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Wellman CD, Ferguson A, McIntosh T, Korkmaz A, Walker RB, Franks AM. Nutrition and Isolation in a Rural US Population over 80 Years Old: A Descriptive Analysis of a Vulnerable Population. J Nutr Gerontol Geriatr 2024; 43:36-45. [PMID: 38235599 DOI: 10.1080/21551197.2024.2304019] [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: 01/19/2024]
Abstract
Factors allowing rural, community-dwelling 80+ year-olds to thrive remain unexplored. Isolation can impact this vulnerable population. In this study, patients were prospectively surveyed for age, gender, cohabitation (self, spouse, family) and location (suburban, rural, and isolated). Mini-nutritional assessment short form (MNA-SF) and BMI were obtained. A p < 0.05 represented statistical significance. Patients (n = 167) were mostly female (120; 71.9%) with an average overweight BMI (26.5) and low-normal MNA-SF scores (11.8). Most live alone (49.7%), followed by spousal (31.7%) and family (18.6%) cohabitation. Over 80% are rural (71) or rural-isolated (67), and of these, 83% had normal nutrition. Self-habitation correlated with lower MNA-SF scores (p = 0.02). Normal BMIs correlated with family cohabitation (OR = 0.90 [CI: 0.82-0.99]) and nourished MNA-SF scores with spousal cohabitation (OR = 1.69; CI: 1.15-2.47) rather than living alone. Self-habitation increases vulnerability to obesity and malnutrition. Interventions should aim to maintain independence while improving the effects of habitation on nutrition.
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Affiliation(s)
- Courtney D Wellman
- Department of Family Medicine and Community Health, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Andrew Ferguson
- Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Thomas McIntosh
- Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Alperen Korkmaz
- Department of Family Medicine and Community Health, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Robert B Walker
- Department of Family Medicine and Community Health, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Adam M Franks
- Department of Family Medicine and Community Health, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USA
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Bardon LA, Corish CA, Lane M, Bizzaro MG, Loayza Villarroel K, Clarke M, Power LC, Gibney ER, Dominguez Castro P. Ageing rate of older adults affects the factors associated with, and the determinants of malnutrition in the community: a systematic review and narrative synthesis. BMC Geriatr 2021; 21:676. [PMID: 34863118 PMCID: PMC8642873 DOI: 10.1186/s12877-021-02583-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 10/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malnutrition negatively impacts on health, quality of life and disease outcomes in older adults. The reported factors associated with, and determinants of malnutrition, are inconsistent between studies. These factors may vary according to differences in rate of ageing. This review critically examines the evidence for the most frequently reported sociodemographic factors and determinants of malnutrition and identifies differences according to rates of ageing. METHODS A systematic search of the PubMed Central and Embase databases was conducted in April 2019 to identify papers on ageing and poor nutritional status. Numerous factors were identified, including factors from demographic, food intake, lifestyle, social, physical functioning, psychological and disease-related domains. Where possible, community-dwelling populations assessed within the included studies (N = 68) were categorised according to their ageing rate: 'successful', 'usual' or 'accelerated'. RESULTS Low education level and unmarried status appear to be more frequently associated with malnutrition within the successful ageing category. Indicators of declining mobility and function are associated with malnutrition and increase in severity across the ageing categories. Falls and hospitalisation are associated with malnutrition irrespective of rate of ageing. Factors associated with malnutrition from the food intake, social and disease-related domains increase in severity in the accelerated ageing category. Having a cognitive impairment appears to be a determinant of malnutrition in successfully ageing populations whilst dementia is reported to be associated with malnutrition within usual and accelerated ageing populations. CONCLUSIONS This review summarises the factors associated with malnutrition and malnutrition risk reported in community-dwelling older adults focusing on differences identified according to rate of ageing. As the rate of ageing speeds up, an increasing number of factors are reported within the food intake, social and disease-related domains; these factors increase in severity in the accelerated ageing category. Knowledge of the specific factors and determinants associated with malnutrition according to older adults' ageing rate could contribute to the identification and prevention of malnutrition. As most studies included in this review were cross-sectional, longitudinal studies and meta-analyses comprehensively assessing potential contributory factors are required to establish the true determinants of malnutrition.
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Affiliation(s)
- Laura A Bardon
- School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland.
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland.
| | - Clare A Corish
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Meabh Lane
- School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland
| | - Maria Gabriella Bizzaro
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Katherine Loayza Villarroel
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Michelle Clarke
- School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
| | - Lauren C Power
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Eileen R Gibney
- School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
| | - Patricia Dominguez Castro
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
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Katsas K, Mamalaki E, Kontogianni MD, Anastasiou CA, Kosmidis MH, Varlamis I, Hadjigeorgiou GM, Dardiotis E, Sakka P, Scarmeas N, Yannakoulia M. Malnutrition in older adults: Correlations with social, diet-related, and neuropsychological factors. Nutrition 2019; 71:110640. [PMID: 31812000 DOI: 10.1016/j.nut.2019.110640] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 09/20/2019] [Accepted: 11/02/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND The number of older adults is increasing rapidly. Malnutrition is a major problem in this age group, which may adversely affect health and quality of life. Several physiological, socioeconomic, and neuropsychological factors can lead to malnutrition. OBJECTIVES The aim of this study was to evaluate the nutritional status of community-dwelling older adults, and explore the associations of malnutrition risk with physiological, socioeconomic, and neuropsychological characteristics. METHODS This study is part of the Hellenic Longitudinal Investigation of Aging and Diet study, a cross-sectional observational study in Greece, and study participants were 1831 urban-dwelling elderly individuals (mean age: 73.1 ± 5.9 y; 40.8% men). Risk for malnutrition was assessed with the Determine Your Nutritional Health checklist. Data on age, sex, level of education, marital status, depression, cognitive performance, body mass index, total energy intake, and adherence to the Mediterranean diet were recorded. Correlations and multivariate analyses were performed between these variables and risk for malnutrition. RESULTS The estimated prevalence of moderate and high nutritional risks was 34.8% and 29.4%, respectively. Risk for malnutrition was associated with marital status (unmarried), increased body mass index, male sex, lower level of education, lower cognitive performance, and lower adherence to the Mediterranean diet (P < 0.05). CONCLUSIONS Nutritional screening should be performed frequently in all community-dwelling older adults. Health experts should perform nutritional screening in all community-dwelling older adults as part of secondary prevention, and nutrition counselling and support should be offered in those at risk for malnutrition.
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Affiliation(s)
| | - Eirini Mamalaki
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | - Costas A Anastasiou
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece; Department of Social Medicine, Psychiatry and Neurology, First Department of Neurology, Aeginition University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Mary H Kosmidis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Greece
| | - Iraklis Varlamis
- Department of Informatics and Telematics, Harokopio University, Athens, Greece
| | - Georgios M Hadjigeorgiou
- Department of Neurology, Medical School, University of Cyprus, Aglantzia, Cyprus; Department of Neurology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Efthimios Dardiotis
- Department of Neurology, Medical School, University of Cyprus, Aglantzia, Cyprus
| | - Paraskevi Sakka
- Athens Association of Alzheimer's disease and Related Disorders, Marousi, Greece
| | - Nikolaos Scarmeas
- Department of Social Medicine, Psychiatry and Neurology, First Department of Neurology, Aeginition University Hospital, National and Kapodistrian University of Athens, Athens, Greece; Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, New York
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
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Bailly N, Maître I, Wymelbeke VV. Relationships between nutritional status, depression and pleasure of eating in aging men and women. Arch Gerontol Geriatr 2015; 61:330-6. [DOI: 10.1016/j.archger.2015.08.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Revised: 08/23/2015] [Accepted: 08/24/2015] [Indexed: 11/29/2022]
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Batchelor P. The changing epidemiology of oral diseases in the elderly, their growing importance for care and how they can be managed. Age Ageing 2015; 44:1064-70. [PMID: 26504122 DOI: 10.1093/ageing/afv148] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This article provides an overview of the changing epidemiology of oral diseases and the impacts for the population. Considerable improvements have occurred in oral health, and many more people are retaining teeth for longer. However, the conditions of teeth and mouth are varied, and all older people are at risk of future oral disease. With the increased prevalence of other more general health conditions, the risks of poor oral health are increasing. Poor oral health gives rise to considerable problems that impact both on an individual's well-being and qualities of life as well as increasing the risks of general health issues. To ensure that the risks of such adverse impacts are minimised, a more collaborative approach involving all care workers is required, addressing the determinants of health and ensuring that better care management arrangements for older people are developed.
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Affiliation(s)
- Paul Batchelor
- Faculty of General Dental Practice (UK), Royal College of Surgeons, London WC1, UK
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Yoshimura K, Yamada M, Kajiwara Y, Nishiguchi S, Aoyama T. Relationship between depression and risk of malnutrition among community-dwelling young-old and old-old elderly people. Aging Ment Health 2013; 17:456-60. [PMID: 23176659 DOI: 10.1080/13607863.2012.743961] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES This study explores the association between nutritional status and depression among healthy community-dwelling young-old (aged 65-74) and old-old elderly (aged 75 and older). METHOD A cross-sectional design was implemented. A total of 274 community-dwelling older individuals (142 young-old; 132 old-old) were assessed using the Geriatric Depression Scale (GDS), Mini-Nutritional Assessment Short-Form (MNA-SF) and Life-Space Assessment. Logistic regression analysis was used to determine if depression was independently associated with risk of malnutrition, stratified by age (young-old vs. old-old). RESULTS In the logistic regression model for young-old, being at risk of malnutrition (MNA-SF (≦11) was strongly associated with depression (GDS (≧5;) (likelihood ratio ν = 6.26; 95% confidence interval [CI]: 1.91-20.49). In contrast, in the old-old group, the model was not statistically significant. CONCLUSION Depression and nutritional status were strongly correlated in young-old but not in old-old community-dwelling elderly. This study reveals that not only the factors correlated with but also the symptoms of depression may vary among different age stratifications of the elderly.
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Affiliation(s)
- Kazuya Yoshimura
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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Relvas M, Diz P, Seoane J, Tomás I. Oral Health Scales: design of an oral health scale of infectious potential. Med Oral Patol Oral Cir Bucal 2013; 18:e664-70. [PMID: 23524418 PMCID: PMC3731096 DOI: 10.4317/medoral.18427] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 12/19/2012] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES In this paper we propose a new Global Oral Health Scale that will allow the infectious potential of the oral cavity, clinically manifest as local and focal infections, to be condensed into a single parameter. STUDY DESIGN Based on a number of oral health scales previously designed by our group, we designed a final version that incorporates dental and periodontal variables (some of them evaluated using corroborated objective indices) that reflect the presence of caries and periodontal disease. RESULTS The application of the proposed oral health scale requires the examination of 6 sites per tooth (mesio-buccal, medio-buccal, disto-buccal, disto-lingual, medio-lingual and mesio-lingual). The following variables are analysed: number of tooth surfaces with supragingival plaque, determined using the O'Leary index; number of teeth with caries and the severity of the caries; number of tooth surfaces with gingival inflammation, determined using the Ainamo and Bay index; and number of tooth surfaces with pockets ≥ 4 mm and severity of the pockets. These variables are then grouped into 2 categories, dental and periodontal. The final grades of dental and periodontal health correspond to the grades assigned to a least 2 of the 3 variables analysed in each of these categories. The category (dental or periodontal) with the highest grade is the one that determines the grade of the Global Oral Health Scale. CONCLUSION This scale could be particularly useful for the epidemiological studies comparing different populations and for analysis of the influence of distinct degrees of oral health on the development of certain systemic diseases.
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Affiliation(s)
- Marta Relvas
- Department of Dental Sciences, Higher Institute of the Health Sciences-North, Oporto, Portugal
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Ji L, Meng H, Dong B. Factors associated with poor nutritional status among the oldest-old. Clin Nutr 2012; 31:922-6. [PMID: 22521179 DOI: 10.1016/j.clnu.2012.03.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Revised: 02/18/2012] [Accepted: 03/26/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND & AIMS Older adults are at increased risk for malnutrition. The aim was to investigate the prevalence of and risk factors for poor nutritional status in oldest-old Chinese. METHODS Community-living Chinese aged 90 and over were included in the study. Nutritional status was evaluated by using the Mini Nutritional Assessment short-form (MNA-SF). Demographic and socioeconomic status, health status, cognitive, behavioral, and lifestyle factors were collected via structured questionnaires during face-to-face interviews. RESULTS 632 individuals (424 F, 208 M, 94 ± 3 y) were included. We found that 36 (5.7%) participants were classified as being malnourished (MNA-SF < 7), 445 (70.4%) were classified as being at risk for malnutrition (8 ≤ MNA-SF ≤ 11), and 151 (23.9%) were considered as well-nourished (MNA-SF ≥ 12). Ordinal logistic regression showed that significant risk factors for poor nutritional status included older age, poor cognitive function, gastrointestinal (GI) system disease, poor self-rated health, and lower serum albumin level. CONCLUSION The findings suggest that the majority of the Chinese oldest-old were at risk for malnutrition. Nutritional assessment should be incorporated into regular geriatric screening among community-living oldest-old in China. Interventions targeting those at risk for malnutrition should be developed to improve health outcomes among this vulnerable population.
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Affiliation(s)
- Luxi Ji
- Department of Preventive Medicine, Stony Brook University, Stony Brook, NY 11794-8338, USA.
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Lee MR, Berthelot ER. Community covariates of malnutrition based mortality among older adults. Ann Epidemiol 2010; 20:371-9. [PMID: 20382338 DOI: 10.1016/j.annepidem.2010.01.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Revised: 01/04/2010] [Accepted: 01/30/2010] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of this study was to identify community level covariates of malnutrition-based mortality among older adults. A community level framework was delineated which explains rates of malnutrition-related mortality among older adults as a function of community levels of socioeconomic disadvantage, disability, and social isolation among members of this group. METHODS County level data on malnutrition mortality of people 65 years of age and older for the period 2000-2003 were drawn from the CDC WONDER system databases. County level measures of older adult socioeconomic disadvantage, disability, and social isolation were derived from the 2000 US Census of Population and Housing. Negative binomial regression models adjusting for the size of the population at risk, racial composition, urbanism, and region were estimated to assess the relationships among these indicators. RESULTS Results from negative binomial regression analysis yielded the following: a standard deviation increase in socioeconomic/physical disadvantage was associated with a 12% increase in the rate of malnutrition mortality among older adults (p < 0.001), whereas a standard deviation increase in social isolation was associated with a 5% increase in malnutrition mortality among older adults (p < 0.05). CONCLUSIONS Community patterns of malnutrition based mortality among older adults are partly a function of levels of socioeconomic and physical disadvantage and social isolation among older adults.
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Affiliation(s)
- Matthew R Lee
- Department of Sociology, Louisiana State University, Baton Rouge, 70803, USA.
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Mamhidir AG, Kihlgren M, Soerlie V. Malnutrition in elder care: qualitative analysis of ethical perceptions of politicians and civil servants. BMC Med Ethics 2010; 11:11. [PMID: 20553607 PMCID: PMC2927875 DOI: 10.1186/1472-6939-11-11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2009] [Accepted: 06/16/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Few studies have paid attention to ethical responsibility related to malnutrition in elder care. The aim was to illuminate whether politicians and civil servants reason about malnutrition in elder care in relation to ethical responsibility, and further about possible causes and how to address them. METHOD Eighteen elected politicians and appointed civil servants at the municipality and county council level from two counties in Sweden were interviewed. They worked at a planning, control and executive level, with responsibility for both the elder care budget and quality of care. Qualitative method was used for the data analysis. RESULTS Two themes emerged from their reasoning about malnutrition related to ethical responsibility. The theme assumed role involves the subthemes quality of care and costs, competent staff and govern at a distance. Old and ill patients were mentioned as being at risk for malnutrition. Caregivers were expected to be knowledgeable and stated primary responsible for providing adequate nutritional care. Extended physician responsibility was requested owing to patients' illnesses. Little was reported on the local management's role or on their own follow-up routines. The theme moral perception includes the subthemes discomfort, trust and distrust. Feelings of discomfort concerned caregivers having to work in a hurried, task-oriented manner. Trust meant that they believed for the most part that caregivers had the competence to deal appropriately with nutritional care, but they felt distrust when nutritional problems reappeared on their agenda. No differences could be seen between the politicians and civil servants. CONCLUSION New knowledge about malnutrition in elder care related to ethical responsibility was illuminated by persons holding top positions. Malnutrition was stressed as an important dimension of the elder care quality. Governing at a distance meant having trust in the staff, on the one hand, and discomfort and distrust when confronted with reports of malnutrition, on the other. Distrust was directed at caregivers, because despite the fact that education had been provided, problems reappeared. Discomfort was felt when confronted with examples of poor nutritional care and indicates that the participants experienced failure in their ethical responsibility because the quality of nutritional care was at risk.
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Affiliation(s)
- Anna-Greta Mamhidir
- Department of Neurobiology, Caring Sciences and Society, Karolinska Institute, Stockholm, Sweden.
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Buffa R, Floris G, Lodde M, Cotza M, Marini E. Nutritional status in the healthy longeval population from Sardinia (Italy). J Nutr Health Aging 2010; 14:97-102. [PMID: 20126955 DOI: 10.1007/s12603-010-0018-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate sex- and age-related variations of the nutritional status in the aged population of central Sardinia, a geographical area with a high frequency of long-lived people, particularly men. DESIGN The sample consisted of 200 subjects over 70 years of age (men: N= 100, age= 81.0 +/- 7.0 years; women: N= 100, age= 81.5 +/- 7.3 years). SETTING Orroli (central Sardinia, Italy). MEASUREMENTS Mini nutritional assessment (MNA) and bioelectrical impedance vector analysis (BIVA) were used to evaluate nutritional status and body composition. RESULTS The indicators revealed a generally good nutritional status. The MNA results (men: 24.6 +/- 2.2; women: 23.4 +/- 2.5) showed that 64.1% of the subjects had a normal nutritional status and only a small proportion (1.2%) could be classified as malnourished. BIVA showed that most subjects (74.2%) were normal, while the prevalence of low body cell mass was 10.7% and that of dehydration 11.2%. According to the MNA, the nutritional status was significantly better in the men. Almost three-quarters of the men (73.1%) were well nourished vs. half of the women (50.6%). A worsening of the nutritional status with age was observed. The proportion of malnourished individuals, as assessed by MNA, increased from 0% to 9.1% from 70-79 to > 90 years. CONCLUSIONS With respect to their contemporaries from other regions, the elderly of Orroli presented a better nutritional status, a similar worsening with age and generally higher sexual dimorphism.
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Affiliation(s)
- R Buffa
- Department of Experimental Biology, University of Cagliari, Monserrato (Cagliari), Cagliari, Italy
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Chen CCH, Tang ST, Wang C, Huang GH. Trajectory and determinants of nutritional health in older patients during and six-month post-hospitalisation. J Clin Nurs 2009; 18:3299-307. [DOI: 10.1111/j.1365-2702.2009.02932.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Ávila-Funes JA, Gray-Donald K, Payette H. Association of Nutritional Risk and Depressive Symptoms with Physical Performance in the Elderly: The Quebec Longitudinal Study of Nutrition as a Determinant of Successful Aging (NuAge). J Am Coll Nutr 2008; 27:492-8. [DOI: 10.1080/07315724.2008.10719730] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Takata Y, Ansai T, Soh I, Akifusa S, Sonoki K, Fujisawa K, Yoshida A, Kagiyama S, Hamasaki T, Nakamichi I, Awano S, Torisu T, Takehara T. Relationship between chewing ability and high-level functional capacity in an 80-year-old population in Japan. Gerodontology 2008; 25:147-54. [PMID: 18194329 DOI: 10.1111/j.1741-2358.2007.00203.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the association between high-level functional capacity and chewing in a middle-old community-based population. BACKGROUND Although basic and instrumental activities of daily living are known to be associated with chewing ability in the elderly, an association between higher levels of competence and chewing ability has not been evaluated in the elderly. MATERIALS AND METHODS The association between chewing ability using a number of different foods and high-level functional capacity by the Tokyo Metropolitan Institute of Gerontology was evaluated in 694, 80-year-old people residing in Fukuoka Prefecture, Japan. RESULTS A significant correlation was found, using multiple regression or logistic regression analyses adjusted for various confounding factors, between the number of total chewable foods, hard foods or moderately hard foods, and total functional capacity, instrumental activity, intellectual activity or social role ability. In contrast, the number of slightly hard foods, easily chewable foods and remaining teeth were only partly related to total functional capacity and intellectual activity. CONCLUSION High-level functional capacity including intellectual activity and social role in middle-old elderly was associated with the ability to chew hard foods than to chew easily chewable foods. Maintenance of chewing ability in elderly might result in better intellectual activity and social role.
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Affiliation(s)
- Yutaka Takata
- Division of General Internal Medicine, Department of Health Promotion, Kyushu Dental College, Kitayushu, Japan.
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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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Bachrach-Lindström M, Jensen S, Lundin R, Christensson L. Attitudes of nursing staff working with older people towards nutritional nursing care. J Clin Nurs 2007; 16:2007-14. [PMID: 17419794 DOI: 10.1111/j.1365-2702.2006.01868.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIM The aim of this study was to examine attitudes of the nursing staff in geriatric care towards factors of importance for nutritional nursing care. BACKGROUND Studies show that nutritional risk assessment is seldom performed on older patients as routine and very few patients have a nutritional care plan. Patients in long-term care who are easy to feed are also found to be looked upon more positively than those with high feeding needs. METHODS A total of 252 registered nurses and nurse aids working at geriatric rehabilitation and medical care clinics and resident homes participated in the study. Attitudes were examined using the Staff Attitudes to Nutritional Nursing Care Geriatric scale. The scale includes 18 items and was designed as a one to five-point Lickert-type scale. It gives a total score and five subscales representing the dimensions 'Norms', 'Habits', 'Assessment', 'Intervention' and 'Individualization'. A higher score indicates a more positive attitude. RESULTS Of all nursing staff, 53% displayed a positive attitude towards factors of importance for nutritional nursing care and the rest displayed a neutral or negative attitude. The 'Intervention' dimension, dealing with nutritional problems and how to manage them, reflected the highest level of positive attitudes, which represents 71% of the nursing staff. The 'Norms' dimension had the lowest relative frequency of positive attitudes, 27%. The registered nurses held significantly more positive attitudes than the nurse aids did. CONCLUSIONS Nutritional issues comprise an important and time-consuming responsibility in geriatric care; however, nursing staff do not show an unequivocal positive attitude regarding this responsibility. The consequences this entails for the older patient need to be examined further. Relevance to clinical practice. Nursing staff play an important role in caring for patients who are malnourished or at risk for malnutrition. Positive attitudes might hinder the development of undernourishment or the further worsening of an already undernourished patient's condition.
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Affiliation(s)
- Margareta Bachrach-Lindström
- Department of Medicine and Care, Division of Nursing Science, Faculty of Health Sciences, Linköpings Universitet, Linköping, Sweden.
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Abstract
AIM The aim of this study is to revisit the concept of malnutrition in older people, trace the new development and test the use of refined framework with empirical data. BACKGROUND Malnutrition in older people is a common and significant problem worldwide. Continuing Chen's earlier work in 2001, a refinement was conducted and a prospective study was designed to test the use of this refined framework. DESIGN A cohort study of 114 hospitalized older patients in Northern Taiwan. METHODS The sample consists of 114 older patients aged 65 years and older, who were admitted for the cardiac and orthopaedic services at a tertiary 2300-bed hospital. From March to August 2004, assessed by one trained nurse, participants completed a structured face-to-face interview evaluating their age, visual/hearing impairments, oral health, cognitive status, comorbidities, medication use, social economic status, functional status, social support, depressive symptoms and nutritional status within 48 hours of admission. Participants who stayed >5 days were reassessed before discharge (n = 70). The data from admission were the main focus of this report. RESULTS Regression analysis revealed that that more medication taken, female gender, lower functional status (beta = 0.34, P < 0.001) and higher depressive symptoms were independent predictors of poor nutritional status, with the full model accounting for 48.2% of the variance. The result is in-line with the original theoretical underpinnings and it suggests that this refined framework detailing sub-concepts and measurable indices appears to fit the empirical data and suitable for clinical use. CONCLUSION The findings lend support to the use of this framework in managing malnutrition in older people. RELEVANCE TO CLINICAL PRACTICE Nurses have an essential role in providing care for older people a framework like this would provide a road map guiding the intervention efforts.
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Affiliation(s)
- Cheryl Chia-Hui Chen
- National Taiwan University School of Nursing & National Taiwan University Hospital, Taipei, Taiwan
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Chia-Hui Chen C, Chyun DA, Li CY, McCorkle R. A Single-Item Approach to Screening Elders for Oral Health Assessment. Nurs Res 2007; 56:332-8. [PMID: 17846554 DOI: 10.1097/01.nnr.0000289504.30037.d8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Oral health contributes significantly to overall health. Finding a single item that can be used by primary care providers to screen elders who are in need of oral care is important. OBJECTIVES The objective of this article was to evaluate usefulness of the item: "Do you have regular dental checkups?" as a means to decide whether an oral health assessment or further referral is indicated. Answering no is postulated as a positive predictor of poor oral health and need for care. METHODS This study was a secondary analysis of a nutritional survey of 240 community-dwelling elders. Examiner-rated Kayser-Jones Brief Oral Health Status Examination; self-reported General Oral Health Assessment Index; number of remaining teeth; and pattern of checkups (regular vs. irregular) were evaluated by a trained gerontological nurse practitioner during an in-home assessment. RESULTS A dental visit within the past year for any reason was reported by 132 subjects (55.0%), but only 81 (33.8%) reported some sort of regular dental checkups. For dentate elders (n = 147), an irregular checkup was associated with lower educational level, Protestant faith, and Black race. People with irregular checkups scored significantly lower on all three oral indices. The negative predictive values and likelihood ratio negative values ranged 98.7-100.0% and 0.00-0.98, respectively, indicating that this item of interest is valid for ruling-out dentate subjects with good oral health. For edentulous elders (n = 93), the item was less effective. DISCUSSION A single item, "Do you have regular dental checkups?" can be used effectively to rule out dentate elders with good oral health and identify those who are in need of further oral health assessment or referrals.
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Abstract
AIM This paper reports an evaluation of a range-of-motion exercise programme aimed at improving joint flexibility, activity function, perception of pain, and depressive symptoms in a sample of stroke survivors in long-term care facilities. BACKGROUND The benefits of physical rehabilitation for stroke survivors have been well established. There is, however, little empirical data on the effects of a simple nurse-led range-of-motion exercise programme in improving function for these people. METHOD A randomized controlled trial was conducted in 1999 with 59 bedridden older stroke survivors in residential care. Participants were randomly assigned to usual care or one of two intervention groups. The 4-week, twice-per-day, 6 days-per-week range-of-motion exercise protocols were similar in both intervention groups, and consisted of full range-of-motion exercises of the upper and lower extremities. To test the effect of different degrees of staff involvement, in intervention group I, a Registered Nurse was present to supervise participants performing the exercises, while intervention group II involved a Registered Nurse physically assisting participants to achieve maximum range-of-motion within or beyond their present abilities. RESULTS Both intervention groups had statistically significant improvement in joint angles, activity function, perception of pain and depressive symptoms compared with the usual care group (P < 0.05). Post hoc comparison revealed that the joint angles in intervention group II were statistically significantly wider than in both the other groups (P < 0.01). CONCLUSIONS A simple nurse-led range-of-motion exercise programme can generate positive effects in enhancing physical and psychological function of bedridden older people with stroke. Further studies are needed to investigate the long-term effects of the programme in maximizing function, reducing care utilization and enhancing quality of life for this population.
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