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Lourenço PDF, Angst L, Srinivasan M. Quality of nutritional uptake of community-dwelling, care-dependent older adults in Zurich. J Dent 2024; 148:105155. [PMID: 38944266 DOI: 10.1016/j.jdent.2024.105155] [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: 06/03/2024] [Revised: 06/21/2024] [Accepted: 06/22/2024] [Indexed: 07/01/2024] Open
Abstract
OBJECTIVE This study evaluated the quality of nutritional uptake of the care-dependent, community-dwelling older adults. METHODS Community-dwelling care-dependent elders were recruited in this study. The food items along with their nutritional content were extracted from the participants' refrigerators and categorized according to the NOVA classification (G1: unprocessed/minimally processed; G2: processed culinary ingredients; G3: processed; G4: ultra-processed). The nutritional information of the food items was entered into a dietary analysis software that analyzed the content. Data was verified for a normal distribution and non-parametric tests were applied for statistical analysis (p < 0.05). RESULTS 100 subjects (mean age = 81.1±9.5 y; mean MMSE: 26.6±6.8) participated in this study. The participants had significantly more G1 than G2, G3 or G4 (p < 0.001) foods. Women had more G1 items in their refrigerators than men (rs = 0.372, p < 0.001). Higher socio-economic status indicated a presence of more G1 (rs = 0.313, p = 0.002), G2 (rs = 0.342, p < 0.001) and G4 (rs = 0.237, p = 0.024) foods. Higher cognitive scores revealed an increase in presence of G4 (rs = 0.238, p = 0.023) items. Participants with an increased need for assistance had less G2 (rs = -0.332, p = 0.001), and G4 (rs = -0.215, p = 0.041) foods; age had no influence. CONCLUSION The findings of this study confirm that the majority of care-dependent, community-dwelling adults procured healthy dietary aliments for their daily living; however, whether this correlated to the actual nutritional state of these older adults needs to be further investigated. This highlights the need for further investigation and tailored interventions to ensure good nutrition, emphasizing regular assessments and comprehensive support beyond just food access. CLINICAL RELEVANCE Clinicians must recognize that access to healthy food alone may not ensure good nutrition in older adults. Regular nutritional assessments, personalized dietary interventions, and additional support services like meal preparation assistance, nutritional counseling, and tailored programs are essential to address specific dietary needs and preferences.
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Affiliation(s)
- Patricia Daniela Ferreira Lourenço
- Clinic of General-, Special Care- and Geriatric Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; Clinic of Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Lea Angst
- Clinic of General-, Special Care- and Geriatric Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; Clinic of Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Murali Srinivasan
- Clinic of General-, Special Care- and Geriatric Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland.
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Borda MG, Salazar-Londoño S, Lafuente-Sanchis P, Patricio Baldera J, Venegas LC, Tarazona-Santabalbina FJ, Aarsland D, Martín-Marco A, Pérez-Zepeda MU. Neutrophil-to-lymphocyte ratio and lymphocyte count as an alternative to body mass index for screening malnutrition in older adults living in the community. Eur J Nutr 2024; 63:1889-1899. [PMID: 38613694 DOI: 10.1007/s00394-024-03392-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/03/2024] [Indexed: 04/15/2024]
Abstract
PURPOSE Accurate height and weight measurement can be challenging in older adults and complicates nutritional status assessment. Other parameters like the neutrophil-to-lymphocyte ratio (NLR) and the lymphocyte count (LC) could be an option to these measurements. We aimed to test these variables as subrogates of body mass index (BMI) or calf-circumference (CC) for malnutrition screening in community-dwelling older adults. METHODS This is a secondary analysis from the Salud, Bienestar y Envejecimiento (SABE) survey from Ecuador (2009). Includes data on demographics, health-related factors, physical assessments, and complete blood count, allowing to calculate NLR and LC to be used as part of the Mini Nutritional Assessment (MNA), instead of the BMI. Consequently, 4 models were included: standard MNA, MNA-CC, MNA-NLR and MNA-LC. Finally, age, sex, and comorbidities were considered as confounding variables. RESULTS In our analysis of 1,663 subjects, 50.81% were women. Positive correlations with standard MNA were found for MNA-NLR (Estimate = 0.654, p < 0.001) MNA-CC (Estimate = 0.875, p value < 0.001) and MNA-LC (Estimate = 0.679, p < 0.001). Bland-Altman plots showed the smallest bias in MNA-CC. Linear association models revealed varying associations between MNA variants and different parameters, being MNA-NLR strongly associated with all of them (e.g. Estimate = 0.014, p = 0.001 for albumin), except BMI. CONCLUSION The newly proposed model classified a greater number of subjects at risk of malnutrition and fewer with normal nutrition compared to the standard MNA. Additionally, it demonstrated a strong correlation and concordance with the standard MNA. This suggests that hematological parameters may offer an accurate alternative and important insights into malnutrition.
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Affiliation(s)
- Miguel Germán Borda
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, PB, 8100, N-4068, Norway.
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia.
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
- Geriatric Medicine Department, Hospital Universitario de la Ribera, Carretera de Corbera km. 1, Alzira, 46600, Spain.
| | - Salomón Salazar-Londoño
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Pablo Lafuente-Sanchis
- Unidad de Hospitalizacion Domiciliaria, Hospital Universitario de la Ribera, Carretera de Corbera km. 1, Alzira, 46600, Spain
| | - Jonathan Patricio Baldera
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, PB, 8100, N-4068, Norway
- Escuela de Estadística de la Universidad Autónoma de Santo Domingo, Santo Domingo, República Dominicana
| | - Luis Carlos Venegas
- Hospital Universitario Mayor-Méderi, Universidad del Rosario, Bogotá, Colombia
| | - Francisco José Tarazona-Santabalbina
- Geriatric Medicine Department, Hospital Universitario de la Ribera, Carretera de Corbera km. 1, Alzira, 46600, Spain
- Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, 28029, Spain
- Medical School, Universidad Católica de Valencia San Vicente Mártir, Valencia, 46001, Spain
| | - Dag Aarsland
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, PB, 8100, N-4068, Norway
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Antonio Martín-Marco
- Unidad de Hospitalizacion Domiciliaria, Hospital Universitario de la Ribera, Carretera de Corbera km. 1, Alzira, 46600, Spain
| | - Mario Ulises Pérez-Zepeda
- Instituto Nacional de Geriatría, Ciudad de México, México
- Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México, Huixquilucan Edo, México
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Paiella S, Secchettin E, Azzolina D, De Pastena M, Gentilini N, Trestini I, Casciani F, Sandini M, Lionetto G, Milella M, Malleo G, Gianotti L, Gregori D, Salvia R. Evaluation of five nutritional scores as predictors of postoperative outcome following pancreatic resection: A prospective, single-center study. Clin Nutr ESPEN 2024; 63:635-641. [PMID: 39053696 DOI: 10.1016/j.clnesp.2024.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 06/07/2024] [Accepted: 07/15/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND AND AIMS Patients undergoing pancreatic resection are commonly malnourished. It is still unclear whether nutritional scores reliably predict postoperative outcomes after pancreatic resection. This study evaluated whether five commonly used preoperative nutritional screening scores predicted severe complications and length of stay. METHODS Patients scheduled for pancreatic resection (pancreatoduodenectomy, distal and total pancreatectomy) at a national referral center for pancreatic surgery from September 2022 to June 2023 were prospectively screened for malnutrition with MNA, MUST, SGA, SNAQ, and NRS2002 scores. Postoperative complications were classified using the Clavien-Dindo classification. #NCT05608538. RESULTS Three hundred patients were enrolled, including 168 pancreatoduodenectomies (56%), 102 distal pancreatectomies (34%), and 30 total pancreatectomies (10%). Final pathology revealed malignancy in 203 cases (67.7%). When applying the scores, the proportion of patients malnourished or at risk of malnutrition ranged from 21.7% for SGA to 79.3% for NRS2002. After adjusting for selected confounders, only an MNA <17 was associated with severe postoperative complications (OR 8.39, 95%CI [1.95-32.31], p = 0.01). MNA, SGA, and SNAQ predicted the length of stay (all p < 0.01), while MNA and SGA also correlated with a higher probability of having a greater heterogeneity in the length of stay (p = 0.04 and 0.002, respectively). DISCUSSION We promote using MNA to detect malnourished patients at risk of severe postoperative complications and longer hospitalization after pancreatic surgery. SGA and SNAQ may also have value in predicting patients who will be hospitalized longer. More prospective studies will be needed to corroborate these findings.
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Affiliation(s)
- Salvatore Paiella
- Pancreatic Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona Hospital Trust, Verona, Italy; University of Verona, Verona, Italy.
| | - Erica Secchettin
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy
| | - Danila Azzolina
- Department of Environmental and Preventive Science, University of Ferrara, Ferrara, Italy
| | - Matteo De Pastena
- Pancreatic Surgery Unit, Verona Integrated University Hospital, Policlinico GB Rossi, Verona, Italy
| | - Nicola Gentilini
- Pancreatic Surgery Unit, Verona Integrated University Hospital, Policlinico GB Rossi, Verona, Italy
| | - Ilaria Trestini
- Dietetic Service, Medical Direction, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Fabio Casciani
- Pancreatic Surgery Unit, Verona Integrated University Hospital, Policlinico GB Rossi, Verona, Italy
| | - Marta Sandini
- Department of Medical, Surgical, and Neurologic Sciences, University of Siena, Siena, Italy
| | - Gabriella Lionetto
- Pancreatic Surgery Unit, Verona Integrated University Hospital, Policlinico GB Rossi, Verona, Italy
| | - Michele Milella
- Section of Innovation Biomedicine-Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Verona, Italy
| | - Giuseppe Malleo
- Pancreatic Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona Hospital Trust, Verona, Italy; University of Verona, Verona, Italy
| | - Luca Gianotti
- School of Medicine and Surgery, Milano-Bicocca University, Monza, Italy; Hepatopancreaticobiliary Unit, IRCCS San Gerardo Hospital, Monza, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padova, Padova, Italy
| | - Roberto Salvia
- University of Verona, Verona, Italy; Pancreatic Surgery Unit, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Verona, Italy.
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Chung E, Park Y, Lee HJ, Kang YA. Usefulness of the mini nutritional assessment short-form for evaluating nutritional status in patients with nontuberculous mycobacterial pulmonary disease: a prospective cross-sectional study. BMC Infect Dis 2024; 24:604. [PMID: 38898397 PMCID: PMC11186144 DOI: 10.1186/s12879-024-09499-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/12/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Although the Mini Nutritional Assessment (MNA) is recognized as a useful tool for evaluating nutritional status in patients with various diseases, its applicability in patients with nontuberculous mycobacterial pulmonary disease (NTM-PD) remains undetermined. METHODS We designed a prospective cross-sectional study to investigate whether the MNA Short-Form (MNA-SF) score can serve as a screening tool to assess the nutritional status of patients with NTM-PD. The MNA-SF was conducted upon patient enrollment, and correlation analyses were performed to compare MNA-SF scores with other nutritional measurements and disease severity. Multivariable logistic regression analyses were conducted to evaluate the association between MNA-SF scores and NTM-PD severity. RESULTS The 194 patients with NTM-PD included in the analysis had a median age of 65.0 (59.0-69.0) years; 59.3% (n = 115) had low MNA-SF scores (< 12). The low MNA-SF group exhibited a lower body mass index (19.7 vs. 22.4 kg/m2, p < 0.001) and fat-free mass index (14.7 vs. 15.6 kg/m2, p < 0.001) than the normal MNA-SF group, as well as higher incidences of sarcopenia (20.0% vs. 6.3%, p = 0.008) and adipopenia (35.7% vs. 5.1%, p < 0.001). However, no significant differences in calorie and protein intakes were observed between the two groups. Low MNA-SF scores were associated with radiographic severity (adjusted odds ratio 2.72, 95% confidence interval 1.38-5.36) but not with forced vital capacity. CONCLUSIONS The MNA-SF can effectively assess the nutritional status of patients with NTM-PD and can serve as an important clinical indicator in NTM-PD where treatment timing is determined by clinical judgment.
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Affiliation(s)
- Eunki Chung
- Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
- Yonsei University Graduate School of Medicine, Seoul, Republic of Korea
| | - Youngmok Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Hye-Jeong Lee
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Ae Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Institute for Immunology and Immunological Disease, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Jayawardena R, Wickramawardhane P, Dalpatadu C, Hills AP, Ranasinghe P. Impact of an oral nutritional supplement on the body composition of older adults with or at risk of malnutrition in an institutionalised setting: A randomised controlled trial. J Hum Nutr Diet 2024. [PMID: 38865444 DOI: 10.1111/jhn.13334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 05/23/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Malnutrition often manifests as a body weight (BW) reduction and unhealthy alteration in body composition. The present study aimed to assess the efficacy of an oral nutritional supplement (ONS) in improving BW and body composition among older adults with malnutrition. METHODS An open-label randomised controlled, parallel-group study was conducted among older adults (age ≥ 60 years) with/at risk of malnutrition (mini nutrition assessment-short form score ≤ 11). In total, 50 participants were randomly assigned to the intervention (IG) and control (CG) groups (1:1 ratio). The IG received the ONS (57 g/day; 247 kcal/serving, 12 g protein) before bedtime for 12 weeks. CG received 200 mL of water. Anthropometric measurements, body composition analysis, and dietary and physical activity assessments were performed at the beginning and end of the study. RESULTS Forty-two participants (IG: 20, CG: 22) completed the study. The mean ± SD ages of the IG and CG were 75.4 ± 6.1 and 74.8 ± 5.2 years, respectively (p = 0.73). The IG had a significant increase in BW (+1.68 ± 1.16 vs. -0.46 ± 0.95 kg; p < 0.001), lean mass (+1.23 ± 0.93 vs. -0.45 ± 0.90 kg; p < 0.001) and fat mass (+0.54 ± 0.82 vs. -0.06 ± 0.82 kg; p = 0.02) compared to the CG. One-quarter of the IG (n = 5) achieved a weight gain > 5% of BW, whereas none in the CG did (p = 0.01). No significant changes were observed in bone mineral content in either group. CONCLUSIONS For malnourished older adults, supplementing with an ONS, along with regular food intake, significantly increased BW, lean mass and fat mass compared to control following the regular diet without supplementation.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Chamila Dalpatadu
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
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Zhao X, Meng L, Wang D, Shi J, Wu W, Fan G, Shi H, Dong J, Yu P, Yang R. Targeted metabolomic profiles of serum amino acids are independently correlated with malnutrition in older adults. BMC Geriatr 2024; 24:341. [PMID: 38622502 PMCID: PMC11020810 DOI: 10.1186/s12877-024-04937-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/31/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Malnutrition is a common geriatric syndrome that is closely associated with adverse clinical outcomes and poses significant harm to older adults. Early assessment of nutritional status plays a crucial role in preventing and intervening in cases of malnutrition. However, there is currently a lack of measurable methods and biomarkers to evaluate malnutrition in older adults accurately. The aim of this study is to investigate the independent correlation between serum levels of amino acids and malnutrition in older adults, and to identify effective metabolomics biomarkers that can aid in the early detection of geriatric malnutrition. METHODS A total of 254 geriatric medical examination participants from Beijing Hospital were included in the study, consisting of 182 individuals with normal nutritional status (Normal group) and 72 patients at risk of malnutrition or already malnourished (MN group). Malnutrition was assessed using the Mini-Nutritional Assessment Short-Form (MNA-SF). Demographic data were collected, and muscle-related and lipid indexes were determined. Serum amino acid concentrations were measured using isotope dilution liquid chromatography-tandem mass spectrometry (LC-MS/MS). The correlation between serum amino acid levels and malnutrition was analyzed using non-parametric tests, partial correlation analysis, linear regression, and logistic regression. RESULTS The geriatric MN group exhibited significantly lower serum aromatic amino acid levels (P < 0.05) compared to the normal group. A positive correlation was observed between serum aromatic amino acid levels and the MNA-SF score (P = 0.002), as well as with known biomarkers of malnutrition such as body mass index (BMI) (P < 0.001) and hemoglobin (HGB) (P = 0.005). Multivariable logistic or linear regression analyses showed that aromatic amino acid levels were negatively correlated with MN and positively correlated with the MNA-SF score, after adjusting for some confounding factors, such as age, gender, BMI, smoking status, history of dyslipidemia, diabetes mellitus and frailty. Stratified analyses revealed that these trends were more pronounced in individuals without a history of frailty compared to those with a history of frailty, and there was an interaction between aromatic amino acid levels and frailty history (P = 0.004). CONCLUSION Our study suggests that serum aromatic amino acids are independently associated with malnutrition in older adults. These results have important implications for identifying potential biomarkers to predict geriatric malnutrition or monitor its progression and severity, as malnutrition can result in poor clinical outcomes.
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Affiliation(s)
- Xianghui Zhao
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, 100730, Beijing, China
| | - Li Meng
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, 100730, Beijing, China
| | - Daguang Wang
- Department of Laboratory Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Jing Shi
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, 100730, Beijing, China
| | - Wenbin Wu
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, National Clinical Research Center for Geriatrics, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Guoqing Fan
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, National Clinical Research Center for Geriatrics, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Hong Shi
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, National Clinical Research Center for Geriatrics, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Jun Dong
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, 100730, Beijing, China
| | - Pulin Yu
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, 100730, Beijing, China.
| | - Ruiyue Yang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, 100730, Beijing, China.
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Jabr CL, Oliveira LP, Pero AC, de Assis Mollo Júnior F, Filho JNA. Masticatory performance, self-perception of oral health, oral health-related quality of life and nutritional status of completely edentulous elderly patients submitted to different rehabilitation treatments: A cross-sectional study. J Oral Rehabil 2024; 51:724-732. [PMID: 38151857 DOI: 10.1111/joor.13640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 09/10/2023] [Accepted: 12/06/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND The impact of treatments on completely edentulous individuals on masticatory performance (MP), oral health-related quality of life (OHRQoL), nutritional status (NS) and socio-economic profile (SP) is unclear in the literature. OBJECTIVE To compare the MP, OHRQoL, NS and SP of totally edentulous elderly users of bimaxillary complete dentures (CD) and users of lower implant-supported fixed complete dentures (IFCD). METHODS Forty participants were allocated into groups according to rehabilitation treatment (n = 20): bimaxillary CD (G1) and lower IFCD, and upper CD (G2). The evaluation of MP used almonds by the method of sieves. Four questionnaires (Geriatric Oral Health Assessment Index-GOHAI and Oral Health Impact Profile Edent-OHIP-Edent, Brazilian Economic Classification Criteria-ABEP and Mini Nutritional Assessment-MNA) were applied to assess the OHRQoL, SP and NS of the elderly, respectively. After evaluating the statistical assumptions, the Mann-Whitney (α = .05) test was applied to compare the groups regarding MP, OHRQoL, NS and SP. Spearman's correlation (α = .05) was performed to verify the correlation between the MP, the OHRQoL and the NS of the participants. RESULTS G2 showed better MP (p < .05) in all masticatory cycles, OHRQoL (p < .05) and NS than the G1. However, the participants' self-perception of oral health did not differ between groups (p < .05). A moderate negative correlation was found between MP and OHRQoL for 40 masticatory cycles (r2 = -0.513; p = .001). CONCLUSION Individuals rehabilitated with IFCD had a higher average monthly family income and achieved superior behaviour in MP and OHRQoL, in addition to lower risks of malnutrition when compared to individuals using bimaxillary CD.
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Affiliation(s)
- Camila Luiz Jabr
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, Brazil
| | - Lucas Portela Oliveira
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, Brazil
| | - Ana Carolina Pero
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, Brazil
| | - Francisco de Assis Mollo Júnior
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, Brazil
| | - João Neudenir Arioli Filho
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, Brazil
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Cedeno-Veloz B, Lozano-Vicario L, Rodríguez-García A, Zambom-Ferraresi F, Galbete A, Fernández-Irigoyen J, Santamaría E, García-Hermoso A, Calvani R, Ramírez-Vélez R, Izquierdo M, Martínez-Velilla N. Serum biomarkers related to frailty predict negative outcomes in older adults with hip fracture. J Endocrinol Invest 2024; 47:729-738. [PMID: 37603268 DOI: 10.1007/s40618-023-02181-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 08/17/2023] [Indexed: 08/22/2023]
Abstract
PURPOSE Hip fracture is a public health problem worldwide. Traditional prognostic models do not include blood biomarkers, such as those obtained by proteomics. This study aimed to investigate the relationships between serum inflammatory biomarkers and frailty in older adults with hip fracture as well as adverse outcomes at one and three months after discharge. METHODS A total of 45 patients aged 75 or older who were admitted for hip fracture were recruited. At admission, a Comprehensive Geriatric Assessment (CGA) was conducted, which included a frailty assessment using the Clinical Frailty Scale (CFS). Blood samples were collected before surgery. Participants were followed up at one and three months after discharge. The levels of 45 cytokines were analyzed using a high-throughput proteomic approach. Binary logistic regression was used to determine independent associations with outcomes, such as functional recovery, polypharmacy, hospital readmission, and mortality. RESULTS The results showed that IL-7 (OR 0.66 95% CI 0.46-0.94, p = 0.022) and CXCL-12 (OR 0.97 95% CI 0.95-0.99, p = 0.011) were associated with better functional recovery at three months after discharge, while CXCL-8 (OR 1.07 95% CI 1.01-1.14, p = 0.019) was associated with an increased risk of readmission. CONCLUSIONS These findings suggest that immunology biomarkers may represent useful predictors of clinical outcomes in hip fracture patients.
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Affiliation(s)
- B Cedeno-Veloz
- Geriatric Department, Navarre University Hospital (HUN), Irunlarrea 3, 31008, Pamplona, Navarra, Spain.
- Navarrabiomed-Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008, Pamplona, Navarra, Spain.
- Public University of Navarre, Av Cataluña s/n, 31006, Pamplona, Navarra, Spain.
| | - L Lozano-Vicario
- Geriatric Department, Navarre University Hospital (HUN), Irunlarrea 3, 31008, Pamplona, Navarra, Spain
- Navarrabiomed-Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008, Pamplona, Navarra, Spain
- Public University of Navarre, Av Cataluña s/n, 31006, Pamplona, Navarra, Spain
| | - A Rodríguez-García
- Geriatric Department, Navarre University Hospital (HUN), Irunlarrea 3, 31008, Pamplona, Navarra, Spain
| | - F Zambom-Ferraresi
- Geriatric Department, Navarre University Hospital (HUN), Irunlarrea 3, 31008, Pamplona, Navarra, Spain
- Navarrabiomed-Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008, Pamplona, Navarra, Spain
- Public University of Navarre, Av Cataluña s/n, 31006, Pamplona, Navarra, Spain
| | - A Galbete
- Public University of Navarre, Av Cataluña s/n, 31006, Pamplona, Navarra, Spain
| | - J Fernández-Irigoyen
- Navarrabiomed-Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008, Pamplona, Navarra, Spain
| | - E Santamaría
- Navarrabiomed-Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008, Pamplona, Navarra, Spain
| | - A García-Hermoso
- Navarrabiomed-Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008, Pamplona, Navarra, Spain
| | - R Calvani
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore and Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, 00168, Rome, Italy
| | - R Ramírez-Vélez
- Navarrabiomed-Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008, Pamplona, Navarra, Spain
- Public University of Navarre, Av Cataluña s/n, 31006, Pamplona, Navarra, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Av Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
| | - M Izquierdo
- Navarrabiomed-Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008, Pamplona, Navarra, Spain
- Public University of Navarre, Av Cataluña s/n, 31006, Pamplona, Navarra, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Av Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
| | - N Martínez-Velilla
- Geriatric Department, Navarre University Hospital (HUN), Irunlarrea 3, 31008, Pamplona, Navarra, Spain
- Navarrabiomed-Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008, Pamplona, Navarra, Spain
- Public University of Navarre, Av Cataluña s/n, 31006, Pamplona, Navarra, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Av Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
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da Silva LSL, Abdalla PP, Marcos-Pardo PJ, Romo-Perez V, Garcia-Soidan JL, Mota J, Machado DRL. Sarcopenic obesity does not impair lower limb strength and physical performance in sufficiently active older adults: a cross-sectional study. Sci Rep 2024; 14:3061. [PMID: 38321169 PMCID: PMC10847493 DOI: 10.1038/s41598-024-53538-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 02/01/2024] [Indexed: 02/08/2024] Open
Abstract
This study investigated the associations of sarcopenic obesity (SO) with muscle strength and physical performance in sufficiently active older adults. Data from 72 older sarcopenic obese adults classified as sufficiently active were analyzed. Participants were categorized into four groups based on sex and SO status. Muscle strength/physical performance tests were compared using independent sample t-tests. Multiple linear regression and binary logistic regression were performed to examine the associations between SO and muscle strength and physical performance, adjusting for confounding variables. Only handgrip strength showed differences between SO groups, regardless of sex (p < 0.05). SO negatively explained the variability of handgrip strength (p < 0.05). An increase in handgrip strength values was associated with a decrease in the chances of older adults being classified as SO (p < 0.05). The findings suggest that even with SO, sufficiently active older adults did not present a significant reduction in muscle strength in the lower limbs and physical performance.
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Affiliation(s)
- Leonardo Santos Lopes da Silva
- School of Physical Education and Sport of Ribeirao Preto, University of São Paulo, Bandeirantes Avenue No 3900, University Campus - Monte Alegre, Ribeirao Preto, SP, 14030-680, Brazil.
- Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), University of São Paulo, School of Physical Education and Sport of Ribeirão Preto, Ribeirão Preto, Brazil.
| | - Pedro Pugliesi Abdalla
- Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), University of São Paulo, School of Physical Education and Sport of Ribeirão Preto, Ribeirão Preto, Brazil
| | - Pablo Jorge Marcos-Pardo
- Department of Education, Faculty of Educational Sciences, University of Almería, 04120, Almería, Spain
- CERNEP Research Center, SPORT Research Group (CTS-1024), University of Almería, 04120, Almería, Spain
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040, Madrid, Spain
| | - Vicente Romo-Perez
- Faculty of Education and Sport Sciences, University of Vigo, Vigo, Spain
| | | | - Jorge Mota
- The Research Centre in Physical Activity, Health, and Leisure (CIAFEL), University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
| | - Dalmo Roberto Lopes Machado
- School of Physical Education and Sport of Ribeirao Preto, University of São Paulo, Bandeirantes Avenue No 3900, University Campus - Monte Alegre, Ribeirao Preto, SP, 14030-680, Brazil
- Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), University of São Paulo, School of Physical Education and Sport of Ribeirão Preto, Ribeirão Preto, Brazil
- The Research Centre in Physical Activity, Health, and Leisure (CIAFEL), University of Porto, Porto, Portugal
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, SP, Brazil
- ESEC - Universidade do Algarve, Campus da Penha, Faro, Portugal
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10
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Cedeno-Veloz BA, Casadamon-Munarriz I, Rodríguez-García A, Lozano-Vicario L, Zambom-Ferraresi F, Gonzalo-Lázaro M, Hidalgo-Ovejero ÁM, Izquierdo M, Martínez-Velilla N. Effect of a Multicomponent Intervention with Tele-Rehabilitation and the Vivifrail© Exercise Programme on Functional Capacity after Hip Fracture: Study Protocol for the ActiveFLS Randomized Controlled Trial. J Clin Med 2023; 13:97. [PMID: 38202104 PMCID: PMC10779784 DOI: 10.3390/jcm13010097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION Hip fractures are the most common fracture leading to hospitalization and are associated with high costs, mortality rates and functional decline. Although several guidelines exist for preventing new fractures and promoting functional recovery, they tend to focus on osteoporosis treatment and do not take into account the complexity of frailty in older adults and geriatric syndromes, which are important factors in individuals at risk of suffering from frailty fractures. Moreover, most health systems are fragmented and are incapable of providing appropriate management for frail and vulnerable individuals who are at risk of experiencing fragility fractures. Multicomponent interventions and physical exercise using tele-rehabilitation could play a role in the management of hip fracture recovery. However, the effectiveness of exercise prescription and its combination with a comprehensive geriatric assessment (CGA) is still unclear. METHODS This randomized clinical trial will be conducted at the Hospital Universitario de Navarra (Pamplona, Spain). A total of 174 older adults who have suffered a hip fracture and fulfil the criteria for inclusion will be randomly allocated to either the intervention group or the control group. The intervention group will receive a multicomponent intervention consisting of individualized home-based exercise using the @ctive hip app for three months, followed by nine months of exercise using Vivifrail. Additionally, the intervention group will receive nutrition intervention, osteoporosis treatment, polypharmacy adjustment and evaluation of patient mood, cognitive impairment and fear of falling. The control group will receive standard outpatient care according to local guidelines. This research aims to evaluate the impact of the intervention on primary outcome measures, which include changes in functional status during the study period based on the Short Physical Performance Battery. DISCUSSION The findings of this study will offer valuable insights into the efficacy of a comprehensive approach that considers the complexity of frailty in older adults and geriatric syndromes, which are important factors in individuals at risk of suffering from frailty fractures. This study's findings will contribute to the creation of more effective strategies tailored to the requirements of these at-risk groups.
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Affiliation(s)
- Bernardo Abel Cedeno-Veloz
- Navarre University Hospital (HUN), Irunlarrea 3, 31008 Pamplona, Navarra, Spain; (I.C.-M.); (A.R.-G.); (L.L.-V.); (F.Z.-F.); (M.G.-L.); (N.M.-V.)
- Navarrabiomed, Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008 Pamplona, Navarra, Spain;
- Department of Health Sciences, Public University of Navarre, Av Cataluña s/n, 31006 Pamplona, Navarra, Spain
| | - Irache Casadamon-Munarriz
- Navarre University Hospital (HUN), Irunlarrea 3, 31008 Pamplona, Navarra, Spain; (I.C.-M.); (A.R.-G.); (L.L.-V.); (F.Z.-F.); (M.G.-L.); (N.M.-V.)
| | - Alba Rodríguez-García
- Navarre University Hospital (HUN), Irunlarrea 3, 31008 Pamplona, Navarra, Spain; (I.C.-M.); (A.R.-G.); (L.L.-V.); (F.Z.-F.); (M.G.-L.); (N.M.-V.)
| | - Lucia Lozano-Vicario
- Navarre University Hospital (HUN), Irunlarrea 3, 31008 Pamplona, Navarra, Spain; (I.C.-M.); (A.R.-G.); (L.L.-V.); (F.Z.-F.); (M.G.-L.); (N.M.-V.)
- Navarrabiomed, Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008 Pamplona, Navarra, Spain;
- Department of Health Sciences, Public University of Navarre, Av Cataluña s/n, 31006 Pamplona, Navarra, Spain
| | - Fabricio Zambom-Ferraresi
- Navarre University Hospital (HUN), Irunlarrea 3, 31008 Pamplona, Navarra, Spain; (I.C.-M.); (A.R.-G.); (L.L.-V.); (F.Z.-F.); (M.G.-L.); (N.M.-V.)
- Navarrabiomed, Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008 Pamplona, Navarra, Spain;
- Department of Health Sciences, Public University of Navarre, Av Cataluña s/n, 31006 Pamplona, Navarra, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Av Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - María Gonzalo-Lázaro
- Navarre University Hospital (HUN), Irunlarrea 3, 31008 Pamplona, Navarra, Spain; (I.C.-M.); (A.R.-G.); (L.L.-V.); (F.Z.-F.); (M.G.-L.); (N.M.-V.)
| | - Ángel María Hidalgo-Ovejero
- Department of Orthopaedics Clinics and Traumatology, University Hospital of Navarre (HUN), 31008 Pamplona, Navarra, Spain;
| | - Mikel Izquierdo
- Navarrabiomed, Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008 Pamplona, Navarra, Spain;
- Department of Health Sciences, Public University of Navarre, Av Cataluña s/n, 31006 Pamplona, Navarra, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Av Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Nicolás Martínez-Velilla
- Navarre University Hospital (HUN), Irunlarrea 3, 31008 Pamplona, Navarra, Spain; (I.C.-M.); (A.R.-G.); (L.L.-V.); (F.Z.-F.); (M.G.-L.); (N.M.-V.)
- Navarrabiomed, Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008 Pamplona, Navarra, Spain;
- Department of Health Sciences, Public University of Navarre, Av Cataluña s/n, 31006 Pamplona, Navarra, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Av Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
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11
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Cedeno-Veloz BA, Lozano-Vicario L, Zambom-Ferraresi F, Fernández-Irigoyen J, Santamaría E, Rodríguez-García A, Romero-Ortuno R, Mondragon-Rubio J, Ruiz-Ruiz J, Ramírez-Vélez R, Izquierdo M, Martínez-Velilla N. Effect of immunology biomarkers associated with hip fracture and fracture risk in older adults. Immun Ageing 2023; 20:55. [PMID: 37853468 PMCID: PMC10583364 DOI: 10.1186/s12979-023-00379-z] [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: 07/04/2023] [Accepted: 10/02/2023] [Indexed: 10/20/2023]
Abstract
Osteoporosis is a skeletal disease that can increase the risk of fractures, leading to adverse health and socioeconomic consequences. However, current clinical methods have limitations in accurately estimating fracture risk, particularly in older adults. Thus, new technologies are necessary to improve the accuracy of fracture risk estimation. In this observational study, we aimed to explore the association between serum cytokines and hip fracture status in older adults, and their associations with fracture risk using the FRAX reference tool. We investigated the use of a proximity extension assay (PEA) with Olink. We compared the characteristics of the population, functional status and detailed body composition (determined using densitometry) between groups. We enrolled 40 participants, including 20 with hip fracture and 20 without fracture, and studied 46 cytokines in their serum. After conducting a score plot and two unpaired t-tests using the Benjamini-Hochberg method, we found that Interleukin 6 (IL-6), Lymphotoxin-alpha (LT-α), Fms-related tyrosine kinase 3 ligand (FLT3LG), Colony stimulating factor 1 (CSF1), and Chemokine (C-C motif) ligand 7 (CCL7) were significantly different between fracture and non-fracture patients (p < 0.05). IL-6 had a moderate correlation with FRAX (R2 = 0.409, p < 0.001), while CSF1 and CCL7 had weak correlations with FRAX. LT-α and FLT3LG exhibited a negative correlation with the risk of fracture. Our results suggest that targeted proteomic tools have the capability to identify differentially regulated proteins and may serve as potential markers for estimating fracture risk. However, longitudinal studies will be necessary to validate these results and determine the temporal patterns of changes in cytokine profiles.
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Affiliation(s)
- Bernardo Abel Cedeno-Veloz
- Geriatric Department, Hospital Universitario de Navarra (HUN), 2 Navarrabiomed, Pamplona, Navarra, IdiSNA, 31008, Spain.
- Navarrabiomed, Navarra Medical Research Institute, Pamplona, Navarra, 31008, Spain.
- Department of Health Sciences, Public University of Navarra, Pamplona, Navarra, 31008, Spain.
| | - Lucía Lozano-Vicario
- Geriatric Department, Hospital Universitario de Navarra (HUN), 2 Navarrabiomed, Pamplona, Navarra, IdiSNA, 31008, Spain
- Navarrabiomed, Navarra Medical Research Institute, Pamplona, Navarra, 31008, Spain
| | - Fabricio Zambom-Ferraresi
- Navarrabiomed, Navarra Medical Research Institute, Pamplona, Navarra, 31008, Spain
- Department of Health Sciences, Public University of Navarra, Pamplona, Navarra, 31008, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Joaquín Fernández-Irigoyen
- Navarrabiomed, Navarra Medical Research Institute, Pamplona, Navarra, 31008, Spain
- Clinical Neuroproteomics Unit, Navarrabiomed, Pamplona, 31008, Spain
| | - Enrique Santamaría
- Navarrabiomed, Navarra Medical Research Institute, Pamplona, Navarra, 31008, Spain
- Clinical Neuroproteomics Unit, Navarrabiomed, Pamplona, 31008, Spain
| | - Alba Rodríguez-García
- Geriatric Department, Hospital Universitario de Navarra (HUN), 2 Navarrabiomed, Pamplona, Navarra, IdiSNA, 31008, Spain
| | - Roman Romero-Ortuno
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Jaime Mondragon-Rubio
- Department of Orthopaedics Clinics and Traumatology, University Hospital of Navarre (HUN), Pamplona, Navarra, 31008, Spain
| | - Javier Ruiz-Ruiz
- Department of Orthopaedics Clinics and Traumatology, University Hospital of Navarre (HUN), Pamplona, Navarra, 31008, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Navarra Medical Research Institute, Pamplona, Navarra, 31008, Spain
- Department of Health Sciences, Public University of Navarra, Pamplona, Navarra, 31008, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Mikel Izquierdo
- Navarrabiomed, Navarra Medical Research Institute, Pamplona, Navarra, 31008, Spain
- Department of Health Sciences, Public University of Navarra, Pamplona, Navarra, 31008, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Nicolás Martínez-Velilla
- Geriatric Department, Hospital Universitario de Navarra (HUN), 2 Navarrabiomed, Pamplona, Navarra, IdiSNA, 31008, Spain
- Navarrabiomed, Navarra Medical Research Institute, Pamplona, Navarra, 31008, Spain
- Department of Health Sciences, Public University of Navarra, Pamplona, Navarra, 31008, Spain
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12
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Sawada N, Takeuchi N, Ekuni D, Morita M. Effect of oral health status and oral function on malnutrition in community-dwelling older adult dental patients: A two-year prospective cohort study. Gerodontology 2023. [PMID: 37847782 DOI: 10.1111/ger.12718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVES To survey oral status in detail and clarify the factors associated with nutritional status as evaluated by the Mini Nutritional Assessment. BACKGROUND Malnutrition is common in older adults and increases the risk of frailty, sarcopenia, and mortality. However, few longitudinal studies have been performed to investigate the causal effect of oral status on malnutrition in detail, and the information reported in those longitudinal studies has been limited to dentition status and swallowing ability. MATERIALS AND METHODS The participants in this prospective cohort study were patients who visited the Preventive Dentistry Clinic at Okayama University Hospital from November 2017 to January 2021. The number of teeth, periodontal condition, oral function (oral diadochokinesis, masticatory ability, number of bacteria in tongue coating, occlusal force, oral moisture, tongue pressure, swallowing function), nutritional status, the number of comorbidities, and mental health status were examined. These variables were analysed using structural equation modelling (SEM). RESULTS The final analysis included 141 participants (40 males and 101 females; mean age, 73.5 ± 6.3 years; follow-up rate: 79.7%). The results of the SEM revealed that oral status (number of teeth present and swallowing function) was positively associated with nutritional status 2 years later. In addition, age was negatively associated with oral status. CONCLUSION In community-dwelling older adult dental patients (age ≥60 years), oral function at baseline was associated with nutritional status two years later.
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Affiliation(s)
- Nanami Sawada
- Department of Preventive Dentistry, Okayama University Hospital, Okayama, Japan
| | - Noriko Takeuchi
- Department of Preventive Dentistry, Okayama University Hospital, Okayama, Japan
| | - Daisuke Ekuni
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Manabu Morita
- Department of Oral Health, Takarazuka University of Medical and Health Care, Takarazuka, Japan
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13
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Jayawardena R, Wickramawardhane P, Dalpatadu C, Hills AP, Ranasinghe P. The impact of an oral nutritional supplement on body weight gain in older adults with malnutrition: an open-label randomized controlled trial. Trials 2023; 24:625. [PMID: 37784119 PMCID: PMC10544200 DOI: 10.1186/s13063-023-07622-4] [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: 04/08/2023] [Accepted: 09/04/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND The global aging population is expanding rapidly and many individuals have a particularly higher risk of malnutrition. Malnutrition can lead to impaired body function, morbidity, and mortality. Meeting nutritional requirements is a key strategy to minimize multiple debilitating adverse outcomes associated with malnutrition in the elderly. Oral nutritional supplements (ONS) have been widely used as a dietary intervention for malnutrition in older adults. These supplements provide additional nutrients and calories to support nutritional requirements and have been shown to improve nutritional status, physical function, and quality of life in malnourished older adults. METHODS This is an open-label, randomized controlled, parallel-group study including 50 institutionalized older adults (aged > 60 years) with malnutrition or at risk of malnutrition, living in a selected elderly care institution in Colombo, Sri Lanka. The aim is to assess improvement in healthy body weight gain and body composition in older adults with malnutrition at risk of malnutrition by using an ONS. Older adults will be screened for malnutrition using the Mini Nutrition Assessment (MNA) tool and eligible participants randomized using the simple random sampling technique to intervention and control groups (1:1 allocation ratio). The intervention group will consume 200 mL of ONS before bed continuously for 12 weeks. The primary outcome is the percentage who achieved at least 5% weight gain in the intervention group compared to the control group. Nutritional status (anthropometric, biochemical, clinical, and dietary), body composition (dual-energy X-ray absorptiometry), frailty, functional capacity (hand grip strength, knee extension, and Barthel index) cognitive status (Montreal Cognitive Assessment), and physical activity will be assessed as secondary outcomes at baseline and at the end of the 12-week intervention. Some measurements (anthropometry, dietary, and functional assessments) will also be performed at the end of the 4th week. Data will be analyzed using SPSS V-23. DISCUSSION This study will determine whether the use of an ONS is effective in promoting healthy weight gain in older adults with malnutrition or at risk of malnutrition. In addition, investigating the impact of an ONS on multiple outcomes via clinical, nutritional, functional, and cognitive function will provide a more comprehensive understanding of the potential benefits of these supplements. TRIAL REGISTRATION Sri Lanka Clinical Trail Registry SLCTR/2022/021. Oct. 6, 2022.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | | | - Chamila Dalpatadu
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
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14
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Shadmand Foumani Moghadam MR, Shahraki Jazinaki M, Rashidipour M, Rezvani R, Pezeshki P, Ghayour Mobarhan M, Hosseini Z. Mini Nutrition Assessment-Short Form score is associated with sarcopenia even among nourished people - A result of a feasibility study of a registry. Aging Med (Milton) 2023; 6:264-271. [PMID: 37711256 PMCID: PMC10498828 DOI: 10.1002/agm2.12257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/24/2023] [Accepted: 04/27/2023] [Indexed: 09/16/2023] Open
Abstract
Objectives This study aims to identify a new barrier to the use of the Mini-Nutrition Assessment Short-Form (MNA-SF), which is a malnutrition assessment tool for the risk assessment of sarcopenia in a nourished population. Methods The MNA-SF was completed, and individuals with a score of > 11 were considered nourished in this cross-sectional feasibility study of a registry. Sarcopenia was assessed in 766 healthy, nourished adults (33.4% men, 64.9 ± 7.1 years) based on the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Results The MNA-SF scores for non-sarcopenia, pre-, confirmed, and severe sarcopenia were 13.59 ± 0.69, 13.73 ± 0.60, 12.64 ± 0.74, and 12.5 ± 0.71, respectively. The higher MNA-SF score association with pre-sarcopenia [odds ratio (OR): 1.41, 95% confidence interval (CI): 1.06-1.86, P = 0.02], confirmed sarcopenia (OR = 0.25, 95% CI: 0.13-0.49, P < 0.001), and severe sarcopenia (OR = 0.20, 95% CI: 0.09-0.46, P < 0.001) was as significant as in the MNA-SF categories. Individuals with a score = 13 (compared with 14), had a higher risk of confirmed sarcopenia (OR = 10.07, 95% CI: 1.92-52.71, P = 006) and severe sarcopenia (OR = 12.09, 95% CI: 1.24-117.50, P = 0.032). Individuals with a score of 12 had a higher risk of confirmed sarcopenia (OR = 30.94, 95% CI: 4.25-103.02, P < 0.001) and severe sarcopenia (OR = 35.90, 95% CI: 4.25-303.07, P = 0.001) compared with subjects with a score of 14. The models also showed that MNA-SF < 13 could predict sarcopenia. Conclusion There was a significant association between MNA-SF and confirmed and severe sarcopenia in nourished people. Sarcopenia assessment in people with MNA-SF < 13 can be beneficial. Developing a tool to identify the risk of malnutrition and sarcopenia at the same time based on MNA-SF can be considered.
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Affiliation(s)
| | - Mostafa Shahraki Jazinaki
- Department of Nutrition Science, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Mina Rashidipour
- Department of Health and NutritionIslamic Azad University, Science And Research BranchTehranIran
| | - Reza Rezvani
- Department of Nutrition Science, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Parnian Pezeshki
- Department of Food Science and TechnologyVarastegan Institute for Medical SciencesMashhadIran
| | - Majid Ghayour Mobarhan
- Department of Nutrition Science, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
- International UNESCO Center for Health‐Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
| | - Zohre Hosseini
- Department of Nutrition ScienceVarastegan Institute for Medical SciencesMashhadIran
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15
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Expósito D, Morales-Suarez MM, Soriano JM, Soler C. Tools for Nutrition Assessment of Adults with Cerebral Palsy: Development of a Gold Standard. Curr Nutr Rep 2023; 12:545-553. [PMID: 37486592 DOI: 10.1007/s13668-023-00485-w] [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] [Accepted: 06/16/2023] [Indexed: 07/25/2023]
Abstract
PURPOSE OF REVIEW Cerebral palsy (CP) is a group of disorders caused by non-stabilized cerebral lesions. Individuals with this disorder are at a higher risk of suffering from malnutrition and other related detrimental effects to their quality of life. For this reason, accurate methods of nutritional assessment are vital for people suffering from this condition. While assessment of nutritional status in children with CP has been extensively studied, very few studies have been carried out on adults. These limitations are due to the great anatomical-functional variability characteristic of this syndrome. Difficulties that derive from this variability in adult patients with CP mean that there remains an urgent need for certain standards of nutritional assessment for this population. The objective of this review is to compile the latest trends in nutritional assessment in adults with CP to guide the development of a conceptual framework for future research. RECENT FINDINGS With this aim, relevant studies have been identified. The most commonly used technique to evaluate nutritional status is the BMI because of its ease-of-use. However, its well-known limitations fail to adequately estimate the nutritional status in this population, with measurements of patients with CP yielding results that are much less accurate than those that already exist in the general population. Although more studies are needed, kinanthropometry is considered one of the most reliable techniques; nevertheless, the anatomical limitation characteristic of CP plays a limiting factor.
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Affiliation(s)
- D Expósito
- Food & Health Lab. Instituto de Ciencias de los Materiales, Universitat de València, C/ Catedrático José Beltrán 2, 46980, Paterna, Valencia, Spain.
- Department of Basic Medical Sciences, Universidad Católica de Valencia, 46001, Valencia, Spain.
- Department of Nutrition, Universidad Católica de Valencia, 46001, Valencia, Spain.
| | - M M Morales-Suarez
- Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, 46100, Burjassot, Valencia, Spain
- CIBER Epidemiologia Y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - J M Soriano
- Food & Health Lab. Instituto de Ciencias de los Materiales, Universitat de València, C/ Catedrático José Beltrán 2, 46980, Paterna, Valencia, Spain
- Joint Research Unit On Endocrinology, Nutrition and Clinical Dietetics, UV-IIS La Fe, 46012, Valencia, Spain
| | - C Soler
- Food & Health Lab. Instituto de Ciencias de los Materiales, Universitat de València, C/ Catedrático José Beltrán 2, 46980, Paterna, Valencia, Spain
- Joint Research Unit On Endocrinology, Nutrition and Clinical Dietetics, UV-IIS La Fe, 46012, Valencia, Spain
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Huang R, Huang X, Wang Y, Xie Y, Chen K, Ma S, Zhou X, Li W, Tan S, Yang L. The nutritional risk in patients with neuromyelitis optica spectrum disorder. Mult Scler Relat Disord 2023; 77:104900. [PMID: 37487344 DOI: 10.1016/j.msard.2023.104900] [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: 03/16/2023] [Revised: 06/18/2023] [Accepted: 07/16/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND The effect of nutrition on chronic autoimmune diseases is well known. This study is the first to assess the nutritional status of patients with neuromyelitis optica spectrum disorder (NMOSD) by administering the Mini Nutritional Assessment (MNA), to explore the impacts of nutrition on patients' quality of life and to identify the factors associated with the nutritional status of NMOSD patients. METHODS Our study enrolled 70 NMOSD patients and 66 healthy controls. The following data were assessed: demographic information, disease features, and composite evaluations of life status, including nutrition, sleep, anxiety/depression, fatigue, and quality of life. Then, statistical analysis was performed. RESULTS The MNA score of NMOSD patients was 20.4 ± 3.3, which was significantly lower than that of HCs (23.3 ± 2.5, P = 0.002), especially for the dimensions of global evaluation and anthropometric assessment. Nearly 85% of patients were at risk of malnutrition or had definite malnutrition. The total MNA score was positively correlated with the patient's quality of life (P<0.01). Lower MNA scores were correlated with gender (P = 0.02), longer disease duration (P<0.001), more severe anxiety (P = 0.004), more severe depression (P = 0.003), more severe sleep disturbances (P<0.001), and more severe fatigue (P = 0.01). Sleep disturbance was revealed to be a significant independent factor for the NMOSD patients' malnutritional risk (P = 0.001). CONCLUSIONS These results suggest that the risk of malnutrition is very high in NMOSD patients and that malnutrition is closely related to their quality of life. Malnutrition among NMOSD patients is caused by a combination of various physiological and psychological factors. A multifaceted and personalized intervention is required to improve the prognosis of NMOSD.
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Affiliation(s)
- Rui Huang
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West Second Section of First Ring Road, Chengdu 611731, China
| | - Xinyue Huang
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West Second Section of First Ring Road, Chengdu 611731, China
| | - Yuan Wang
- Department of Clinical Nutrition, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yan Xie
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West Second Section of First Ring Road, Chengdu 611731, China
| | - Kai Chen
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West Second Section of First Ring Road, Chengdu 611731, China
| | - Shuai Ma
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West Second Section of First Ring Road, Chengdu 611731, China
| | - Xiaobo Zhou
- Department of Psychosomatic, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Wenjing Li
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West Second Section of First Ring Road, Chengdu 611731, China
| | - Song Tan
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West Second Section of First Ring Road, Chengdu 611731, China; Sichuan Provincial Key Laboratory for Human Disease Gene Study, Chengdu, China; Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, Sichuan, China.
| | - Lili Yang
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West Second Section of First Ring Road, Chengdu 611731, China.
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Papadimitriou K, Detopoulou P, Soufleris K, Voulgaridou G, Tsoumana D, Ntopromireskou P, Giaginis C, Chatziprodromidou IP, Spanoudaki M, Papadopoulou SK. Nutritional Risk and Sarcopenia Features in Patients with Crohn's Disease: Relation to Body Composition, Physical Performance, Nutritional Questionnaires and Biomarkers. Nutrients 2023; 15:3615. [PMID: 37630805 PMCID: PMC10458234 DOI: 10.3390/nu15163615] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/10/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Patients with Crohn's disease (CD) face malnutrition risk, which, combined with inflammation, can lead to sarcopenia, associated with a worse prognosis. The purpose of the present study was to assess malnutrition and sarcopenia in patients with CD. Fifty-three patients (26 women) participated (38.1 ± 10.9 years, 79% in remission). Body composition, physical performance, nutritional questionnaires, and biomarkers were performed. Malnutrition was screened with the Mini Nutritional Assessment (MNA) and the Malnutrition Inflammation Risk Tool (MIRT) and was assessed with the Global Leadership Initiative on Malnutrition (GLIM) tool using etiologic along with three different phenotypic criteria: low Body Mass Index (BMI), low Calf Circumference (CC), and low Fat-Free Mass Index (FFMI). To find cases and evaluate sarcopenia, the Sarcopenia Questionnaire (SARC-F) and European Working Group on Sarcopenia2 (EWGSOP2) criteria were used. Malnutrition rates were 11.3% (n = 6), 7.5% (n = 4), and 5.6% (n = 3) based on low FFMI, CC, and BMI, correspondingly. Four (7%) patients had low Hand-Grip Strength (HGS), n = 8 (14.8%) had low Appendicular Lean Mass (ALM), and n = 3 (5.6%) had low gait speed. No-one had sarcopenia. A high albumin and triceps skinfold pattern, identified by principal component analysis, was related to reduced C-Reactive Protein (CRP) levels (B = -0.180, SE = 0.085, p = 0.045). In conclusion, based on the studied anthropometric, nutritional, and functional variables, CD patients were not diagnosed with sarcopenia in the present study. Body composition patterns were related to the inflammatory burden, underlying the interplay of inflammation and malnutrition, even in remission states. Further studies on older populations and during disease exacerbation are necessary to explore the potential link between CD, inflammation, and sarcopenia.
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Affiliation(s)
- Konstantinos Papadimitriou
- Faculty of Health and Rehabilitation Sciences, Metropolitan College of Thessaloniki, University of East London, 546 24 Thessaloniki, Greece
| | - Paraskevi Detopoulou
- Department of Clinical Nutrition, General Hospital Korgialenio Benakio, 115 26 Athens, Greece;
| | - Konstantinos Soufleris
- Gastroenterology-Oncology Department, Theageneio Anticancer Hospital of Thessaloniki, 546 39 Thessaloniki, Greece;
| | - Gavriela Voulgaridou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 570 01 Thessaloniki, Greece; (G.V.); (D.T.); (M.S.)
| | - Despoina Tsoumana
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 570 01 Thessaloniki, Greece; (G.V.); (D.T.); (M.S.)
| | - Panagiotis Ntopromireskou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 811 00 Myrina, Greece; (P.N.); (C.G.)
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 811 00 Myrina, Greece; (P.N.); (C.G.)
| | | | - Maria Spanoudaki
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 570 01 Thessaloniki, Greece; (G.V.); (D.T.); (M.S.)
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 570 01 Thessaloniki, Greece; (G.V.); (D.T.); (M.S.)
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Cano-García L, Redondo-Rodríguez R, Manrique-Arija S, Domínguez-Quesada C, Crisóstomo Vacas J, Armenteros-Ortiz P, Ruiz-Vilchez D, Martín-Martín JM, García-Studer A, Ortiz-Márquez F, Mena-Vázquez N, Fernández-Nebro A. Prevalence of Malnutrition and Associated Factors in Older Patients with Rheumatoid Arthritis: A Cross-Sectional Study. Nutrients 2023; 15:3500. [PMID: 37630691 PMCID: PMC10460011 DOI: 10.3390/nu15163500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/03/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
OBJECTIVE To describe the frequency of malnutrition in older patients with rheumatoid arthritis (RA) and investigate associated risk factors. METHODS This multicenter, cross-sectional study included participants aged ≥65 years who met the 2010 ACR/EULAR criteria for RA. Nutritional status was assessed using the Mini Nutritional Assessment Short Form (MNA-SF) and based on variables, such as albumin level, the Geriatric Nutritional Risk Index (GNRI), and vitamin D. Data were also collected on epidemiological variables, inflammatory disease activity, quality of life, physical function, and frailty. Multivariate models were used to study factors associated with nutritional status. RESULTS The study population comprised 76 RA patients aged ≥65 years, of whom 68.4% had a normal nutritional status, and 31.5% had an impaired nutritional status: 28.9% were at risk of malnutrition, and 2.6% were malnourished. Additionally, 10% had albumin levels <3.8 g/L. Patients with impaired nutritional status had poorer quality of life and physical function. The factors associated with compromised nutritional status (OR [95% CI]) were age (1.0 [1.0-1.1]; p = 0.035), DAS28-ESR (1.8 [1.0-3.2]; p = 0.024), and EuroQoL-5D-5L (0.9 [0.9-0.9]; p = 0.040). Furthermore, the GNRI was associated with the MNA score (0.06 [0.0-0.1]; p = 0.014). CONCLUSIONS Approximately one-third of older patients with RA have impaired nutritional status. Older age, higher inflammatory disease activity, and decreased quality of life are associated with impaired nutritional status. The MNA and GNRI are valuable tools for assessing the nutritional status of patients with RA.
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Affiliation(s)
- Laura Cano-García
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Málaga, Spain; (L.C.-G.); (R.R.-R.); (S.M.-A.); (A.G.-S.); (F.O.-M.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
| | - Rocío Redondo-Rodríguez
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Málaga, Spain; (L.C.-G.); (R.R.-R.); (S.M.-A.); (A.G.-S.); (F.O.-M.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
- Departamento de Medicina, Universidad de Málaga, 29010 Málaga, Spain
| | - Sara Manrique-Arija
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Málaga, Spain; (L.C.-G.); (R.R.-R.); (S.M.-A.); (A.G.-S.); (F.O.-M.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
- Departamento de Medicina, Universidad de Málaga, 29010 Málaga, Spain
| | | | - Juan Crisóstomo Vacas
- UGC de Reumatología, Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain; (J.C.V.); (P.A.-O.); (D.R.-V.)
| | - Pedro Armenteros-Ortiz
- UGC de Reumatología, Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain; (J.C.V.); (P.A.-O.); (D.R.-V.)
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain
| | - Desiree Ruiz-Vilchez
- UGC de Reumatología, Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain; (J.C.V.); (P.A.-O.); (D.R.-V.)
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain
| | - José María Martín-Martín
- UGC de Reumatología, Hospital Universitario Nuestra Señora de la Candelaria, 38010 Santa Cruz de Tenerife, Spain;
| | - Aimara García-Studer
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Málaga, Spain; (L.C.-G.); (R.R.-R.); (S.M.-A.); (A.G.-S.); (F.O.-M.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
| | - Fernando Ortiz-Márquez
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Málaga, Spain; (L.C.-G.); (R.R.-R.); (S.M.-A.); (A.G.-S.); (F.O.-M.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
| | - Natalia Mena-Vázquez
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Málaga, Spain; (L.C.-G.); (R.R.-R.); (S.M.-A.); (A.G.-S.); (F.O.-M.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
| | - Antonio Fernández-Nebro
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Málaga, Spain; (L.C.-G.); (R.R.-R.); (S.M.-A.); (A.G.-S.); (F.O.-M.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
- Departamento de Medicina, Universidad de Málaga, 29010 Málaga, Spain
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Hamidi L. Decreasing Pressure Injuries on an Adult Inpatient Unit through Implementation of a Nutrition Assessment and Management Process. Adv Skin Wound Care 2023; 36:1-5. [PMID: 37471453 DOI: 10.1097/asw.0000000000000004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
OBJECTIVE To lower the rate of hospital-acquired pressure injuries (HAPIs) by identifying at-risk patients based on the Braden Scale score, evaluating nutrition using a Mini Nutrition Assessment (MNA) tool, and implementing nutrition improvement measures. METHODS There were three steps in this intervention. First, patients with a Braden Scale score of 18 or lower were identified as being at risk for HAPI. Next, the MNA screening tool was implemented to identify nutrition deficiencies. The MNA screening tool can predict malnutrition, HAPI development, and/or additional complications. It is validated, cost-effective, and easy to administer to patients who are hospitalized with HAPI complications. In the final step, the author implemented a multicomponent nutrition intervention to improve the nutrition status of patients at risk for developing HAPI. RESULTS Included patients (N = 205) were hospitalized in the intermediate ICU, had a Braden Scale score of 18 or lower, and had poor nutrition status. There was a 74% decrease in HAPI rate following the MNA nutrition screening and management, with HAPI incidence decreasing from 1.9% preintervention to 0.5% postintervention. CONCLUSIONS Categorizing patients who are at risk for developing HAPI, assessing for nutrition deficiency, and then implementing a multicomponent nutrition intervention considerably reduced the rate of HAPIs per number of patients admitted to the unit.
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Affiliation(s)
- Lida Hamidi
- Lida Hamidi, DNP, BSN, RN, PCCN, is Doctor of Nursing Practitioner, College of Nursing, Medical University of South Carolina, Charleston, USA. Acknowledgment : This manuscript was completed as a requirement for the Doctorate of Nursing Practice degree from the College of Nursing, Medical University of South Carolina. The project described and the article was completed with the assistance of Drs Martha Sylvia, Michelle Mollica, and Emily Johnson at the Medical University of South Carolina, and Drs Marsha Lee and John Knauff at Lexington Medical Center. The author has disclosed no financial relationships related to this article. Submitted July 29, 2022; accepted in revised form November 18, 2022
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20
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Berk T, Thalmann M, Jensen KO, Schwarzenberg P, Jukema GN, Pape HC, Halvachizadeh S. Implementation of a novel nursing assessment tool in geriatric trauma patients with proximal femur fractures. PLoS One 2023; 18:e0284320. [PMID: 37294793 PMCID: PMC10256203 DOI: 10.1371/journal.pone.0284320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 03/29/2023] [Indexed: 06/11/2023] Open
Abstract
BACKGROUND Geriatric trauma patients represent a special challenge in postoperative care and are prone to specific complications. The goal of this study was to analyse the predictive potential of a novel nursing assessment tool, the outcome-oriented nursing assessment for acute care (ePA-AC), in geriatric trauma patients with proximal femur fractures (PFF). METHODS A retrospective cohort study of geriatric trauma patients aged ≥ 70 years with PFF was conducted at a level 1 trauma centre. The ePA-AC is a routinely used tool that evaluates pneumonia; confusion, delirium and dementia (CDD); decubitus (Braden Score); the risk of falls; the Fried Frailty index (FFI); and nutrition. Assessment of the novel tool included analysis of its ability to predict complications including delirium, pneumonia and decubitus. RESULTS The novel ePA-AC tool was investigated in 71 geriatric trauma patients. In total, 49 patients (67.7%) developed at least one complication. The most common complication was delirium (n = 22, 44.9%). The group with complications (Group C) had a significantly higher FFI compared with the group without complications (Group NC) (1.7 ± 0.5 vs 1.2 ± 0.4, p = 0.002). Group C had a significantly higher risk score for malnutrition compared with Group NC (6.3 ± 3.4 vs 3.9 ± 2.8, p = 0.004). A higher FFI score increased the risk of developing complications (odds ratio [OR] 9.8, 95% confidence interval [CI] 2.0 to 47.7, p = 0.005). A higher CDD score increased the risk of developing delirium (OR 9.3, 95% CI 2.9 to 29.4, p < 0.001). CONCLUSION The FFI, CDD, and nutritional assessment tools are associated with the development of complications in geriatric trauma patients with PFF. These tools can support the identification of geriatric patients at risk and might guide individualised treatment strategies and preventive measures.
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Affiliation(s)
- Till Berk
- Department of Trauma, University Hospital Zurich, Zurich, Switzerland
- Harald-Tscherne Laboratory for Orthopedic and Trauma Research, University of Zurich, Zurich, Switzerland
| | - Marion Thalmann
- Harald-Tscherne Laboratory for Orthopedic and Trauma Research, University of Zurich, Zurich, Switzerland
| | - Kai Oliver Jensen
- Department of Trauma, University Hospital Zurich, Zurich, Switzerland
| | | | | | - Hans-Christoph Pape
- Department of Trauma, University Hospital Zurich, Zurich, Switzerland
- Harald-Tscherne Laboratory for Orthopedic and Trauma Research, University of Zurich, Zurich, Switzerland
| | - Sascha Halvachizadeh
- Department of Trauma, University Hospital Zurich, Zurich, Switzerland
- Harald-Tscherne Laboratory for Orthopedic and Trauma Research, University of Zurich, Zurich, Switzerland
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Bres E, Bouvier J, Courtay A, Delaire L, Humblot J, Cuerq C, Tripoz-Dit-Masson S, Fauvernier M, Gilbert T, Bonnefoy M. FGF19 and muscle architecture in older patients. Exp Gerontol 2023; 174:112120. [PMID: 36764368 DOI: 10.1016/j.exger.2023.112120] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/20/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Sarcopenia has a significant medical and economic impact. Serum fibroblast growth factor 19 (FGF19) has recently been described as promoting muscle mass and strength, and could be an interesting marker for early diagnosis of sarcopenia and prevention of its consequences. Ultrasound is a robust non-invasive technique used to measure muscle parameters, which cannot be evaluated by usual body composition measures, but are known to be associated with muscle function. In this cross-sectional cohort study, we aimed to determine whether FGF19 levels were correlated with functional muscle tests and muscle ultrasound parameters. METHODS Patients over 70 years old with a mobility disability risk were recruited from the cohort of the "well on your feet" mobility loss prevention program. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older Patients 2 (EWGSOP2) criteria. We have performed functional battery tests, muscle ultrasound measures and bioimpedance spectroscopy. FGF19 levels were measured by the ELISA method. RESULTS Out of 52 patients involved (34 women, mean age 81.3 years), 30 patients were sarcopenic (15 patients with probable sarcopenia and 15 with certain sarcopenia). Sarcopenic patients were older (mean 82.8 versus 79.6 years, P = 0.033), with higher frailty Fried score (P = 0.006), lower IADL score (P = 0.008), had lower daily protein intakes (P = 0.023) and were less performant to muscle functional tests than non-sarcopenic patients. Serum FGF19 levels were negatively correlated with the SPPB score (rs = 0.28; P = 0.045). FGF19 levels were correlated positively with the pennation angle (rs = 0.31; P = 0.024), but negatively with muscle fiber length (rs = -0.44; P = 0.001). We found no association between FGF19 and muscle thickness (P = 0.243). CONCLUSION We highlighted in older patients significant correlations between FGF19 levels, pennation angle and muscle fiber length, suggesting that FGF19 could provide an enabling environment for the development of large muscle fibers, as previously suggested in histological studies in mice. However, high FGF-19 levels were unexpectedly associated with a low SPPB score. Further studies are needed to validate and further elucidate these exploratory findings.
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Affiliation(s)
- Emilie Bres
- Department of Gerontology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France.
| | - Julia Bouvier
- Department of Gerontology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | - Aymeric Courtay
- Department of Gerontology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | - Léo Delaire
- Department of Gerontology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | - Joannes Humblot
- Department of Gerontology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | - Charlotte Cuerq
- Department of Biochemistry, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | | | - Mathieu Fauvernier
- Department of Biostatistics, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, Cedex F-69495, France
| | - Thomas Gilbert
- Department of Gerontology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; Research on Healthcare professionals and Performance (RESHAPE, Inserm U1290), Université Claude Bernard Lyon1, Lyon, France
| | - Marc Bonnefoy
- Department of Gerontology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; CarMeN Laboratory, INSERM U1060, INRA 1397, Université Claude Bernard Lyon 1, INSA Lyon, Oullins, France
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Domaszewski P, Konieczny M, Dybek T, Łukaniszyn-Domaszewska K, Anton S, Sadowska-Krępa E, Skorupska E. Comparison of the effects of six-week time-restricted eating on weight loss, body composition, and visceral fat in overweight older men and women. Exp Gerontol 2023; 174:112116. [PMID: 36739795 DOI: 10.1016/j.exger.2023.112116] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/26/2023] [Accepted: 02/02/2023] [Indexed: 02/05/2023]
Abstract
The aim of this study was to determine the effectiveness of a six-week time-restricted eating (TRE) intervention in reducing body weight, fat loss, and visceral fat in overweight, older adult men and women (age range = 65-74 years). Another objective was to determine the feasibility of widespread use of TRE in older women and men. The study randomly assigned 116 healthy, non-smoking participants to one of two conditions: TRE or educational control participants. Participants in the TRE group were instructed to not consume calorie containing beverages or food for 16 h per day, from 8:00 pm to 12:00 pm. Participants in the control group were instructed to follow a meal plan based on their previous habits. The changes in body weight and body composition were determined using a SECA mBCA 515 analyzer. The six-week TRE intervention resulted in a significant decrease in body weight in both men and women (-1.8 kg and-1.3 kg, respectively; p = 0.03). In men, a significant decrease in visceral fat mass (-0.54 l; p ≤ 0.001) and waist circumference (-2.9 cm; p ≤ 0.015) was observed. No significant changes in either visceral fat or waist circumference were observed in women. Additionally, no change in skeletal muscle mass was observed in either the control or TRE group. More than 99 % of female and 98 % of male participants were able to adhere to the prescribed time-restricted eating (16/8) plan, suggesting that this dietary approach could have beneficial effects on the body composition of overweight older men and may also reduce body weight in overweight, older women.
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Affiliation(s)
- Przemysław Domaszewski
- Department of Health Sciences, Institute of Health Sciences, University of Opole, Opole, Poland.
| | - Mariusz Konieczny
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
| | - Tomasz Dybek
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
| | | | - Stephen Anton
- Department of Aging and Geriatric Research, Institute on Aging, University of Florida, Gainesville, USA
| | - Ewa Sadowska-Krępa
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Elżbieta Skorupska
- Department of Physiotherapy, Poznan University of Medical Sciences, Poznan, Poland
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Kim H, Park SG. Effect of a Single Multi-Vitamin and Mineral Supplement on Nutritional Intake in Korean Elderly: Korean National Health and Nutrition Examination Survey 2018-2020. Nutrients 2023; 15:nu15071561. [PMID: 37049402 PMCID: PMC10097026 DOI: 10.3390/nu15071561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 04/14/2023] Open
Abstract
Inadequate nutritional intake is common, especially among elderly individuals. Although micronutrient intake may help fill nutritional gaps, the effects of multi-vitamin and mineral supplements (MVMS) among the Korean elderly are not well known. Therefore, we investigated the nutrition-improving effects of a single MVMS. A total of 2478 people aged ≥65 years who participated in the Korea National Health and Nutrition Survey 2018-2020 were analyzed. Nutrient intake from food and supplements was measured using the 24 h recall method. We compared the nutritional intake and insufficiency between the food-only group (n = 2170) and the food and MVMS group (n = 308). We also evaluated the differences in inadequate nutritional intake after taking MVMS with food. The analysis included vitamins A and C, thiamine, riboflavin, niacin, calcium, iron, and phosphorus. The proportion of insufficient intake ranged from 6.2% to 80.5% for men and from 21.2% to 82.4% for women, depending on the nutrients. Intake of MVMS with food was associated with lower rates of inadequacy (3.8-68.5% for men and 3.3-75.5% for women) compared to the food-only group. The results suggest that micronutrient deficiency frequently occurs in the Korean elderly population and can be improved by MVMS intake.
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Affiliation(s)
- Hyoeun Kim
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan 48108, Republic of Korea
| | - Seung Guk Park
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan 48108, Republic of Korea
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24
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Scarcella M, Scarpellini E, Piergallini S, Rinninella E, Routhiaux K, Rasetti C, Abenavoli L, De Robertis E, Manzi P, Commissari R, Monti R, Zanetti M. Effect of Immuno-Nutrition on Malnutrition, Inflammatory Response and Clinical Course of Semi-Critically Ill COVID-19 Patients: A Pilot Perspective Study. Nutrients 2023; 15:nu15051250. [PMID: 36904249 PMCID: PMC10004815 DOI: 10.3390/nu15051250] [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: 01/23/2023] [Revised: 02/27/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND The SARS-COV 2 pandemic has hit on our lives since early 2020. During different contagion waves, both malnutrition and overweight significantly correlated with patient mortality. Immune-nutrition (IN) has shown promising results in the clinical course of pediatric inflammatory bowel disease (IBD) and in both the rate of extubation and mortality of patients admitted to an intensive care unit (ICU). Thus, we wanted to assess the effects of IN on a clinical course of patients admitted to a semi-intensive COVID-19 Unit during the fourth wave of contagion that occurred at the end of 2021. METHODS we prospectively enrolled patients admitted to the semi-intensive COVID-19 Unit of San Benedetto General hospital. All patients had a biochemical, anthropometric, high-resolution tomography chest scan (HRCT) and complete nutritional assessments at the time of admission, after oral administration of immune-nutrition (IN) formula, and at 15 days interval follow-up. RESULTS we enrolled 34 consecutive patients (age 70.3 ± 5.4 years, 6 F, BMI 27.0 ± 0.5 kg/m2). Main comorbidities were diabetes (20%, type 2 90 %), hyperuricemia (15%), hypertension (38%), chronic ischemic heart disease (8 %), COPD (8%), anxiety syndrome (5%), and depression (5%). 58% of patients were affected as moderately-to-severely overweight; mini nutritional assessment (MNA) score (4.8 ± 0.7) and phase angle (PA) values (3.8 ± 0.5) suggestive of malnutrition were present in 15% of patients, mainly with a history of cancer. After 15 days upon admission, we recorded 3 deaths (mean age 75.7 ± 5.1 years, BMI 26.3 ± 0.7 kg/m2) and 4 patients were admitted to the ICU. Following IN formula administration, inflammatory markers significantly decreased (p < 0.05) while BMI and PA did not worsen. These latter findings were not observed in a historical control group that did not receive IN. Only one patient needed protein-rich formula administration. CONCLUSIONS in this overweight COVID-19 population immune-nutrition prevented malnutrition development with a significant decrease of inflammatory markers.
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Affiliation(s)
- Marialaura Scarcella
- Anesthesia, Intensive Care and Nutritional Science—Azienda Ospedaliera “Santa Maria”, Via Tristano di Joannuccio, 05100 Terni, Italy
| | - Emidio Scarpellini
- Clinical Nutrition Unit and Internal Medicine Unit, “Madonna del Soccorso” General Hospital, Via Luciano Manara 7, 63074 San Benedetto del Tronto, Italy
- Translational Research Center for Gastrointestinal Disease (T.A.R.G.I.D.), Gasthuisberg University Hospital, KULeuven, Herestraat 49, 3000 Lueven, Belgium
| | - Sara Piergallini
- Clinical Nutrition Unit and Internal Medicine Unit, “Madonna del Soccorso” General Hospital, Via Luciano Manara 7, 63074 San Benedetto del Tronto, Italy
- School of Nursing, Politechnics University of Marche, 60121 Ancona, Italy
| | - Emanuele Rinninella
- Department of Translational Medicine and Surgery, Clinical Nutrition Unit, Catholic University of Sacred Heart, Gemelli Foundation, 00168 Rome, Italy
| | - Karen Routhiaux
- Translational Research Center for Gastrointestinal Disease (T.A.R.G.I.D.), Gasthuisberg University Hospital, KULeuven, Herestraat 49, 3000 Lueven, Belgium
| | - Carlo Rasetti
- Clinical Nutrition Unit and Internal Medicine Unit, “Madonna del Soccorso” General Hospital, Via Luciano Manara 7, 63074 San Benedetto del Tronto, Italy
| | - Ludovico Abenavoli
- Department of Health Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Edoardo De Robertis
- Division of Anaesthesia, Analgesia, and Intensive Care - Department of Medicine and Surgery-University of Perugia, 06121 Perugia, Italy
| | - Pietro Manzi
- Azienda Ospedaliera Santa Maria di Terni, 05100 Terni, Italy
| | - Rita Commissari
- Anesthesia and Intensive Care Azienda Ospedaliera Santa Maria Terni, 05100 Terni, Italy
| | - Riccardo Monti
- Cardiologic and Pediatric Intensive Care Unit, 05100 Terni, Italy
| | - Michela Zanetti
- Department of Medical and Surgical Sciences, Azienda Sanitaria Universitaria “Giuliano-Isontina”, Trieste University, 34148 Trieste, Italy
- Correspondence:
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25
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Powell-Brett S, Hodson J, Pande R, Mann S, Freer A, Wyrko Z, Hughes C, Isaac J, Sutcliffe RP, Roberts K. Are physical performance and frailty assessments useful in targeting and improving access to adjuvant therapy in patients undergoing resection for pancreatic cancer? Langenbecks Arch Surg 2023; 408:88. [PMID: 36787026 PMCID: PMC9928938 DOI: 10.1007/s00423-023-02828-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 02/02/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND Many patients fail to receive adjuvant chemotherapy following pancreatic cancer surgery. This study implemented a multimodal, multidisciplinary approach to improving recovery after pancreatoduodenectomy (the 'Fast Recovery' programme) and measured its impact on adjuvant chemotherapy uptake and nutritional decline. The predictive accuracies of a bundle of frailty and physical performance assessments, with respect to the recipient of adjuvant chemotherapy, were also evaluated. RESULTS The N = 44 patients treated after the introduction of the 'Fast Recovery' programme were not found to have a significantly higher adjuvant chemotherapy uptake than the N = 409 treated before the pathway change (80.5 vs. 74.3%, p = 0.452), but did have a significantly lower average weight loss at six weeks post-operatively (mean: 4.3 vs. 6.9 kg, p = 0.013). Of the pre-operative frailty and physical performance assessments tested, the 6-min walk test was found to be the strongest predictor of the receipt of adjuvant chemotherapy (area under the ROC curve: 0.91, p = 0.001); all patients achieving distances ≥ 360 m went on to receive adjuvant chemotherapy, compared to 33% of those walking < 360 m. CONCLUSIONS The multimodal 'Fast Recovery' programme was not found to significantly improve access to adjuvant chemotherapy, but did appear to have benefits in reducing nutritional decline. Pre-operative assessments were found to be useful in identifying patients at risk of non-receipt of adjuvant therapies, with markers of physical performance appearing to be the best predictors. As such, these markers could be useful in targeting pre- and post-habilitation measures, such as physiotherapy and improved dietetic support.
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Affiliation(s)
- S Powell-Brett
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Queen Elizabeth Hospital, Birmingham, B15 2TH, Birmingham, UK.
| | - J Hodson
- Research Development and Innovation, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - R Pande
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Queen Elizabeth Hospital, Birmingham, B15 2TH, Birmingham, UK
| | - S Mann
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Queen Elizabeth Hospital, Birmingham, B15 2TH, Birmingham, UK
| | - Alice Freer
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Queen Elizabeth Hospital, Birmingham, B15 2TH, Birmingham, UK
| | - Zoe Wyrko
- Department of Geriatric Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Clare Hughes
- Department of Geriatric Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - J Isaac
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Queen Elizabeth Hospital, Birmingham, B15 2TH, Birmingham, UK
| | - R P Sutcliffe
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Queen Elizabeth Hospital, Birmingham, B15 2TH, Birmingham, UK
| | - K Roberts
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Queen Elizabeth Hospital, Birmingham, B15 2TH, Birmingham, UK
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
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Okoye C, Arosio B, Carino S, Putrino L, Franchi R, Rogani S, Cesari M, Mari D, Vitale G, Malara A, Calsolaro V, Monzani F. The Free Triiodothyronine/Free Thyroxine Ratio Is Associated with Frailty in Older Adults: A Longitudinal Multisetting Study. Thyroid 2023; 33:169-176. [PMID: 36641642 DOI: 10.1089/thy.2022.0422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background: Various models have been proposed to predict frailty, including those based on clinical criteria and phenotypes. However, a simple biomarker associated with frailty has been not yet identified. The aim of this study is to evaluate the relationship between free triiodothyronine (fT3)/free thyroxine (fT4) ratio value and the degree of frailty among three different cohorts of older individuals: (1) acutely ill hospitalized patients, (2) nursing-home (NH) residents, and (3) home-dwelling centenarians. Methods: We performed a secondary analysis of de-identified patient-level data from two prospective observational studies on acutely hospitalized older patients (Geriatric Acute Unit [GAU]), and home-dwelling centenarians (CENT), and a retrospective-prospective observational study on older NH residents. Demographic characteristics, along with a 30-items Frailty Index (FI) and serum thyrotropin, fT3 and fT4 measurements were obtained. Results: Six hundred fifteen individuals (aged 86.4 ± 8.9 years; 55.1% females) were included in the study, including 298 (48.5%) GAU, 250 (40.6%) NH, and 67 (10.9%) CENT. A significant inverse relationship between fT3/fT4 ratio and FI values was observed (ρs = -0.17 [confidence interval; CI: -0.092 to 0.252], p < 0.001), and this was confirmed by logistic multivariate analysis (β = -0.44, odds ratio [OR]: 0.64 [CI: 0.47-0.87], p < 0.001) (after adjustment for age, sex, and cohorts). Moreover, a progressively decreased mortality risk was associated with rising fT3/fT4 ratio (OR 0.60 [CI: 0.44-0.80] β = -0.51, p < 0.001]. Conclusions: The fT3/fT4 ratio value was inversely correlated with frailty degree and mortality risk in a large cohort of older individuals, including centenarians, regardless of their sex and clinical condition. fT3/fT4 ratio value could represent an easily measured independent biochemical marker of frailty degree in older people.
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Affiliation(s)
- Chukwuma Okoye
- Geriatrics Unit, Department of Clinical and Experimental Medicine, Interdepartmental Research Centre on Biology and Pathology of Aging, University of Pisa, Pisa, Italy
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - Beatrice Arosio
- Geriatrics Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | | | - Riccardo Franchi
- Geriatrics Unit, Department of Clinical and Experimental Medicine, Interdepartmental Research Centre on Biology and Pathology of Aging, University of Pisa, Pisa, Italy
| | - Sara Rogani
- Geriatrics Unit, Department of Clinical and Experimental Medicine, Interdepartmental Research Centre on Biology and Pathology of Aging, University of Pisa, Pisa, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Daniela Mari
- Laboratory of Geriatric and Oncologic Neuroendocrinology Research, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Giovanni Vitale
- Laboratory of Geriatric and Oncologic Neuroendocrinology Research, Istituto Auxologico Italiano, IRCCS, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine (BIOMETRA), University of Milan, Milan, Italy
| | | | - Valeria Calsolaro
- Geriatrics Unit, Department of Clinical and Experimental Medicine, Interdepartmental Research Centre on Biology and Pathology of Aging, University of Pisa, Pisa, Italy
| | - Fabio Monzani
- Geriatrics Unit, Department of Clinical and Experimental Medicine, Interdepartmental Research Centre on Biology and Pathology of Aging, University of Pisa, Pisa, Italy
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Shuremu M, Belachew T, Hassen K. Nutritional status and its associated factors among elderly people in Ilu Aba Bor Zone, Southwest Ethiopia: a community-based cross-sectional study. BMJ Open 2023; 13:e067787. [PMID: 36720579 PMCID: PMC9890780 DOI: 10.1136/bmjopen-2022-067787] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES This study aimed to assess the nutritional status and its associated factors among elderly people. DESIGN A community-based cross-sectional study. SETTING The study was conducted in urban and semiurban areas. PARTICIPANTS The study included 620 elderly community dwellers in Southwest Ethiopia from 3 October 2021 to 10 November 2021. Those who were seriously ill, could not get around or were on special diets were excluded from the study. OUTCOME MEASURE The Mini Nutritional Assessment was used to evaluate nutritional status and the STEPwise approach was used to collect data on backgrounds and lifestyle. SPSS V.22.0 was used for data analysis. Logistic regression was computed. The level of significance was set at 0.05. RESULTS Elderly people who were malnourished or at risk of malnutrition were found to make up 48.1% (44.1%) and 17.4% (14.5%) of the population, respectively. Those aged 80 years and older had a chance of being at risk of malnutrition (adjusted OR (AOR)=22.555; 95% CI: 7.963 to 63.881), while the odds of being malnourished were 11.5 times higher (AOR=11.755; 95% CI: 4.825 to 28.638). Informal education was a significant predictor of being at risk of malnutrition (AOR=6.102; 95% CI: 2.684 to 13.871). Urban dwellers were 8.9 times more likely to be malnourished. Inadequate financial resources make people 3.7 times more likely to be malnourished. A lower wealth index was a significant predictor of being at risk of malnutrition (AOR=4.156; 95% CI: 1.361 to 12.692). Single elderly people had a 3.4-fold higher risk of malnutrition. Elderly people with chronic pain, who were smokers and alcoholics, and who had depression were all at risk of nutritional problems. CONCLUSION The risk of malnutrition and malnourishment was high. Age, urbanisation, finances, education, economics, being a woman, smoking and alcohol are associated factors. Interventional studies are warranted to minimise malnutrition challenges in the study population.
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Affiliation(s)
- Muluneh Shuremu
- Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
- Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Nutrition and Dietetics, Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
| | - Kalkidan Hassen
- Nutrition and Dietetics, Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
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Kim I, Lim JY, Kim JK, Lee JH, Sohn TS, Park S, Kang SH, Lee JY, Hwang JH. Effectiveness of a personalized digital exercise and nutrition-based rehab program for patients with gastric cancer after surgery: Study protocol for a randomized controlled trial. Digit Health 2023; 9:20552076231187602. [PMID: 37485329 PMCID: PMC10357057 DOI: 10.1177/20552076231187602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/23/2023] [Indexed: 07/25/2023] Open
Abstract
Background Patients with gastric cancer often encounter impaired quality of life and reduced tolerability to adjuvant treatments after surgery. Weight preservation is crucial for the overall prognosis of these patients, and exercise and supplemental nutrition play the main role. This study is the first randomized clinical trial to apply personalized, treatment stage-adjusted digital intervention with wearable devices in gastric cancer rehabilitation intervention for 12 months, commencing immediately after surgery. Methods This is a prospective, multicenter, two-armed, randomized controlled trial and aims to recruit 324 patients from two hospitals. Patients will be randomly allocated to two groups for 1 year of rehabilitation, starting immediately after the operation: a personalized digital therapeutic (intervention) group and a conventional education-based rehabilitation (control) group. The primary objective is to clarify the effect of mobile applications and wearable smart bands in reducing weight loss in patients with gastric cancer. The secondary outcomes are quality of life measured by the EORTC-QLQ-C30 and STO22; nutritional status by mini nutrition assessment; physical fitness level measured by grip strength test, 30-s chair stand test and 2-min walk test; physical activity measured by IPAQ-SF; pain intensity; skeletal muscle mass; and fat mass. These measurements will be performed on enrollment and at 1, 3, 6, and 12 months thereafter. Conclusions Digital therapeutic programs include exercise and nutritional interventions modified by age, body mass index, surgery type and postoperative days. Thus, expert intervention is pivotal for precise and safe calibration of this program. Trial registration Clinicaltrials.gov identifier: NCT04907591 (registration date: June 11, 2020; https://clinicaltrials.gov/ct2/show/NCT04907591).
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Affiliation(s)
- Inah Kim
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji Young Lim
- Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | | | - Jun Ho Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Tae Sung Sohn
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sungsoo Park
- Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seok Ho Kang
- Department of Urology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Ji Youl Lee
- Department of Urology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ji Hye Hwang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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29
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Lu L, He X, Song Y, Zhuang M, Wu X, Chen N. Prevalence and risk factors of sarcopenia without obesity and sarcopenic obesity among Chinese community older people in suburban area of Shanghai: A cross-sectional study. Front Aging Neurosci 2022; 14:1034542. [PMID: 36605360 PMCID: PMC9807613 DOI: 10.3389/fnagi.2022.1034542] [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: 09/01/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives The aim of the present study was to explore the prevalence and risk factors of sarcopenia without obesity (S) and sarcopenic obesity (SO) among community-dwelling older people in the Chongming District of Shanghai, China, according to the Asian Working Group for Sarcopenia (AWGS) 2019 Consensus as the diagnostic criteria of sarcopenia. Methods In this cross-sectional study, a total of 1,407 subjects aged ≥65 years were included, where the mean age of the subjects was 71.91 ± 5.59 years and their mean body mass index (BMI) was 24.65 ± 3.32 kg/m2. According to the Asian Working Group for Sarcopenia (AWGS) 2019 Consensus, sarcopenia was defined as a low appendicular skeletal muscle mass index (≤7.0 kg/m2 in males and ≤5.7 kg/m2 in females), decreased handgrip strength (<28.0 kg in males and <18.0 kg in females), and/or low gait speed (<1.0 m/s) or poor 5-time chair stand test (5CST) (≥12s). The SO met both the diagnostic criteria for sarcopenia and obesity, meanwhile obesity was defined as an increased percentage of body fat (PBF) (≥25% in males and ≥35% in females). Univariate and multiple logistic regression analyses were performed to explore the risk factors of both S and SO. Results The prevalence of S and SO was 9.74% (M: 9.29%, F: 10.05%) and 9.95% (M: 13.94%, F: 7.14%). Lower BMI (OR = 0.136, 95% CI: 0.054-0.340, p < 0.001), lower hip circumference (OR = 0.858, 95% CI: 0.816-0.903, p < 0.001), farming (OR = 1.632, 95% CI: 1.053-2.530, p = 0.028), higher high-density lipoprotein cholesterol (HDL-C) level (OR = 2.235, 95% CI: 1.484-3.367, p < 0.001), and a sleep duration <7 h (OR = 0.561, 95% CI: 0.346-0.909, p = 0.019) were risk factors for S. While aging (70-74 y, OR = 1.923, 95% CI: 1.122-3.295, p = 0.017; 75-79 y, OR = 3.185, 95% CI: 1.816-5.585, p < 0.001; ≥80 y, OR = 7.192, 95% CI: 4.133-12.513, p < 0.001), male (OR = 1.981, 95% CI: 1.351-2.904, p < 0.001), higher BMI (OR = 4.865, 95% CI: 1.089-21.736, p = 0.038), higher monocyte level (OR = 4.203, 95% CI: 1.340-13.181, p = 0.014), and a sleep duration >9 h (OR = 1.881, 95% CI: 1.117-3.166, p = 0.017) were risk factors for SO. Conclusion Our study showed the high prevalence of S and SO among community-dwelling older people in the Chongming District. The SO was more prevalent in males. Behavioral factors and lifestyle (such as farming and sleep duration) were associated more with the development of S, while age and male gender were associated more with the development of SO.
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Affiliation(s)
- Linqian Lu
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China,Department of Rehabilitation, Xinhua Hospital Chongming Branch, Shanghai, China,School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Xiangfeng He
- Department of Rehabilitation, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Yanping Song
- Department of Rehabilitation, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Min Zhuang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Xie Wu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China,*Correspondence: Xie Wu ✉
| | - Nan Chen
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China,Department of Rehabilitation, Xinhua Hospital Chongming Branch, Shanghai, China,School of Kinesiology, Shanghai University of Sport, Shanghai, China,Nan Chen ✉
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30
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Swan L, Martin N, Horgan NF, Warters A, O’Sullivan M. Assessing Sarcopenia, Frailty, and Malnutrition in Community-Dwelling Dependant Older Adults-An Exploratory Home-Based Study of an Underserved Group in Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16133. [PMID: 36498213 PMCID: PMC9736424 DOI: 10.3390/ijerph192316133] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Adults of advanced age, with functional dependency, socioeconomic disadvantage, or a need for home care, are expected to be at high risk of sarcopenia, frailty and malnutrition, yet are likely to be underrepresented in research. We aimed to explore the assessment of sarcopenia, frailty, and malnutrition in-home, and to describe the practicality of performing these assessments. METHODS Home-based health assessments and post-study feedback surveys were conducted among community-dwelling older adults ≥65 years in receipt of state-funded home care (n = 31). Assessments included probable sarcopenia [hand-grip strength (HGS), chair rise-test, and SARC-F case-finding tool], the Mini Nutritional Assessment (MNA), and the Clinical Frailty Scale (CFS). RESULTS The study group was of mean age 83.2 ± 8.2 years, 74% were female and 23% lived in socioeconomically disadvantaged areas. Almost all met the criteria for probable sarcopenia (94%, n = 29/31), were frail or vulnerable by the CFS (97%, n = 30/31), and over a quarter were at risk of malnutrition (26%, n = 8). Participants had low physical activity (71.0%, n = 22/31), with a mean daytime average of 11.4 ± 1.6 h spent sitting. It was possible to assess probable sarcopenia (by HGS and SARC-F, but not the chair rise test), malnutrition (MNA), and frailty (CFS). Home-based research was a complex environment, and unearthed significant unmet need, prompting referrals to health services (36%, n = 11), in addition to technology assistance. The majority of participants (93%) reported a willingness to partake in future research. CONCLUSIONS Most community-dwelling older people in receipt of home support, assessed in this exploratory study, were at risk of probable sarcopenia, frailty, and low physical activity, with over a quarter were at risk of malnutrition. Our initial findings provide practical data for large scale studies and may inform the development of intervention studies aiming to support ageing in place.
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Affiliation(s)
- Lauren Swan
- Department of Clinical Medicine, Trinity College, D02 PN40 Dublin, Ireland
| | - Niamh Martin
- Older Person Services CHO9, Health Service Executive (HSE), D09 C8P5 Dublin, Ireland
| | - N Frances Horgan
- School of Physiotherapy, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, D02 YN77 Dublin, Ireland
| | - Austin Warters
- Older Person Services CHO9, Health Service Executive (HSE), D09 C8P5 Dublin, Ireland
| | - Maria O’Sullivan
- Department of Clinical Medicine, Trinity College, D02 PN40 Dublin, Ireland
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De Luca V, Femminella GD, Patalano R, Formosa V, Lorusso G, Rivetta C, Di Lullo F, Mercurio L, Rea T, Salvatore E, Korkmaz Yaylagul N, Apostolo J, Silva RC, Dantas C, van Staalduinen WH, Liotta G, Iaccarino G, Triassi M, Illario M. Assessment Tools of Biopsychosocial Frailty Dimensions in Community-Dwelling Older Adults: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16050. [PMID: 36498125 PMCID: PMC9739796 DOI: 10.3390/ijerph192316050] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/21/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
Frailty is a complex interplay between several factors, including physiological changes in ageing, multimorbidities, malnutrition, living environment, genetics, and lifestyle. Early screening for frailty risk factors in community-dwelling older people allows for preventive interventions on the clinical and social determinants of frailty, which allows adverse events to be avoided. By conducting a narrative review of the literature employing the International Narrative Systematic Assessment tool, the authors aimed to develop an updated framework for the main measurement tools to assess frailty risks in older adults, paying attention to use in the community and primary care settings. This search focused on the biopsychosocial domains of frailty that are covered in the SUNFRAIL tool. The study selected 178 reviews (polypharmacy: 20; nutrition: 13; physical activity: 74; medical visits: 0; falls: 39; cognitive decline: 12; loneliness: 15; social support: 5; economic constraints: 0) published between January 2010 and December 2021. Within the selected reviews, 123 assessment tools were identified (polypharmacy: 15; nutrition: 15; physical activity: 25; medical visits: 0; falls: 26; cognitive decline: 18; loneliness: 9; social support: 15; economic constraints: 0). The narrative review allowed us to evaluate assessment tools of frailty domains to be adopted for multidimensional health promotion and prevention interventions in community and primary care.
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Affiliation(s)
- Vincenzo De Luca
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Grazia Daniela Femminella
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Roberta Patalano
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Valeria Formosa
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Grazia Lorusso
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Cristiano Rivetta
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Federica Di Lullo
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Lorenzo Mercurio
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Teresa Rea
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Elena Salvatore
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | | | - Joao Apostolo
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Avenida Bissaya Barreto, 3004-011 Coimbra, Portugal
| | - Rosa Carla Silva
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Avenida Bissaya Barreto, 3004-011 Coimbra, Portugal
| | | | | | - Giuseppe Liotta
- Dipartimento di Biomedicina e Prevenzione, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Guido Iaccarino
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Maria Triassi
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Maddalena Illario
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
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The Implementation of a Geriatrics Co-Management Model of Care Reduces Hospital Length of Stay. Healthcare (Basel) 2022; 10:healthcare10112160. [DOI: 10.3390/healthcare10112160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/10/2022] [Accepted: 10/27/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Older adults comprise a large proportion of hospitalized patients. Many are frail and require complex care. Geriatrics has developed models of care specific to this inpatient population. Our objective was to demonstrate the effect of a geriatric co-management team on clinical administrative indicators of care in Clinical Teaching Units (CTUs) that have adopted the Age-friendly Hospital (AFH) principles in Brazilian hospitals. (2) Methods: Following 3 months of implementation of the AFH principles in CTUs, two periods of the same 6 months of two consecutive years were compared. (3) Results: The total number of participants in the study was 641 and 743 in 2015 and 2016, respectively. Average length of patient-stay (length of stay: 8.7 ± 2.7 vs. 5.4 ± 1.7 days) and number of monthly complaints (44.2 ± 6.5 vs. 13.5 ± 2.2) were significantly lower with the co-management model. Number of homecare service referrals/month was also significantly higher (2.5 ± 1 vs. 38.3 ± 6.3). The 30-day readmission rates and total hospital costs per patient remained unchanged. (4) Conclusion: The presence of a geriatric co-management team in CTUs is of added benefit to increase the efficiency of the AFH for vulnerable older inpatients with reduced LOS and increased referrals to homecare services without increasing hospital costs.
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Ścisło L, Bodys-Cupak I, Walewska E, Kózka M. Nutritional Status Indicators as Predictors of Postoperative Complications in the Elderly with Gastrointestinal Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13453. [PMID: 36294035 PMCID: PMC9603671 DOI: 10.3390/ijerph192013453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
In patients scheduled for surgery, nutritional disorders worsen during the perioperative period, which is often a risk factor for postoperative complications. The aim of the study was to determine relationship between the preoperative nutritional status of elderly people with stomach, pancreatic and colon cancer and the incidence of postoperative complications and the length of hospital stay. The study included 143 patients with gastrointestinal cancer, aged 65-68, qualified for surgery. Mini Nutritional Assessment, body mass index questionnaires and medical records were used. Malnutrition was found in 9.8%, and a risk of malnutrition in 53.5% of the respondents. Body mass index showed overweight in 28% and obesity in 14% of the patients. Complications occurred in all types of nutritional status, the most common were those requiring intensive care unit treatment (36.8%), pancreatic and biliary fistulas (29.4%) and surgical site infections (58.2%). Gastric cancer patients at risk of malnutrition stayed longer in the hospital. Postoperative complications and longer hospital stays were observed more frequently in cases of overweight, obesity, malnutrition and its risk. Disturbances in the nutritional status, in the form of malnutrition and its risk, as well as overweight and obesity, determined more frequent occurrence of postoperative complications and longer hospital stay.
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Affiliation(s)
- Lucyna Ścisło
- Department of Clinical Nursing, Faculty of Health Sciences, Institute of Nursing and Midwifery, Jagiellonian University Medical College, 31-501 Krakow, Poland
| | - Iwona Bodys-Cupak
- Laboratory of Theory and Fundamentals of Nursing, Faculty of Health Sciences, Institute of Nursing and Midwifery, Jagiellonian University Medical College, 31-126 Krakow, Poland
| | - Elżbieta Walewska
- Department of Clinical Nursing, Faculty of Health Sciences, Institute of Nursing and Midwifery, Jagiellonian University Medical College, 31-501 Krakow, Poland
| | - Maria Kózka
- Department of Clinical Nursing, Faculty of Health Sciences, Institute of Nursing and Midwifery, Jagiellonian University Medical College, 31-501 Krakow, Poland
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Kiani AK, Medori MC, Dhuli K, Donato K, Caruso P, Fioretti F, Perrone MA, Ceccarini MR, Manganotti P, Nodari S, Codini M, Beccari T, Bertelli M. Clinical assessment for diet prescription. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E102-E124. [PMID: 36479490 PMCID: PMC9710416 DOI: 10.15167/2421-4248/jpmh2022.63.2s3.2753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Accurate nutritional assessment based on dietary intake, physical activity, genetic makeup, and metabolites is required to prevent from developing and/or to treat people suffering from malnutrition as well as other nutrition related health issues. Nutritional screening ought to be considered as an essential part of clinical assessment for every patient on admission to healthcare setups, as well as on change in clinical conditions. Therefore, a detailed nutritional assessment must be performed every time nutritional imbalances are observed or suspected. In this review we have explored different techniques used for nutritional and physical activity assessment. Dietary Intake (DI) assessment is a multidimensional and complex process. Traditionally, dietary intake is assessed through self-report techniques, but due to limitations like biases, random errors, misestimations, and nutrient databases-linked errors, questions arise about the adequacy of self-reporting dietary intake procedures. Despite the limitations in assessing dietary intake (DI) and physical activity (PA), new methods and improved technologies such as biomarkers analysis, blood tests, genetic assessments, metabolomic analysis, DEXA (Dual-energy X-ray absorptiometry), MRI (Magnetic resonance imaging), and CT (computed tomography) scanning procedures have made much progress in the improvement of these measures. Genes also plays a crucial role in dietary intake and physical activity. Similarly, metabolites are also involved in different nutritional pathways. This is why integrating knowledge about the genetic and metabolic markers along with the latest technologies for dietary intake (DI) and physical activity (PA) assessment holds the key for accurately assessing one's nutritional status and prevent malnutrition and its related complications.
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Affiliation(s)
| | | | | | | | - Paola Caruso
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Trieste, Italy
| | - Francesco Fioretti
- Department of Cardiology, University of Brescia and ASST "Spedali Civili" Hospital, Brescia, Italy
| | | | | | - Paolo Manganotti
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Trieste, Italy
| | - Savina Nodari
- Department of Cardiology, University of Brescia and ASST "Spedali Civili" Hospital, Brescia, Italy
| | - Michela Codini
- Department of Pharmaceutical Sciences; University of Perugia, Perugia, Italy
| | - Tommaso Beccari
- Department of Pharmaceutical Sciences; University of Perugia, Perugia, Italy
| | - Matteo Bertelli
- MAGI EUREGIO, Bolzano, Italy
- MAGI'S LAB, Rovereto (TN), Italy
- MAGISNAT, Peachtree Corners (GA), USA
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Seok JW, Kwon YJ, Lee H. Feasibility and efficacy of TouchCare system using application for older adults living alone: a pilot pre-experimental study. BMC Geriatr 2022; 22:799. [PMID: 36474186 PMCID: PMC9829959 DOI: 10.1186/s12877-022-03482-w] [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: 02/08/2022] [Accepted: 09/23/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND With the number of older people living alone continuously rising, health-monitoring systems using information and communication technology (ICT) have been developed to manage their health issues. Life logging and human body communication sensor, types of ICT, have been adapted to manage and monitor health status of the elderly. However, its feasibility and efficacy remain unclear. This study aimed to examine the feasibility of TouchCare system which combined life logging with human body communication technology and its effect on the physical and psychological status of older adults living alone. METHODS The TouchCare system, which consisted of a wearable watch, touchpad sensors, TouchCare application, and context-aware artificial intelligence, was developed by DNX Co. Ltd and used by the participants for 5 months. Out of the 111 selected participants, 91 replied to the satisfaction survey, and 22 participated in further investigation regarding their physical and psychological status. Finally, health assessment from 14 participants and sensor data from 13 participants (mean age = 77.4; SD = 3.8) were analyzed to compare their health status and health-related behaviors before and after use of the system. RESULTS Out of the 91 participants who took the survey, 51.6% were satisfied with the system. Nutritional status (pre-intervention (10.6 ± 2.0) vs. post-intervention (11.8 ± 1.9), P = 0.04) and fall efficacy (pre-intervention (89.2 ± 15.3) vs. post-intervention (99.9 ± 0.5), P = 0.001) significantly improved after use of the system. Chronic pain (pre-intervention (4.8 ± 2.5) vs. post-intervention (4.4 ± 3.7), P = 0.78) and depressive symptoms (pre-intervention (5.7 ± 3.9) vs. post-intervention (5.4 ± 3.1), P = 0.60) reduced, while cognitive function (pre-intervention (4.1 ± 1.4) vs. post-intervention (4.6 ± 1.1), P = 0.15) and physical performance related to walking improved (pre-intervention (3.9 ± 0.2) vs. post-intervention (4.0 ± 0), P = 0.35), but were not significant. Behaviors related to physical activity and gait improved after use of the system; touch counts of refrigerator and microwave also increased with a decrease in night touch counts. CONCLUSIONS The TouchCare system was acceptable to older people living alone, and it efficiently managed their daily living while promoting their health-related behaviors. Further experimental studies are required to verify the effectiveness of the system, and to develop the system which meet the individualized needs of older people living alone.
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Affiliation(s)
- Jo Woon Seok
- grid.15444.300000 0004 0470 5454College of Nursing, Mo-Im Kim Research Institute, Yonsei University, 50-1, Yonsei-Ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
| | - Yu-Jin Kwon
- grid.15444.300000 0004 0470 5454Department of Family Medicine, Yonsei University College of Medicine, Yongin Severance Hospital, Yongin, Gyeonggi-do 16995 Republic of Korea
| | - Hyangkyu Lee
- grid.15444.300000 0004 0470 5454College of Nursing, Mo-Im Kim Research Institute, Yonsei University, 50-1, Yonsei-Ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
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McGRATH C, SUEN RPC, McKENNA G, MOORE C, WONG MCM. Oral Health and Successful Ageing - The PROS and dPROS: A Scoping Review. J Evid Based Dent Pract 2022; 22:101714. [DOI: 10.1016/j.jebdp.2022.101714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/23/2021] [Accepted: 01/09/2022] [Indexed: 11/24/2022]
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Chemotherapy Toxicity in Older Adults Optimized by Geriatric Assessment and Intervention: A Non-Comparative Analysis. Curr Oncol 2022; 29:6167-6176. [PMID: 36135053 PMCID: PMC9498117 DOI: 10.3390/curroncol29090484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022] Open
Abstract
The Comprehensive Geriatric Assessment (CGA) is recommended to guide treatment choices in older patients with cancer. Patients ≥ 70 years referred to our oncology service with a new cancer diagnosis are screened using the G-8. Patients with a score of ≤14 are eligible to attend the Geriatric Oncology and Liaison (GOAL) Clinic in our institution, with referral based on physician discretion. Referred patients undergo multidimensional assessments at baseline. CGA domains assessed include mobility, nutritional, cognitive, and psychological status. Chemotherapy toxicity risk is estimated using the Cancer Aging and Research Group (CARG) calculator. We undertook a retrospective analysis of patients attending the GOAL clinic over a 30-month period to April 2021. The objective was to determine rates of treatment dose modifications, delays, discontinuation, and unscheduled hospitalizations as surrogates for cytotoxic therapy toxicity in these patients. These data were collected retrospectively. Ninety-four patients received chemotherapy; the median age was 76 (70–87) and 45 were female (48%). Seventy-five (80%) had an ECOG PS of 0–1. Seventy-two (77%) had gastrointestinal cancer, and most had stage III (47%) or IV (40%) disease. Chemotherapy with curative intent was received by 51% (n = 48) and 51% received monotherapy. From the CGA, the median Timed Up and Go was 11 s (7.79–31.6), and 90% reported no falls in the prior 6 months. The median BMI was 26.93 (15.43–39.25), with 70% at risk or frankly malnourished by the Mini Nutritional Assessment. Twenty-seven (29%) patients had impaired cognitive function. Forty-three (46%) had a high risk of toxicity based on the baseline CARG toxicity calculator. Twenty-six (28%) required dose reduction, 55% (n = 52) required a dose delay, and 36% (n = 34) had a hospitalization due to toxicity. Thirty-nine patients (42%) discontinued treatment due to toxicity. Despite intensive assessment, clinical optimization and personalized treatment decisions, older adults with cancer remain at high risk of chemotherapy toxicity.
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Malnutrition Screening and Assessment. Nutrients 2022; 14:nu14122392. [PMID: 35745121 PMCID: PMC9228435 DOI: 10.3390/nu14122392] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/01/2022] [Accepted: 06/06/2022] [Indexed: 01/04/2023] Open
Abstract
Malnutrition is a serious problem with a negative impact on the quality of life and the evolution of patients, contributing to an increase in morbidity, length of hospital stay, mortality, and health spending. Early identification is fundamental to implement the necessary therapeutic actions, involving adequate nutritional support to prevent or reverse malnutrition. This review presents two complementary methods of fighting malnutrition: nutritional screening and nutritional assessment. Nutritional risk screening is conducted using simple, quick-to-perform tools, and is the first line of action in detecting at-risk patients. It should be implemented systematically and periodically on admission to hospital or residential care, as well as on an outpatient basis for patients with chronic conditions. Once patients with a nutritional risk are detected, they should undergo a more detailed nutritional assessment to identify and quantify the type and degree of malnutrition. This should include health history and clinical examination, dietary history, anthropometric measurements, evaluation of the degree of aggression determined by the disease, functional assessment, and, whenever possible, some method of measuring body composition.
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Zhao X, Wang Y, Yang Y, Pan Y, Liu J, Ge S. Association between preoperative nutritional status, inflammation, and intestinal permeability in elderly patients undergoing gastrectomy: a prospective cohort study. J Gastrointest Oncol 2022; 13:997-1006. [PMID: 35837193 DOI: 10.21037/jgo-22-367] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/27/2022] [Indexed: 11/06/2022] Open
Abstract
Background Malnutrition is relatively common among elderly patients with gastric cancer. This study sought to analyze whether preoperative nutritional status, inflammatory cytokines, and intestinal permeability were correlated in elderly gastric cancer patients undergoing surgery, and their effects on postoperative recovery. Methods This study was a single-center prospective cohort study. Patients aged 65-90 years who underwent gastrectomy were included. Preoperative nutritional status was assessed by the Mini Nutritional Score (MNA), Nutritional Risk Screening-2002 (NRS2002), body mass index (BMI), free fatty acids (FFAs), albumin, and prealbumin concentrations. Intestinal permeability was assessed by D-lactate and intestinal fatty acid-binding protein (i-FABP). The inflammatory factors included interleukin (IL)-6, IL-10, neutrophil, and lymphocyte counts. The time to first defecation, time to first liquid diet, length of hospital stay (LOS), and postoperative complications were recorded. Results A total of 134 patients were included. According to the MNA, 50.7% and 32.1% of the cohort had mild to moderate malnutrition, and severe malnutrition, respectively. According to the NRS2002, 38.8% of the patients scored >4 points. I-FABP was significantly negatively correlated with albumin (r=-0.409, P<0.001) and prealbumin (r=-0.397, P<0.001), and significantly positively correlated with MNA (r=0.291, P=0.001), the NRS2002 (r=0.284, P=0.001), and LOS (r=0.245, P=0.004). D-lactate was significantly negatively correlated with BMI (r=-0.229, P=0.008), albumin (r=-0.426, P<0.001), and prealbumin (r=-0.358, P<0.001), and significantly positively correlated with the NRS2002 (r=0.187, P=0.030), time to first defecation (r=0.264, P=0.002), and LOS (r=0.409, P<0.001). There were significant differences in BMI, prealbumin, FFAs, i-FABP, time to first defecation, and time to first fluid diet (P<0.05) among groups based on MNA score. The multivariate logistic analysis showed that D-lactate was an independent risk factor of postoperative complications [odds ratio (OR) =1.354, 95% confidence interval (CI): 1.099-1.669, P=0.004]. Conclusions The preoperative intestinal permeability indicators (i.e., D-lactate and i-FABP) are significantly correlated with some nutritional indicators and postoperative recovery indicators. The preoperative D-lactate level is an independent risk factor of postoperative complications, suggesting that altered gut barrier function before surgery could to some extent influence postoperative recovery in the elderly.
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Affiliation(s)
- Xining Zhao
- Department of Anesthesiology, Zhongshan Hospital Fudan University, Shanghai, China
| | - Ying Wang
- Department of Anesthesiology, Zhongshan Hospital Fudan University, Shanghai, China
| | - Yuying Yang
- Department of Anesthesiology, Zhongshan Hospital Fudan University, Shanghai, China
| | - Yan Pan
- Department of Anesthesiology, Zhongshan Hospital Fudan University, Shanghai, China
| | - Jie Liu
- Department of Anesthesiology, Zhongshan Hospital Fudan University, Shanghai, China
| | - Shengjin Ge
- Department of Anesthesiology, Zhongshan Hospital Fudan University, Shanghai, China
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Veronese N, Noale M, Cella A, Custodero C, Smith L, Barbagelata M, Maggi S, Barbagallo M, Sabbà C, Ferrucci L, Pilotto A. Multidimensional frailty and quality of life: data from the English Longitudinal Study of Ageing. Qual Life Res 2022; 31:2985-2993. [PMID: 35579730 PMCID: PMC9470717 DOI: 10.1007/s11136-022-03152-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 11/26/2022]
Abstract
Purpose Frailty has been found to be associated with poor quality of life (QoL) in older people, but data available are limited to cross-sectional studies. We therefore aimed to assess the association between multidimensional frailty, determined by Multidimensional Prognostic Index (MPI), with mortality and good QoL expectancy (GQoLE) in a large representative sample of older adults, over 10 years of follow-up. Methods In the English Longitudinal Study of Ageing, using the data from 2004–2005 and 2014–2015, MPI was calculated using a weighted score of domains of comprehensive geriatric assessment, i.e., number of difficulties in activities of daily living (ADL) and instrumental ADL, depressive symptoms, number of medical conditions, body mass index, physical activity level, and social aspects. Mortality was assessed using administrative data, GQoLE indicators were used for longitudinal changes in QoL. Results 6244 Participants (mean age 71.8 years, 44.5% males) were followed up for 10 years. After adjusting for potential confounders, compared to people in the MPI low-risk group, people in the moderate (hazard ratio, HR = 4.27; 95% confidence interval, CI 3.55–5.14) and severe-risk group (HR = 10.3; 95% CI 7.88–13.5) experienced a significantly higher mortality rate. During the follow-up period, people in the moderate and severe-risk groups reported lower GQoLE values than their counterparts, independently from age and gender. Conclusions Multidimensional frailty was associated with a higher risk of mortality and significantly lower GQoLE, suggesting that the multifactorial nature of frailty is associated not only with mortality, but also poor QoL. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-022-03152-9.
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Affiliation(s)
- Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy.
| | - Marianna Noale
- Neuroscience Institute, National Research Council, Padua, Italy
| | - Alberto Cella
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Ospedali Galliera, Genoa, Italy
| | - Carlo Custodero
- Department of Interdisciplinary Medicine, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari "Aldo Moro", Bari, Italy
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Marina Barbagelata
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Ospedali Galliera, Genoa, Italy
| | - Stefania Maggi
- Neuroscience Institute, National Research Council, Padua, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
| | - Carlo Sabbà
- Department of Interdisciplinary Medicine, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari "Aldo Moro", Bari, Italy
| | - Luigi Ferrucci
- National Institute on Aging, National Institute of Health, Bethesda, MD, USA
| | - Alberto Pilotto
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Ospedali Galliera, Genoa, Italy
- Department of Interdisciplinary Medicine, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari "Aldo Moro", Bari, Italy
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Thomas J, Lawless C, Christie A, Kuhr O, Miller M. In patients admitted to a home rehabilitation service, is remote completion of the PG-SGA physical examination using still images captured by Allied Health Assistants a valid alternative to an in-person physical examination? J Acad Nutr Diet 2022; 122:2320-2329. [PMID: 35589068 DOI: 10.1016/j.jand.2022.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 05/08/2022] [Accepted: 05/12/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND There is increasing provision of telehealth services, including nutrition services. However remote nutrition assessments are challenging due to difficulties in conducting physical assessments remotely, a crucial component of assessing nutritional status. OBJECTIVE The aim of this study was to evaluate whether remote completion of the PG-SGA physical examination using still images captured by Allied Health Assistants is a valid alternative to an in-person physical examination in patients admitted to a home rehabilitation service. DESIGN This study was Cross-sectional in design. PARTICIPANTS/SETTING This study involved 104 adults admitted to the home-rehabilitation service at Southern Adelaide Local Health Network, Adelaide Australia over two sampling periods in 2019 and 2020 who were receiving home visits by an AHA and were engaged in rehabilitation activities. MAIN OUTCOME MEASURES Validity of the still-image based physical assessment was determined using still-images collected by an AHA and an in-person physical assessment completed by a dietitian from each participant. A dietitian blinded to the in-person results later assessed the de-identified still-images to determine the presence and extent of deficit at each anatomical site and overall physical examination component of the Patient-generated subjective global assessment (PG-SGA). STATISTICAL ANALYSES PERFORMED Percentage agreement, weighted kappa, sensitivity and specificity between the still-image based and in-person physical examinations were determined to assess agreement between the two methods of assessment. RESULTS The still-image based physical examination achieved a percentage agreement of 75% against the in-person examination, with a weighted kappa of 0.662 (0.516, 0.808) and a sensitivity-specificity pair of 76.6% and 89.1%. CONCLUSIONS Physical examination using still-images collected by AHAs achieved percentage agreement, kappa and sensitivity and specificity compared to an in-person physical examination that is consistent with or superior to commonly adopted nutrition screening and assessment tools. There is potential for implementation of this method to facilitate remote nutritional assessments by dietitians however further work is needed to ensure dietitians are able to assess still-images reliably.
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Affiliation(s)
- Jolene Thomas
- College of Nursing & Health Sciences, Flinders University, Bedford Park, SA. 5042
| | | | - Alexandra Christie
- College of Nursing & Health Sciences, Flinders University, Bedford Park, SA. 5042; Southern Adelaide Local Health Network, Bedford Park, SA 5042
| | - Owen Kuhr
- College of Nursing & Health Sciences, Flinders University, Bedford Park, SA. 5042
| | - Michelle Miller
- College of Nursing & Health Sciences, Flinders University, Bedford Park, SA. 5042
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Hussein S, Kantawalla RF, Dickie S, Suarez-Durall P, Enciso R, Mulligan R. Association of Oral Health and Mini Nutritional Assessment in Older Adults: A Systematic Review with Meta-analyses. J Prosthodont Res 2022; 66:208-220. [PMID: 34261845 DOI: 10.2186/jpr.jpr_d_20_00207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To evaluate whether poor oral health is associated with a higher risk of malnutrition based on the Mini Nutritional Assessment (MNA) or MNA-SF (short form) in older adults. STUDY SELECTION For this meta-analysis, cohort and cross-sectional studies with adults 65 years and older, reporting oral health outcomes (i.e. edentulism, number of teeth) and either the MNA or MNA-SF were selected. Four electronic databases were searched (Medline via PubMed, Web of Science, Cochrane Library and EMBASE) through June 2020. Risk of bias was assessed with the checklist by the Agency for Healthcare Research and Quality scale. RESULTS A total of 928 abstracts were reviewed with 33 studies, comprising 27,559 participants, aged ≥65 being ultimately included. Meta-analyses showed that the lack of daily oral hygiene (teeth or denture cleaning), chewing problems and being partially/fully edentulous, put older adults at higher risk of malnutrition (p<0.05). After adjustment for socio-demographic variables, the included studies reported lack of autonomy for oral care, poor/moderate oral health, no access to the dentist and being edentulous with either no dentures or only one denture were risk factors significantly associated with a higher risk of malnutrition (p<0.05). CONCLUSION These findings may imply that once elders become dependent on others for assistance with oral care, have decreased access to oral healthcare, and lack efficient chewing capacity, there is increased risk of malnourishment. Limitations of the study include heterogeneity of oral health variables and the observational nature of the studies. Further studies are needed to validate our findings.
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Affiliation(s)
- Sahar Hussein
- Herman Ostrow School of Dentistry of University of Southern California Los Angeles, California, USA
| | - Rifat Falak Kantawalla
- Herman Ostrow School of Dentistry of University of Southern California Los Angeles, California, USA
| | - Stephenie Dickie
- Herman Ostrow School of Dentistry of University of Southern California Los Angeles, California, USA
| | - Piedad Suarez-Durall
- Herman Ostrow School of Dentistry of University of Southern California Los Angeles, California, USA
| | - Reyes Enciso
- Herman Ostrow School of Dentistry of University of Southern California Los Angeles, California, USA
| | - Roseann Mulligan
- Herman Ostrow School of Dentistry of University of Southern California Los Angeles, California, USA
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De Rui M, Tarzia V, Mazzochin M, Bertocco A, Ceolin C, Trevisan C, Tessari C, Cavalli C, Piperata A, Coin A, Gerosa G, Sergi G. Surgical aortic valve replacement in elderly patients: effects on physical performance, cognitive function and health-related quality of life. Aging Clin Exp Res 2022; 34:643-652. [PMID: 34448150 PMCID: PMC8894170 DOI: 10.1007/s40520-021-01969-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/18/2021] [Indexed: 12/02/2022]
Abstract
Background Surgical aortic valve replacement (SAVR) is still the gold standard for treating aortic valve stenosis (AVS). Its effectiveness has been extensively examined in terms of perioperative mortality, but its impact on overall health has received much less attention. Aims To assess the physical performance, cognitive status, and health-related quality of life of elderly patients undergoing SAVR, in the short, medium and long term. Methods This single-center prospective study enrolled patients aged > 70 years who underwent isolated SAVR for severe AVS. Data were collected on each participant’s clinical status, physical performance, cognitive status, mood, and health-related quality of life. This multidimensional geriatric assessment was performed before surgery (T0), and again at 45 days (T1), 3 months (T2), 6 months (T3), and 12 months (T4) post-surgery. Baseline (T0) and follow-up (T2-T4) data were compared separately for patients grouped by gender using paired t-tests. Results Data from a total of 35 patients were analyzed. Compared with the baseline (T0), nutritional status worsened at T1, then gradually improved through to T4. Physical performance, mood, and health-related quality of life improved significantly after surgery. Cognitive function showed no change through to T3, but then deteriorated at T4. Conclusions Our results show that SAVR in patients over 70 years of age has a positive impact on nutrition, mood, and health-related quality of life. Cognitive function was not negatively affected in the short and medium term, although it deteriorated in the long term. SAVR also had a positive impact on the physical performance of our sample.
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Affiliation(s)
- Marina De Rui
- Department of Medicine-DIMED, Geriatrics Division, Clinica Geriatrica, University of Padova, via Giustiniani 2, 35128, Padova, Italy.
| | - Vincenzo Tarzia
- Department of Cardiac, Thoracic and Vascular Sciences, and Public Health, Cardiac Surgery Unit, University of Padova, Padova, Italy
| | - Mattia Mazzochin
- Department of Medicine-DIMED, Geriatrics Division, Clinica Geriatrica, University of Padova, via Giustiniani 2, 35128, Padova, Italy
| | - Anna Bertocco
- Department of Medicine-DIMED, Geriatrics Division, Clinica Geriatrica, University of Padova, via Giustiniani 2, 35128, Padova, Italy
| | - Chiara Ceolin
- Department of Medicine-DIMED, Geriatrics Division, Clinica Geriatrica, University of Padova, via Giustiniani 2, 35128, Padova, Italy
| | - Caterina Trevisan
- Department of Medicine-DIMED, Geriatrics Division, Clinica Geriatrica, University of Padova, via Giustiniani 2, 35128, Padova, Italy
| | - Chiara Tessari
- Department of Cardiac, Thoracic and Vascular Sciences, and Public Health, Cardiac Surgery Unit, University of Padova, Padova, Italy
| | - Chiara Cavalli
- Department of Cardiac, Thoracic and Vascular Sciences, and Public Health, Cardiac Surgery Unit, University of Padova, Padova, Italy
| | - Antonio Piperata
- Department of Cardiac, Thoracic and Vascular Sciences, and Public Health, Cardiac Surgery Unit, University of Padova, Padova, Italy
| | - Alessandra Coin
- Department of Medicine-DIMED, Geriatrics Division, Clinica Geriatrica, University of Padova, via Giustiniani 2, 35128, Padova, Italy
| | - Gino Gerosa
- Department of Cardiac, Thoracic and Vascular Sciences, and Public Health, Cardiac Surgery Unit, University of Padova, Padova, Italy
| | - Giuseppe Sergi
- Department of Medicine-DIMED, Geriatrics Division, Clinica Geriatrica, University of Padova, via Giustiniani 2, 35128, Padova, Italy
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Emara AK, Hadad MJ, Dube M, Klika AK, Burguera B, Piuzzi NS. Team Approach: Nutritional Assessment and Interventions in Elective Hip and Knee Arthroplasty. JBJS Rev 2022; 10:01874474-202203000-00001. [PMID: 35230998 DOI: 10.2106/jbjs.rvw.21.00138] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
» Nutritional assessment is a critical element of routine preoperative assessment and should be approached by an interdisciplinary team that involves the primary care physician, dietitian, and orthopaedist. » Patients should be stratified on the basis of their nutritional risk, which influences downstream optimization and deficiency reversal. » The scientific literature indicates that nutritional supplementation affords protection against adverse outcomes and helps functional recovery, even among patients who are not at nutritional risk. » Published investigations recommend a sufficient preoperative interval (at least 4 weeks) to ensure an adequate nutritional intervention in malnourished patients as opposed to regarding them as nonsurgical candidates.
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Affiliation(s)
- Ahmed K Emara
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Matthew J Hadad
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Michael Dube
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.,Northeast Ohio Medical University, Rootstown, Ohio
| | - Alison K Klika
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Bartolome Burguera
- Department of Endocrinology, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Nicolas S Piuzzi
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
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45
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Elfert P, Berndt J, Dierkes L, Eichelberg M, Rösch N, Hein A, Diekmann R. A Novel Digital Nutrition Diary for Geriatric Patients at High Risk of Frailty Syndrome. Nutrients 2022; 14:nu14030400. [PMID: 35276760 PMCID: PMC8838007 DOI: 10.3390/nu14030400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 12/30/2021] [Accepted: 01/03/2022] [Indexed: 02/01/2023] Open
Abstract
Due to the physical, psychological, or socioeconomic changes that accompany aging, many people will be affected by geriatric frailty syndrome, which can lead to multimorbidity and premature death. Nutrition counseling is often used to prevent and intervene in frailty syndrome, especially in geriatric rehabilitation. To this end, the consumption behavior of geriatric patients is recorded using paper-based, as well as retrospective memory logs in face-to-face interviews between patients and nutritionists. To simplify this procedure, a digital nutrition diary was developed that is specially adapted to the needs of geriatric patients (>=70 years), enabling them to record their consumption behavior themselves. In an initial study (Study 1), conducted in a geriatric rehabilitation division with twelve subjects (ten male, two female, mean age 79.2 ±5.9 years), feedback about the usability of the digital nutrition diary, and how to improve it, was surveyed. In addition, the usability of an activity tracker and a body composition scale was surveyed to determine whether geriatric patients are generally able to use these devices. In a second study (Study 2), also conducted in the geriatric rehabilitation division, this time with sixteen subjects (ten male, six female, mean age 79.3 ±3.9 years), the usability of the digital nutrition diary was surveyed again to evaluate its modifications based on the feedback from Study 1. In Study 1, the usability rating of the system (0−100) was 82.5 for the activity tracker, 29.71 for the body composition scale, and 51.66 initially for the digital nutrition diary, which increased to 76.41 in Study 2.
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Affiliation(s)
- Patrick Elfert
- R&D Division Health, OFFIS Institute for Information Technology, 26121 Oldenburg, Germany;
- Correspondence:
| | - Julia Berndt
- Assistance Systems and Medical Device Technology, Department of Health Services Research, Carl von Ossietzky University of Oldenburg, 26111 Oldenburg, Germany; (J.B.); (L.D.); (A.H.); (R.D.)
| | - Louisa Dierkes
- Assistance Systems and Medical Device Technology, Department of Health Services Research, Carl von Ossietzky University of Oldenburg, 26111 Oldenburg, Germany; (J.B.); (L.D.); (A.H.); (R.D.)
| | - Marco Eichelberg
- R&D Division Health, OFFIS Institute for Information Technology, 26121 Oldenburg, Germany;
| | - Norbert Rösch
- Department of Computer Sciences and Microsystems Technology, University of Applied Sciences Kaiserslautern, 66482 Zweibrücken, Germany;
| | - Andreas Hein
- Assistance Systems and Medical Device Technology, Department of Health Services Research, Carl von Ossietzky University of Oldenburg, 26111 Oldenburg, Germany; (J.B.); (L.D.); (A.H.); (R.D.)
| | - Rebecca Diekmann
- Assistance Systems and Medical Device Technology, Department of Health Services Research, Carl von Ossietzky University of Oldenburg, 26111 Oldenburg, Germany; (J.B.); (L.D.); (A.H.); (R.D.)
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46
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Cesari M, Sadana R, Sumi Y, Amuthavalli Thiyagarajan J, Banerjee A. What Is Intrinsic Capacity and Why Should Nutrition Be Included in the Vitality Domain? J Gerontol A Biol Sci Med Sci 2022; 77:91-93. [PMID: 35015816 DOI: 10.1093/gerona/glab318] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Matteo Cesari
- Ageing and Health Unit, Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland.,IRCCS Istituti Clinici Scientifici Maugeri, University of Milan, Milan, Italy
| | - Ritu Sadana
- Ageing and Health Unit, Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Yuka Sumi
- Ageing and Health Unit, Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | | | - Anshu Banerjee
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
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47
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Veronese N, Smith L, Zigoura E, Barbagallo M, Dominguez LJ, Barone A, Cella A, Cooper C, Rizzoli R, Reginster JY, Maggi S, Pilotto A. Multidimensional prognostic index and the risk of fractures: an 8-year longitudinal cohort study in the Osteoarthritis Initiative. Arch Osteoporos 2021; 17:5. [PMID: 34905117 PMCID: PMC8669664 DOI: 10.1007/s11657-021-01015-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 09/27/2021] [Indexed: 02/03/2023]
Abstract
In this longitudinal study, with a follow-up of 8 years, multidimensional prognostic index (MPI), a product of the comprehensive geriatric assessment, significantly predicted the onset of fractures in older people affected by knee osteoarthritis. PURPOSE Frailty may be associated with higher fracture risk, but limited research has been carried out using a multidimensional approach to frailty assessment and diagnosis. The present research aimed to investigate whether the MPI, based on comprehensive geriatric assessment (CGA), is associated with the risk of fractures in the Osteoarthritis Initiative (OAI) study. METHODS Community-dwellers affected by knee OA or at high risk for this condition were followed-up for 8 years. A standardized CGA including information on functional, nutritional, mood, comorbidity, medication, quality of life, and co-habitation status was used to calculate the MPI. Fractures were diagnosed using self-reported information. Cox's regression analysis was carried out and results are reported as hazard ratios (HRs), with their 95% confidence intervals (CIs), adjusted for potential confounders. RESULTS The sample consisted of 4024 individuals (mean age 61.0 years, females = 59.0%). People with incident fractures had a significant higher MPI baseline value than those without (0.42 ± 0.18 vs. 0.40 ± 0.17). After adjusting for several potential confounders, people with an MPI over 0.66 (HR = 1.49; 95%CI: 1.11-2.00) experienced a higher risk of fractures. An increase in 0.10 point in MPI score corresponded to an increase in fracture risk of 4% (HR = 1.04; 95%CI: 1.008-1.07). Higher MPI values were also associated with a higher risk of non-vertebral clinical fractures. CONCLUSION Higher MPI values at baseline were associated with an increased risk of fractures, reinforcing the importance of CGA in predicting fractures in older people affected by knee OA.
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Affiliation(s)
- Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro, 141 90127, Palermo, Italy.
- Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia.
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Ekaterini Zigoura
- Department Geriatric Care, Orthogeriatrics and Rehabilitation, Frailty Area, E.O. Galliera Hospital, Genova, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro, 141 90127, Palermo, Italy
| | - Ligia J Dominguez
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro, 141 90127, Palermo, Italy
| | - Antonella Barone
- Department Geriatric Care, Orthogeriatrics and Rehabilitation, Frailty Area, E.O. Galliera Hospital, Genova, Italy
| | - Alberto Cella
- Department Geriatric Care, Orthogeriatrics and Rehabilitation, Frailty Area, E.O. Galliera Hospital, Genova, Italy
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - Renè Rizzoli
- Division of Bone Diseases, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Jean-Yves Reginster
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liège, Belgium
- Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Stefania Maggi
- Aging Branch, Neuroscience Institute, National Research Council, Padua, Italy
| | - Alberto Pilotto
- Department Geriatric Care, Orthogeriatrics and Rehabilitation, Frailty Area, E.O. Galliera Hospital, Genova, Italy
- Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
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48
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Zhang Q, Li XR, Zhang X, Ding JS, Liu T, Qian L, Song MM, Song CH, Barazzoni R, Tang M, Wang KH, Xu HX, Shi HP. PG-SGA SF in nutrition assessment and survival prediction for elderly patients with cancer. BMC Geriatr 2021; 21:687. [PMID: 34893024 PMCID: PMC8665602 DOI: 10.1186/s12877-021-02662-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 11/24/2021] [Indexed: 12/25/2022] Open
Abstract
Background This study was sought to report the prevalence of malnutrition in elderly patients with cancer. Validate the predictive value of the nutritional assessment tool (Patient-Generated Subjective Global Assessment Short Form, PG-SGA SF) for clinical outcomes and assist the therapeutic decision. Methods This is a secondary analysis of a multicentric, observational cohort study. Elderly patients with cancer older than 65 years were enrolled after the first admission. Nutritional status was identified using the PG-SGA SF. Results Of the 2724 elderly patients included in the analysis, 65.27% of patients were male (n = 1778); the mean age was 71.00 ± 5.36 years. 31.5% of patients were considered malnourished according to PG-SGA SF. In multivariate analysis, malnutrition(PG-SGA SF > 5) was significantly associated with worse OS (HR: 1.47,95%CI:1.29–1.68), affects the quality of life, and was related to more frequent nutrition impact symptoms. During a median follow-up of 4.5 years, 1176 death occurred. The mortality risk was 41.10% for malnutrition during the first 12 months and led to a rate of 323.98 events per-1000-patient-years. All nutritional assessment tools were correlated with each other (PG-SGA SF vs. PG-SGA: r = 0.98; PG-SGA SF vs. GLIM[Global Leadership Initiative on Malnutrition]: r = 0.48, all P < 0.05). PG-SGA SF and PG-SGA performed similarly to predict mortality but better than GLIM. PG-SGA SF improves the predictive ability of the TNM classification system for mortality in elderly patients with cancer, including distinguishing patients’ prognoses and directing immunotherapy. Conclusions The nutritional status as measured by PG-SGA SF which is a prognostic factor for OS in elderly cancer patients and could improve the prognostic model of TNM. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02662-4.
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Affiliation(s)
- Qi Zhang
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Capital Medical University, Beijing, 100038, China
| | - Xiang-Rui Li
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
| | - Xi Zhang
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
| | - Jia-Shan Ding
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Tong Liu
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
| | - Liang Qian
- Department of Obstetrics and Gynecology, Hangzhou Women's hospital/ Hangzhou Maternal and Child Health Hospital/ Hangzhou First People's Hospital Qianjiang New City Campus, Hangzhou, 310008, China
| | - Meng-Meng Song
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
| | - Chun-Hua Song
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences - University of Trieste, Trieste, Italy
| | - Meng Tang
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
| | - Kun-Hua Wang
- Department of Gastrointestinal Surgery, Institute of Gastroenterology, the First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, China
| | - Hong-Xia Xu
- Department of Clinical Nutrition, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Han-Ping Shi
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China. .,Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China. .,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.
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Cristina NM, Lucia D. Nutrition and Healthy Aging: Prevention and Treatment of Gastrointestinal Diseases. Nutrients 2021; 13:4337. [PMID: 34959889 PMCID: PMC8706789 DOI: 10.3390/nu13124337] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 12/16/2022] Open
Abstract
Nutritional well-being is a fundamental aspect for the health, autonomy and, therefore, the quality of life of all people, but especially of the elderly. It is estimated that at least half of non-institutionalized elderly people need nutritional intervention to improve their health and that 85% have one or more chronic diseases that could improve with correct nutrition. Although prevalence estimates are highly variable, depending on the population considered and the tool used for its assessment, malnutrition in the elderly has been reported up to 50%. Older patients are particularly at risk of malnutrition, due to multiple etiopathogenetic factors which can lead to a reduction or utilization in the intake of nutrients, a progressive loss of functional autonomy with dependence on food, and psychological problems related to economic or social isolation, e.g., linked to poverty or loneliness. Changes in the aging gut involve the mechanical disintegration of food, gastrointestinal motor function, food transit, intestinal wall function, and chemical digestion of food. These alterations progressively lead to the reduced ability to supply the body with adequate levels of nutrients, with the consequent development of malnutrition. Furthermore, studies have shown that the quality of life is impaired both in gastrointestinal diseases, but especially in malnutrition. A better understanding of the pathophysiology of malnutrition in elderly people is necessary to promote the knowledge of age-related changes in appetite, food intake, homeostasis, and body composition in order to better develop effective prevention and intervention strategies to achieve healthy aging.
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Affiliation(s)
- Neri Maria Cristina
- Division of Gastroenterology, Geriatric Institute Pio Albergo Trivulzio, 20146 Milan, Italy
| | - d’Alba Lucia
- Department of Gastroenterology and Endoscopy, San Camillo Forlanini Hospital, 00149 Rome, Italy;
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Hoseinzadeh-Chahkandak F, Rahimlou M, Salmani F, Ansarifar E, Moodi M, Sharifi F, Zeinali T. Nutrition assessment and geriatric associated conditions among free living elderly people in Birjand, East of Iran: a cross-sectional study. BMC Geriatr 2021; 21:612. [PMID: 34717587 PMCID: PMC8557026 DOI: 10.1186/s12877-021-02518-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/04/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Few data are available on the nutritional status of Iranian geriatric population. The present study aimed to determine the nutritional status of older adults' population in Birjand, East of Iran. METHODS The community-based cohort study was performed on older adults population (60 years and older) living in urban and rural areas of Birjand. The mini nutritional assessment (MNA) questionnaire was used to assess nutritional status. Anthropometric and biochemical evaluation were also performed for all of the participants. RESULTS A total of 1417 geriatric person were enrolled in this study, which, most of them were female (51.9 %). According to MNA tool, most of the participants (73.3 %) had normal nutrition (MNA score ≥ 24). Malnourished (MNA score < 17) and at high risk of malnutrition (MNA score: 17- 23.5) were constituted 0.9 % and 25.8 % of the participants, respectively. Marital status, occupation, period of education and family member were associated with nutritional status. Multiple logistic regression showed that with increase of body mass index (BMI) (OR = 0.96), education years (OR = 0.95), hemoglobin (OR = 0.86) and lymphocyte (OR = 0.98), the odds of malnutrition decreased, but with increase of age the odds (1.03) of malnutrition is also elevated. CONCLUSIONS MNA could successfully forecast the risk of malnutrition and malnourished people. Sociodemographic factors are associated with the nutritional status.
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Affiliation(s)
- Fatemeh Hoseinzadeh-Chahkandak
- Social Determinants of Health Research Center, Department of Public health, School of Health, Birjand University of Medical sciences, Birjand, Iran
| | - Mehran Rahimlou
- Department of Nutrition, School of Medicine, Zanjan University of Medical sciences, Zanjan, Iran
| | - Fatemeh Salmani
- Social Determinants of Health Research Center, Department of Epidemiology and Biostatistics, School of Health, Birjand University of Medical Sciences, Birjand, Iran
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Elham Ansarifar
- Social Determinants of Health Research Center, Department of Public health, School of Health, Birjand University of Medical sciences, Birjand, Iran
| | - Mitra Moodi
- Social Determinants of Health Research Center, Department of Public health, School of Health, Birjand University of Medical sciences, Birjand, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Tayebeh Zeinali
- Social Determinants of Health Research Center, Department of Public health, School of Health, Birjand University of Medical sciences, Birjand, Iran.
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