight status. Conclusions Our findings suggest that MNA-SF2 is a more sensitive tool for identifying malnourishment than MNA-SF1. Obesity can obscure the identification of malnourished patients if clinicians rely solely on the MNA-SF1, which uses the body mass index.
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Muñoz Díaz B, Arenas de Larriva AP, Molina-Recio G, Moreno-Rojas R, Martínez de la Iglesia J. [Study of the nutritional status of patients over 65 years included in the home care program in an urban population]. Aten Primaria 2018; 50:88-95. [PMID: 28595900 PMCID: PMC6837150 DOI: 10.1016/j.aprim.2017.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 02/03/2017] [Accepted: 02/06/2017] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To analyse the nutritional status of patients older than 65 years included in the home care program (PAD). DESIGN Croos-sectional study. EMPLACEMENT 3 urban health centers. PARTICIPANTS 218 patients in the PAD. METHOD Mini Nutritional Assessment questionnaire (MNA) was applied. Sociodemographic, anthropometric, dependency, emotional and cognitive status and analytical parameters: 57 variables were collected. Possible associations were analysed by applying the chi square and variance analysis. The level of significance was considered to be P<.05 was considered. RESULTS The mean age was 83.9 years (SD=7.4); 34.9% were institutionalized and 80.7% were women; 21.2% of patients were malnourished and 40.1% were at risk of it. A significant association was established between poorer nutritional status and older age, lower BMI, greater dependence on basic and instrumental activities of daily living and greater cognitive impairment. The lowest mean hemoglobin, albumin, and iron levels were also associated with malnutrition and risk of malnutrition. CONCLUSIONS More than half of PAD patients are malnourished or at risk for it, and a high proportion of them some laboratory abnormality susceptible to be corrected. Most cognitive impairment and functional dependence are closely related to malnutrition; so patients with these characteristics should receive more attention from the nutritional point of view.
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Affiliation(s)
| | | | | | - Rafael Moreno-Rojas
- Departamento de Bromatología y Tecnología de los Alimentos, Universidad de Córdoba, Córdoba, España
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Abstract
OBJECTIVES Using both clinical parameters and subjective measures of oral health, this study aimed to identify useful oral health indicators for the risk of malnutrition in elders. DESIGN Cross-sectional study. SETTING Five community centers run by non-government organizations (NGOs). PARTICIPANTS 195 community dwelling elders (65 or above). MEASUREMENTS An interviewer-administered questionnaire was completed to collect information on elders' socio-demographic background and oral health perception and practice. Their number of teeth, number of occluding tooth pairs, dental caries, and periodontal condition were examined. General Oral Health Assessment Index (GOHAI), an instrument for assessing oral health related quality of life (OHQoL), was used as a subjective measure of oral health. The elders' nutritional status was evaluated by using the Mini-Nutritional Assessment (MNA). RESULTS The mean (SD) DFT was 3.3 (3.1). Over 60% of elders had periodontal pockets; 33% had fewer than 20 teeth and 6% were edentulous. The mean (SD) of occluding tooth pairs was 7.1 (4.8). The mean (SD) total GOHAI score was 56.4 (8.0); 60% reported negative impact of oral health on their quality of life. The mean (SD) MNA score was 25.0 (2.9); 30% had malnutrition or were at risk. After controlling for socio-demographic factors, none of the clinical indicators (dental caries, periodontal status, number of teeth, and number of occluding tooth pairs) were associated with risk of malnutrition (all p>0.05). Poorer OHQoL indicated a higher chance for malnutrition in both adjusted models (OR of 0.914; 95% CI of 0.850-0.982; p=0.014 and OR of 0.915; 95% CI of 0.852-0.984; p=0.017). Tooth loss and untreated decayed teeth (DT) were significant/marginally significant determinants of poor OHQoL. CONCLUSION Elders' tooth loss and unmet treatment need for dental caries were associated with compromised quality of life, which indicated increased likelihood for malnutrition.
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Affiliation(s)
- L L Wu
- Dr. Xiaoli Gao, Dental Public health, Faculty of Dentistry, The University of Hong Kong, 3rd Floor, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong, ;
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Achón M, Serrano M, García-González Á, Alonso-Aperte E, Varela-Moreiras G. Present Food Shopping Habits in the Spanish Adult Population: A Cross-Sectional Study. Nutrients 2017; 9:E508. [PMID: 28524085 PMCID: PMC5452238 DOI: 10.3390/nu9050508] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 04/30/2017] [Accepted: 05/12/2017] [Indexed: 12/22/2022] Open
Abstract
Information on grocery shopping patterns is one key to understanding dietary changes in recent years in Spain. This report presents an overview of Spanish food shopping patterns in the adult population. A cross-sectional, nationally representative telephone survey was conducted in Spain. Individuals were asked about food shopping responsibility roles, types of visited food stores, time spent, additional behaviors while shopping, the influence of marketing/advertising and, in particular, fresh produce shopping profile. Binary logistic regression models were developed. The final random sample included 2026 respondents aged ≥18 years, of which 1223 were women and 803 were men. Women reported being in charge of most of the food shopping activities. Looking for best prices, more than looking for healthy or sustainable foods, seemed to be a general behavior. Supermarkets were the preferred retail spaces for food price consideration, convenience, variety and availability. Fresh produce shopping was associated with traditional markets and neighborhood stores in terms of reliance and personalized service. It is essential to highlight the importance of the role played by women. They are the main supporters concerned in preserving adequate dietary habits. Economic factors, more than health or food sustainability, are commonly considered by the population. Traditional markets may play an important role in preserving some healthy dietary habits of the Mediterranean food culture in Spain.
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Affiliation(s)
- María Achón
- Department of Pharmaceutical and Health Sciences, Facultad de Farmacia, Universidad CEU San Pablo, Alcorcón, 28925 Madrid, Spain.
| | - María Serrano
- Department of Pharmaceutical and Health Sciences, Facultad de Farmacia, Universidad CEU San Pablo, Alcorcón, 28925 Madrid, Spain.
| | - Ángela García-González
- Department of Pharmaceutical and Health Sciences, Facultad de Farmacia, Universidad CEU San Pablo, Alcorcón, 28925 Madrid, Spain.
| | - Elena Alonso-Aperte
- Department of Pharmaceutical and Health Sciences, Facultad de Farmacia, Universidad CEU San Pablo, Alcorcón, 28925 Madrid, Spain.
| | - Gregorio Varela-Moreiras
- Department of Pharmaceutical and Health Sciences, Facultad de Farmacia, Universidad CEU San Pablo, Alcorcón, 28925 Madrid, Spain.
- Spanish Nutrition Foundation (FEN), 28024 Madrid, Spain.
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Montejano Lozoya R, Martínez-Alzamora N, Clemente Marín G, Guirao-Goris SJA, Ferrer-Diego RM. Predictive ability of the Mini Nutritional Assessment Short Form (MNA-SF) in a free-living elderly population: a cross-sectional study. PeerJ 2017; 5:e3345. [PMID: 28533984 PMCID: PMC5438591 DOI: 10.7717/peerj.3345] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 04/22/2017] [Indexed: 11/20/2022] Open
Abstract
Background Various scales have been used to perform a quick and first level nutritional assessment, and the MNA is one of the most used and recommended by experts in the elderly in all areas. This scale has a short form, the MNA-SF, revised and validated in 2009, which has two versions: the BMI-MNA-SF contains the first six items of the full scale including Body Mass Index while the CC-MNA-SF includes Calf Circumference instead of BMI. Objective To evaluate the predictive ability for nutritional status of the two versions of the MNA-SF against the MNA in free-living elderly in the province of Valencia. Methods Cross-sectional study of 660 free-living elderly in the province of Valencia selected in 12 community centres using stratified sampling by blocks. Inclusion criteria: being aged 65 or over, living at home, having functional autonomy, residing in the province of study for more than one year, regularly attending community centres and voluntarily wanting to take part. Results Of the 660 subjects studied, 319 were men (48.3%) and 341 (51.7%) women with a mean age of 74.3 years (SD = 6.6). In terms of nutritional assessment, using the BMI-MNA-SF and the CC-MNA-SF we found that 26.5% and 26.2% were at risk of malnutrition and 0.9% and 1.5% were malnourished respectively. With the full MNA, 23.3% were at risk of malnutrition. Spearman’s rank correlation coefficients indicate a high association between the full MNA score and the MNA-SFs scores (BMI-MNA-SF: ρ = 0.78p < 0.001; CC-MNA-SF: ρ = 0.78p < 0.001). In addition we obtained a very high correlation between the two MNA-SFs (ρ = 0.96p < 0.001). We evaluated the agreement between the full MNA and the MNA-SFs classification in three nutritional categories (normal nutritional status, risk of malnutrition, malnutrition) with Cohen’s kappa coefficients (BMI-MNA-SF: κ = 0.54p < 0.001; CC-MNA-SF: κ = 0.52p < 0.001). These values indicate moderate agreement with the full MNA. There is very good agreement between the BMI-MNA-SF and CC-MNA-SF (κ = 0.88p < 0.001). In order to determine the ability of both MNA-SFs to identify subjects not requiring any nutritional intervention, we considered the dichotomised categorisation of the full MNA and the MNA-SFs as “normal nutritional status” vs. “malnutrition and risk of malnutrition” Areas under the ROC curves using MNA as the gold standard indicate moderately high prognostic accuracy (BMI-MNA-SF: AUC = 0.88p < 0.001; CC-MNA-SF: AUC = 0.87 p < 0.001). Both versions of the MNA-SF showed similar sensitivity, specificity and diagnostic effectiveness (BMI-MNA-SF: 73.4%, 86.6%, 83.5%; CC-MNA-SF 73.4%, 86.2%, 83.2%). Conclusions In its two versions the MNA-SF presents useful predictive ability against the MNA. The advantage of the CC-MNA-SF is that using it requires fewer resources and less time in primary care, although always the characteristics of the population must take into account to make the right decision based on the MNA-SF scales.
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Affiliation(s)
- Raimunda Montejano Lozoya
- La Fe School of Nursing, University of Valencia, Valencia, España.,Health Research Institute La Fe (IIS La Fe), Valencia, España
| | - Nieves Martínez-Alzamora
- Department of Applied Statistics and Operational Research and Quality, Polytechnic University of Valencia, Valencia, España
| | - Gonzalo Clemente Marín
- Department of Applied Statistics and Operational Research and Quality, Polytechnic University of Valencia, Valencia, España
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The efficacy of a nutrition education intervention to prevent risk of malnutrition for dependent elderly patients receiving Home Care: A randomized controlled trial. Int J Nurs Stud 2017; 70:131-141. [PMID: 28273591 DOI: 10.1016/j.ijnurstu.2017.02.020] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 02/20/2017] [Accepted: 02/21/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To assess the effect of a nutrition education intervention included in the Home Care Program for caregivers to prevent the increasing risk of malnutrition of dependent patients at risk of malnutrition. DESIGN Randomized controlled multicenter trial of 6 months of duration and 12 months follow-up. SETTINGS 10 Primary Care Centers, Spain. PARTICIPANTS Patients enrolled in the Home Care Program between January 2010 and March 2012, who were dependent and at risk of malnutrition, older than 65, and had caregivers (n=190). INTERVENTION The nurses conducted initial educational intervention sessions for caregivers and then monitored at home every month for 6 months. MEASUREMENTS The nutritional status was assessed using the Mini Nutritional Assessment test (primary outcome), diet, anthropometry, and biochemical parameters (albumin, prealbumin, hemoglobin and cholesterol). Other descriptive and outcome measures were recorded: current medical history, Activities of daily living (Barthel test), cognitive state (Pfeiffer test), and mood status (Yesavage test). All the measures were recorded in a schedule of 0-6-12 months. RESULTS 173 individuals participated after exclusions (intervention n=101; control n=72). Mean age was 87.8±8.9years, 68.2% were women. Difference were found between the groups for Mini Nutritional Assessment test score change (repeated measures ANOVA, F=10.1; P<0.001), the intervention improved the Mini Nutritional Assessment test score of the participants in the intervention group. The egg consumption (F=4.1; P=0.018), protein intake (F=3.0; P=0.050), polyunsaturated fatty acid intake (F=5.3; P=0.006), folate (F=3.3; P=0.041) and vitamin E (F=6.4; P=0.002) showed significant group×time interactions. CONCLUSION A nutrition education intervention for caregivers halted the tendency of nutritional decline, and reduced the risk of malnutrition of older dependent patients. TRIAL REGISTRATION Clinical Trial Registration-URL: www.clinicaltrials.gov. Identifier: NCT01360775.
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Nutritional status assessment of the elderly patients with congestive heart failure by mini nutritional assessment test. Res Cardiovasc Med 2017. [DOI: 10.5812/cardiovascmed.31898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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van der Pols-Vijlbrief R, Wijnhoven HAH, Visser M. Perspectives on the Causes of Undernutrition of Community-Dwelling Older Adults: A Qualitative Study. J Nutr Health Aging 2017; 21:1200-1209. [PMID: 29188880 DOI: 10.1007/s12603-017-0872-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Undernutrition is a major health concern particularly in vulnerable older adults. The present study aimed to reveal the causes of undernutrition as reported by community-dwelling older adults. DESIGN Twenty-five semi-structured interviews and two focus group discussions were performed and analyzed. SETTING Community-dwelling. PARTICIPANTS Older adults. MEASUREMENTS A questionnaire on demographics, Short Nutritional Assessment Questionnaire 65+ and interviews on the potential causes of undernutrition. RESULTS 33 older adults agreed to participate in the interviews and focus groups. Our findings indicate that a wide variety of causes of undernutrition, both modifiable and non-modifiable, were mentioned by the older adults. Many modifiable causes of undernutrition were reported in the mental, social or food and appetite theme, such as poor food quality provided by meal services, the inability to do groceries, loneliness and mourning. Non-modifiable causes included, forgetfulness, aging, surgery and hospitalization. CONCLUSIONS This study provides guidance to better understand the underlying causes of undernutrition from an older adult's perspective. The modifiable causes provide specific direction towards practical implications that might decrease or prevent undernutrition. Non-modifiable causes should raise awareness of an increased risk of undernutrition by health professionals in primary and secondary care, caregivers and family members.
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Affiliation(s)
- R van der Pols-Vijlbrief
- Rachel van der Pols-Vijlbrief, Department of Health Sciences and the EMGO+ Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands, E-mail address: ; Telephone number: +31 (0)20 59 83 701; Fax number: +31 (0)20 59 86 940
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Hernández-Galiot A, Goñi I. Quality of life and risk of malnutrition in a home-dwelling population over 75 years old. Nutrition 2016; 35:81-86. [PMID: 28241994 DOI: 10.1016/j.nut.2016.10.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 10/10/2016] [Accepted: 10/19/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To evaluate the quality of life of a noninstitutionalized population aged older than 75 y by determining nutritional and health status, and to investigate the relationship between nutritional risk and quality of life. METHODS A cross-sectional study of elderly people was conducted in Garrucha (Almería) in southern Spain. A total of 102 participants (61 women and 41 men) aged older than 75 y. The Mini Nutritional Assessment test was used to detect nutritional risk. Quality of life was assessed using the EuroQol-5D test. Body mass index, education level, physical activity, history of illness, use of medication, and smoking and alcoholic habits were also determined. RESULTS Most of the population presented an acceptable nutritional status, were functionally independent and presented a best health state evaluated by the EuroQol-5D index. However, almost 20.6% were at risk of malnutrition, especially women and participants over the age of 90 y. A significant negative association (P < 0.05) between the risk of malnutrition and index of quality of life was found. CONCLUSIONS Risk of malnutrition was common among community-dwelling older people. Participants who were malnourished or at high risk of malnutrition also had a lower rate of quality of life and greater loss of personal autonomy.
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Affiliation(s)
- Ana Hernández-Galiot
- Department of Nutrition, School of Pharmacy, University Complutense of Madrid, Madrid, Spain
| | - Isabel Goñi
- Department of Nutrition, School of Pharmacy, University Complutense of Madrid, Madrid, Spain; Departamento de Nutrición I. Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain.
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Misu S, Asai T, Doi T, Sawa R, Ueda Y, Saito T, Nakamura R, Murata S, Sugimoto T, Yamada M, Ono R. Association between gait abnormality and malnutrition in a community-dwelling elderly population. Geriatr Gerontol Int 2016; 17:1155-1160. [DOI: 10.1111/ggi.12839] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 05/02/2016] [Accepted: 05/10/2016] [Indexed: 12/25/2022]
Affiliation(s)
- Shogo Misu
- Department of Community Health Sciences; Kobe University Graduate School of Health Sciences; Kobe Japan
- Kobe City Hospital Organization, Kobe City Medical Center, West Hospital; Kobe Japan
| | - Tsuyoshi Asai
- Department of Physical Therapy, Faculty of Rehabilitation; Kobegakuin University; Kobe Japan
| | - Takehiko Doi
- Department of Preventive Gerontology; Center for Gerontology and Social Science; Aichi Japan
| | - Ryuichi Sawa
- Department of Physical Therapy; School of Health Sciences at Narita ,International University of Health and Welfare; Chiba Japan
| | - Yuya Ueda
- Department of Community Health Sciences; Kobe University Graduate School of Health Sciences; Kobe Japan
| | - Takashi Saito
- Department of Community Health Sciences; Kobe University Graduate School of Health Sciences; Kobe Japan
| | - Ryo Nakamura
- Department of Community Health Sciences; Kobe University Graduate School of Health Sciences; Kobe Japan
| | - Shunsuke Murata
- Department of Community Health Sciences; Kobe University Graduate School of Health Sciences; Kobe Japan
| | - Taiki Sugimoto
- Department of Community Health Sciences; Kobe University Graduate School of Health Sciences; Kobe Japan
- The Center for Comprehensive Care and Research on Memory Disorders; National Center for Geriatrics and Gerontology; Aichi Japan
- Medical Genome Center; National Center for Geriatrics and Gerontology; Aichi Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences; University of Tsukuba; Tokyo Japan
| | - Rei Ono
- Department of Community Health Sciences; Kobe University Graduate School of Health Sciences; Kobe Japan
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Health determinants of nutritional status in community-dwelling older population: the VERISAÚDE study. Public Health Nutr 2016; 19:2220-8. [PMID: 26975221 DOI: 10.1017/s1368980016000434] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Malnutrition is a common and relevant syndrome in elderly people due to its influence on quality of life. The main aim of the present study was to identify health determinants of malnutrition or risk of malnutrition. DESIGN Cross-sectional study collecting information on sociodemographic and health factors (co-morbidity, cognitive or affective problems, prescription medication use, frailty status, self-rated health) as determinants of nutritional status, assessed by the short form of the Mini Nutritional Assessment. SETTING Forty-three senior centres from Galicia (north-western Spain) participated to recruit participants. SUBJECTS A representative community-dwelling sample of 749 elderly people aged ≥65 years. RESULTS Of the total participants, 14·3 % were malnourished/at risk of malnutrition. Presence of overweight or obesity, depressive symptoms, polypharmacy (use of five or more prescription medications), presence of pre-frailty or frailty status and poor self-rated health showed the strongest relationship to malnutrition/risk of malnutrition. This model predicted 86·0 % of the cases correctly. The best determinants for women were polypharmacy and poor self-rated health, reaching 82·8 % of cases of malnourishment/risk of malnutrition predicted correctly. In men, the main determinants were overweight or obesity, depressive symptomatology and polypharmacy, with 89·8 % of cases of malnourishmen/risk of malnutrition predicted correctly. CONCLUSIONS Screening for nutritional status and its determinant factors should be included as part of comprehensive assessments to ensure an early screening of malnutrition and to propose possible intervention strategies that would be important for both elderly people and the health-care system.
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Naidoo I, Charlton KE, Esterhuizen TM, Cassim B. High risk of malnutrition associated with depressive symptoms in older South Africans living in KwaZulu-Natal, South Africa: a cross-sectional survey. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2015; 33:19. [PMID: 26825267 PMCID: PMC5026002 DOI: 10.1186/s41043-015-0030-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 10/02/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Malnutrition contributes to functional and cognitive decline in older adults, which results in decreased quality of life and loss of independence. This study aimed to identify determinants of nutritional risk among community-dwelling adults in KwaZulu-Natal, South Africa. METHODS A cross-sectional survey was undertaken in 1008 subjects aged 60 years and over who were randomly selected by systematic sampling. Demographics, socioeconomic data and self-reported history of medical conditions were recorded. The Mini Nutritional Assessment-Short Form (MNA-SF) was used to screen for nutritional risk, and the Centre for Epidemiologic Studies Depression scale was administered to all subjects. Descriptive statistics and the Pearson chi-square and Kruskal-Wallis tests were used for statistical analysis. Logistic regression modelling determined predictors of nutritional risk. RESULTS Of the 984 participants (mean age = 68.8 ± 7.4 years; range 60-103 years) who completed the MNA-SF, 51% were classified as having a normal nutritional status, 43.4% at risk for malnutrition and 5.5% classified as malnourished. Men were more likely to be either at risk for malnutrition or be malnourished than women (p = 0.008), as were subjects with a monthly household income of ≤R1600 per month (~133 USD) (p = 0.003). In logistic regression models, depressed people were 2.803 (p < 0.001) times more likely to be at risk or be malnourished than those not depressed. CONCLUSION A high prevalence of risk of malnutrition was identified in older South Africans living in an urban area with poor infrastructure. Further investigations are warranted to determine whether the higher prevalence of depressive symptomatology in nutritionally at risk individuals is a determinant or a consequence of malnutrition, in order to develop targeted nutritional interventions in this age group.
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Affiliation(s)
- I Naidoo
- Department of Geriatrics, University of KwaZulu-Natal, Durban, South Africa
| | - Karen E Charlton
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia.
| | - T M Esterhuizen
- Centre for Evidence Based Health Care, Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - B Cassim
- Department of Geriatrics, University of KwaZulu-Natal, Durban, South Africa
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