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Owari G, Kono K, Nishida Y. Depressive Symptoms and Associated Factors in Older Rehabilitation Inpatients: A Cross-Sectional Study. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2021. [DOI: 10.1080/02703181.2021.1920655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Go Owari
- Inzai General Hospital, Inzai City, Chiba, Japan
| | - Kenichi Kono
- Department of Physical Therapy, International University Health and Welfare, Narita city, Chiba, Japan
| | - Yusuke Nishida
- Department of Physical Therapy, International University Health and Welfare, Narita city, Chiba, Japan
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Karim KMR, Tasnim T, Shams SD, Zaher MA, Mamun S. Mini Nutritional Assessment and physical function of older people in residential aged care facility, Bangladesh. Nutr Health 2021; 28:443-452. [PMID: 34250851 DOI: 10.1177/02601060211030119] [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: 11/16/2022]
Abstract
BACKGROUND Malnutrition may decrease physical function and exacerbate health conditions and thus have a negative effect on health-related quality of life of older people. AIM The study was aimed at evaluating the extent of malnutrition, physical function and other associated risk factors for the older persons (>65 years) living in the residential aged care facilities in Bangladesh. METHODS A cross-sectional study was performed with a sample of 200 older people in various residential aged care facilities in Dhaka, Bangladesh. Nutritional status was evaluated using the Mini Nutritional Assessment. A structured questionnaire was used to assess the socioeconomic condition, dietary diversity, functional ability and other related risk factors for malnutrition. RESULTS According to the Mini Nutritional Assessment, 33.5% of participants living in residential aged care facilities were malnourished and 52.5% were at risk of malnutrition. Dietary diversity score differs significantly (p<0.001) among malnourished (3.78 ± 0.45), at risk of malnutrition (4.46 ± 0.98) and well-nourished (4.75 ± 1.11) groups. Twenty-five percent of the study participants reported limitations in mobility and 26.5% reported limitations in activities of daily living. Females were more vulnerable in terms of malnutrition and physical function than males. Mini Nutritional Assessment score is significantly correlated (p<0.05) with several risk factors for malnutrition such as body mass index, education level, meal, protein consumption, dietary diversity score, weight loss, reduced food intake, mobility and activities of daily living of the older people. CONCLUSIONS The study reaffirms that a high rate of malnutrition and risk of malnutrition is prevalent among aged care residents, who need special attention and may benefit from individualized nutrition interventions.
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Affiliation(s)
| | - Tasmia Tasnim
- Department of Nutrition and Food Engineering, 130058Daffodil International University, Bangladesh
| | - Sabrin Deeba Shams
- Institute of Nutrition and Food Science, 95324University of Dhaka, Bangladesh
| | | | - Sumaiya Mamun
- Institute of Nutrition and Food Science, 95324University of Dhaka, Bangladesh
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The effects of self-efficacy enhancing program on foot self-care behaviour of older adults with diabetes: A randomised controlled trial in elderly care facility, Peninsular Malaysia. PLoS One 2018. [PMID: 29534070 PMCID: PMC5849313 DOI: 10.1371/journal.pone.0192417] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Self-care behaviour is essential in preventing diabetes foot problems. This study aimed to evaluate the effectiveness of health education programs based on the self-efficacy theory on foot self-care behaviour for older adults with diabetes. METHODS A randomised controlled trial was conducted for 12 weeks among older adults with diabetes in elderly care facility in Peninsular Malaysia. Six elderly care facility were randomly allocated by an independent person into two groups (intervention and control). The intervention group (three elderly care facility) received a health education program on foot self-care behaviour while the control group (three elderly care facility) received standard care. Participants were assessed at baseline, and at week-4 and week-12 follow-ups. The primary outcome was foot-self-care behaviour. Foot care self-efficacy (efficacy expectation), foot care outcome expectation, knowledge of foot care and quality of life were the secondary outcomes. Data were analysed with Mixed Design Analysis of Variance using the Statistical Package for the Social Sciences version 22.0. RESULTS 184 respondents were recruited but only 76 met the selection criteria and were included in the analysis. Foot self-care behaviour, foot care self-efficacy (efficacy expectation), foot care outcome expectation and knowledge of foot care improved in the intervention group compared to the control group (p < 0.05). However, some of these improvements did not significantly differ compared to the control group for QoL physical symptoms and QoL psychosocial functioning (p > 0.05). CONCLUSION The self-efficacy enhancing program improved foot self-care behaviour with respect to the delivered program. It is expected that in the future, the self-efficacy theory can be incorporated into diabetes education to enhance foot self-care behaviour for elderly with diabetes living in other institutional care facilities. TRIAL REGISTRATION Australian New Zealand Clinical Trial Registry ACTRN12616000210471.
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Sharoni SKA, Abdul Rahman H, Minhat HS, Shariff Ghazali S, Azman Ong MH. A self-efficacy education programme on foot self-care behaviour among older patients with diabetes in a public long-term care institution, Malaysia: a Quasi-experimental Pilot Study. BMJ Open 2017; 7:e014393. [PMID: 28600363 PMCID: PMC5623401 DOI: 10.1136/bmjopen-2016-014393] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE A pilot self-efficacy education programme was conducted to assess the feasibility, acceptability and potential impact of the self-efficacy education programme on improving foot self-care behaviour among older patients with diabetes in a public long-term care institution. METHOD A prequasi-experimental and postquasi-experimental study was conducted in a public long-term care institution in Selangor, Malaysia. Patients with diabetes aged 60 years and above who fulfilled the selection criteria were invited to participate in this programme. Four self-efficacy information sources; performance accomplishments, vicarious experience, verbal persuasion and physiological information were translated into programme interventions. The programme consisted of four visits over a 12-week period. The first visit included screening and baseline assessment and the second visit involved 30 min of group seminar presentation. The third and fourth visits entailed a 20-min one-to-one follow-up discussion and evaluation. A series of visits to the respondents was conducted throughout the programme. The primary outcome was foot self-care behaviour. Foot self-efficacy (efficacy-expectation), foot care outcome expectation, knowledge of foot care, quality of life, fasting blood glucose and foot condition were secondary outcomes. Data were analysed with descriptive and inferential statistics (McNemar's test and Wilcoxon signed-rank test) using the Statistical Package for the Social Sciences V.20.0. RESULTS Fifty-two residents were recruited but only 31 met the inclusion criteria and were included in the analysis at baseline and at 12 weeks postintervention. The acceptability rate was moderately high. At postintervention, foot self-care behaviour (p<0.001), foot self-efficacy (efficacy-expectation), (p<0.001), foot care outcome expectation (p<0.001), knowledge of foot care (p<0.001), quality of life (physical symptoms) (p=0.003), fasting blood glucose (p=0.010), foot hygiene (p=0.030) and anhydrosis (p=0.020) showed significant improvements. CONCLUSION Findings from this pilot study would facilitate the planning of a larger study among the older population with diabetes living in long-term care institutions. TRIAL REGISTRATION NUMBER ACTRN12616000210471; Pre-results.
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Affiliation(s)
- Siti Khuzaimah Ahmad Sharoni
- Department of Nursing, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Selangor, Malaysia
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Hejar Abdul Rahman
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Halimatus Sakdiah Minhat
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Sazlina Shariff Ghazali
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Mohd Hanafi Azman Ong
- Department of Statistics, Faculty of Computer Science and Mathematics, Universiti Teknologi MARA, Segamat, Johor, Malaysia
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Vieira LS, Assunção MCF, Schäfer AA, Santos IDSD. Validity assessment of the nutrition screening initiative checklist in older adults. Clin Nutr ESPEN 2016; 15:16-20. [PMID: 28531778 DOI: 10.1016/j.clnesp.2016.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 05/03/2016] [Accepted: 05/05/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To ascertain whether the NSI (Nutrition Screening Initiative Checklist) is a valid screening instrument for diagnosing nutritional risk in an older population from a medium-size city in the south of Brazil. METHODS The study population comprised individuals aged 60 years or older selected from a population-based cross-sectional survey. Data collection was carried out at two different timepoints: first, the NSI (instrument under test) was applied and later a dietary recall (gold standard) based on the previous day. Validity analyses were performed based on sensitivity and specificity as well as the Receiver Operating Characteristic Curve. RESULTS A total of 183 older adults were studied. Agreement between the dietary recall and the NSI for positive and negative results was 54.6%.The sensitivity and specificity values were low for all cut-off points of the instrument. The area under the curve was 0.52 (95%CI: 0.44-0.62) for the cut-off point ≥6. CONCLUSION Based on sensitivity and specificity values, the NSI proved ineffective for application in the population studied.
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Affiliation(s)
- Luna Strieder Vieira
- Federal University of Pelotas, Rua Marechal Deodoro 1160, Pelotas, 96020-220, Brazil.
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Singh DKA, Manaf ZA, Yusoff NAM, Muhammad NA, Phan MF, Shahar S. Correlation between nutritional status and comprehensive physical performance measures among older adults with undernourishment in residential institutions. Clin Interv Aging 2014; 9:1415-23. [PMID: 25187701 PMCID: PMC4149334 DOI: 10.2147/cia.s64997] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
PURPOSE The consequences of combined undernourishment and decreased physical performance in older adults are debilitating and increases cost of care. To date, the information regarding the association between nutritional status and physical performance does not provide a complete picture. Most studies used limited or self-reported measures to evaluate physical performance. The objective of this study was to examine the correlation between nutritional status and comprehensive physical performance measures among undernourished older adults who reside in residential institutions. METHODS Forty-seven older adults (26 males, 21 females) aged ≥ 60 (69.23 ± 8.63) years who were identified as undernourished from two residential institutions participated in this study. A battery of physical performance tests (10 m gait speed test, dominant hand grip strength test, timed five-repetition sit-to-stand test, ten step test, arm curl test, scratch test, and respiratory muscle strength test), biochemical profiles (serum albumin, hemoglobin, serum ferritin, and prealbumin levels), and falls risk using the short-form Physiological Profile Approach were performed. The Functional Ability Questionnaire and Geriatric Depression Scale were also administered. RESULTS The results demonstrated that generally older adults with undernourishment scored poorly on the physical performance tests, had depression, and a high risk of falls. Biochemical results demonstrated that 10.9% of the participants were anemic, 63% had hypoalbuminemia (<3.5 g/dL), and 21.7% were at risk of protein energy malnutrition with prealbumin level (100-170 mg/L). A significant correlation (P<0.05) was demonstrated between hand grip strength and ferritin, between self-reported mobility dependence and prealbumin levels, and between self-reported mobility tiredness and body mass index. CONCLUSION These results confirm that older adults with undernutrition have poor physical function, higher falls risk, and depression. Clinically, overall health that includes nutritional status, physical function, and depression level should be taken into consideration in the assessment and treatment of older adults residing at residential institutions.
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Affiliation(s)
- Devinder K A Singh
- Physiotherapy Program, School of Rehabilitation Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Zahara A Manaf
- Nutrition and Dietetics Program, School of Health Care Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Nur A Muhammad
- Nutrition and Dietetics Program, School of Health Care Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mei Fang Phan
- Physiotherapy Program, School of Rehabilitation Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Nutrition and Dietetics Program, School of Health Care Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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de Morais C, Oliveira B, Afonso C, Lumbers M, Raats M, de Almeida MDV. Nutritional risk of European elderly. Eur J Clin Nutr 2013; 67:1215-9. [PMID: 24065060 DOI: 10.1038/ejcn.2013.175] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 08/20/2013] [Accepted: 08/22/2013] [Indexed: 01/04/2023]
Abstract
BACKGROUND/OBJECTIVES The elderly constitute a population group with a high prevalence of non-communicable chronic diseases and high risk of malnutrition. The aim of this study was to identify factors associated to nutritional risk in free-living European elderly. SUBJECTS/METHODS The sample included 644 European citizens, free living in the community, aged 65 years or more. The sample was quota controlled for age groups (65-74, ≥75 years), gender (male/female) and living circumstances (living alone/with others). Logistic regression was performed to identify factors associated with nutritional risk. RESULTS Several variables regarding socio-demographic characteristics, food choice, health status and the satisfaction with food-related life were included in the analysis. According to the recoded score of the 'Determine your nutritional health' (NSI checklist), 53% of the elderly were at nutritional risk. Nutritional risk was more likely to occur in elderly who considered that it was more important to choose foods 'easy to chew'; with lower average number of fruit and vegetables (F&V) intake episodes and lower score for general health. It was also found in non-married participants; those that did not identify changes in their appetite; and those that felt changes in health status. In this sample, the lowest nutritional risk was found for body mass index (BMI) around 18.5 kg/m(2). Country of residence, gender and age were not found to have a significant effect on nutritional risk. CONCLUSIONS Attention should be drawn to the living circumstances, changes in appetite or health, the general heath perception, F&V intake, choice of foods easy to chew and having a low or high BMI.
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Affiliation(s)
- C de Morais
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
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John BK, Bullock M, Brenner L, McGaw C, Scolapio JS. Nutrition in the elderly. Frequently asked questions. Am J Gastroenterol 2013; 108:1252-66; quiz 1267. [PMID: 23711624 DOI: 10.1038/ajg.2013.125] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2012] [Accepted: 04/02/2013] [Indexed: 12/11/2022]
Affiliation(s)
- Bijo K John
- Division of Gastroenterology, Department of Internal Medicine, University of Florida College of Medicine, Jacksonville, FL 32209, USA
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Tsai HJ. Nutrition risk, functional dependence, and co-morbidities affect depressive symptoms in Taiwanese aged 53 years and over: a population-based longitudinal study. J Psychosom Res 2013; 75:173-7. [PMID: 23915775 DOI: 10.1016/j.jpsychores.2013.04.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 04/14/2013] [Accepted: 04/29/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study examined cross-sectional and longitudinal associations of nutritional risk, functional dependence and co-morbidities with depressive symptoms in people aged 53 years and over in Taiwan. METHODS Study data were obtained from a population-based longitudinal study, the Taiwan Longitudinal Study of Aging (TLSA), with a nationally representative sample of nearly-old and old Taiwanese. RESULTS The prevalence of having depressive symptoms and being at risk of malnutrition/malnourishment in 1999 was 23% and 21%. Mini-Nutritional Assessment (MNA) score, being at risk of malnutrition/malnourishment, number of self-reported co-morbidities, and activities of daily living (ADL) score were all cross-sectionally correlated with depressive symptoms (all p<.05). Being at risk of malnutrition/malnourishment and number of co-morbidities were also longitudinally associated with increased risk of subsequent depressive symptoms over four and eight years (all p<.05). The relationship between nutritional risk and subsequent depressive symptoms was stronger than the relationship between co-morbidities and ADL score and subsequent depressive symptoms. CONCLUSIONS These results suggested that nutritional risk, co-morbidities and functional dependence are all associated with increased risks of depressive symptoms in people aged 53 years and above. Nutritional risk contributes significantly to subsequent depressive symptoms and is a strong and consistent predictor of subsequent depressive symptoms in nearly-old and old Taiwanese.
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Affiliation(s)
- Hsin-Jen Tsai
- Department of Health Management, I-Shou University, Kaohsiung, Taiwan.
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Determinants of depression and insomnia among institutionalized elderly people in Malaysia. Asian J Psychiatr 2011; 4:188-95. [PMID: 23051116 DOI: 10.1016/j.ajp.2011.06.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Revised: 06/08/2011] [Accepted: 06/19/2011] [Indexed: 12/15/2022]
Abstract
Depression and insomnia are common psychiatric disorders among elderly people and reported to be related to several social and health factors. However, their occurrences in relation to food intake have rarely been investigated. Therefore, this study was to identify determinants of depression and insomnia, with emphasised on food intake among 71 elderly people residing in a government funded institution in Malaysia. An interview based questionnaire was used to obtain information on socio-demography, health and functional status, depression, insomnia and food intake. A total of 71.8% subjects had depression and 53% had insomnia. Subjects who had insomnia [Adjusted Odds Ratio (AOR) 19.55, 95% CI=4.04-94.64], needed help/unable to perform >4 items of IADL (AOR=16.65, 95% CI=3.95-70.22), had hypertension (AOR=7.66, 95% CI=1.37-42.76), had >50% wastage of poultry or fish (AOR=3.66, 95% CI=1.06-12.60) and wastage of vegetables (AOR 3.31, 95% CI=1.03-10.60) were more likely to have depression. Subjects who had depression (AOR 19.55, 95% CI=4.04-94.64), needed help/unable to perform >4 items of IADL (AOR 2.97, 95% CI=1.12-7.84), needed help/unable to handle financial matters (AOR 5.01, 95% CI=1.37-18.27) and had >50% wastage of vegetables (AOR 3.91, 95% CI=1.42-10.82) were at a higher risk to develop insomnia. Depression and insomnia affected more than half of the subjects, interrelated, and associated with functional inability, socioeconomic factor and high food wastage of specific foods.
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Graf CE, Zekry D, Giannelli S, Michel JP, Chevalley T. Efficiency and applicability of comprehensive geriatric assessment in the emergency department: a systematic review. Aging Clin Exp Res 2011; 23:244-54. [PMID: 20930499 DOI: 10.1007/bf03337751] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Comprehensive geriatric assessment (CGA) may benefit frail or chronically ill patients in the emergency department (ED), but take too much time to be performed routinely in ED. An alternative approach is to use first a screening tool to detect high-risk patients and then perform CGA in these patients only. This systematic review focuses on the use and value of CGA in ED for evaluation of older patients and its influence on adverse outcomes. This approach is compared with an alternative one using existing screening tools, validated in ED, to detect high-risk patients needing subsequent CGA. This review ends by suggesting a short assessment of CGA to be used in ED and ways to improve home discharge management from ED. METHODS A systematic English Medline literature search was conducted in December 2009, with no date limit with the following Medical Subject Heading (MeSH) terms: "Frail Elderly", "Health Services for Aged", "Community Health Nursing", "Emergency Service, Hospital", "Geriatric Assessment", "Patient Discharge", "Risk Assessment" and "Triage". RESULTS We selected 8 studies on CGA efficiency and 14 on screening tools. CGA in ED is efficient for decreasing functional decline, ED readmission and possibly nursing home admission in high-risk patients. As CGA takes too much time to be performed routinely in ED, validated screening tools can be applied to detect high-risk patients who will benefit most from CGA. CONCLUSIONS The selected studies demonstrated that screening of high-risk patients is more efficient than age-based screening, and that CGA performed in ED, followed by appropriate interventions, improves outcomes.
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Affiliation(s)
- Christophe E Graf
- Rehabilitation and Geriatrics Department, Geneva University Hospitals, 3, chemin du Pont-Bochet, Thônex, Switzerland.
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Ngoh HJ, Chen ST, Harith S. Anthropometric measurements among institutionalized elderly men in Northern Peninsular Malaysia. JOURNAL OF MENS HEALTH 2011. [DOI: 10.1016/s1875-6867(11)60023-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Ambigga KS, Ramli AS, Suthahar A, Tauhid N, Clearihan L, Browning C. Bridging the gap in ageing: Translating policies into practice in Malaysian Primary Care. ASIA PACIFIC FAMILY MEDICINE 2011; 10:2. [PMID: 21385446 PMCID: PMC3068088 DOI: 10.1186/1447-056x-10-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Accepted: 03/08/2011] [Indexed: 05/30/2023]
Abstract
Population ageing is poised to become a major challenge to the health system as Malaysia progresses to becoming a developed nation by 2020. This article aims to review the various ageing policy frameworks available globally; compare aged care policies and health services in Malaysia with Australia; and discuss various issues and challenges in translating these policies into practice in the Malaysian primary care system. Fundamental solutions identified to bridge the gap include restructuring of the health care system, development of comprehensive benefit packages for older people under the national health financing scheme, training of the primary care workforce, effective use of electronic medical records and clinical guidelines; and empowering older people and their caregivers with knowledge, skills and positive attitudes to ageing and self care. Ultimately, family medicine specialists must become the agents for change to lead multidisciplinary teams and work with various agencies to ensure that better coordination, continuity and quality of care are eventually delivered to older patients across time and settings.
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Affiliation(s)
- Krishnapillai S Ambigga
- Discipline of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), 40450 Shah Alam, Selangor, Malaysia
| | - Anis Safura Ramli
- Discipline of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), 40450 Shah Alam, Selangor, Malaysia
| | - Ariaratnam Suthahar
- Discipline of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), 40450 Shah Alam, Selangor, Malaysia
| | - Norlaili Tauhid
- Healthy Ageing Research Unit, School of Primary Health Care, Monash University, Notting Hill, 3168 Victoria, Australia
| | - Lyn Clearihan
- Department of General Practice, School of Primary Health Care, Monash University, Notting Hill, 3168 Victoria, Australia
| | - Colette Browning
- Healthy Ageing Research Unit, School of Primary Health Care, Monash University, Notting Hill, 3168 Victoria, Australia
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The multidimensional background of malnutrition among rural older individuals in Bangladesh--a challenge for the Millennium Development Goal. Public Health Nutr 2009; 12:2270-8. [PMID: 19257922 DOI: 10.1017/s1368980009005096] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate the associations and relative impact of illness, socio-economic and social indicators for nutritional status among elderly persons in rural Bangladesh. DESIGN A multidisciplinary, cross-sectional study employing home interviews to collect information on demographic, socio-economic and social status; clinical examination to classify medical diagnoses; and Mini Nutritional Assessment (MNA) to assess the nutritional status of each participant. SETTING Matlab, Bangladesh. SUBJECTS A total of 625 randomly selected individuals (>or=60 years of age) participated in home interviews and 473 underwent clinical examination. Complete information on nutritional status was available for 457 individuals, median age 68 years, 55 % women. RESULTS Twenty-six per cent of the elderly participants were undernourished and 62 % were at risk of malnutrition according to MNA. More than three-quarters of the participants had acute infections, 66 % suffered from chronic illnesses, 36 % had sensory impairments and 81 % were suffering from gastrointestinal disorders. Acute infections (P < 0.001), gastrointestinal disorders (P < 0.01), depressive symptoms (P < 0.001) and impaired cognitive function (P < 0.01) were significantly and independently associated with poorer nutritional status. Moreover, female gender (P < 0.05), having no income (P < 0.01), being illiterate (P < 0.01) and not receiving regular financial support (P < 0.05) were also independently associated with poor nutritional status. CONCLUSIONS Malnutrition among elderly people in rural Bangladesh is associated with female gender, medical, psychological, socio-economic and social indicators. A multidimensional approach is probably needed to reduce undernutrition in older populations in low-income countries like Bangladesh.
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Arlappa N, Rao KM, Venkaiah K, Brahmam G, Vijayaraghavan K. Nutritional Parameters and Chronic Energy Deficiency in Older Adults of Desert Areas of Western Rajasthan, India. ACTA ACUST UNITED AC 2009; 28:61-71. [DOI: 10.1080/01639360802633987] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Cabrera MAS, Mesas AE, Garcia ARL, de Andrade SM. Malnutrition and Depression among Community-dwelling Elderly People. J Am Med Dir Assoc 2007; 8:582-4. [DOI: 10.1016/j.jamda.2007.07.008] [Citation(s) in RCA: 135] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Revised: 07/18/2007] [Indexed: 11/15/2022]
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Mini Nutritional Assessment of rural elderly people in Bangladesh: the impact of demographic, socio-economic and health factors. Public Health Nutr 2006. [DOI: 10.1017/phn2006990] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveIn stating the Millennium Development Goals, the United Nations aims to halve malnutrition around the world by 2015. Nutritional status of the elderly population in low-income countries is seldom focused upon. The present study aimed to evaluate the magnitude of malnutrition among an elderly population in rural Bangladesh.Design and settingData collection for a multidimensional cross-sectional study of community-based elderly people aged 60 years and over was conducted in a rural area in Bangladesh.SubjectsOf 850 randomly selected elderly individuals, 625 participated in home interviews. Complete nutritional information was available for 457 individuals (mean age 69 ± 8 years, 55% female). Nutritional status was assessed using an adapted form of the Mini Nutritional Assessment (MNA) including body mass index (BMI). Age, sex, education, household expenditure on food and self-reported health problems were investigated as potential predictors of nutritional status.ResultsBMI < 18.5 kg m− 2, indicating chronic energy deficiency, was found in 50% of the population. MNA revealed a prevalence of 26% for protein–energy malnutrition and 62% for risk of malnutrition. Health problems rather than age had a negative impact on nutritional status. Level of education and food expenditure were directly associated with nutritional status.ConclusionIn order to reduce world hunger by half in the coming decade, it is important to recognise that a substantial proportion of the elderly population, particularly in low-income countries, is undernourished.
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Abstract
The fast rate of increase in the number of older people in less-developed countries threatens to further strain the limited health resources of these countries. However, very little is known about their health status and the risk factors that contribute to it. In this article, we review the burden of infectious diseases in elderly people in less-developed countries, discuss the contribution of nutrition and immune response to morbidity and mortality, identify gaps in current knowledge, and suggest strategies to address this fast-growing public health problem.
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Affiliation(s)
- Ahou Meydani
- Yale School of Medicine, New Haven, Connecticut, USA
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