Part II. Common nutritional issues in older adults

Assessment of Subnutritional Indices and Associated Risk Factors of Malnutrition Among Older Adults

Malnutrition is a multifactorial problem affecting older adults especially in developing countries like Nigeria. Eighty-five subjects which comprise 55 older adults and 30 controls were recruited. Total protein, Albumin, Calcium, Vitamin-C and Vitamin D were estimated using Biuret's method, Bromo-Cresol Green method, O-Cresolphthalein-Complexone, High performance liquid chromatography, and ELISA methods respectively. Cognitive and nutritional status information were obtained using Mini-Cog test and MNA-short form. Data were analyzed at p < .05. Activities of daily living (ADL) was observed to be associated with nutritional status in older adults. The prevalence of older adults at risk of malnutrition was found to be 58.2%. Blood pressure, albumin and total protein were significantly higher in older adults (p < .05) compared to the younger adults. Total protein was significantly higher in older female subjects (p < .05) compared to older male subjects. It was also significantly higher in non- institutionalized older adults than in those who were institutionalized. Calf circumference was significantly lower (p < .05) in those with poor cognitive status. BMI and calcium were significantly lower in the malnourished older adults. It is concluded that older adults who are dependent, most of which are institutionalized may be more exposed to malnutrition, frailty and cognitive impairment.

Nutrient intake and immune function of elderly subjects

OBJECTIVE

Food intake, aging, and immune function share complex influences. Therefore, the purpose of this study was to examine relationships between nutrient intakes from food and dietary supplements and a biomarker of immune function.

DESIGN

Data were collected from participants in a cross-sectional study as well as baseline data from a longitudinal study (n=89). Subjects completed 24-hour food recalls, including supplement intake. Polyclonal mitogen phytohemmagluttin (PHA) was the immune function stimulator used. Height and weight were used to calculate body mass index.

STATISTICAL ANALYSES PERFORMED

Descriptive, bivariate correlation, Spearman's rho for nonparametric data, t tests, and stepwise regression with nutrient intakes as independent variables and T-cell proliferation as dependent variables.

RESULTS

Significant positive correlations (P< or =0.05) were found between PHA-induced proliferation and intake of docosahexaenoic acid (DHA), eicosahexaenoic acid (EPA), sodium, and selenium, although intakes of DHA plus EPA were inadequate when compared to recommended intakes. A significant negative correlation with total vitamin A, with many vitamin A levels being above the upper limit of safety. Regression analyses found these nutrients to be variables significant in explaining the variance in PHA (P=0.005).

CONCLUSIONS

Selenium, sodium, DHA, EPA, and vitamin A intake from diet and supplements were associated with PHA-induced proliferative responses. Clients may be counseled to have adequate selenium, EPA, DHA intake, and vitamin A, but avoid excess vitamin A.