[Serum levels of vitamin A, E, C and B2, carotenoid and zinc in hospitalized elderly patients]

Product indiscriminate use of vitamin risks: A review

Most of the population does not seek professional advice before taking vitamin products and their indiscriminate use can lead to serious health risks. This study aims to demonstrate, through bibliographic survey, the risks of indiscriminate use of vitamin products related to hypervitaminosis and major drug interactions which the multivitamins are involved. A bibliographic survey was conducted in the databases LILACS, SciELO, PubMed, Medline, Micromedex, Drugs.com and textbooks on the subject. Vitamins are commonly described as harmless products by the majority of the population, but these trace elements can interact with other substances, causing mild disconforts or treatment failure for the patient, severe consequences to the body and can lead to death. To avoid the indiscriminate use of vitamin products, it is necessary that health professionals know and use specific laboratory tests for the determination of vitamins in the body, preventing these products from being unnecesarily prescribed. Also, the knowledge about what the possible effects of the indiscriminate use of vitamin supplements can lead to the rational use of these products.

Características de mastigação e deglutição na doença de Alzheimer

OBJETIVOS: comparar as características de mastigação e deglutição em idosos com e sem Doença de Alzheimer (DA). MÉTODO: estudo comparativo desenvolvido com 86 idosos, na faixa etária entre 60 e 93 anos, de ambos os sexos, distribuídos nos grupos controle (sem DA, n=43) e experimental (com DA, n=43). A função cognitiva e o estadiamento da DA foram avaliados por meio da aplicação da CDR (Clinical Dementia Rating). Para a caracterização da mastigação e deglutição foi aplicado o protocolo de avaliação miofuncional orofacial. RESULTADOS: as características de mastigação e deglutição sofreram variações importantes quando comparados os dois grupos. Houve diferença significante para movimentos mandibulares, reflexo de deglutição, deglutições múltiplas, presença de resíduos e dificuldade para ingerir comprimidos. CONCLUSÕES: as características de mastigação e deglutição, de maneira geral, sofrem maior comprometimento nos idosos com DA, quando comparados a idosos saudáveis.

The use of calf circumference measurement as an anthropometric tool to monitor nutritional status in elderly inpatients

OBJECTIVE

The objective of this study was to identify the nutritional status of hospitalized elderly and verify if calf circumference can be a tool to monitor nutritional status in this population.

METHODS

A total of 170 inpatients (79 men and 91 women) aged more than 60 years were assessed. Anthropometric and dietary assessments were done according to standard procedures. The software STATISTICA 6.0 was used for the statistical analysis. The confidence interval was set at 95% and significance level at 5% (p < 0.05).

RESULTS

Body mass index assessment revealed a high rate of underweight patients (45.3%), and arm circumference and triceps skinfold revealed a high prevalence of depletion. Males had more lean mass according to the mid-arm muscle circumference (p=0.017) and mid-arm muscle area (p=0.01), and females presented higher triceps skinfold values (p < 0.001). There was a positive correlation between calf circumference and Body Mass Index (p < 0.001), arm circumference (p=0.001), triceps skinfold (p=0.001), mid-arm muscle circumference (p=0.001), and mid-arm muscle area (p=0.001).

CONCLUSION

This study found a positive correlation between calf circumference and nutritional status of assessed patients indicating that this measurement can be used as a complementary tool for monitoring the nutritional status of elderly inpatients.

[Infeccious diseases as causes of death in autopsied elderly]

The population aging in Brazil was associated with the alterations in the morbimortality of the population. The aim of this study was to verify the causes of death and other pathological processes in autopsied elderly. The elderly with 60 years or more in the period from 1976 to 1998 represented 394 cases (24.4%). The age median was 69 years ranged from 60 to 120 years, being higher in the women (70.5 versus 68 yrs;p<0.05). The male gender (67.5%), white color (69.8%), and the cardiovascular (43.7%) and infectious (31%) causes of death were dominate. In the malnourished (76.2%) it had association of pneumonia and cystitis, (p<0.05). Arteriosclerosis (61.9%), and the chagasic (42.1%) and hypertensive cardiopathies (39.1%) were the most frequent processes. Therefore, it was observed an overlapping of chronic-degenerative and infectious causes of death. This study shows the necessity to value of follow up of body mass index and of risk factors for the development of illness in aging patients like pneumonia.

Serum levels assessment of vitamin A, E, C, B2 and carotenoids in malnourished and non-malnourished hospitalized elderly patients

AIMS & METHODS

Serum levels of vitamins A, E, C, B2 and carotenoids were determined in protein-energy malnourished (PEM, with body mass index, BMI<18.5 kg/m2) and non-PEM (BMI+/-18.5 kg/m2) hospitalized elderly (age > or = 65 years) patients, in the University Hospital of Faculty of Medicine of Ribeirão Preto, São Paulo University.

RESULTS

PEM (n=21) and non-PEM (n=106) patients were paired for age (73.6+/-7.3 vs. 71.6+/-5.6 years) and male percentage (65.1 vs. 52.4%). As expected, PEM elderly showed lower (P<0.05) body weight (median 43.1; range: 29.9-51.4 vs. 58.1; range: 45.7-143.5 kg), triceps skinfold (5.2+/-3.1 vs. 10.1+/-4.9 mm), and mid-arm muscle circumference (20.3+/-2.5 vs. 23.1+/-3.4 cm). Serum albumin (4.0+/-0.9 vs. 4.1+/-0.7 g/dl) and total lymphocytes count (1918.3+/-919 vs. 1842.7+/-862 mm(3)) were similar, respectively, among PEM and non-PEM patients. The percentage of biochemical riboflavin deficiency (58.8 vs. 56.2), low serum levels of vitamin A (28.6 vs. 29.6) and vitamin E (18.7 vs. 25) were similar, respectively, between PEM and non-PEM groups. The prevalence of low serum levels of water soluble vitamins was higher (P<0.01) in malnourished elderly than in the non-PEM group (ascorbic acid, 80.9 vs. 56.7%, and carotenoids, 14.3 vs. 3%, respectively).

CONCLUSIONS

These results suggest that hospitalized malnourished elderly show high percentage of low water soluble vitamin serum levels, a phenomenon possibly linked to decreased food intake, especially fruits and vegetables.

Food intake of a typical Brazilian diet among hospitalized malnourished patients

AIM

To verify whether malnourished inpatients receiving a typical Brazilian diet meet their food requirements.

METHODS

Thirty-five consecutive surgical and medical hospitalized adults, able to feed themselves, received rice and beans based diets for 3 consecutive days. All served food was weighed before and after the meals. Nutrient intake was determined and results compared to American Recommended Dietary Allowances (RDA). Malnutrition was defined by the presence of at least one of these criteria: body mass index &lE 18.5 kg/m(2); height-creatinine index << 70%; or albumin level << 3. 5 g/dl.

RESULTS

Malnourished and non-malnourished patients were paired in relation to age, gender, diagnoses and clinical parameters. Despite showing distinct anthropometric parameters and laboratory data, malnourished patients ingested enough quantities of food and met or exceeded RDA for energy and other nutrients.

CONCLUSIONS

Clinically-stable malnourished inpatients, supplied with rice- and beans based diets have adequate energy and nutrient intake, the same occurring for non-malnourished ones.