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Correia Rodriguez B, Rosendo I, Santos Coelho TI, Duarte Mendes P, Dos Santos Rodrigues G, Faustino Francisco Â, Cerqueira Martins AS, Boto T, Guerra Fernandes F, Figueiredo Costa Â, Lamarão C, Miguéis Ferreira I, Andrade Glória J, Vicente Osório I, Couto Gonçalves TD, Rosas Pereira A, Almeida Guedes AS, Fernandes Mendes C, Pires da Silva S, Carvalhal A, Vasconcelos Costa P, Alves Dos Reis B. [Eating Habits of People with Type 2 Diabetes Mellitus in Portugal: A Cross-Sectional Study]. ACTA MEDICA PORT 2024; 37:27-35. [PMID: 38183233 DOI: 10.20344/amp.19738] [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: 02/17/2023] [Accepted: 08/28/2023] [Indexed: 01/07/2024]
Abstract
INTRODUCTION Nutrition is a cornerstone of diabetes mellitus prevention and management; therefore, it is essential to enable patients to adopt healthy eating habits. Previous studies have not yet documented the main errors in the eating habits of Portuguese people with type 2 diabetes mellitus. This study aims to identify the main errors in the eating habits of people living with type 2 diabetes mellitus in Portugal and to evaluate its associations with sociodemographic variables. METHODS Cross-sectional multicentric study in a convenience sample of people with type 2 diabetes mellitus in Primary Health Care Units. The UK Diabetes and Diet Questionnaire (UKDDQ) - translated and adapted, was applied from July to October 2022. Descriptive and inferential statistical analyses were conducted. RESULTS Of the 550 participants, 52.2% were female, 68.3% were 65 years or over, 55.8 % had an education level up to the fourth grade, 24.7% had economic deprivation, and the mean time since diagnosis was 10.60 ± 8.13 years. Only 36.2% of the sample had a healthy UKDDQ score. Less than 50% of the sample had healthy scores for the items "high-fiber rice or pasta", "high-fiber bread", "butter, margarine and vegetable oils" and "vegetables and pulses". Only 8.9% of the sample had a healthy consumption of fiber. About 70.4% reported healthy scores for the consumption of "high-added-sugar foods" and 54.7% for "high-saturated fat". A statistically significant weak positive correlation was found between the UKDDQ score and age (ρ = 0.201, p < 0.001) with a more frequent choice of healthy foods with increasing age. Female respondents reported healthier habits, particularly in the consumption of "high-saturated fat" and "high-fiber foods". CONCLUSION The majority of our sample did not take advantage of the potential benefits of healthy eating habits. The main food groups whose consumption should be emphasized or discouraged were individualized, particularly the need to encourage the consumption of high-fiber foods. Targeted educational actions must focus especially on younger and/or male patients.
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Affiliation(s)
| | - Inês Rosendo
- Faculdade de Medicina. Universidade de Coimbra. Coimbra; Unidade de Saúde Familiar Coimbra Centro. Coimbra. Portugal
| | | | | | | | | | | | - Tânia Boto
- Unidade de Saúde Familiar Infante D. Henrique. Viseu. Portugal
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Caldo-Silva A, Furtado GE, Chupel MU, Letieri RV, Neves RS, Direto F, Barros MP, Bachi ALL, Matheu A, Martins F, Massart A, Teixeira AM. Empowering frail older adults: multicomponent elastic-band exercises and BCAA supplementation unleash physical health and preserve haematological biomarkers. Front Sports Act Living 2023; 5:1171220. [PMID: 37720080 PMCID: PMC10502309 DOI: 10.3389/fspor.2023.1171220] [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: 02/21/2023] [Accepted: 08/03/2023] [Indexed: 09/19/2023] Open
Abstract
The effectiveness of Branched Chain Amino Acids (BCAAs) supplementation on enhancing exercise performance in both young and older adults remains a topic of debate. Recent research suggests that BCAAs combined with regular exercise might have an impact on human erythropoiesis, blood dynamics, and iron homeostasis. Given the increasing longevity of the global population, it is crucial to investigate the potential benefits of BCAA supplementation and regular exercise as non-pharmacological interventions for improving the overall health of frail older adults. To assess the influence of a 40-week multicomponent exercise intervention (MEP) combined BCCA supplementation on the haematological indicators of frail older adults (83-93 years old) residing in nursing homes. A prospective, naturalistic, controlled clinical trial employing an intervention-washout-intervention was conducted for this purpose. The study included four experimental groups: MEP plus BCAA supplementation (MEP + BCAA, n = 8), MEP only (n = 7), BCAA supplementation only (n = 7), and control group non exercising (CG, n = 13). Fried's physical frailty (PF) protocol was employed to stratify the participants. Additionally, the assessment included the evaluation of nutritional status, comorbidities, and anthropometric measurements. Among the several haematological markers examined, only mean cellular Haemoglobin Concentration (MCH) [F = 4.09; p < 0.03] and Mean Cell haemoglobin Concentration (MCHC) [F = 10, 323; p < 0,0001] showed significant effects of time group. Our findings demonstrate that a long-term intervention with BCAA plus MEP did not lead to significant alterations in the haematological profile. An 8-week withdrawal from interventions did not affect the frailty status in the MEP and MEP + BCAA groups, whereas the control group exhibited an increase in PF status. The findings, demonstrating the potential pro-immune effect and maintenance of MCH and MCHC levels, highlight the relevance of incorporating exercise and nutritional strategies to promote healthy aging. This study contributes to the achievement of the United Nations Sustainable Development Goals 3 (good health and well-being) and 10 (reduced Inequalities) for all.
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Affiliation(s)
- Adriana Caldo-Silva
- Research Centre for Sport and Physical Activity, CIDAF, Faculty of Sport Science and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Guilherme E. Furtado
- Research Centre for Sport and Physical Activity, CIDAF, Faculty of Sport Science and Physical Education, University of Coimbra, Coimbra, Portugal
- Polytechnic Institute of Coimbra, Applied Research Institute, Rua da Misericórdia, Lagar dos Cortiços-S, Martinho do Bispo, Coimbra, Portugal
- Research Centre for Natural Resources Environment and Society (CERNAS), Polytechnic Institute of Coimbra, Bencanta, Coimbra, Portugal
| | - Matheus Uba Chupel
- Biological Sciences Platform- Hurvitz Brain Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Rubens Vinícius Letieri
- Multidisciplinary Research Nucleus in Physical Education (NIMEF), Physical Education Department, Avenida Nossa Senhora de Fátima, Federal University of North of Tocantins (UFNT), Tocantinópolis, Brazil
| | - Rafael Santos Neves
- Research Centre for Sport and Physical Activity, CIDAF, Faculty of Sport Science and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Fábio Direto
- Research Centre for Sport and Physical Activity, CIDAF, Faculty of Sport Science and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Marcelo P. Barros
- Institute of Physical Activity Sciences and Sports (ICAFE), Interdisciplinary Program in Health Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - André L. L. Bachi
- Post-Graduation Program in Health Sciences, Santo Amaro University (UNISA), São Paulo, Brazil
| | - Ander Matheu
- Group of Cellular Oncology, Biodonostia Health Research Institute, San Sebastian, Spain
- CIBER On Frailty and Healthy Aging (CIBERfes), Institute of Health Carlos III, Madrid, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Faber Martins
- Laboratory for the Evaluation of Sports Performance, Physical Exercise, and Health (LABMOV), Polytechnic of Guarda, Guarda, Portugal
| | - Alain Massart
- Research Centre for Sport and Physical Activity, CIDAF, Faculty of Sport Science and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Ana Maria Teixeira
- Research Centre for Sport and Physical Activity, CIDAF, Faculty of Sport Science and Physical Education, University of Coimbra, Coimbra, Portugal
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Carrasco C, Reis G, Sim-Sim M, Parraca JA, Fernandes O, Tomas-Carus P. Sex, cognitive state and falls as factors associated with malnutrition: a cross-sectional study of institutionalized older adults living in a rural area of Portugal. BMC Public Health 2023; 21:2337. [PMID: 37131189 PMCID: PMC10152580 DOI: 10.1186/s12889-023-15601-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/03/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Malnutrition is an underestimated geriatric problem, with a high prevalence in institutionalized older adults. The identification of risk factors for malnutrition in elderly individuals must be a priority for governmental organizations worldwide. METHODS A total of 98 institutionalized seniors were enrolled in a cross-sectional study. For the assessment of risk factors, sociodemographic characteristics and health-related information were collected. The Mini-Nutritional Assessment Short-Form test was used to assess malnutrition in the sample population. RESULTS A significantly greater proportion of women than men were malnourished or at risk of malnutrition. In addition, the comparative analysis revealed that comorbidity, arthritis, balance impairment, dementia and fall episodes with serious injuries were significantly more frequent in the older adults categorized as malnourished or at risk of malnutrition than in those categorized as well-nourished. CONCLUSIONS Multivariable regression analysis revealed that being female, having a poor cognitive status and experiencing falls with injuries are the main independent factors influencing nutritional status in institutionalized older adults living in a rural area of Portugal.
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Affiliation(s)
- Cristina Carrasco
- Department of Physiology, Faculty of Medicine/Sciences, University of Extremadura, Avd. de Elvas S/N 06006, Badajoz, Spain.
| | - Gorete Reis
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Évora, Portugal
- Comprehensive Health Research Center (CHRC), University of Évora, Évora, Portugal
| | - Margarida Sim-Sim
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Évora, Portugal
- Comprehensive Health Research Center (CHRC), University of Évora, Évora, Portugal
| | - Jose A Parraca
- Comprehensive Health Research Center (CHRC), University of Évora, Évora, Portugal
- Departamento de Desporto E Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
| | - Orlando Fernandes
- Comprehensive Health Research Center (CHRC), University of Évora, Évora, Portugal
- Departamento de Desporto E Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
| | - Pablo Tomas-Carus
- Comprehensive Health Research Center (CHRC), University of Évora, Évora, Portugal
- Departamento de Desporto E Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
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Vucic V, Ristic-Medic D, Arsic A, Petrovic S, Paunovic M, Vasiljevic N, Ilich JZ. Nutrition and Physical Activity as Modulators of Osteosarcopenic Adiposity: A Scoping Review and Recommendations for Future Research. Nutrients 2023; 15:nu15071619. [PMID: 37049460 PMCID: PMC10096523 DOI: 10.3390/nu15071619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/19/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
Osteosarcopenic adiposity (OSA) syndrome denotes the confluence of bone, muscle, and adipose tissue deterioration. Being a complex entity, numerous uncertainties about OSA still exist, despite the extensive research on the topic. Our objectives were to evaluate human studies addressing dietary intake/nutritional status and the quantity/types of physical activity related to OSA. The search in PubMed, Scopus, and Web of Science databases was conducted to examine relevant articles published from inception to the end of December 2022, utilizing the MeSH strings in the search strategy. Only studies published in English and conducted in humans (≥18 years) without chronic conditions (cancers, kidney/liver disease) or pregnancy were used. Book chapters, abstracts-only, and studies in which participants did not have all three body composition components measured to identify OSA or when body composition components could not be related to the independent/exposure variables were excluded. A total of n = 1020 articles were retrieved from all three databases and eight more from the reference lists. After the exclusion of duplicates and other unsuitable articles, n = 23 studies were evaluated. Among those, eleven were from epidemiological or cross-sectional studies relating nutrients/dietary intake or nutritional status with OSA. Another four examined the relationship between serum biomarkers (vitamin D and ferritin) with OSA, while eight articles presented the results of the interventional studies with resistance training. Overall, higher protein, calcium, potassium, and vitamins D and C intakes emerged as nutrients positively modifying OSA, along with a diet higher in fruits and low-fat dairy foods. Higher serum vitamin D and ferritin were respectively positively and negatively related to OSA. Resistance training was a safe intervention yielding several beneficial outcomes for the OSA syndrome in older women.
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Lem K, McGilton KS, Aelick K, Iaboni A, Babineau J, Hewitt Colborne D, Edwards C, Bretzlaff M, Lender D, Gibson JL, Bethell J. Social connection and physical health outcomes among long-term care home residents: a scoping review. BMC Geriatr 2021; 21:722. [PMID: 34922469 PMCID: PMC8683818 DOI: 10.1186/s12877-021-02638-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 11/16/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Social connection is recognized as an important determinant of health and well-being. The negative health impacts of poor social connection have been reported in research in older adults, however, less is known about the health impacts for those living in long-term care (LTC) homes. This review seeks to identify and summarize existing research to address the question: what is known from the literature about the association between social connection and physical health outcomes for people living in LTC homes? METHODS A scoping review guided by the Arksey & O'Malley framework was conducted. Articles were included if they examined the association between social connection and a physical health outcome in a population of LTC residents. RESULTS Thirty-four studies were included in this review. The most commonly studied aspects of social connection were social engagement (n = 14; 41%) and social support (n = 10; 29%). A range of physical health outcomes were assessed, including mortality, self-rated health, sleep, fatigue, nutrition, hydration, stress, frailty and others. Findings generally support the positive impact of social connection for physical health among LTC residents. However, most of the studies were cross-sectional (n = 21; 62%) and, of the eleven cohort studies, most (n = 8; 73%) assessed mortality as the outcome. 47% (n = 16) were published from 2015 onwards. CONCLUSIONS Research has reported positive associations between social connection and a range of physical health outcomes among LTC residents. These findings suggest an important role for social connection in promoting physical health. However, further research is needed to consider the influence of different aspects of social connection over time and in different populations within LTC homes as well as the mechanisms underlying the relationship with health.
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Affiliation(s)
- Kaitlyn Lem
- Faculty of Arts & Sciences, University of Toronto, Toronto, ON, Canada
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada
| | - Katherine S McGilton
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Katelynn Aelick
- Behavioural Supports Ontario Provincial Coordinating Office, North Bay Regional Health Centre, North Bay, ON, Canada
| | - Andrea Iaboni
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jessica Babineau
- Library and Information Services, University Health Network, Toronto, ON, Canada
| | - Debbie Hewitt Colborne
- Behavioural Supports Ontario Provincial Coordinating Office, North Bay Regional Health Centre, North Bay, ON, Canada
| | | | - Monica Bretzlaff
- Behavioural Supports Ontario Provincial Coordinating Office, North Bay Regional Health Centre, North Bay, ON, Canada
| | - Dee Lender
- Ontario Association of Residents' Councils, Newmarket, ON, Canada
| | - Josie-Lee Gibson
- Ontario Association of Residents' Councils, Newmarket, ON, Canada
| | - Jennifer Bethell
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada.
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
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Efendioglu EM, Cigiloglu A, Turkbeyler IH. Malnutrition and Depressive Symptoms in Elderly Palliative Care Patients. J Palliat Care 2021; 37:503-509. [PMID: 34647838 DOI: 10.1177/08258597211045500] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objective: The aim of this study is to determine the prevalence of and relationship between malnutrition and depressive symptoms in older palliative care inpatients. Methods: One hundred and thirty-six older adults were included in the study. The Geriatric Depression Scale, Mini Nutritional Assessment Short Form, Mini Mental State Examination, Barthel index, and Lawton & Brody index were used to evaluate the mood, nutrition status, mental status, and activities of daily living of the patients. Results: The mean age of the patients was 74.88 ± 8.82 years, and 63.2% of the patients were female. According to the nutritional assessment, 39.7% of the patients suffered from malnutrition, while 47.1% were at risk for it, and depressive symptoms were detected in 79.4% of the patients. A strong negative correlation was found between the scores for nutritional and depressive symptoms (r = -.750, 95% CI = -.834 to -.668). Conclusion: Malnutrition, risk of malnutrition, and depressive symptoms were found to occur often among the patients, and the relationship between them was statistically significant. Our results highlight that the quality of life of palliative care patients could be improved by providing adequate nutrition and psychological support.
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Affiliation(s)
| | | | - Ibrahim H Turkbeyler
- Gaziantep Dr Ersin Arslan Education Research Hospital, Sahinbey, Gaziantep, Turkey
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Cachioni M, Cipolli GC, Borim FSA, Batistoni SST, Yassuda MS, Neri AL, Paúl C. Factors Associated With Positive Self-Rated Health: Comparing Older Adults in Brazil and in Portugal. Front Public Health 2021; 9:650294. [PMID: 33869133 PMCID: PMC8044971 DOI: 10.3389/fpubh.2021.650294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/01/2021] [Indexed: 01/22/2023] Open
Abstract
Introduction: Self-rated health is a multidimensional health indicator and a predictor of adverse events in old age. Answers to this assessment are influenced by social, cultural and personality factors. Aim: Exploring common and distinctive characteristics of Brazilian and Portuguese older adults aged 70 and over regarding positive self-rated health according to sociodemographic variables, to functional capacity, to independent performance of basic activities of daily living and to neuroticism, as well as analyzing associations between positive self-rated health and these variables. Methods: The present paper is a comparative and cross-sectional study based on secondary data contained in the databases of the FIBRA (Frailty in Brazilian Older Adults) follow-up study, with 418 Brazilian older adults, and of the DIA (From Disability to Activity: The Challenge of Aging) study, with 380 Portuguese older adults. Both samples had higher percentages of women: 68.4% for Portugal and 69.9% for Brazil. The Brazilian sample had a higher average age (80.31 ± 4.67) than the Portuguese sample (76.80 ± 5.28). Results: The Portuguese older adults had better overall cognition scores, higher handgrip strength and higher neuroticism values than the Brazilian older adults. In the simple and multiple logistic regression analyses, it was found that among Brazilian older adults, subjects with higher scores in the MMSE (OR 1.16; 95% CI 1.08-1.24), regardless of ADL performance (OR 2.13; 95% CI 1.31-3.47) and with scores 24-29 (OR 1.92; 95% CI 1.07-3.43) or 11-23 (OR 2.09; 95% CI 1.15-3.79) in neuroticism were more likely to assess their health as very good/good. On the other hand, the Portuguese older adults with intermediate 24-9 (OR 2.38; 95% CI 1.31-4.33) or low 11-23 (OR 5.31; 95% CI 2.69-10.45) scores in neuroticism were more likely to evaluate their health as very good/good. Conclusion: Based on the findings of the present study and on the existing literature, it may be said that it is possible for people to age while keeping a positive perception of their own health, even in advanced old age; comparisons between the above-mentioned countries, however, point to the need for investments in healthcare systems so that older adults may enjoy greater physical independence and improved mental health.
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Affiliation(s)
- Meire Cachioni
- University of São Paulo, São Paulo, São Paulo, Brazil.,Institute of Biomedical Sciences Abel Salazar (ICBAS), Center for Research in Health Technologies and Services (CINTESIS), University of Porto, Porto, Portugal
| | | | | | | | | | - Anita Liberalesso Neri
- Graduate Studies in Gerontology, State University of Campinas, Campinas, São Paulo, Brazil
| | - Constança Paúl
- Institute of Biomedical Sciences Abel Salazar (ICBAS), Center for Research in Health Technologies and Services (CINTESIS), University of Porto, Porto, Portugal
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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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Velázquez-Alva MC, Irigoyen-Camacho ME, Cabrer-Rosales MF, Lazarevich I, Arrieta-Cruz I, Gutiérrez-Juárez R, Zepeda-Zepeda MA. Prevalence of Malnutrition and Depression in Older Adults Living in Nursing Homes in Mexico City. Nutrients 2020; 12:E2429. [PMID: 32823579 PMCID: PMC7468927 DOI: 10.3390/nu12082429] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/08/2020] [Accepted: 08/11/2020] [Indexed: 01/12/2023] Open
Abstract
This study evaluated the association between nutritional status, depressive symptoms, and the number of prescription drugs taken by older adults living in nursing homes in Mexico City. In a cross-sectional study, 262 participants were subjected to anthropometric and nutritional (Mini Nutritional Assessment (MNA)) evaluations; additionally, their depression (Geriatric Depression Scale (GDS)) and functional status were assessed. Multiple logistic regression was used for identifying factors associated with the risk of malnutrition/malnourishment. The mean age of participants was 83.1 ± 8.6 years. A total of 59.9% and 21.1% were at risk of malnutrition and malnourished, respectively. With respect to depression, 27.9% of the participants had mild depression, while 11.4% showed severe depression. An inverse correlation between MNA evaluations and depression scores was found (Spearman's ρ = -0.4624, p < 0.001); residents with a better nutritional status had lower depression scores. Individuals with depressive symptoms were approximately five times more likely to be at risk of malnutrition or malnourished (OR = 5.82, 95% CI = 2.27-14.89) than individuals without depression. Residents taking three or more prescription drugs daily (OR = 1.83, 95% CI = 1.27-2.63, p < 0.001) were more likely to be at risk of malnutrition or malnourished. In summary, poor nutritional status was associated with depression, while the intake of numerous prescription drugs was associated with being at risk of malnutrition or malnourished.
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Affiliation(s)
- María Consuelo Velázquez-Alva
- Health Care Department, Metropolitan Autonomous University, Unit Xochimilco, Mexico City 04960, Mexico; (M.C.V.-A.); (M.F.C.-R.); (I.L.); (M.A.Z.-Z.)
| | - María Esther Irigoyen-Camacho
- Health Care Department, Metropolitan Autonomous University, Unit Xochimilco, Mexico City 04960, Mexico; (M.C.V.-A.); (M.F.C.-R.); (I.L.); (M.A.Z.-Z.)
| | - María Fernanda Cabrer-Rosales
- Health Care Department, Metropolitan Autonomous University, Unit Xochimilco, Mexico City 04960, Mexico; (M.C.V.-A.); (M.F.C.-R.); (I.L.); (M.A.Z.-Z.)
| | - Irina Lazarevich
- Health Care Department, Metropolitan Autonomous University, Unit Xochimilco, Mexico City 04960, Mexico; (M.C.V.-A.); (M.F.C.-R.); (I.L.); (M.A.Z.-Z.)
| | - Isabel Arrieta-Cruz
- Department of Basic Research, National Institute of Geriatrics, Ministry of Health, Mexico City 10200, Mexico;
| | - Roger Gutiérrez-Juárez
- Department of Biomedical Sciences, School of Medicine, Faculty of High Studies Zaragoza, National Autonomous University of Mexico, Mexico City 09230, Mexico;
| | - Marco Antonio Zepeda-Zepeda
- Health Care Department, Metropolitan Autonomous University, Unit Xochimilco, Mexico City 04960, Mexico; (M.C.V.-A.); (M.F.C.-R.); (I.L.); (M.A.Z.-Z.)
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Association between living setting and malnutrition among older adults: The PEN-3S study. Nutrition 2020; 73:110660. [PMID: 32179404 DOI: 10.1016/j.nut.2019.110660] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 10/18/2019] [Accepted: 11/18/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Malnutrition is frequent among older adults, especially those living in nursing homes, but the association between residential setting and nutritional status is controversial. The aim of this study was to examine the association between living setting (nursing home versus community) and malnutrition while adjusting for demographic, socioeconomic, health-related, and psychosocial factors. METHODS This cross-sectional study included a randomly selected representative sample of Portuguese adults ≥65 y of age. Interviewers collected data regarding demographic and socioeconomic characteristics, nutritional status, physical activity, energy intake, cognitive function, self-reported general health, functional status, symptoms of depression, and loneliness. Logistic regression models were used to estimate the association between residential setting and malnutrition. RESULTS Participants were 1186 nursing home residents (72.8% women, 49.2% ≥85 y of age) and 1120 community dwellers (49% women, 21.3% ≥85 y of age). Following Mini Nutritional Assessment (MNA®) criteria, 29.6% of nursing home residents and 14.1% of community dwellers were at risk of malnutrition, whereas 2.3% and 0.3%, respectively, were malnourished. The living setting was not significantly associated with malnutrition after adjusting for functional status, symptoms of depression, and feelings of loneliness (odds ratio, 1.03; 95% confidence interval, 0.67-1.58). CONCLUSIONS Risk of malnutrition and malnutrition are more prevalent among nursing home residents than community dwellers. Physical (functional status) and mental health (symptoms of depression and loneliness) seems more relevant to nutritional status than residential setting by itself. These findings should be taken into account when designing public health policies to tackle malnutrition among older adults.
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Besora-Moreno M, Llauradó E, Tarro L, Solà R. Social and Economic Factors and Malnutrition or the Risk of Malnutrition in the Elderly: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients 2020; 12:nu12030737. [PMID: 32168827 PMCID: PMC7146387 DOI: 10.3390/nu12030737] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/03/2020] [Accepted: 03/08/2020] [Indexed: 12/31/2022] Open
Abstract
Malnutrition in the elderly could be tackled by addressing socioeconomic factors. This study aimed to determine the magnitude of the relationship between socioeconomic factors and the malnutrition or malnutrition risk (MR) in the elderly. The PubMed and SCOPUS databases were searched for observational studies that included assessment of malnutrition or/and MR and socioeconomic variables (educational level, living alone, marital status, income and occupational level, feeling of loneliness, place of residence, and food expenditure) in ≥60-year-old subjects, published in English among 2000–2018 (PROSPERO: CRD42019137097). The systematic review included 40 observational studies (34 cross-sectional and 4 cohort studies) and 16 cross-sectional studies in the meta-analysis (34,703 individuals) of malnutrition and MR in relation to low educational level (Odds Ratio (OR): 1.48; 95% Confidence Interval (CI): 1.33–1.64; p < 0.001), living alone (OR: 1.92; 95% CI: 1.73–2.14; p < 0.001), being single, widowed, or divorced (OR: 1.73; 95% CI: 1.57–1.90; p < 0.001), and low income level (OR: 2.69; 95% CI: 2.35–3.08; p < 0.001), and considering these four socioeconomic factors, malnutrition and MR is associated with them (OR: 1.83; 95% CI: 1.73–1.93; p < 0.001). Malnutrition and MR could be reduced by increasing economic level, supporting people living alone or being single, widowed, and divorced, and improving lifelong learning.
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Affiliation(s)
- Maria Besora-Moreno
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), 43201 Reus, Spain; (M.B.-M.); (L.T.); (R.S.)
| | - Elisabet Llauradó
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), 43201 Reus, Spain; (M.B.-M.); (L.T.); (R.S.)
- Correspondence: ; Tel.: +34-977-75-89-20
| | - Lucia Tarro
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), 43201 Reus, Spain; (M.B.-M.); (L.T.); (R.S.)
- Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Eurecat, 43204 Reus, Spain
| | - Rosa Solà
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), 43201 Reus, Spain; (M.B.-M.); (L.T.); (R.S.)
- Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Eurecat, 43204 Reus, Spain
- Hospital Universitari Sant Joan de Reus, Department of Internal Medicine, 43204 Reus, Spain
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