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Katsas K, Mamalaki E, Kontogianni MD, Anastasiou CA, Kosmidis MH, Varlamis I, Hadjigeorgiou GM, Dardiotis E, Sakka P, Scarmeas N, Yannakoulia M. Malnutrition in older adults: Correlations with social, diet-related, and neuropsychological factors. Nutrition 2019; 71:110640. [PMID: 31812000 DOI: 10.1016/j.nut.2019.110640] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 09/20/2019] [Accepted: 11/02/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND The number of older adults is increasing rapidly. Malnutrition is a major problem in this age group, which may adversely affect health and quality of life. Several physiological, socioeconomic, and neuropsychological factors can lead to malnutrition. OBJECTIVES The aim of this study was to evaluate the nutritional status of community-dwelling older adults, and explore the associations of malnutrition risk with physiological, socioeconomic, and neuropsychological characteristics. METHODS This study is part of the Hellenic Longitudinal Investigation of Aging and Diet study, a cross-sectional observational study in Greece, and study participants were 1831 urban-dwelling elderly individuals (mean age: 73.1 ± 5.9 y; 40.8% men). Risk for malnutrition was assessed with the Determine Your Nutritional Health checklist. Data on age, sex, level of education, marital status, depression, cognitive performance, body mass index, total energy intake, and adherence to the Mediterranean diet were recorded. Correlations and multivariate analyses were performed between these variables and risk for malnutrition. RESULTS The estimated prevalence of moderate and high nutritional risks was 34.8% and 29.4%, respectively. Risk for malnutrition was associated with marital status (unmarried), increased body mass index, male sex, lower level of education, lower cognitive performance, and lower adherence to the Mediterranean diet (P < 0.05). CONCLUSIONS Nutritional screening should be performed frequently in all community-dwelling older adults. Health experts should perform nutritional screening in all community-dwelling older adults as part of secondary prevention, and nutrition counselling and support should be offered in those at risk for malnutrition.
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Affiliation(s)
| | - Eirini Mamalaki
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | - Costas A Anastasiou
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece; Department of Social Medicine, Psychiatry and Neurology, First Department of Neurology, Aeginition University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Mary H Kosmidis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Greece
| | - Iraklis Varlamis
- Department of Informatics and Telematics, Harokopio University, Athens, Greece
| | - Georgios M Hadjigeorgiou
- Department of Neurology, Medical School, University of Cyprus, Aglantzia, Cyprus; Department of Neurology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Efthimios Dardiotis
- Department of Neurology, Medical School, University of Cyprus, Aglantzia, Cyprus
| | - Paraskevi Sakka
- Athens Association of Alzheimer's disease and Related Disorders, Marousi, Greece
| | - Nikolaos Scarmeas
- Department of Social Medicine, Psychiatry and Neurology, First Department of Neurology, Aeginition University Hospital, National and Kapodistrian University of Athens, Athens, Greece; Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, New York
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
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Roediger MDA, Marucci MDFN, Latorre MDRDDO, Hearst N, Oliveira CMD, Duarte YADO. Validation, reliability and operational equivalency of the nutritional screening method “Determine The Nutritional Health Of The Elderly”. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2018. [DOI: 10.1590/1981-22562018021.170035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Abstract Objective: To analyze the reliability, validity and operational equivalence of the nutritional screening method "Assessing The Nutritional Condition Of The Elderly". Method: This study was conducted with a subsample of 174 elderly persons from the Health, Welfare and Aging (SABE) study. The “Assessing The Nutritional Condition Of The Elderly” method consists of ten questions which classify individuals according to nutritional risk. Anthropometric and nutritional indicators were adopted as gold standard measures for comparison with the values of the method. Reliability was verified using the McNemar and Bland Altman tests, the validity of the discriminant type was assessed by the Mann-Whitney test and operational equivalence was identified through data relating to the time required to apply the method and the degree of understanding of the same using the Likert scale (1 to 5). Results: Of the 174 elderly persons interviewed, 63.8% were women and 52.3% were in the 60-74 years age group. It was found that 43.1% and 33.3% of the subjects had moderate to high nutritional risk, respectively, with a higher prevalence of high nutritional risk among women (33.3%) and those aged 60-74 years (43.4%). The method analyzed showed satisfactory results for reliability and discriminant validity. The average time required to apply this method was approximately seven minutes and the overall mean grade of understanding was 4.8. Conclusion: The method studied can be used by health professionals in epidemiological and clinical studies to identify the presence of nutritional risk in elderly persons living at home.
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Roediger MDA, Marucci MDFN, Latorre MDRDDO, Hearst N, Oliveira CD, Duarte YADO, Lebrão ML. Adaptação transcultural para o idioma português do método de triagem nutricional Determine your nutritional health®para idosos domiciliados. CIENCIA & SAUDE COLETIVA 2017. [DOI: 10.1590/1413-81232017222.00542016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo O objetivo deste artigo é descrever o processo de adaptação transcultural do método de triagem nutricional, Determine Your Nutritional Health® (DNH), para utilização na população idosa brasileira. O DNH consiste de 10 questões com enunciados afirmativos, às quais são atribuídas pontuações específicas e cuja soma corresponde ao escore final, que classifica os indivíduos de acordo com a presença ou a ausência de risco nutricional. O processo de adaptação transcultural do método DNH envolveu as seguintes etapas: tradução; retrotradução; equivalência semântica; avaliação dos especialistas; pré-teste e versão final do método. Foram realizadas adaptações de palavras e expressões do método DNH, para a realidade brasileira. A versão final do método foi definida para o Brasil como “Verifique a condição nutricional do idoso”, apresentando as mesmas questões da versão original do DNH, contudo, em formato mais claro, por meio de perguntas, consideradas acessíveis e de fácil entendimento, segundo a avaliação de profissionais de saúde e de idosos. A versão brasileira do método de triagem nutricional, “Verifique a condição nutricional do idoso”, encontra-se traduzida e adaptada para uso em idosos brasileiros domiciliados.
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Rosa CB, Garces SBB, Hansen D, Brunelli ÂV, Bianchi PD, Coser J, Krug MDR, Schwanke CHA. Malnutrition risk and hospitalization in elderly assisted in Primary Care. CIENCIA & SAUDE COLETIVA 2017. [DOI: 10.1590/1413-81232017222.15732016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Abstract The aim of this study was to investigate the association of malnutrition risk and single items of the Mini Nutritional Assessment (MNA®) with hospitalization in the last 12 months in the elderly assisted in primary care. A cross-sectional study was conducted with the evaluation of 1229 elderly persons assisted in Family Health Strategies in seven cities of South Brazil. Malnutrition risk was evaluated using the MNA®, and hospitalization was determined by one question of the Probability of Repeated Admission (PRA) instrument. Most of the elderly were women (61.7%), with a mean age of 71.7 ± 7.7 years. The malnutrition risk rate was 23.3% and hospitalization was 32.9%. The frequency of malnutrition and risk of malnutrition was two times greater among the elderly who were hospitalized (36.8 versus 18.6% - P < 0.001). There was a significant association between hospitalization and 11 (64.7%) of the 17 items on the MNA® evaluated (P < 0.05). Of these, seven items were independently associated with hospitalization by multivariate analysis. We observed an association of malnutrition risk and most of the single MNA® items as well, with hospitalization in the elderly assisted in primary care.
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Sugiura Y, Tanimoto Y, Imbe A, Inaba Y, Sakai S, Shishikura K, Tanimoto K, Hanafusa T. Association between Functional Capacity Decline and Nutritional Status Based on the Nutrition Screening Initiative Checklist: A 2-Year Cohort Study of Japanese Community-Dwelling Elderly. PLoS One 2016; 11:e0166037. [PMID: 27824916 PMCID: PMC5100942 DOI: 10.1371/journal.pone.0166037] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 10/21/2016] [Indexed: 11/30/2022] Open
Abstract
Aim To assess whether nutritional status based on the Nutrition Screening Initiative Checklist is useful for predicting functional capacity decline in community-dwelling Japanese elderly. Methods This two-year observational cohort study included 536 community-dwelling Japanese (65 years and older at baseline) who were independent in both activities and instrumental activities of daily living. Demographic attributes, chronic illness, lifestyle-related habits, nutritional status, functional capacity, and anthropometric measurements were assessed, with decline in functional capacity used as the outcome measure. Results Subjects were classified into three groups as follows based on the Nutrition Screening Initiative Checklist: low (59.5%), moderate (23.7%), and high (16.8%) nutritional risk. Significant differences were found between nutritional status and the following four baseline variables: age, hypertension, cerebrovascular diseases, and current smoking. However, no significant differences were evident between nutritional status and sex, body mass index, diabetes, drinking habit, or exercise habit. Logistic regression analysis adjusted for age, sex, body mass index, hypertension, cerebrovascular diseases and smoking habit showed that the high nutritional risk group was significantly associated with a decline in both activities of daily living (odds ratio: 4.96; 95% confidence interval (CI): 1.59–15.50) and instrumental activities of daily living (OR: 2.58; 95% CI: 1.31–5.06) compared with the low nutritional risk group. Conclusions Poor nutritional status based on the Nutrition Screening Initiative Checklist was associated with a decline in functional capacity over a 2-year period in community-dwelling Japanese elderly. These results suggest that the Nutrition Screening Initiative Checklist is a suitable tool for predicting functional capacity decline in community-dwelling elderly.
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Affiliation(s)
- Yumiko Sugiura
- Medical Corporation Hatsunekai Sugiura Clinic, Kariya City, Aichi, Japan
| | - Yoshimi Tanimoto
- Departments of Internal Medicine (I), Osaka Medical College, Takatsuki City, Osaka, Japan
- * E-mail:
| | - Ayumi Imbe
- Departments of Internal Medicine (I), Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Yuiko Inaba
- Departments of Internal Medicine (I), Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Satoshi Sakai
- Departments of Internal Medicine (I), Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Kanako Shishikura
- Departments of Internal Medicine (I), Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Keiji Tanimoto
- Departments of Internal Medicine (I), Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Toshiaki Hanafusa
- Departments of Internal Medicine (I), Osaka Medical College, Takatsuki City, Osaka, Japan
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Vieira LS, Assunção MCF, Schäfer AA, Santos IDSD. Validity assessment of the nutrition screening initiative checklist in older adults. Clin Nutr ESPEN 2016; 15:16-20. [PMID: 28531778 DOI: 10.1016/j.clnesp.2016.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 05/03/2016] [Accepted: 05/05/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To ascertain whether the NSI (Nutrition Screening Initiative Checklist) is a valid screening instrument for diagnosing nutritional risk in an older population from a medium-size city in the south of Brazil. METHODS The study population comprised individuals aged 60 years or older selected from a population-based cross-sectional survey. Data collection was carried out at two different timepoints: first, the NSI (instrument under test) was applied and later a dietary recall (gold standard) based on the previous day. Validity analyses were performed based on sensitivity and specificity as well as the Receiver Operating Characteristic Curve. RESULTS A total of 183 older adults were studied. Agreement between the dietary recall and the NSI for positive and negative results was 54.6%.The sensitivity and specificity values were low for all cut-off points of the instrument. The area under the curve was 0.52 (95%CI: 0.44-0.62) for the cut-off point ≥6. CONCLUSION Based on sensitivity and specificity values, the NSI proved ineffective for application in the population studied.
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Affiliation(s)
- Luna Strieder Vieira
- Federal University of Pelotas, Rua Marechal Deodoro 1160, Pelotas, 96020-220, Brazil.
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