Nutritional assessment of institutionalized elderly

Enhancing Elderly Nutrition: A Qualitative Evaluation of Menus in a Social Solidarity Institution in the North of Portugal

This work addresses the importance of food and nutrition in promoting the health of the elderly population, with a specific focus on the qualitative evaluation of menus provided by a social solidarity institution in Portugal. The aim of this study is to conduct a qualitative evaluation of menus furnished by a social solidarity institution situated in the northern region of Portugal in order to prevent and/or treat malnutrition in the elderly. The methodology involves the evaluation of four weekly menus, totaling 28 complete daily menus for the elderly, using the "Avaliação Qualitativa de Ementas Destinadas a Idosos" (AQEDI) tool. This assessment tool comprises six domains: general items, soup, protein suppliers, carbohydrate suppliers, vegetable suppliers, and dessert, each consisting of various parameters. The findings reveal that all menus were classified as "acceptable," with percentages ranging from 60.73% to 68.84%, and suggest that there exists room for improvement. This study emphasizes the necessity for coordinated efforts within the institution to enhance menu planning, taking into account both nutritional guidelines and sensory aspects of food. Effective coordination within the institution is crucial for maintaining positive aspects and rectifying inadequacies in menu planning.

The Impact of Physical Exercises with Elements of Dance Movement Therapy on Anthropometric Parameters and Physical Fitness among Functionally Limited Older Nursing Home Residents

Changes in the composition of the body mass of functionally limited older patients may contribute to a decrease in functional fitness and the development of chronic diseases. This research aimed to assess the differences in anthropometric parameters and physical fitness of older patients, over the age of 65, in a 12-week clinical intervention study. Method: The study participants were nursing home inhabitants aged 65-85 who were functionally limited. Persons meeting the inclusion criteria were assigned to one of the three groups: Group 1-basic exercises/BE group (n = 56); Group 2-physical exercises with elements of dancing/PED group (n = 57); Group 3-control group/CO group (n = 56) routine care. The data were collected at the beginning of the study and at the 12-week mark. The outcome was observed for hand grip strength (HGS), arm curl test (ACT), Barthel Index (BI), Berg Balance Scale (BBS), triceps skin fold (TSF), waist-to-hip-ratio (WHR), and arm muscle area (AMA). Results: The study included 98 women and 71 men. The average age of the participants was 74.40 years. The analysis of the effects of the 12-week exercise program showed the greatest changes in HGS, ACT, and BI in the exercise groups, especially in the PED group compared to the BE group. Statistically significant differences in the examined parameters of the PED vs. BE vs. CO groups were demonstrated in favour of the exercising groups. In conclusion, a 12-week program of group physical exercises, both PED and BE, improves physical fitness indicators and anthropometric indicators.

Ultrasound Muscle Assessment and Nutritional Status in Institutionalized Older Adults: A Pilot Study

Muscle thickness, measured by ultrasonography, has been investigated for nutritional assessment in older adults, however the associations between muscle ultrasound parameters in the lower limb and nutritional status have not been studied. The aim of this study was to investigate the relationship between muscle thickness echo intensity (EI), and nutritional status in home care residents. A cross sectional study was conducted involving 19 older adults from a home care in Malaga (Spain). We evaluated lower leg muscles by ultrasound, anthropometric data, physical function (measured by gait speed and the Short Physical Performance Battery), strength (handgrip and knee extensors strength) and nutritional status across the Mini-Nutritional Assessment Short-Form (MNA-SF). We found that muscle thickness assessed by ultrasonography independently predicts nutritional status by MNA-SF and after adjusting for handgrip strength or age and sex. As secondary findings, we found relations between strength, functional capacity and the MNA-SF test. These results suggest that lower leg muscle ultrasound parameters could be used as a low-cost objective method for muscle evaluation in nutritional assessment in older adults.

Evaluation of dynapenia in the elderly in São Caetano do Sul, São Paulo, Brazil

Abstract Introduction: Aging is characterized by psychological, social, nutritional and biological changes, among which dynapenia stands out. Objective: To analyze the presence of dynapenia and associated factors in elderly people living in the city of São Caetano do Sul. Method: A cross-sectional study was carried out with 295 elderly individuals aged 60 years or older, who were users of public health units in the city of São Caetano do Sul. Dynapenia was assessed by handgrip strength, and its associations were investigated using multivariate logistic regression, according to sociodemographic variables, nutritional status, protein consumption, presence of diseases, and physical activity. Statistical analysis was performed using the IBM-SPSS (Statistical Package for Social Science) software. The adopted level of significance was p < 0.05. Results: Most of the participants were female (n = 251), with mean age of 70.6 years (± 7.0). The presence of dynapenia was observed in 24.07% (n = 71), among which 47 were women (18.73%) and 24 were men (54.55%). Observed associations concerned older age, male sex, lower circumference of the arm and calf, and lower triceps skinfold (p < 0.05). Conclusion: Approximately one-fourth of the elderly studied presented dynapenia, which represents a higher risk of morbidity and mortality. The inclusion of PPF alongside other anthropometric measures for assessing nutritional status is recommended. It is important for public policies to be directed towards health promotion and risk prevention in this age group.

Agreement between two Meal Quality Indexes adapted to evaluate food consumption of institutionalized elderly

ABSTRACT Objective To assess agreement between two meal quality indexes adapted for elderly people, evidencing their similarities and differences Methods Agreement study with 322 institutionalized elderly individuals. Food consumption data were collected by the method of weighted food record, in two nonconsecutive days. The Meal Quality Index and the Main Meal Quality Index of each older adult were calculated for the lunch meal. Agreement between methods was tested by cross-classification in quartiles and weighted kappa (Kw), and the difference between medians by the Wilcoxon test. Results The Meal Quality Index median was 54.67 points and the Main Meal Quality Index 53.51 points (p=0.723). When the components of each index were assessed, those associated to the consumption of carbohydrates, total fat and saturated fat were similar. The consumption of fruits separated from vegetables in the Main MealQuality Index evidenced low consumption of vegetables by the elderly. Cross-classification by quartiles showed good agreement; the exact one being 48.8% and the disagreement 3.4% (Kw=0,447). The proportion of elderlyindividuals in the same exact or adjacent quartile was greater than 85.0%. Agreement was higher in males (89.4%, Kw=0.475); in the age range of 70 to 79 years (91.1%; Kw=0.562) and in non-profit nursing homes(96.7%; Kw=0.622). Conclusion The two indexes reviewed show a good agreement between them and common characteristics. The number of components is higher in the MMQI and may represent a more detailed assessment of meal quality.

Use of adductor pollicis muscle thickness in hospitalized or ambulatory patients: a systematic review

Objective:

to analyze the use of the Adductor Pollicis Muscle Thickness (APMT) as an anthropometric parameter and prognostic indicator in hospitalized or ambulatory patients.

Method:

systematic review carried out the Web of Science, SCOPUS and Lilacs databases.

Results:

Twenty-three studies were performed on critical, surgical, oncological, nephropathic and hepatopathic patients, collecting data on bibliographic reference, study site, objectives, number of patients, age group, methodology, main results and conclusion. APMT proved to be a good anthropometric parameter for evaluation of nutritional status in critical patients without edema, and surgical, oncological and nephropathic patients, but presented poor performance for diagnosis of malnutrition in hepatopathic patients. It was a good prognostic indicator for mortality in critical, nephropathic and oncological patients, and also a good predictor of hospitalization in nephropathic patients. There was an association with neurological complications in Hepatic Encephalopathy (HE) in the case of hepatophatic patients, but it was not a predictor of postoperative complications in surgical patients.

Conclusion:

APTM was considered a good anthropometric parameter in most clinical conditions, except in patients with liver disease and a good prognostic indicator for mortality in critical, oncological and nephropathic patients, and a predictor of neurological complications in HE. Further prognostic investigation, standardization of cutoff points and evaluation of sensitivity and specificity are required.

Association between adductor pollicis muscle thickness, anthropometric and immunological parameters in HIV-positive patients

BACKGROUNDS AND AIMS

Involuntary weight loss and muscle mass loss among HIV-positive patients are only detectable in late stages, leading poor life quality. The reduction of adductor pollicis muscle thickness (APMT) can be easily and earlier uncovered in those cases. The purpose was to estimate APMT and compare it with immunological and anthropometric parameters of HIV-infected people.

METHODS

A crosssectional study was carried out in an University Hospital including 103 HIV-infected outpatients by subjective global assessment (SGA). Data were compared to APMT for the whole sample and between gender in univariate analysis. Besides that, simple correlation and multiple linear regression were done to check the APMT relation with gender, age, weight body, body mass index, arm circumference, CD4, CD8 and viral load.

RESULTS

The APMT average values of the dominant hand (16.2 ± 4.2 mm) and non-dominant hand (14.8 ± 4.3 mm) were lower than in the healthy population. Through stratified analysis by gender, it was found significant difference in weight, arm muscle circumference, arm muscle area, triceps skinfold thickness and arm fat area (p < 0,01 for each). In any age group, men had significantly higher dominant and non-dominant APMT values than women (p < 0.001). Although the fair correlation among cited variables and APMT of both hands, there were no correlation and no difference between the genders in regards to immunological markers (CD4, CD8 and viral load). In a prediction model to APMT values, gender was determinant in multiple linear regression.

CONCLUSIONS

In a well-nourished HIV sample by SGA with adequate CD4 counts, APMT measures of both hands were lower than in healthy people. In both hands, APMT were positively correlated with weight and male, regardless of other anthropometric data and immunologic factors.