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O'Brien L, Wilkinson TJ, Frampton C, Gearry RB, Wall C. A systematic review and meta-analysis of the dietary fiber menu provision and consumption for older adults living in residential care facilities. Am J Clin Nutr 2024; 120:431-441. [PMID: 38851635 DOI: 10.1016/j.ajcnut.2024.05.026] [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: 12/03/2023] [Revised: 05/12/2024] [Accepted: 05/23/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Older adults living in residential care facilities are commonly given laxatives to treat constipation; however, these may not always provide full relief, and side effects include diarrhea. Dietary fiber effectively prevents constipation, and international guidelines recommend 25 g/d for optimal laxation. Older adults in residential care rely on the facility menu to provide their nutritional requirements, including adequate dietary fiber. Little is known about how much dietary fiber is provided and consumed. OBJECTIVES We aimed to determine the provision and consumption of dietary fiber for older adults living in residential care facilities. METHODS We systematically searched available literature for studies reporting the analysis of residential care menus and meals consumed by residents aged over 65 y. A meta-analysis was performed on the studies that provided the mean amount of dietary fiber provided and consumed by residents. A random effect model was applied due to the heterogeneity of study methodologies. RESULTS The literature search yielded 4406 publications, but only 28 studies were eligible for our meta-analysis. The study sample comprised 4817 residents. The mean amount of fiber provided to residents was 21.4 g/d [standard error (SE): 1.2; 95% confidence interval: 18.8, 24.2 g/d], the mean amount of fiber consumed by residents was 15.8 g/d (SE: 0.6; 95% confidence interval: 14.7, 16.9 g/d). CONCLUSIONS Older adults living in care facilities are provided with dietary fiber below the recommended guidelines. Compounding this is that residents consume much less than what is provided and do not meet the recommendations for dietary fiber consumption. There is scope to improve dietary fiber provision, promote consumption to residents to aid laxation, and potentially reduce laxative use and the unwanted side effects of diarrhea. This trial was registered at PROSPERO as CRD42023427265.
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Affiliation(s)
- Leigh O'Brien
- Department of Medicine, University of Otago, Christchurch, New Zealand.
| | - Tim J Wilkinson
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Chris Frampton
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Richard B Gearry
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Catherine Wall
- Department of Medicine, University of Otago, Christchurch, New Zealand
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2
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Bardon LA, Corish CA, Lane M, Bizzaro MG, Loayza Villarroel K, Clarke M, Power LC, Gibney ER, Dominguez Castro P. Ageing rate of older adults affects the factors associated with, and the determinants of malnutrition in the community: a systematic review and narrative synthesis. BMC Geriatr 2021; 21:676. [PMID: 34863118 PMCID: PMC8642873 DOI: 10.1186/s12877-021-02583-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 10/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malnutrition negatively impacts on health, quality of life and disease outcomes in older adults. The reported factors associated with, and determinants of malnutrition, are inconsistent between studies. These factors may vary according to differences in rate of ageing. This review critically examines the evidence for the most frequently reported sociodemographic factors and determinants of malnutrition and identifies differences according to rates of ageing. METHODS A systematic search of the PubMed Central and Embase databases was conducted in April 2019 to identify papers on ageing and poor nutritional status. Numerous factors were identified, including factors from demographic, food intake, lifestyle, social, physical functioning, psychological and disease-related domains. Where possible, community-dwelling populations assessed within the included studies (N = 68) were categorised according to their ageing rate: 'successful', 'usual' or 'accelerated'. RESULTS Low education level and unmarried status appear to be more frequently associated with malnutrition within the successful ageing category. Indicators of declining mobility and function are associated with malnutrition and increase in severity across the ageing categories. Falls and hospitalisation are associated with malnutrition irrespective of rate of ageing. Factors associated with malnutrition from the food intake, social and disease-related domains increase in severity in the accelerated ageing category. Having a cognitive impairment appears to be a determinant of malnutrition in successfully ageing populations whilst dementia is reported to be associated with malnutrition within usual and accelerated ageing populations. CONCLUSIONS This review summarises the factors associated with malnutrition and malnutrition risk reported in community-dwelling older adults focusing on differences identified according to rate of ageing. As the rate of ageing speeds up, an increasing number of factors are reported within the food intake, social and disease-related domains; these factors increase in severity in the accelerated ageing category. Knowledge of the specific factors and determinants associated with malnutrition according to older adults' ageing rate could contribute to the identification and prevention of malnutrition. As most studies included in this review were cross-sectional, longitudinal studies and meta-analyses comprehensively assessing potential contributory factors are required to establish the true determinants of malnutrition.
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Affiliation(s)
- Laura A Bardon
- School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland.
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland.
| | - Clare A Corish
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Meabh Lane
- School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland
| | - Maria Gabriella Bizzaro
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Katherine Loayza Villarroel
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Michelle Clarke
- School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
| | - Lauren C Power
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Eileen R Gibney
- School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
| | - Patricia Dominguez Castro
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
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3
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Gusdal AK, Johansson-Pajala RM, Arkkukangas M, Ekholm A, Zander V. Preventing Falls and Malnutrition among Older Adults in Municipal Residential Care in Sweden: A Registry Study. SAGE Open Nurs 2021; 7:23779608211026161. [PMID: 34286078 PMCID: PMC8267024 DOI: 10.1177/23779608211026161] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/28/2021] [Indexed: 12/30/2022] Open
Abstract
Introduction Older adults in municipal residential care are among the most vulnerable and in need of most care. The prevalence of negative events, such as falls and malnutrition, is increased among these older adults. The need for strategies to prevent falls and malnutrition is emphasized in guidelines and systematic, individualized risk assessments are prerequisites for adequate interventions. Objectives The overall purpose of this study was to investigate the assessed risks of, and risk factors for, falling and malnutrition and the correlations between these assessed risks among older women and men in residential care. Further, the purpose was to investigate the consistency between planned and performed interventions among women and men assessed as at risk. Methods A cross-sectional registry study based on risk assessment data in the Swedish national quality registry, Senior Alert. Altogether, 5,919 older adults ≥65 in nursing homes and dementia care units in 19 municipalities in Sweden were included. Results Of the older adults, 77% were at risk of falls, and 59% were at risk of malnutrition. The most prevalent risk factors for falls were previous falls and not being cognitively oriented; and for malnutrition were having mild or severe dementia or depression. A significant positive correlation between the risk of falling and the risk of malnutrition was found. Less than half of the planned interventions for falls and malnutrition were performed. Care staff’s least common interventions to prevent falls were balance, muscular function, and strength training, which contrasts with the recommendations; interventions to prevent malnutrition were only partially adhering to recommendations. Conclusions This cross-sectional registry study points towards the importance of using an evidence-based approach, based on adherence to recommended guidelines, in the prevention of falling and malnutrition. Further, the implementation of clinical practice guidelines is needed, which requires educational training for care staff and supportive leadership.
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Affiliation(s)
- Annelie K Gusdal
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
| | | | | | - Anna Ekholm
- Research and Development in Sörmland, Eskilstuna, Sweden
| | - Viktoria Zander
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
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4
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Tjahyo AS, Gandy J, Porter J, Henry CJ. Is Weight Loss More Severe in Older People with Dementia? J Alzheimers Dis 2021; 81:57-73. [PMID: 33720896 DOI: 10.3233/jad-201496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Weight loss, a hallmark feature of dementia, is associated with higher mortality in older people. However, there is a lack of consensus in the literature as to whether the weight loss commonly observed in older people with dementia results from reduced energy intake and/or increased energy expenditure. Understanding the cause of energy imbalance in older people with dementia would allow more targeted interventions to avoid detrimental health effects in this vulnerable group. In this paper, we review studies that have considered weight change, energy intake, and energy expenditure in older people with and without dementia. We critically assess the studies' methodology and outline the various factors which may decrease and increase energy intake and expenditure respectively in older people with and without dementia. Current available literature does not support the view that there is a lower energy intake and/or a higher energy expenditure in older people with dementia when compared to those without dementia. The need for more high-quality studies is also highlighted in order to shed more light towards this issue which continues to elude researchers and clinicians alike.
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Affiliation(s)
- Alvin Surya Tjahyo
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | | | - Judi Porter
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.,Department of Biochemistry, Yong Loo Lin School of Medicine, Singapore, Singapore
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5
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Fayemendy P, Mabiama G, Vernier T, Massoulard-Gainant A, Villemonteix C, Desport JC, Jésus P. Nutritional status, dementia, and mobility among nursing home's residents: First exhaustive cross-sectional study in Limousin territory (France). PLoS One 2021; 16:e0250595. [PMID: 33930046 PMCID: PMC8087088 DOI: 10.1371/journal.pone.0250595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 04/09/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Aging is accompanied by a drop in the level of health and autonomy, within Western countries more and more people being cared for in nursing homes (NH). The nutritional data in NH in France remain poor, not exhaustive and not representative. The objective of the study was to assess the nutritional status, dementia and mobility patterns among residents of NH in the Limousin territory of France. METHODS The study was cross-sectional, descriptive and exhaustive, conducted with the residents of 13 voluntary NH. Undernutrition was identified using French High Authority for Health criteria, and obesity if Body Mass Index >30, in the absence undernutrition criterion. The Mini Mental State examination scores was used for dementia assessment at the threshold of 24. The Mini Nutritional AssessmentTM was used for mobilitity assessment. The statistics were significant at the 5% threshold. RESULTS 866 residents (70.6% women) included with an average age of 85.3 ± 9.3 years. Undernutrition was 27.5%, obesity 22.9%, dementia 45.7% and very low mobility 68.9%. Women were older than men, more often undernourished, more often demented and more often had very low mobility (p<0.01). Undernutrition (p<0.0001) and low mobility (p<0.0001) were significantly higher among those with dementia versus those without dementia. Very low mobility was higher among undernourished (p<0.05). CONCLUSIONS Undernutrition and obesity are important problems in NH in France. Being a woman, having dementia and having a very low mobility may induce undernutrition.
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Affiliation(s)
- Philippe Fayemendy
- Nutrition Unit and Specialized Centre for Obesity of the Limousin territory, University Hospital, Limoges, France
- Inserm U1094, Limoges University, IRD, Tropical Neuroepidemiology, Epidemiology and Neurology Tropical Institute, GEIST, Limoges, France
- Health Regional Agency Network Limousin Nutrition (LINUT), Isle, France
| | - Gustave Mabiama
- Nutrition Unit and Specialized Centre for Obesity of the Limousin territory, University Hospital, Limoges, France
- Inserm U1094, Limoges University, IRD, Tropical Neuroepidemiology, Epidemiology and Neurology Tropical Institute, GEIST, Limoges, France
- Microbiology, Immunology-Hematology and Morphologic Sciences Laboratory (LMIHSM), Doctoral Training Unit in Health Sciences (UFD-SCS), Doctoral School, Douala University, Douala, Cameroun
- * E-mail:
| | - Thibault Vernier
- Nutrition Unit and Specialized Centre for Obesity of the Limousin territory, University Hospital, Limoges, France
| | - Aude Massoulard-Gainant
- Health Regional Agency Network Limousin Nutrition (LINUT), Isle, France
- Home Hospitalization and Geriatric Service, University Hospital, Limoges, France
| | | | - Jean-Claude Desport
- Nutrition Unit and Specialized Centre for Obesity of the Limousin territory, University Hospital, Limoges, France
- Inserm U1094, Limoges University, IRD, Tropical Neuroepidemiology, Epidemiology and Neurology Tropical Institute, GEIST, Limoges, France
- Health Regional Agency Network Limousin Nutrition (LINUT), Isle, France
| | - Pierre Jésus
- Nutrition Unit and Specialized Centre for Obesity of the Limousin territory, University Hospital, Limoges, France
- Inserm U1094, Limoges University, IRD, Tropical Neuroepidemiology, Epidemiology and Neurology Tropical Institute, GEIST, Limoges, France
- Health Regional Agency Network Limousin Nutrition (LINUT), Isle, France
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6
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Assis APM, de Oliveira BTN, Gomes AL, Soares ADN, Guimarães NS, Gomes JMG. The association between nutritional status, advanced activities of daily living, and cognitive function among Brazilian older adults living in care homes. Geriatr Nurs 2020; 41:899-904. [PMID: 32653259 DOI: 10.1016/j.gerinurse.2020.06.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/18/2020] [Accepted: 06/22/2020] [Indexed: 11/29/2022]
Abstract
Institutionalized older adults are at greater risk of malnutrition, which is associated with cognitive impairment. This study investigated the association between nutritional status, advanced activities of daily living (AADL), and cognitive function among Brazilian older adults living in care homes. This cross-sectional study was conducted on 95 older adults (73.3 ± 12.5 years). Socio-demographic variables, cognitive function (measured by Mini Mental State Examination - MMSE), AADL, Mini Nutritional Assessment (MNA), and anthropometric variables were assessed. Regarding MNA, 37.8% were malnourished, 47.3% were at risk of malnutrition, and 14.9% were well-nourished. Malnourished participants (37.8%) and those with fewer number of AADL (82.3%) showed cognitive decline (MMSE < 24) (p = 0.000 and 0.030, respectively). Inadequate waist-hip ratio was associated with cognitive decline (OR 9.3; 95% IC, 9.06 - 9.85; p = 0.03). Nutritional status and AADL were associated with cognitive function. Nutritional assessment helps to early identify malnutrition and possibly to prevent cognitive impairment.
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Affiliation(s)
| | | | - Arlindo Leandro Gomes
- Instituto Federal do Sudeste de Minas Gerais, Campus Barbacena, Barbacena, MG, Brazil
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7
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Doorduijn AS, de van der Schueren MAE, van de Rest O, de Leeuw FA, Fieldhouse JLP, Kester MI, Teunissen CE, Scheltens P, van der Flier WM, Visser M, Boesveldt S. Olfactory and gustatory functioning and food preferences of patients with Alzheimer's disease and mild cognitive impairment compared to controls: the NUDAD project. J Neurol 2019; 267:144-152. [PMID: 31595376 PMCID: PMC6954901 DOI: 10.1007/s00415-019-09561-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 08/16/2019] [Accepted: 09/26/2019] [Indexed: 11/16/2022]
Abstract
Our aim is to compare olfactory and gustatory function and food preferences of patients with Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD) with controls. We included 22 patients with MCI, 30 patients with AD and 40 controls and assessed olfactory threshold, odor discrimination and odor identification (Sniffin’ Sticks), gustatory functioning (Taste Strips), and food preferences (Macronutrient and Taste Preference Ranking Task). Linear regression analyses were used to study associations of five cognitive domains or AD biomarkers with olfactory functioning. Groups did not differ in olfactory threshold, gustatory function and food preferences. Patients with MCI and AD scored lower on odor discrimination and identification than controls. Poorer memory, but no other cognitive domain, was associated with poorer odor discrimination and odor identification, but not with odor threshold. No associations with AD biomarkers were found. In conclusion, patients with MCI and AD have poorer odor discrimination and identification ability than controls, but similar detection thresholds. This is likely a consequence of poorer memory rather than directly caused by AD pathology.
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Affiliation(s)
- A S Doorduijn
- Department of Nutrition and Dietetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. .,Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
| | - M A E de van der Schueren
- Department of Nutrition and Dietetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.,Department of Nutrition and Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - O van de Rest
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - F A de Leeuw
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - J L P Fieldhouse
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - M I Kester
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - C E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - P Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - W M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - M Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam and The Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - S Boesveldt
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
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8
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Associations of AD Biomarkers and Cognitive Performance with Nutritional Status: The NUDAD Project. Nutrients 2019; 11:nu11051161. [PMID: 31126170 PMCID: PMC6566264 DOI: 10.3390/nu11051161] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 05/15/2019] [Accepted: 05/21/2019] [Indexed: 11/17/2022] Open
Abstract
As malnutrition is common in patients with Alzheimer’s disease (AD), we evaluated nutritional status and body composition of patients with AD, mild cognitive impairment (MCI) and controls, and studied associations of AD biomarkers and cognitive performance with nutritional status and body composition. We included 552 participants, of which 198 patients had AD, 135 patients had MCI and 219 controls. We assessed nutritional status (mini nutritional assessment (MNA)) and body composition (body mass index (BMI), fat-free mass (FFM) and waist circumference). Linear regression analyses (adjusted for age, gender and education where appropriate) were applied to test associations of AD biomarkers and cognitive performance on five domains with nutritional parameters (dependent). Patients with MCI and AD had a lower BMI and MNA score than controls. Worse performance in all cognitive domains was associated with lower MNA score, but not with body composition. AD biomarkers were associated with MNA score, BMI and waist circumference, and associations with MNA score remained after adjustment for cognitive performance. Both AD biomarkers and cognitive performance were associated with nutritional status, associations with AD biomarkers remained after adjustment for cognition. Our data suggest that malnutrition is not only related to impaired cognition but also to AD pathology.
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9
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Prell T, Perner C. Disease Specific Aspects of Malnutrition in Neurogeriatric Patients. Front Aging Neurosci 2018; 10:80. [PMID: 29628887 PMCID: PMC5876291 DOI: 10.3389/fnagi.2018.00080] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/12/2018] [Indexed: 12/12/2022] Open
Abstract
Malnutrition in elderly patients is a common condition. Nevertheless, there is evidence on specific risk factors and problems of malnutrition in geriatric patients with neurological diseases. In this review, we summarize recent knowledge on malnutrition in different neurological diseases with a focus on elderly patients. This overview also provides strategies for a more specific and profound assessment of neurogeriatric patients to improve identification and treatment of malnutrition. Early and consequent treatment of malnutrition can lead to a decreased progression of the neurological disease and to a better quality of life in geriatric patients.
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Affiliation(s)
- Tino Prell
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Caroline Perner
- Department of Neurology, Jena University Hospital, Jena, Germany
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10
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Park M, Song JA, Lee M, Jeong H, Lim S, Lee H, Kim CG, Kim JS, Kim KS, Lee YW, Lim YM, Park YS, Yoon JC, Kim KW, Hong GRS. National study of the nutritional status of Korean older adults with dementia who are living in long-term care settings. Jpn J Nurs Sci 2018; 15:318-329. [PMID: 29345106 DOI: 10.1111/jjns.12203] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 08/24/2017] [Accepted: 11/06/2017] [Indexed: 01/22/2023]
Abstract
AIM To evaluate the nutritional status of older adults with dementia who were living in long-term care settings. METHODS As a secondary analysis, this study used the data from the Nationwide Survey on Dementia Care in Korea that was conducted between December 1, 2010, and August 31, 2011, which surveyed 3472 older adults with dementia, aged ≥60 years (mean age: 81.24 years), who were residing in 248 randomly selected long-term care settings in South Korea. Twenty-three different variables that related to the participants' demographics, diseases, and functional and nutritional characteristics were selected. The nutritional status was assessed by using the Mini Nutritional Assessment (MNA). Descriptive statistics, an ANOVA, and a chi-squared test were used to analyze the data. RESULTS The mean MNA score of the participants was 17.90. The malnutrition rate was 38.4% (n = 1333), with 54.7% (n = 1900) of the participants at risk for malnutrition. The largest population with malnutrition resided in long-term care hospitals (47.9%), followed by nursing homes (34.1%), and group homes (25.9%). Being older and female, while exhibiting higher cognitive impairment, more neuropsychiatric symptoms, higher functional dependency, and a higher number of disabilities, were associated with poor nutritional status. CONCLUSION The nutritional status of older adults with dementia who were living in long-term care settings in South Korea was poor and associated with multiple factors. Paying special attention to recognizing, assessing, preventing, and treating malnutrition in this population is necessary.
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Affiliation(s)
- Myonghwa Park
- College of Nursing, Chungnam National University, Daejeon, South Korea
| | - Jun-Ah Song
- College of Nursing, Korea University, Seoul, South Korea
| | - Mihyun Lee
- College of Nursing, Chungnam National University, Daejeon, South Korea
| | - Hyun Jeong
- College of Nursing, Chungnam National University, Daejeon, South Korea
| | - Soyeun Lim
- College of Nursing, Korea University, Seoul, South Korea
| | - Haejung Lee
- College of Nursing, Pusan National University, Yangsan, South Korea
| | - Chun-Gill Kim
- Division of Nursing, Hallym University, Chuncheon, South Korea
| | - Jeong S Kim
- College of Nursing, Chonnam National University, Gwangju, South Korea
| | - Kyung S Kim
- Department of Nursing, Namseoul University, Cheonan, South Korea
| | - Young W Lee
- Department of Nursing, Inha University, Incheon, South Korea
| | - Young M Lim
- Department of Nursing, Yonsei University, Wonju, South Korea
| | - Young S Park
- Department of Nursing, Kyungbok University, Namyangju, South Korea
| | - Jong C Yoon
- Department of Psychiatry, Gyeonggi Provincial Hospital for the Elderly, Yongin, South Korea
| | - Ki W Kim
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea
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11
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Takada K, Tanaka K, Hasegawa M, Sugiyama M, Yoshiike N. Grouped factors of the ‘SSADE: signs and symptoms accompanying dementia while eating’ and nutritional status-An analysis of older people receiving nutritional care in long-term care facilities in Japan. Int J Older People Nurs 2017; 12. [DOI: 10.1111/opn.12149] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 01/30/2017] [Indexed: 01/29/2023]
Affiliation(s)
- Kento Takada
- Aomori University of Health and Welfare Graduate School of Health Sciences; Aomori Japan
- Kanagawa University of Human Services; Kanagawa Japan
| | | | | | | | - Nobuo Yoshiike
- Aomori University of Health and Welfare Graduate School of Health Sciences; Aomori Japan
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12
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Murphy J, Holmes J, Brooks C. Measurements of Daily Energy Intake and Total Energy Expenditure in People with Dementia in Care Homes: The Use of Wearable Technology. J Nutr Health Aging 2017; 21:927-932. [PMID: 28972246 PMCID: PMC5602067 DOI: 10.1007/s12603-017-0870-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 06/21/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To estimate daily total energy expenditure (TEE) using a physical activity monitor, combined with dietary assessment of energy intake to assess the relationship between daily energy expenditure and patterns of activity with energy intake in people with dementia living in care homes. DESIGN AND SETTING A cross-sectional study in care homes in the UK. PARTICIPANTS Twenty residents with confirmed dementia diagnosis were recruited from two care homes that specialised in dementia care. MEASUREMENTS A physical activity monitor (SensewearTM Armband, Body Media, Pittsburgh, PA) was employed to objectively determine total energy expenditure, sleep duration and physical activity. The armband was placed around the left upper triceps for up to 7 days. Energy intake was determined by weighing all food and drink items over 4 days (3 weekdays and 1 weekend day) including measurements of food wastage. RESULTS The mean age was 78.7 (SD ± 11.8) years, Body Mass Index (BMI) 23.0 (SD ± 4.2) kg/m2; 50% were women. Energy intake (mean 7.4; SD ± 2.6) MJ/d) was correlated with TEE (mean 7.6; SD ± 1.8 MJ/d; r=0.49, p<0.05). Duration of sleeping ranged from 0.4-12.5 (mean 6.1) hrs/d and time spent lying down was 1.3-16.0 (8.3) hrs/d. On average residents spent 17.9 (6.3-23.4) hrs/d undertaking sedentary activity. TEE was correlated with BMI (r=0.52, p<0.05) and body weight (r=0.81, p<0.001) but inversely related to sleep duration (r=-0.59, p<0.01) and time lying down (r=-0.62, p<0.01). Multiple linear regression analysis revealed that after taking BMI, sleep duration and time spent lying down into account, TEE was no longer correlated with energy intake. CONCLUSIONS The results show the extent to which body mass, variable activity and sleep patterns may be contributing to TEE and together with reduced energy intake, energy requirements were not satisfied. Thus wearable technology has the potential to offer real-time monitoring to provide appropriate nutrition management that is more person-centred to prevent weight loss in dementia.
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Affiliation(s)
- J Murphy
- Jane Murphy, Bournemouth University, Faculty of Health and Social Sciences, Christchurch Road, Bournemouth, BH1 3LT, United Kingdom, +44 1202 962805,
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Fávaro-Moreira NC, Krausch-Hofmann S, Matthys C, Vereecken C, Vanhauwaert E, Declercq A, Bekkering GE, Duyck J. Risk Factors for Malnutrition in Older Adults: A Systematic Review of the Literature Based on Longitudinal Data. Adv Nutr 2016; 7:507-22. [PMID: 27184278 PMCID: PMC4863272 DOI: 10.3945/an.115.011254] [Citation(s) in RCA: 332] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
The present systematic review critically examines the available scientific literature on risk factors for malnutrition in the older population (aged ≥65 y). A systematic search was conducted in MEDLINE, reviewing reference lists from 2000 until March 2015. The 2499 papers identified were subjected to inclusion criteria that evaluated the study quality according to items from validated guidelines. Only papers that provided information on a variable's effect on the development of malnutrition, which requires longitudinal data, were included. A total of 6 longitudinal studies met the inclusion criteria and were included in the systematic review. These studies reported the following significant risk factors for malnutrition: age (OR: 1.038; P = 0.045), frailty in institutionalized persons (β: 0.22; P = 0.036), excessive polypharmacy (β: -0.62; P = 0.001), general health decline including physical function (OR: 1.793; P = 0.008), Parkinson disease (OR: 2.450; P = 0.047), constipation (OR: 2.490; P = 0.015), poor (OR: 3.30; P value not given) or moderate (β: -0.27; P = 0.016) self-reported health status, cognitive decline (OR: 1.844; P = 0.001), dementia (OR: 2.139; P = 0.001), eating dependencies (OR: 2.257; P = 0.001), loss of interest in life (β: -0.58; P = 0.017), poor appetite (β: -1.52; P = 0.000), basal oral dysphagia (OR: 2.72; P = 0.010), signs of impaired efficacy of swallowing (OR: 2.73; P = 0.015), and institutionalization (β: -1.89; P < 0.001). These risk factors for malnutrition in older adults may be considered by health care professionals when developing new integrated assessment instruments to identify older adults' risk of malnutrition and to support the development of preventive and treatment strategies.
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Affiliation(s)
| | | | - Christophe Matthys
- Department of Clinical and Experimental Medicine,,Clinical Nutrition Unit, Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - Carine Vereecken
- University College Leuven-Limburg, Knowledge and Information Center FOOD, Leuven, Belgium; and
| | - Erika Vanhauwaert
- Department of Clinical and Experimental Medicine,,University College Leuven-Limburg, Knowledge and Information Center FOOD, Leuven, Belgium; and
| | | | | | - Joke Duyck
- Population Studies in Oral Health, Department of Oral Health Sciences, BIOMAT Research Cluster, Department of Oral Health Sciences, Katholieke Universiteit Leuven, Leuven, Belgium;
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Abstract
PURPOSE OF REVIEW Malnutrition in the nursing home is increasingly recognized as a major international research priority, given the expanding geriatric populations, serious consequences, and challenges conducting research in nursing homes. This review examines the recent literature and suggests implications for research and practice. RECENT FINDINGS Across the recent studies, approximately 20% of nursing home residents had some form of malnutrition. However, malnutrition definitions were variable and prevalence ranged from 1.5 to 66.5%. Depression, cognitive impairment, functional impairment, and swallowing difficulty were consistently associated with malnutrition. Mortality was the major consequence of malnutrition among nursing home residents, whereas higher BMIs had lower risks of mortality. Beneficial interventions to reduce malnutrition in the nursing home included dietary supplements, greater resident role in food choice, and staff training programs. SUMMARY To truly tackle the issue of malnutrition in the nursing home setting, a consistent definition is needed. We strongly recommend that an expert consensus panel identify a standard set of measures to more accurately compare the prevalence across countries. Given the mortality consequences of malnutrition and the paucity of intervention studies, research on interventions for malnutrition in the nursing home needs to be a higher priority for facilities, researchers, and funding agencies.
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Affiliation(s)
- Christina L Bell
- aDepartment of Geriatric Medicine, Pacific Islands Geriatric Education Center, University of Hawaii John A. Burns School of Medicine bHealth Sciences Library, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii, USA
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Strupeit S, Meyer S, Buss A, Gräske J, Worch A, Wolf-Ostermann K. Influence of living situation on vulnerable elderly: focus on nutritional status. J Nutr Health Aging 2014; 18:787-91. [PMID: 25389955 DOI: 10.1007/s12603-014-0550-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We compared the nutritional status of elderly people living in two different settings (shared-housing arrangements and home-living arrangements). DESIGN For this secondary analysis, a cross-sectional study was performed. SETTING For the home-living setting, home-dwelling elderly people from Hamburg, Germany who were participants in a prior study were included. For the shared-housing arrangements (SHA) setting, we used baseline data from the WGQual Study. PARTICIPANTS The sample from the home-living setting comprised patients who were discharged from a geriatric rehabilitation clinic within the six months prior to data collection. The sample from the shared-housing arrangements comprised all residents that lived in SHAs. MEASUREMENTS Nutritional status was examined by administering the Mini Nutritional Assessment (MNA). Cognitive status was measured by the Mini Mental State Examination (MMSE). RESULTS Overall, 142 individuals participated in this study. Statistical analysis showed differences in both overall MNA scores and MNA assessment scores. Significantly more participants from the SHA setting were at risk of malnutrition compared to the home-living setting. CONCLUSION Screening and assessment of nutritional status and prevention interventions should be considered in SHA settings.
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Affiliation(s)
- S Strupeit
- Steve Strupeit, Hamburg University of Applied Science (HAW), Alexanderstraβe 1, 20099 Hamburg. E-Mail: , Telephone: 0049-177-5010740
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