1
|
Dericioglu D, Oldham S, Methven L, Shafat A, Clegg ME. Macronutrients effects on satiety and food intake in older and younger adults: A randomised controlled trial. Appetite 2023; 189:106982. [PMID: 37507052 DOI: 10.1016/j.appet.2023.106982] [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: 05/11/2023] [Revised: 07/07/2023] [Accepted: 07/24/2023] [Indexed: 07/30/2023]
Abstract
Older adults are advised to increase their protein intake to maintain their muscle mass. However, protein is considered the most satiating macronutrient and this recommendation may cause a decrease in total energy intake. To date, satiety studies comparing all three macronutrients have been undertaken in young adults, and it is unclear if the same response is seen in older adults. The objective of this study was to compare the effect of preloads high in protein, fat, and carbohydrate but equal in energy (∼300 kcal) and volume (250 ml) on energy intake, perceived appetite, and gastric emptying in younger and older adults. Twenty older and 20 younger adults completed a single-blinded randomised crossover trial involving three study visits. Participants consumed a standard breakfast, followed by a preload milkshake high in either carbohydrate, fat, or protein. Three hours after the preload, participants were offered an ad libitum meal to assess food intake. Visual analogue scales were used to measure perceived appetite and gastric emptying was measured via the 13C-octanoic acid breath test. There was no significant effect of preload type or age on energy intake either at the ad libitum meal, self-recorded food intake for the rest of the test day or subjective appetite ratings. There was a significant effect of preload type on gastric emptying latency phase and ascension time, and an effect of age on gastric emptying latency and lag phase such that older adults had faster emptying. In conclusion, energy intake, and perceived appetite were not affected by macronutrient content of the preloads in both younger and older adults, but gastric emptying times differed.
Collapse
Affiliation(s)
- Dilara Dericioglu
- Hugh Sinclair Human of Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, RG6 6DZ, UK; Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading, RG6 6EU, UK.
| | - Stephanie Oldham
- Hugh Sinclair Human of Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, RG6 6DZ, UK; Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading, RG6 6EU, UK.
| | - Lisa Methven
- Food Research Group, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, RG6 6DZ, UK; Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading, RG6 6EU, UK.
| | - Amir Shafat
- Physiology, School of Medicine, University of Galway, Galway, H91 W5P7, Ireland.
| | - Miriam E Clegg
- Hugh Sinclair Human of Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, RG6 6DZ, UK; Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading, RG6 6EU, UK.
| |
Collapse
|
2
|
Bhalla S, Venishetty N, Sohn G, Menedal A, Sambandam S. Perioperative complications of legally blind patients undergoing total knee arthroplasty: A national inpatient sample database study. J Orthop 2023; 43:69-74. [PMID: 37559882 PMCID: PMC10407030 DOI: 10.1016/j.jor.2023.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Vision impairment is a significant health concern that leads to increased morbidity and mortality globally. Significantly, legally blind (LB) patients have higher rates of hospitalization, cost, and orthopedic-related complications. Total knee arthroplasty (TKA) is commonly used to treat advanced knee osteoarthritis. However, there is limited literature reporting the demographic and hospitalization characteristics and operative outcomes of patients with LB who underwent TKA. This study addresses this gap in literature. METHOD We conducted a retrospective study using a Nationwide Inpatient Sample database. We assessed perioperative complications, length of stay (LOS), and healthcare expenditure among legally blind and control cohort patients who underwent TKA. Propensity matching was conducted to identify factors associated with perioperative complications. RESULTS Between 2016 and 2020, there were 558,371 patients underwent TKA, with 0.1% of patients documented as legally blind. Of this cohort, the average age was significantly older than the control, 70.01 years versus 66.72 years (p < 0.001), respectively. Patients from the LB cohort had a longer length of stay (2.9 ± 1.7 days) than those from the control cohort (2.4 ± 1.3 days) (p < 0.001). Significantly, patients in the legally blind group incurred higher expenditures than those in the control group ($68,936 versus $64,808, respectively; p < 0.001). (Table 2). Propensity matching yields similar results. Analysis of TKA-associated operative complications suggested that legally blind patients had a higher proportion of blood loss anemia (20.97%, p < 0.05), required blood transfusions secondary to surgery (3.1%, p < 0.05), and periprosthetic fractures (2.6%, p < 0.05) than the control group (15.3%, 1.5%, and 0.42%, respectively). CONCLUSION We report that LB patients are, on average, older and have an extended LOS, higher expenditure, and higher rates of specific TKA-associated operative complications than those without legal blindness. To date, this is the first study of its kind to provide large, population-based data on the demographics, costs, and TKA-operative complications in patients with LB and, as such, provides a purposeful basis for future research.
Collapse
Affiliation(s)
- Shubhang Bhalla
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 5001 El Paso Dr, El Paso, TX, USA
| | - Nikit Venishetty
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 5001 El Paso Dr, El Paso, TX, USA
| | - Garrett Sohn
- University of Texas Southwestern, 5323 Harry Hines Blvd, Dallas, TX, USA
| | - Anil Menedal
- Orthopedic Surgeon, Salem VA Medical Center Salem, Virginia, 4200 Hospital Road Coal Township, PA 17866, USA
| | - Senthil Sambandam
- University of Texas Southwestern, Staff Orthopedic Surgeon, Dallas VAMC, 4500 South Lancaster Road, Dallas, TX, USA
| |
Collapse
|
3
|
Arzhang P, Jamshidi S, Aghakhani A, Rezaei M, Rostampoor Y, Yekaninejad MS, Bellissimo N, Azadbakht L. Association between Food Insecurity and Vision Impairment among Older Adults: A Pooled Analysis of Data from Six Low- and Middle-Income Countries. J Nutr Health Aging 2023; 27:257-264. [PMID: 37170432 DOI: 10.1007/s12603-023-1903-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVES Food insecurity has gained attention as a potential risk factor for vision impairment. However, research on this topic is limited. This objective of this study was to investigate the relationship between food insecurity and visual impairment among adults aged 50 years or older using data from six low-and middle-income countries (LMIC). DESIGN AND SETTING Data from the longitudinal Study on global AGEing and adult health (SAGE) were analyzed in a community-based, cross-sectional, and nationally representative sample. PARTICIPANTS Adults aged 50 years or older from six low- and middle-income countries (LMICs) including China, India, Mexico, Russia, South Africa, and Ghana. MEASUREMENTS Food insecurity was evaluated using a questionnaire comprised of two questions that addressed the frequency of eating inadequately and hunger due to a lack of food in last 12 months. Distance and/or near vision impairment was considered as a visual acuity score of less than 6/18 in the eye with better vision. RESULTS The analytical sample consisted of 29,804 adults (mean (SD) for age: 63.2 (9.54) years; 54.3% female). The prevalence of food insecurity, near vision and distance vision impairment in the sample was 16.4%, 36.7%, and 13.9%, respectively. Adjusted pooled analyses across countries revealed a significant association between food insecurity and distance (OR: 1.16; 95% CI: 1.01, 1.33; P=0.04, significant individually in India and South Africa) and near (OR: 1.12; 95% CI: 1.02, 1.22; P=0.01, significant individually in South Africa) vision impairment, and a between-country heterogeneity of 46.30% and 25.99%, respectively. CONCLUSION Food insecurity was associated with both distance and near vision impairment in adults aged 50 years or older across six LMIC. Food policies and intervention programs targeted at decreasing food insecurity in vulnerable households are essential.
Collapse
Affiliation(s)
- P Arzhang
- Leila Azadbakht, PhD. Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, PO Box: 1416643931, Tehran, Iran; ORCID: 0000-0002-5955-6818; ; Mir Saeed Yekaninejad, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Poursina Avenue, Tehran, Iran, Postal Code: 1417613151; Tel: 98-2188992661, Fax: 98-218989127,
| | | | | | | | | | | | | | | |
Collapse
|
4
|
Nève G, Bur L, Lampert L, Höchsmann C, Brombach C, Steinemann N, Schmidt-Trucksäss A. Validation of a Visually Aided Dietary Assessment Tool to Estimate Dietary Intake in an Adult Swiss Population. Front Nutr 2022; 9:844156. [PMID: 35571959 PMCID: PMC9097151 DOI: 10.3389/fnut.2022.844156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/18/2022] [Indexed: 01/11/2023] Open
Abstract
BackgroundAccurately assessing dietary intake is crucial for understanding how diet affects a person’s health. In large cohorts, paper-based dietary assessment tools (DAT) such as food recalls or food frequency questionnaires have emerged as valid tools with a low burden for participants.ObjectiveTo validate a visually aided DAT for use in studies with Swiss adults against the gold standard of a weighed 7-day food record (7 d-FR).DesignFifty-one adults (n = 24 women, n = 27 males) participated in the study and were recruited within two age groups (20–40 and 50–70 y). Each participant filled out the visually aided DAT, then the 7 d-FR. The DAT was compared to the 7 d-FR for total energy intake, macronutrients, sugar, water, and portions of fruits and vegetables. Pearson correlation and Bland–Altman analyses were used for statistical analyses.ResultsTotal correlations ranged from 0.288 (sugar, p < 0.05) to 0.729 (water, p < 0.01). The older age group showed higher correlations for total energy intake, protein, fats, carbohydrates, and sugar, but not for water (p < 0.05). Correlations were moderate at r > 0.5, whereas only water and protein reached those values in the young group. Both groups overestimated total calories in kcal (+14.0%), grams of protein (+ 44.6%), fats (+36.3%), and portions of fruits and vegetables (+16.0%) but strongly underestimated sugar intake (−50.9%).ConclusionThis DAT showed that all macronutrients and total energy intake were estimated more accurately by the older age group and therefore might be adequate to capture dietary habits in older Swiss adults.
Collapse
Affiliation(s)
- Gilles Nève
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- *Correspondence: Gilles Nève,
| | - Laura Bur
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Ladina Lampert
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Christoph Höchsmann
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Christine Brombach
- Institute of Food and Beverage Innovation, Zurich University of Applied Sciences, Life Sciences and Facility Management, Wädenswil, Switzerland
| | - Nina Steinemann
- Department of Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland
| | - Arno Schmidt-Trucksäss
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- Arno Schmidt-Trucksäss,
| |
Collapse
|
5
|
A lifespan perspective of structural and perceived social relationships, food insecurity, and dietary behaviors during the COVID-19 pandemic. Appetite 2021; 168:105717. [PMID: 34582884 PMCID: PMC8464024 DOI: 10.1016/j.appet.2021.105717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/17/2021] [Accepted: 09/24/2021] [Indexed: 12/29/2022]
Abstract
Physical distancing and economic impacts of the COVID-19 pandemic may influence dietary behaviors. Using a parallel mixed method design, we examined the relationships between structural and perceived social relationships on dietary behaviors across the adult lifespan and by food security status. A representative sample of 360 adults (18-78 years old) living in the United States were recruited through Prolific Academic to complete an online cross-sectional survey. Participants provided data about demographics, food insecurity, structural and perceived social relationships, diet quality, and unhealthy snacking at the onset of the pandemic. Participants responded to open-ended questions about perceived changes in social connections and dietary behavior since COVID-19. Quantitative findings indicated food insecure emerging and older adults were at highest risk for low diet quality and frequent unhealthy snacking. Friend support was associated with higher diet quality. Qualitative findings suggested overall decreases in social connection and changes in dietary behavior, with food insecure adults describing decreases in diet quality. Participants who reported increases in emotional eating also reported decreases in social connection. Findings suggest the pandemic may exacerbate inequalities, particularly among food insecure emerging and older adults. Scaling up preventive interventions to increase social connection and reduce food insecurity during unprecedented challenges may promote healthier dietary behaviors now and in the long-term.
Collapse
|
6
|
Lember LM, Di Virgilio TG, Brown EM, Rodriguez-Sanchez N. Hill Runner's Physiology, Performance and Nutrition: A Descriptive Study. Front Sports Act Living 2021; 3:676212. [PMID: 34485900 PMCID: PMC8415831 DOI: 10.3389/fspor.2021.676212] [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: 03/04/2021] [Accepted: 07/22/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives: The aim of this descriptive study was to characterise anthropometric variables, aerobic capacity, running performance and energy intake and expenditure of hill runners in free-living conditions, and to investigate the relationship between age, anthropometric variables, aerobic capacity and running performance. Methods: Twenty-eight hill runners participated in this study (17 males and 11 females; aged 18–65 years). Body fat percentage estimate, sum of eight skinfolds (triceps, subscapular, biceps, iliac crest, supraspinale, abdominal, front thigh and medial calf) and maximal oxygen capacity (VO2max) were assessed in a laboratory setting. Participants also completed a timed hill run (Dumyat Hill, Scotland, ascent: 420 m, distance: 8 km) while wearing a portable gas analyzer to assess oxygen consumption (VO2). Energy intake and energy expenditure were assessed in free-living conditions over three consecutive days different from the testing days through self-reported food diaries and accelerometers. Results: VO2max assessed in the lab (51.2 ± 7.6 ml·min−1·kg−1) showed a weak negative relationship with age [rs(23) = −0.38, p = 0.08]. Neither body fat percentage (median 12.4; IQR 10.1–17.1) nor the sum of skinfolds (median 81.8; IQR 62.4–97.8 mm) correlated with age [rs(28) = 0.001, p = 0.10 and 26 rs(28) = −0.02, p = 0.94, respectively]. The observed intensity of the hill run was 89 ± 6% of the age predicted maximum heart rate and 87 ± 9% of the VO2max observed in the lab. Hill running performance correlated with VO2max [r(21) = 0.76, p < 0.001], age [rs(26) = −0.44, p = 0.02] and with estimated body fat percentage and sum of skinfolds [rs(26) = −0.66, p < 0.001 and rs(26) = −0.49, p = 0.01, respectively]. Energy intake negatively correlated with age [rs(26) = −0.43, p = 0.03], with the overall energy intake being significantly lower than the total energy expenditure (2273 ± 550 vs. 2879 ± 510 kcal·day−1; p < 0.001; d = 1.05). Conclusion: This study demonstrated that hill running performance is positively associated with greater aerobic capacity and negatively associated with increases in adiposity and age. Further, the study highlights that hill runners are at risk of negative energy balance.
Collapse
Affiliation(s)
- Liivia-Mari Lember
- Faculty of Natural Sciences, Department of Psychology, University of Stirling, Stirling, United Kingdom.,Faculty of Health Sciences and Sport, Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, United Kingdom
| | - Thomas George Di Virgilio
- Faculty of Health Sciences and Sport, Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, United Kingdom
| | - Eilidh MacKenzie Brown
- Faculty of Health Sciences and Sport, Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, United Kingdom
| | - Nidia Rodriguez-Sanchez
- Faculty of Health Sciences and Sport, Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, United Kingdom
| |
Collapse
|
7
|
Poggiogalle E, Kiesswetter E, Romano M, Saba A, Sinesio F, Polito A, Moneta E, Ciarapica D, Migliaccio S, Suwalska A, Wieczorowska-Tobis K, Pałys W, Łojko D, Sulmont-Rossé C, Feart C, Brug J, Volkert D, Donini LM. Psychosocial and cultural determinants of dietary intake in community-dwelling older adults: A Determinants of Diet and Physical Activity systematic literature review. Nutrition 2020; 85:111131. [PMID: 33545539 DOI: 10.1016/j.nut.2020.111131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/30/2020] [Accepted: 12/11/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Knowledge of factors determining dietary intake is important to develop targeted strategies to prevent malnutrition and age-related diseases. The aim of the present systematic review was to analyze the state of the art regarding the role of social status, cultural aspects, and psychological distress on dietary intake in community-dwelling older adults. METHODS A systematic search was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedure. Titles, abstracts, and full texts were screened for predefined inclusion and exclusion criteria. RESULTS Thirty-nine studies were included. Seven different groups of psychosocial and cultural determinants were associated with dietary intake. Family structure and living situation (e.g., loneliness, marital status), educational level, and income were the most important determinants associated with dietary choices and eating behavior. Less frequently, social assets, demographic parameters, psychosocial status, and awareness of current dietary recommendations were associated with the quality of the eating pattern. CONCLUSIONS The results of our review indicate heterogeneity of the studies in the field of social and psychological determinants of dietary patterns in older adults, but some important conclusions can be drawn. Further research harmonizing and integrating approaches and methodologies are required to better understand the determinants of dietary intake and the complexity of their interactions.
Collapse
Affiliation(s)
| | - Eva Kiesswetter
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany
| | | | - Anna Saba
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Fiorella Sinesio
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Angela Polito
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Elisabetta Moneta
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Donatella Ciarapica
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Silvia Migliaccio
- Department of Movement, Human and Health Sciences, Foro Italico University of Rome, Rome, Italy
| | - Aleksandra Suwalska
- Department of Mental Health, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Wiktor Pałys
- Department of Mental Health, Poznan University of Medical Sciences, Poznan, Poland
| | - Dorota Łojko
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Claire Sulmont-Rossé
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, University of Bourgogne Franche-Comté, Dijon, France
| | - Catherine Feart
- University of Bordeaux, INSERM, BPH, U1219, Bordeaux, France
| | - Johannes Brug
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Dorothee Volkert
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany
| | - Lorenzo M Donini
- Department of Experimental Medicine, Sapienza University, Rome, Italy.
| |
Collapse
|
8
|
Animal, Plant, Collagen and Blended Dietary Proteins: Effects on Musculoskeletal Outcomes. Nutrients 2020; 12:nu12092670. [PMID: 32883033 PMCID: PMC7551889 DOI: 10.3390/nu12092670] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/26/2020] [Accepted: 08/29/2020] [Indexed: 02/06/2023] Open
Abstract
Dietary protein is critical for the maintenance of musculoskeletal health, where appropriate intake (i.e., source, dose, timing) can mitigate declines in muscle and bone mass and/or function. Animal-derived protein is a potent anabolic source due to rapid digestion and absorption kinetics stimulating robust increases in muscle protein synthesis and promoting bone accretion and maintenance. However, global concerns surrounding environmental sustainability has led to an increasing interest in plant- and collagen-derived protein as alternative or adjunct dietary sources. This is despite the lower anabolic profile of plant and collagen protein due to the inferior essential amino acid profile (e.g., lower leucine content) and subordinate digestibility (versus animal). This review evaluates the efficacy of animal-, plant- and collagen-derived proteins in isolation, and as protein blends, for augmenting muscle and bone metabolism and health in the context of ageing, exercise and energy restriction.
Collapse
|
9
|
Optimizing sensory quality and variety: An effective strategy for increasing meal enjoyment and food intake in older nursing home residents. Appetite 2020; 153:104749. [PMID: 32450092 DOI: 10.1016/j.appet.2020.104749] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/25/2020] [Accepted: 05/18/2020] [Indexed: 01/08/2023]
Abstract
A decline in appetite and consequently in food intake is often observed with ageing, particularly in older adults living in nursing homes. Several strategies have been tested in nursing homes to counter this phenomenon. However, the approaches have rarely focused on food improvement, and most studies have assessed the impact of flavor enhancement on eating behavior. The present experiment aimed to assess the impact of improving sensory quality versus increasing sensory variety on food intake and meal enjoyment in elderly individuals living in a nursing home. Four conditions were compared: control condition, a Quality+ condition (recipes were improved according to sensory preference of the target population), a Variety+ condition (participants were offered a variety of main dishes and several condiments throughout the meal) and a Quality&Variety+ condition combining the two previous conditions. Eighty-two residents (age range: 71-101 years) participated in eight lunchtime sessions (2 replicates × 4 conditions). Compared to control condition, our results showed that improving the sensory quality of the dishes and/or providing variety led to increased meal enjoyment and food intake (energy intake: +5% for Quality+; +7% for Variety+). No additional effect was observed when the two factors were combined (+7% for Quality&Variety+). These results suggest that meal improvement strategies can be used to increase food intake in order to prevent and treat malnutrition in dependent older adults.
Collapse
|
10
|
de Almeida Mello J, Fávaro-Moreira NC, Krausch-Hofmann S, Vanneste D, Matthys C, Declercq A, Duyck J. Can the interRAI home care instrument be applied to the definition criteria of the Global Leadership Initiative on Malnutrition (GLIM)? A longitudinal study. Clin Nutr 2020; 39:3477-3482. [PMID: 32280009 DOI: 10.1016/j.clnu.2020.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 03/02/2020] [Accepted: 03/07/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND & AIMS As malnutrition is an important modifiable risk factor for poor clinical outcomes, it is important to target malnourished older people and older people at risk of malnourishment. The Global Leadership Initiative on Malnutrition (GLIM) recently reached a consensus for a global definition of malnutrition. The primary aim of this study was to apply the interRAI Home Care (interRAI HC) instrument to fit the GLIM definition criteria of malnutrition to the closest. A second goal was to identify potential risk factors associated with malnutrition using this comprehensive assessment and to quantify their association. METHODS This is a case control study, which retrospectively determines the exposure to the risk of malnutrition and estimates its potential risk factors. The longitudinal data came from a larger study called Protocol 3. Eligibility criteria were a minimum age of 65 years old, a minimum score of 6 on the Edmonton Frail Scale or at least a moderate level of functional impairment measured by a Belgian version of the Katz scale. Older people with an official dementia diagnosis were also eligible. Bivariate analysis was performed and logistic regression models were developed in order to identify significant determinants of malnutrition. RESULTS The data consisted of 6334 frail older people (mean age: 80.6 ± 6.9, 70.6% female). About 2.4% became malnourished within a follow-up period of one year after baseline. The adjusted logistic regression yielded significant odds ratios for dysphagia (OR 2.2), loss of appetite (OR 1.8), bladder incontinence (OR 1.5) and low fluid intake (OR 1.5). Diabetes (OR 0.5) and visits to the physician (OR 0.5) had both a significant reverse effect. CONCLUSIONS This study was the first large longitudinal research to explore the risk factors of malnutrition with a comprehensive assessment instrument as the interRAI HC, applying it to the recent GLIM definition criteria. The worldwide use of the interRAI instruments makes these findings relevant for global clinical practice and research. Adapting the interRAI instruments to the GLIM definition improves accurate detection, prevention and early treatment of malnourishment, avoiding further health deterioration in older people.
Collapse
Affiliation(s)
- Johanna de Almeida Mello
- KU Leuven LUCAS - Centre for Care Research and Consultancy, Minderbroedersstraat 8, 3000, Leuven, Belgium.
| | - Nádia Cristina Fávaro-Moreira
- KU Leuven Population Studies in Oral Health - Department of Oral Health Sciences, Kapucijnenvoer 7 Blok a - Bus 7001, 3000, Leuven, Belgium.
| | - Stefanie Krausch-Hofmann
- KU Leuven Population Studies in Oral Health - Department of Oral Health Sciences, Kapucijnenvoer 7 Blok a - Bus 7001, 3000, Leuven, Belgium.
| | - Dirk Vanneste
- KU Leuven LUCAS - Centre for Care Research and Consultancy, Minderbroedersstraat 8, 3000, Leuven, Belgium.
| | - Christophe Matthys
- KU Leuven - Department of Clinical and Experimental Medicine, UZ Herestraat 49, 3000, Leuven, Belgium; Clinical Nutrition Unit, Department of Endocrinology, University Hospitals Leuven, Herestraat 49 - Box 7003-44, 3000, Leuven, Belgium.
| | - Anja Declercq
- KU Leuven LUCAS - Centre for Care Research and Consultancy, Minderbroedersstraat 8, 3000, Leuven, Belgium; Centre for Sociological Research Onderzoek (CeSO), Parkstraat 45 - Bus 3601, 3000 Leuven, Belgium.
| | - Joke Duyck
- KU Leuven Population Studies in Oral Health - Department of Oral Health Sciences, Kapucijnenvoer 7 Blok a - Bus 7001, 3000, Leuven, Belgium; KU Leuven BIOMAT Research Cluster - Department of Oral Health Sciences, Kapucijnenvoer 7 Blok a - Bus 7001, 3000, Leuven, Belgium.
| |
Collapse
|
11
|
Mathieu ME, Reid RER, King NA. Sensory Profile of Adults with Reduced Food Intake and the Potential Roles of Nutrition and Physical Activity Interventions. Adv Nutr 2019; 10:1120-1125. [PMID: 31121014 PMCID: PMC6855938 DOI: 10.1093/advances/nmz044] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/20/2018] [Accepted: 03/29/2019] [Indexed: 12/12/2022] Open
Abstract
The sensory profile, referring to sight, smell, taste, hearing, and touch, plays an essential role in optimizing the habitual intake of energy and macronutrients. However, specific populations, such as older adults, are known to have impaired energy intake. In this paper, the relevance of sensory impairments in this older population is described, and the extent to which nutritional and physical activity interventions can modulate these sensory responses when food intake is insufficient is explored. With aging, all senses deteriorate, and in most cases, such deteriorations diminish the nutritional response. The only exception is sight, for which both positive and negative impacts on nutritional response have been reported. From a prevention perspective, nutritional interventions have been understudied, and to date, only hearing is known to be positively affected by a good nutritional profile. In comparison, physical activity has been more frequently studied in this context, and is linked to an improved preservation of 4 senses. Regarding treatment, very few studies have directly targeted sensory training, and the focus of research has tended to be on nutrition and physical activity intervention. Sensory training, and nutritional and physical activity treatments all have beneficial effects on the senses. In the future, researchers should focus on exploring gaps in the literature specifically concerning prevention, treatment, and sensory response to understand how to improve the efficacy of current approaches. In order to maintain sensory acuity and recover from sensory impairment, the current state of knowledge supports the importance of improving nutritional habits as well as physical activity early on in life. A combined approach, linking a detailed lifestyle profile with the assessment of numerous senses and one or more interventional approaches (nutrition, physical activity, sensory training, etc.), would be required to identify effective strategies to improve the nutritional state of older individuals.
Collapse
Affiliation(s)
- Marie-Eve Mathieu
- École de kinésiologie et des sciences de l'activité physique, Université de Montréal, Montréal, Canada,Sainte-Justine University Hospital Center, Montréal, Canada,Address correspondence to M-EM (E-mail: )
| | - Ryan E R Reid
- École de kinésiologie et des sciences de l'activité physique, Université de Montréal, Montréal, Canada,Sainte-Justine University Hospital Center, Montréal, Canada
| | - Neil A King
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| |
Collapse
|
12
|
Zhang X, Pang L, Sharma SV, Li R, Nyitray AG, Edwards BJ. Prevalence and factors associated with malnutrition in older patients with cancer. J Geriatr Oncol 2019; 10:763-769. [DOI: 10.1016/j.jgo.2019.01.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 12/12/2018] [Accepted: 01/28/2019] [Indexed: 02/08/2023]
|
13
|
Wong MMH, So WKW, Choi KC, Cheung R, Chan HYL, Sit JWH, Ho B, Li F, Lee TY, Chair SY. Malnutrition risks and their associated factors among home-living older Chinese adults in Hong Kong: hidden problems in an affluent Chinese community. BMC Geriatr 2019; 19:138. [PMID: 31122189 PMCID: PMC6533669 DOI: 10.1186/s12877-019-1148-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 04/26/2019] [Indexed: 01/04/2023] Open
Abstract
Background Although China is undergoing rapid economic development, it is facing an ageing population. No data exists on malnutrition risks of older adults in an affluent Chinese society. The aim of this study is to examine these risks and identify their associated factors among home-living older Chinese adults in Hong Kong. Methods This is a cross-sectional study, to which home-living subjects aged 60 or above were recruited, between May and September 2017, from a non-governmental community organisation located in three different districts of Hong Kong. Nutritional status was assessed by the Mini Nutritional Assessment (MNA), and its associated factors examined included socio-demographic characteristics, lifestyle, health status and diet. Multivariable logistic regression analysis was performed to identify factors associated with malnutrition risks (MNA < 24). Results Six hundred thirteen subjects (mean age: 78.5 ± 7.4; 54.0% females) completed the survey. Nearly 30% (n = 179) were at risk of malnutrition. By multivariable logistic regression, subjects (1) whose vision was only fair or unclear, (2) with poor usual appetite and (3) with main meal skipping behaviour had significantly higher malnutrition risk (all p < 0.05). Conclusions In this affluent Chinese society, the malnutrition risk in older adults is close to the global average, which is a matter for much concern. Interventions are therefore warranted that target vulnerable groups with poor vision, appetite, and meal skipping behaviour. Trial registration Not applicable.
Collapse
Affiliation(s)
- Martin M H Wong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Winnie K W So
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China.
| | - Kai Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Regina Cheung
- The Neighbourhood Advice-Action Council, North Point, Hong Kong, China
| | - Helen Y L Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Janet W H Sit
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Brenda Ho
- The Neighbourhood Advice-Action Council, North Point, Hong Kong, China
| | - Francis Li
- The Neighbourhood Advice-Action Council, North Point, Hong Kong, China
| | - Tin Yan Lee
- The Neighbourhood Advice-Action Council, North Point, Hong Kong, China
| | - Sek Ying Chair
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| |
Collapse
|
14
|
Lacau St Guily J, Bouvard É, Raynard B, Goldwasser F, Maget B, Prevost A, Seguy D, Romano O, Narciso B, Couet C, Balon JM, Vansteene D, Salas S, Grandval P, Gyan E, Hebuterne X. NutriCancer: A French observational multicentre cross-sectional study of malnutrition in elderly patients with cancer. J Geriatr Oncol 2018; 9:74-80. [DOI: 10.1016/j.jgo.2017.08.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 07/11/2017] [Accepted: 08/11/2017] [Indexed: 01/19/2023]
|
15
|
Hajek A, König HH. The longitudinal association between informal caregiving and body mass index in the second half of life: findings of the German Ageing Survey. Public Health 2017; 151:81-86. [PMID: 28753532 DOI: 10.1016/j.puhe.2017.06.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 06/13/2017] [Accepted: 06/24/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE We aimed to investigate the relation between informal caregiving and body mass index (BMI) longitudinally. STUDY DESIGN The data were drawn from wave 2 (2002) to wave 5 (2014) of the German Ageing Survey. This is a representative sample of the community-dwelling population aged 40 years and above in Germany. METHODS Self-rated BMI was used. Individuals were asked whether they provide informal care on a regular basis. Adjusting for employment status, age, marital status, morbidity and depressive symptoms, fixed effects regressions were used. RESULTS The fixed effects regressions showed that the onset of informal caregiving was not associated with changes in BMI in the total sample and in women, whereas the onset of informal caregiving was associated with increasing BMI in men (β = 0.15, P < 0.05). In addition, an increase in BMI was positively associated with ageing, an increase in morbidity and a decrease in frequency of sports activities in the total sample and in both sexes. CONCLUSIONS Our findings stress the longitudinal relation between informal caregiving and BMI in men. Consequently, it might be helpful to generate weight management strategies specifically designed for male informal caregivers.
Collapse
Affiliation(s)
- A Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - H-H König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| |
Collapse
|
16
|
Shlisky J, Bloom DE, Beaudreault AR, Tucker KL, Keller HH, Freund-Levi Y, Fielding RA, Cheng FW, Jensen GL, Wu D, Meydani SN. Nutritional Considerations for Healthy Aging and Reduction in Age-Related Chronic Disease. Adv Nutr 2017; 8:17-26. [PMID: 28096124 PMCID: PMC5227979 DOI: 10.3945/an.116.013474] [Citation(s) in RCA: 229] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
A projected doubling in the global population of people aged ≥60 y by the year 2050 has major health and economic implications, especially in developing regions. Burdens of unhealthy aging associated with chronic noncommunicable and other age-related diseases may be largely preventable with lifestyle modification, including diet. However, as adults age they become at risk of "nutritional frailty," which can compromise their ability to meet nutritional requirements at a time when specific nutrient needs may be high. This review highlights the role of nutrition science in promoting healthy aging and in improving the prognosis in cases of age-related diseases. It serves to identify key knowledge gaps and implementation challenges to support adequate nutrition for healthy aging, including applicability of metrics used in body-composition and diet adequacy for older adults and mechanisms to reduce nutritional frailty and to promote diet resilience. This review also discusses management recommendations for several leading chronic conditions common in aging populations, including cognitive decline and dementia, sarcopenia, and compromised immunity to infectious disease. The role of health systems in incorporating nutrition care routinely for those aged ≥60 y and living independently and current actions to address nutritional status before hospitalization and the development of disease are discussed.
Collapse
Affiliation(s)
- Julie Shlisky
- The Sackler Institute for Nutrition Science at the New York Academy of Sciences, New York, NY;
| | - David E Bloom
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA
| | | | - Katherine L Tucker
- Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA
| | - Heather H Keller
- Schlegel-UW Research Institute for Aging, Applied Health Sciences, University of Waterloo, Ontario, Canada
| | - Yvonne Freund-Levi
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
- Department of Geriatrics, Karolinska University Hospital, Huddinge, Sweden
- Department of Psychiatry, Tiohundra Hospital, Stockholm, Sweden
| | | | - Feon W Cheng
- The Pennsylvania State University, University Park, PA; and
| | | | - Dayong Wu
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - Simin N Meydani
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| |
Collapse
|
17
|
Sharkey JR, Haines PS. Use of Telephone-Administered Survey for Identifying Nutritional Risk Indicators Among Community-Living Older Adults in Rural Areas. J Appl Gerontol 2016. [DOI: 10.1177/073346480202100307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The ability of Elderly Nutrition Programs, especially in rural areas, to address increasing needs for disparate program services is linked to determining which older people are most likely to be at nutritional risk and what constitutes the potential risk. The purpose of this study is to characterize nutritional risk factors in a probability sample of rural elders (n = 152) through telephone interviews using a 67-question modified version of the Nutrition Screening Initiative's Level I and II screens. Participants reported high levels of unintentional weight loss, medication use, multiple health conditions, and depression. This study demonstrates that comprehensive information on general health, eating habits, living environment, and functional status can be collected from rural elders by telephone. Because much of the reported nutritional risk in this sample occurs in residents living in areas not receiving nutrition services, expanded nutritional risk data can be used to anticipate need for programs and services in areas not presently served.
Collapse
|
18
|
Bierhals IO, Meller FDO, Assunção MCF. Dependence for food-related activities in the elderly. CIENCIA & SAUDE COLETIVA 2016; 21:1297-308. [PMID: 27076028 DOI: 10.1590/1413-81232015214.12922015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 08/23/2015] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to describe dependence for the activities of food shopping, preparing meals and eating in elderly residents from the city of Pelotas, Rio Grande do Sul. Bivariate analysis and ordinal logistic regression were employed to assess the three dependencies and exposure variables studied. Of the 1,451 older adults assessed, 21.1% required assistance for some activities where this care was given predominantly by son/daughter and partners. The highest prevalence of dependence was for food shopping (20.7%), followed by preparing meals (11.5%) and eating (2.0%). Elderly aged 80 years or older were more likely to be in a greater dependence category than individuals aged 60-69 years, with odds ratios of 5.0 for men and 7.1 for women. The odds ratio in individuals who self-rated their health as regular, poor or very poor was approximately 2.3 times greater, proving similar for both genders. Women with no partner had a 1.7 times greater chance of dependence whilst individuals with greater educational level exhibited 70.0% protection for their reference category; men with lower socioeconomic level had a 5.3 times greater chance of dependence than individuals with higher socioeconomic level. These results highlight the most vulnerable subgroups for dependencies and the importance of a family caregiver.
Collapse
|
19
|
Factors associated with (risk of) undernutrition in
community-dwelling older adults receiving home care: a cross-sectional study in
the Netherlands. Public Health Nutr 2016; 19:2278-89. [DOI: 10.1017/s1368980016000288] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
AbstractObjectiveIt is generally thought that causes of undernutrition are multifactorial, but
there are limited quantitative studies performed. We therefore examined a
wide range of potential factors associated with undernutrition in
community-dwelling older adults.DesignCross-sectional study.SettingCommunity-dwelling older adults (≥65 years) receiving home care in the
Netherlands.SubjectsData on potential factors associated with (risk of) undernutrition were
collected among 300 older adults. Nutritional status was assessed by the
SNAQ65+ instrument. Undernutrition was defined as
mid-upper arm circumference <25 cm or unintentional weight loss of
≥4 kg in 6 months. Being at risk of undernutrition was defined as
having poor appetite and inability to walk up and down stairs of fifteen
steps, without resting.ResultsOf all participants, ninety-two (31·7 %) were undernourished
and twenty-four (8·0 %) were at risk of undernutrition. Based
on multivariate logistic regression analyses, the statistically significant
factors associated with (risk of) undernutrition
(P<0·05) were: unable to go outside
(OR=5·39), intestinal problems (OR=2·88),
smoking (OR=2·56), osteoporosis (OR=2·46),
eating fewer than three snacks daily (OR=2·61), dependency in
activities of daily living (OR=1·21), physical inactivity
(OR=2·01), nausea (OR=2·50) and cancer
(OR=2·84); a borderline significant factor was depression
symptoms (OR=1·83,
P=0·053).ConclusionsThe study suggests that (risk of) undernutrition is a multifactorial problem
and that associated factors can be found in several domains. These findings
may support the development of intervention trials for the prevention and
treatment of undernutrition in community-dwelling older adults.
Collapse
|
20
|
Hamirudin AH, Charlton K, Walton K. Outcomes related to nutrition screening in community living older adults: A systematic literature review. Arch Gerontol Geriatr 2016; 62:9-25. [DOI: 10.1016/j.archger.2015.09.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 09/18/2015] [Accepted: 09/20/2015] [Indexed: 01/04/2023]
|
21
|
Naseer M, Fagerström C. Prevalence and Association of Undernutrition with Quality of Life among Swedish People Aged 60 Years and Above: Results of the SNAC-B Study. J Nutr Health Aging 2015; 19:970-9. [PMID: 26624207 DOI: 10.1007/s12603-015-0656-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to assess the prevalence of undernutrition among elderly and to investigate the association of risk of undernutrition with health-related quality of life and life satisfaction controlling for age, gender, marital status, economic status, housing arrangement, education level, functional ability, and diseases. DESIGN A cross-sectional study design was used for this study. The baseline data (2001-2003) of "The Swedish National Study of Aging and Care-Blekinge (SNAC-B)" was used. SETTING This population-based study focused on both home-living and special-housing residents. PARTICIPANTS The participants (n=1402) were randomly selected and included both males and females 60-96 years of age residing in a municipality of south-east Sweden. MEASUREMENTS The risk of undernutrition was estimated by the occurrence of at least one anthropometric measure (body mass index, mid-arm circumference, and calf circumference) below cut-off, in addition to the presence of at least one subjective measure (declined food intake, weight loss, and eating difficulty). The dependent variables, health-related quality of life and life satisfaction, were measured by the validated short form health survey (SF-12) and Liang's life satisfactions index A (LSIA), respectively. RESULTS According to the criterion, 8.5% of the participants were at risk of undernutrition, and subjects at nutritional risk were significantly older, female, unmarried/widowed/divorced, residing in special housing, and functionally impaired. The risk of undernutrition was significantly associated with poor health-related quality of life, both in the physical (OR 2.31, 95% CI 1.18-4.52) and mental (OR 2.34, 95% CI 1.22-4.47) dimensions. However, no significant association was observed between nutritional status and life satisfaction (OR 1.30, 95% CI 0.70-2.40). CONCLUSION The risk of undernutrition significantly increases the risk of poor physical and mental health-related quality of life but has negligible impact on life satisfaction. This study also highlights the importance of functional ability both for the prevention of undernutrition and promotion of quality of life. However, more studies are needed to validate the tool used here for undernutrition risk assessment before it can be used in clinical or population settings.
Collapse
Affiliation(s)
- M Naseer
- Dr Cecilia Fagerström, Department of health, Blekinge Institute of Technology, SE-371 39 Karlskrona, Sweden, Phone: 00 46 (0) 455 385445, Fax: 00 46 (0) 455 385407,
| | | |
Collapse
|
22
|
Pilgrim AL, Robinson SM, Sayer AA, Roberts HC. An overview of appetite decline in older people. Nurs Older People 2015; 27:29-35. [PMID: 26018489 DOI: 10.7748/nop.27.5.29.e697] [Citation(s) in RCA: 152] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Poor appetite is a common problem in older people living at home and in care homes, as well as hospital inpatients. It can contribute to weight loss and nutritional deficiencies, and associated poor healthcare outcomes, including increased mortality. Understanding the causes of reduced appetite and knowing how to measure it will enable nurses and other clinical staff working in a range of community and hospital settings to identify patients with impaired appetite. A range of strategies can be used to promote better appetite and increase food intake.
Collapse
Affiliation(s)
- Anna L Pilgrim
- National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust; MRC Lifecourse Epidemiology Unit, University of Southampton
| | | | | | | |
Collapse
|
23
|
Ter Borg S, Verlaan S, Mijnarends DM, Schols JMGA, de Groot LCPGM, Luiking YC. Macronutrient Intake and Inadequacies of Community-Dwelling Older Adults, a Systematic Review. ANNALS OF NUTRITION & METABOLISM 2015; 66:242-255. [PMID: 26183836 DOI: 10.1159/000435862] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 06/03/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Anorexia of ageing may predispose older adults to under-nutrition and protein energy malnutrition. Studies, however, report a large variation in nutrient inadequacies among community-dwelling older adults. SUMMARY This systematic review provides a comprehensive overview of the energy and macronutrient intakes and possible inadequacies in community-dwelling older adults. PubMed and EMBASE were screened up to December 2013; data from national nutrition surveys were added. Forty-six studies were included, following the PRISMA guideline. KEY MESSAGES Mean daily energy intake was 8.9 MJ in men and 7.3 MJ in women. Mean daily carbohydrate and protein intakes were 46 and 15 En% in men and 47 and 16 En% in women, respectively. Mean daily total fat, saturated fatty acid (SFA), mono-unsaturated fatty acid (MUFA) and poly-unsaturated fatty acid intakes were respectively 34, 13, 13 and 5-6 En%. The carbohydrates and MUFA intakes are below the acceptable macronutrient distribution ranges (AMDR). Fat intake is relatively high, and SFA intake exceeds the upper-AMDR. Based on the estimated average requirement (EAR) cut-point method, 10-12% of older adults do not meet the EAR for protein. To interpret a possible energy imbalance additional information is needed on physical activity, energy expenditure and body weight changes. This systematic review indicates a suboptimal dietary macronutrient distribution and a large variation in nutrient intakes among community-dwelling older adults.
Collapse
|
24
|
Fernández-Barrés S, Martín N, Canela T, García-Barco M, Basora J, Arija V. Dietary intake in the dependent elderly: evaluation of the risk of nutritional deficit. J Hum Nutr Diet 2015; 29:174-84. [PMID: 25918988 DOI: 10.1111/jhn.12310] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Malnutrition is a frequent problem in elderly dependent patients and their prognosis is adversely affected. Assessment of food consumption and adequacy of energy and nutrient intake of dependent elderly is needed to plan any selected actions for this population. METHODS The study comprised a multicentre cross-sectional study of 190 users (≥65 years) of a home care programme provided by primary care centers in Tarragona (Spain), at nutritional risk (Mini Nutritional Assessment: 17-23.5 points). Food consumption was assessed using a semiquantitative validated food frequency questionnaire. Energy intake was compared with the Spanish dietary reference intake (DRI) and nutritional intakes with the DRI of the American Institute of Medicine. RESULTS Mean (SD) age was 85.0 (7.2) years (67.5% female). The food items consumed were varied but lower than the recommended portions for cereals, fruits, vegetables and legumes. Energy intake was 7454.2 (1553.9 kJ day(-1)) [1781.6 (371.4) kcal day(-1)] (97.7% of recommended dietary allowance; RDA) and protein intake was 1.0 (0.4) g kg(-1) of weight (121.4% of RDA). Proteins provided 13.3%, carbohydrates provided 39.9% and fats provided 45.8% of energy intake. The intakes of calcium, vitamin D, vitamin E and folates were less than two-thirds of the RDA and their probability of inadequate intake was >85%. CONCLUSIONS Dietary intakes of elderly dependent patients at nutritional risk were well balanced. In general, energy and protein intakes meet the recommendations. The diet was high in energy density, low in complex carbohydrates, high in simple carbohydrates and excessive in fats. The dependent elderly had inadequate intake of micronutrients often related to fragility, such as calcium, vitamin D, vitamin E and folates.
Collapse
Affiliation(s)
- S Fernández-Barrés
- Unitat de Suport a la Recerca Tarragona-Reus, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.,Nutrition and Public Health Unit, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Spain
| | - N Martín
- Centre d'Atenció Primària, Direcció d'Atenció Primària Tarragona, Institut Català de la Salut, Tarragona, Spain
| | - T Canela
- Centre d'Atenció Primària, Direcció d'Atenció Primària Tarragona, Institut Català de la Salut, Tarragona, Spain
| | - M García-Barco
- Centre d'Atenció Primària, Direcció d'Atenció Primària Tarragona, Institut Català de la Salut, Tarragona, Spain
| | - J Basora
- Unitat de Suport a la Recerca Tarragona-Reus, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.,Institut de Investigació Sanitària Pere Virgili, Reus, Spain
| | - V Arija
- Unitat de Suport a la Recerca Tarragona-Reus, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.,Nutrition and Public Health Unit, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Spain.,Institut de Investigació Sanitària Pere Virgili, Reus, Spain
| | | |
Collapse
|
25
|
Shpata V, Ohri I, Nurka T, Prendushi X. The prevalence and consequences of malnutrition risk in elderly Albanian intensive care unit patients. Clin Interv Aging 2015; 10:481-6. [PMID: 25733824 PMCID: PMC4337415 DOI: 10.2147/cia.s77042] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Many investigators have reported rising numbers of elderly patients admitted to the intensive care units (ICUs). The aim of the study was to estimate the prevalence of malnutrition risk in the ICU by comparing the prevalence of malnutrition between older adults (aged 65 years and above) and adults (aged 18-64 years), and to examine the negative consequences associated with risk of malnutrition in older adults. MATERIALS AND METHODS A prospective cohort study in the ICU of the University Hospital Center of Tirana, Albania, was conducted. Logistic regression analysis was used to analyze the effect of malnutrition risk on the length of ICU stay, the duration of being on the ventilator, the total complications, the infectious complications, and the mortality. RESULTS In this study, 963 patients participated, of whom 459 patients (47.7%) were aged ≥65 years. The prevalence of malnutrition risk at the time of ICU admission of the patients aged ≥65 years old was 71.24%. Logistic regression adjusted for confounders showed that malnutrition risk was an independent risk factor of poor clinical outcome for elderly ICU patients, for 1) infections (odds ratio [OR] =4.37; 95% confidence interval [CI]: 2.61-7.31); 2) complications (OR =6.73; 95% CI: 4.26-10.62); 3) mortality (OR =2.68; 95% CI: 1.72-4.18); and 4) ICU length of stay >14 days (OR =5.18, 95% CI: 2.43-11.06). CONCLUSION Malnutrition risk is highly prevalent among elderly ICU patients, especially among severely ill patients with malignancy admitted to the emergency ward. ICU elderly patients at malnutrition risk will have higher complication and infection rates, longer duration of ICU stay, and increased mortality. Efforts should be made to implement a variety of nutritional care strategies, to change the nutritional practices not only at ward level, but nationally, according to the best clinical practice and recent guidelines.
Collapse
Affiliation(s)
- Vjollca Shpata
- Faculty of Medical Technical Sciences, University of Medicine in Tirana, Tirana, Albania
| | - Ilir Ohri
- University Hospital Center of Tirana "Mother Theresa", Faculty of Medicine, University of Medicine in Tirana, Tirana, Albania
| | - Tatjana Nurka
- Faculty of Medical Technical Sciences, University of Medicine in Tirana, Tirana, Albania
| | - Xhensila Prendushi
- Faculty of Medical Technical Sciences, University of Medicine in Tirana, Tirana, Albania
| |
Collapse
|
26
|
van der Pols-Vijlbrief R, Wijnhoven HAH, Schaap LA, Terwee CB, Visser M. Determinants of protein-energy malnutrition in community-dwelling older adults: a systematic review of observational studies. Ageing Res Rev 2014; 18:112-31. [PMID: 25257179 DOI: 10.1016/j.arr.2014.09.001] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 09/05/2014] [Accepted: 09/15/2014] [Indexed: 01/17/2023]
Abstract
Protein-energy malnutrition is associated with numerous poor health outcomes, including high health care costs, mortality rates and poor physical functioning in older adults. This systematic literature review aims to identify and provide an evidence based overview of potential determinants of protein-energy malnutrition in community-dwelling older adults. A systematic search was conducted in PUBMED, EMBASE, CINAHL and COCHRANE from the earliest possible date through January 2013. Observational studies that examined determinants of protein-energy malnutrition were selected and a best evidence synthesis was performed to summarize the results. In total 28 studies were included in this review from which 122 unique potential determinants were derived. Thirty-seven determinants were examined in sufficient number of studies and were included in a best evidence synthesis. The best evidence score comprised design (cross-sectional, longitudinal) and quality of the study (high, moderate) to grade the evidence level. Strong evidence for an association with protein-energy malnutrition was found for poor appetite, and moderate evidence for edentulousness, having no diabetes, hospitalization and poor self-reported health. Strong evidence for no association was found for anxiety, chewing difficulty, few friends, living alone, feeling lonely, death of spouse, high number of diseases, heart failure and coronary failure, stroke (CVA) and the use of anti-inflammatory medications. This review shows that protein-energy malnutrition is a multifactorial problem and that different domains likely play a role in the pathway of developing protein-energy malnutrition. These results provide important knowledge for the development of targeted, multifactorial interventions that aim to prevent the development of protein-energy malnutrition in community-dwelling older adults.
Collapse
Affiliation(s)
- Rachel van der Pols-Vijlbrief
- Department of Health Sciences, EMGO(+) Institute for Health and Care Research, VU University, Amsterdam, The Netherlands.
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, EMGO(+) Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
| | - Laura A Schaap
- Department of Epidemiology and Biostatistics, EMGO(+) Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Caroline B Terwee
- Department of Epidemiology and Biostatistics, EMGO(+) Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, EMGO(+) Institute for Health and Care Research, VU University, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, EMGO(+) Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
27
|
Watkinson-Powell A, Barnes S, Lovatt M, Wasielewska A, Drummond B. Food provision for older people receiving home care from the perspectives of home-care workers. HEALTH & SOCIAL CARE IN THE COMMUNITY 2014; 22:553-560. [PMID: 24981791 DOI: 10.1111/hsc.12117] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/06/2014] [Indexed: 06/03/2023]
Abstract
Malnutrition is a significant cause of morbidity and mortality, particularly among older people. Attention has focused on the inadequacies of food provision in institutions, yet the majority suffering from malnutrition live in the community. The aim of this study was to explore barriers and facilitators to food provision for older people receiving home care. It was a qualitative exploratory study using semi-structured interviews with nine home-care workers in June 2013 employed by independent agencies in a large city in northern England. Data were analysed thematically, based on the principles of grounded theory. Findings showed that significant time pressures limited home-care workers in their ability to socially engage with service users at mealtimes, or provide them with anything other than ready meals. Enabling choice was considered more important than providing a healthy diet, but choice was limited by food availability and reliance on families for shopping. Despite their knowledge of service users and their central role in providing food, home-care workers received little nutritional training and were not involved by healthcare professionals in the management of malnutrition. Despite the rhetoric of individual choice and importance of social engagement and nutrition for health and well-being, nutritional care has been significantly compromised by cuts to social care budgets. The potential role for home-care workers in promoting good nutrition in older people is undervalued and undermined by the lack of recognition, training and time dedicated to food-related care. This has led to a situation whereby good quality food and enjoyable mealtimes are denied to many older people on the basis that they are unaffordable luxuries rather than an integral component of fundamental care.
Collapse
|
28
|
Vision impairment and nutritional status among older assisted living residents. Arch Gerontol Geriatr 2014; 58:384-7. [DOI: 10.1016/j.archger.2013.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 12/10/2013] [Accepted: 12/12/2013] [Indexed: 11/18/2022]
|
29
|
Wham CA, Redwood KM, Kerse N. Validation of the nutrition screening tool 'Seniors in the Community: Risk Evaluation for Eating and Nutrition, version II' among octogenarians. J Nutr Health Aging 2014; 18:39-43. [PMID: 24402387 DOI: 10.1007/s12603-013-0361-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To determine the validity of the nutrition screening tool 'Seniors in the Community: Risk Evaluation for Eating and Nutrition, version II' (SCREEN II) among a purposive sample of octogenarians. DESIGN Cross-sectional validation study. SETTING Bay of Plenty, New Zealand. PARTICIPANTS Forty-five community-living residents aged 85-86 years. Equal proportions of participants were recruited at low, medium and high nutrition risk based on their SCREEN II score 12 months prior. MEASUREMENTS Nutrition risk was assessed using SCREEN II. Demographic and health data were established. Using established criterion a dietitian's nutrition risk rating assessment ranked participants from low risk (score of 1) to high risk (score of 10). The assessment included a medical history, anthropometric measures and dietary intake. Dietary intake was established from three 24 hour multiple pass recalls (MPR). A Spearman's correlation determined the association between the SCREEN II score and the dietitian's risk score. Receiver operating characteristic (ROC) curves were completed to determine the sensitivity and specificity of the cut-off point for high nutrition risk. RESULTS The SCREEN II score was significantly correlated with the dietitian's risk rating (rs = -0.76 (p<0.01). A newly defined cut-off point <49 was established for high nutrition risk derived from ROC curves and AUC (0.87, p < 0.01); sensitivity 90% and specificity 86%. CONCLUSION SCREEN II is a simple, easy to use, 14 item questionnaire and appears to be a valid tool for detection of nutrition risk people aged 85-86 years.
Collapse
Affiliation(s)
- C A Wham
- C.A. Wham, Massey University, Institute of Food Nutrition and Human Health, Auckland, New Zealand,
| | | | | |
Collapse
|
30
|
Allen VJ, Methven L, Gosney M. Impact of serving method on the consumption of nutritional supplement drinks: randomized trial in older adults with cognitive impairment. J Adv Nurs 2013; 70:1323-33. [DOI: 10.1111/jan.12293] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Victoria J. Allen
- Royal Berkshire NHS Foundation Trust; Reading UK
- Clinical Health Sciences; University of Reading; UK
| | - Lisa Methven
- Food and Nutritional Sciences; University of Reading; UK
| | | |
Collapse
|
31
|
Hirose T, Hasegawa J, Izawa S, Enoki H, Suzuki Y, Kuzuya M. Accumulation of geriatric conditions is associated with poor nutritional status in dependent older people living in the community and in nursing homes. Geriatr Gerontol Int 2013; 14:198-205. [PMID: 24118829 DOI: 10.1111/ggi.12079] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2013] [Indexed: 11/30/2022]
Abstract
AIM To clarify the association between nutritional status and the prevalence of geriatric conditions in dependent older adults. METHODS A cross-sectional observational study of dependent older adults aged 65years or older who were living either in the community (n = 511, mean age 81.2years) or in nursing homes (n = 587, mean age 85.2years) was carried out. Data included the participants' demographic characteristics, basic activities of daily living, Charlson Comorbidity Index and the prevalence of eight geriatric conditions (visual impairment, hearing impairment, falls, bladder control problems, cognitive impairment, impaired mobility, swallowing disturbance and loss of appetite). Nutritional status was assessed by the Mini Nutritional Assessment short form (MNA-SF). RESULTS Of 1098 participants, 21.4% (n = 235) were categorized as "malnourished", according to the MNA-SF classification. Participants in the "malnourished" group had a greater number of geriatric conditions than those in the other two groups. A higher prevalence of all the geriatric conditions except for falls was detected in the group with poorer nutritional status. Multivariate logistic regression analysis showed that malnutrition was associated with the number of geriatric conditions, but not with that of comorbidities, even after controlling for confounders. CONCLUSIONS Malnutrition was confirmed to have significant associations with geriatric conditions in dependent older adults.
Collapse
Affiliation(s)
- Takahisa Hirose
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate, School of Medicine, Nagoya, Japan
| | | | | | | | | | | |
Collapse
|
32
|
Fuchida S, Yamamoto T, Takiguchi T, Kandaudahewa G, Yuyama N, Hirata Y. Association between underweight and taste sensitivity in middle- to old-aged nursing home residents in Sri Lanka: a cross-sectional study. J Oral Rehabil 2013; 40:854-63. [DOI: 10.1111/joor.12099] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2013] [Indexed: 11/29/2022]
Affiliation(s)
- S. Fuchida
- Department of Dental Sociology; Kanagawa Dental University Graduate School of Dentistry; Yokosuka Japan
| | - T. Yamamoto
- Department of Dental Sociology; Kanagawa Dental University Graduate School of Dentistry; Yokosuka Japan
| | - T. Takiguchi
- Department of Dental Sociology; Kanagawa Dental University Graduate School of Dentistry; Yokosuka Japan
- Department of Health Informatics; Niigata University of Health and Welfare; Niigata Japan
| | - G. Kandaudahewa
- Department of Dental Sociology; Kanagawa Dental University Graduate School of Dentistry; Yokosuka Japan
- Oral Health Unit; The Ministry of Healthcare & Nutrition; Colombo Sri Lanka
| | - N. Yuyama
- Department of Dental Education; Kanagawa Dental University Graduate School of Dentistry; Yokosuka Japan
| | - Y. Hirata
- Department of Dental Sociology; Kanagawa Dental University Graduate School of Dentistry; Yokosuka Japan
| |
Collapse
|
33
|
Locher JL, Vickers KS, Buys DR, Ellis A, Lawrence JC, Newton LE, Roth DL, Ritchie CS, Bales CW. A randomized controlled trial of a theoretically-based behavioral nutrition intervention for community elders: lessons learned from the Behavioral Nutrition Intervention for Community Elders Study. J Acad Nutr Diet 2013; 113:1675-82. [PMID: 24021733 DOI: 10.1016/j.jand.2013.06.352] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 06/18/2013] [Indexed: 01/17/2023]
Abstract
Older adults with multiple comorbidities are often undernourished or at high risk for becoming so, especially after a recent hospitalization. Randomized controlled trials of effective, innovative interventions are needed to support evidence-based approaches for solving nutritional problems in this population. Self-management approaches where participants select their own behavioral goals can enhance success of interventions. The purpose of this study was to evaluate the feasibility and efficacy of a multilevel self-management intervention to improve nutritional status in a group of high-risk older adults. The Behavioral Nutrition Intervention for Community Elders (B-NICE) trial used a prospective randomized controlled design to determine whether the intervention, compared to standard care, maintained or increased caloric intake (depending on baseline body mass index) and, consequently, stabilized or increased body weight. Participants were 34 Medicare-eligible, age 65 years old or older, homebound adults who were consuming insufficient calories and/or had a history of weight loss ≥2.5% over 6 months. The intervention took place within participants' homes. Outcome measures, including energy intake (based on collection of three 24-hour dietary recalls) and body weights were assessed at baseline and at 60 days post randomization. The primary analyses included analyses of covariance and Pearson's χ(2). We hypothesized that the intervention would result in increased caloric intake and weight gain in underweight older adults and increased or stabilized caloric intake and weight for everyone else. The intervention was feasible; however, it did not result in differences between groups for desired outcomes of either caloric intake or body weight. Future interventions might either deliberately involve caregivers or reduce burden for both patients and caregivers.
Collapse
|
34
|
Lundin H, Sääf M, Strender LE, Mollasaraie HA, Salminen H. Mini nutritional assessment and 10-year mortality in free-living elderly women: a prospective cohort study with 10-year follow-up. Eur J Clin Nutr 2013; 66:1050-3. [PMID: 22947901 DOI: 10.1038/ejcn.2012.100] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Mini nutritional assessment (MNA) is the most frequently used screening test for malnutrition in elderly populations in continental Europe and Asia. Most studies on MNA's ability to predict mortality have only included persons admitted to hospital, living in nursing homes or at home with professional help with activities of daily living. The aim of this cohort study was to examine if MNA can predict 10-year mortality in the general elderly female population. SUBJECTS/METHODS Of the 584 free-living elderly women invited, 351 agreed to participate and were tested with MNA between 1999 and 2000. A 10-year follow-up was conducted in 2010 with dates of death obtained from the Swedish death register. RESULTS Participants whose MNA score was ≤ 23.5 points at inclusion had a significantly higher age-adjusted 10-year mortality risk than participants with a MNA score of >23.5 points. The hazard ratio was 2.36 (95% confidence interval 1.25-4.46), P <0.01. CONCLUSIONS Participants with a MNA score, indicating an increased risk for malnutrition, were more than twice as likely to die during the 10-year follow-up as participants whose MNA score indicated normal nutritional status. Hence, MNA can predict mortality in a general, free-living, elderly female population.
Collapse
Affiliation(s)
- H Lundin
- Centre for Family Medicine (CeFAM), Karolinska Institutet, Stockholm, Sweden.
| | | | | | | | | |
Collapse
|
35
|
Vafaei Z, Mokhtari H, Sadooghi Z, Meamar R, Chitsaz A, Moeini M. Malnutrition is associated with depression in rural elderly population. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2013; 18:S15-9. [PMID: 23961277 PMCID: PMC3743311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 01/20/2013] [Accepted: 02/04/2013] [Indexed: 11/11/2022]
Abstract
BACKGROUND Aging induces physiological changes and affects all of organs. Nutritional status and mental health deteriorate with aging. As malnutrition and depression are main problem in elderly this study was performed to assess the association between malnutrition and depression among rural elderly. MATERIALS AND METHODS Three hundred and seventy rural elderly aged over 60 years were examined in a cross-sectional study by systematic sampling method and using mini nutritional assessment (MNA), which is a standard questionnaire for evaluating nutrition status. Depression was evaluated by a validated questionnaire in the elderly. Correlation between Socio-demographic characteristic, diseases, and nutrition status was obtained by t-test, Chi-square test and logistic regression in elderly population. RESULTS Mean ± SD age was 70.6 ± 7.3 years. Frequency of malnutrition was similar in both genders. According to MNA, 3.8% of subjects suffered from malnutrition, 32.7% were at risk of malnutrition and 63.5% were well-nourished. Nutrition status correlated with body mass index (P = 0.028) and depression (P = 0.001). The risk of severe depression in patients with malnutrition was 15.5 times higher than non-depressed persons (odd ratio: 15.5; 95% CI: 2.9-82.5). CONCLUSION Depression could act as a powerful risk for malnutrition in elderly population that it should be controlled by physicians.
Collapse
Affiliation(s)
- Zamane Vafaei
- Department of Epidemiology, Isfahan university of Medical Science, Isfahan, Iran
| | - Habibollah Mokhtari
- Cardiovascular research institute, Isfahan university of Medical Science, Isfahan, Iran
| | - Zahra Sadooghi
- Department of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rokhsareh Meamar
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Medical Science, Islamic Azad University, Najafabad Branch, Isfahan, Iran
| | - Ahmad Chitsaz
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Neurology, Isfahan University of Medical Sciences Isfahan, Iran
| | - Mina Moeini
- Cardiovascular research institute, Isfahan university of Medical Science, Isfahan, Iran
| |
Collapse
|
36
|
Schilp J, Kruizenga HM, Wijnhoven HAH, van Binsbergen JJ, Visser M. Effects of a dietetic treatment in older, undernourished, community-dwelling individuals in primary care: a randomized controlled trial. Eur J Nutr 2013; 52:1939-48. [DOI: 10.1007/s00394-013-0495-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 01/14/2013] [Indexed: 12/21/2022]
|
37
|
Blankson B, Hall A. The anthropometric status of elderly women in rural Ghana and factors associated with low body mass index. J Nutr Health Aging 2012; 16:881-6. [PMID: 23208026 DOI: 10.1007/s12603-012-0065-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To describe the anthropometric and physical status of a sample of elderly women in rural Ghana and examine factors associated with a low body mass index (BMI). DESIGN A cross-sectional survey. SETTING Two rural villages in Ashanti Region, Ghana. PARTICIPANTS Fifty-nine elderly women aged 60 to 92 years. MEASUREMENTS The weight, height, half armspan and mid-upper arm circumference (MUAC) of each woman was measured; body mass index (BMI) and body mass for armspan (BMA) were calculated. The state of each woman's teeth and visual acuity was assessed. Data on food security, eating habits and socio-economic status were collected by questionnaire. RESULTS 41% (95%CI 27.8, 53.6) of women were underweight and 16.9% (95%CI 7.18, 26.8) were overweight or obese. Factors associated with a low BMI (<18.5 kg/m2) were: age (P=0.001), chewing tobacco (P=0.002), drinking alcohol (P=0.012), a visual acuity score of <30% (P=0.038), using a walking aid (P=0.016) and the number of children who gave the women cash (P=0.005). BMI was strongly positively correlated with BMA (r=0.999, P<0.001) and with MUAC (r=0.91, P<0.001), and a BMI of 18.5 was equivalent to a MUAC of about 23cm. CONCLUSION Elderly women in Ghana with poor teeth and eyesight are at risk of undernutrition. Measurements of MUAC, which is simple, or BMA, which is based on weight and half armspan and is more easily measured and calculated than height and BMI, could be used to identify undernourished elderly women in rural Africa.
Collapse
Affiliation(s)
- B Blankson
- Centre for Public Health Nutrition, School of Life Sciences, University of Westminster, London, UK.
| | | |
Collapse
|
38
|
Poor nutritional status of older subacute patients predicts clinical outcomes and mortality at 18 months of follow-up. Eur J Clin Nutr 2012; 66:1224-8. [DOI: 10.1038/ejcn.2012.130] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
39
|
Hanisah R, Suzana S, Lee FS. Validation of screening tools to assess appetite among geriatric patients. J Nutr Health Aging 2012; 16:660-5. [PMID: 22836710 DOI: 10.1007/s12603-012-0056-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Poor appetite is one of the main contributing factors of poor nutritional status among elderly individuals. Recognizing the importance of assessment of appetite, a cross sectional study was conducted to determine the validity of appetite screening tools namely, the Council on Nutrition Appetite questionnaire (CNAQ) and the simplified nutritional appetite questionnaire (SNAQ) against the appetite, hunger and sensory perception questionnaire (AHSPQ), measures of nutritional status and food intake among geriatric patients at the main general hospital in Malaysia. Nutritional status was assessed using the subjective global assessment (SGA) while food intake was measured using the dietary history questionnaire (DHQ). Anthropometric parameters included weight, height, body mass index (BMI), calf circumference (CC) and mid upper arm circumference (MUAC). A total of 145 subjects aged 60 to 86 years (68.3 ± 5.8 years) with 31.7% men and 68.3% women were recruited from outpatients (35 subjects) and inpatients (110 subjects) of Kuala Lumpur Hospital of Malaysia. As assessed by SGA, most subjects were classified as mild to moderately malnourished (50.4%), followed by normal (38.6%) and severely malnourished (11.0%). A total of 79.3% and 57.2% subjects were classified as having poor appetite according to CNAQ and SNAQ, respectively. CNAQ (80.9%) had a higher sensitivity than SNAQ (69.7%) when validated against nutritional status as assessed using SGA. However, the specificity of SNAQ (62.5%) was higher than CNAQ (23.2%). Positive predictive value for CNAQ and SNAQ were 62.6% and 74.7%, respectively. Cronbach's alpha for CNAQ and SNAQ were 0.546 and 0.578, respectively. History of weight loss over the past one year (Adjusted odds ratio 2.49) (p < 0.01) and thiamine intake less than the recommended nutrient intake (RNI) (Adjusted odds ratio 3.04) (p < 0.05) were risk factors for poor appetite among subjects. In conclusion, malnutrition and poor appetite were prevalent among the geriatric outpatients and inpatients. SNAQ was more reliable and valid as an appetite screening tool among this special group of population. There is a need to regularly include nutritional and appetite assessment for early intervention measures in order to prevent consequences of malnutrition.
Collapse
Affiliation(s)
- R Hanisah
- Department of Nutrition and Dietetics, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda A. Aziz, 50300 Kuala Lumpur, Malaysia
| | | | | |
Collapse
|
40
|
Hayman KJ, Kerse N, Dyall L, Kepa M, Teh R, Wham C, Clair VWS, Wiles J, Keeling S, Connolly MJ, Wilkinson TJ, Moyes S, Broad JB, Jatrana S. Life and living in advanced age: a cohort study in New Zealand--e Puāwaitanga o Nga Tapuwae Kia Ora Tonu, LiLACS NZ: study protocol. BMC Geriatr 2012; 12:33. [PMID: 22747503 PMCID: PMC3502153 DOI: 10.1186/1471-2318-12-33] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 06/29/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The number of people of advanced age (85 years and older) is increasing and health systems may be challenged by increasing health-related needs. Recent overseas evidence suggests relatively high levels of wellbeing in this group, however little is known about people of advanced age, particularly the indigenous Māori, in Aotearoa, New Zealand. This paper outlines the methods of the study Life and Living in Advanced Age: A Cohort Study in New Zealand. The study aimed to establish predictors of successful advanced ageing and understand the relative importance of health, frailty, cultural, social & economic factors to successful ageing for Māori and non-Māori in New Zealand. METHODS/DESIGN A total population cohort study of those of advanced age. Two cohorts of equal size, Māori aged 80-90 and non-Māori aged 85, oversampling to enable sufficient power, were enrolled. A defined geographic region, living in the Bay of Plenty and Lakes District Health Board areas of New Zealand, defined the sampling frame. Rūnanga (Māori tribal organisations) and Primary Health Organisations were subcontracted to recruit on behalf of the University. Measures--a comprehensive interview schedule was piloted and administered by a trained interviewer using standardised techniques. Socio-demographic and personal history included tribal affiliation for Māori and participation in cultural practices; physical and psychological health status used standardised validated research tools; health behaviours included smoking, alcohol use and nutrition risk; and environmental data included local amenities, type of housing and neighbourhood. Social network structures and social support exchanges are recorded. Measures of physical function; gait speed, leg strength and balance, were completed. Everyday interests and activities, views on ageing and financial interests complete the interview. A physical assessment by a trained nurse included electrocardiograph, blood pressure, hearing and vision, anthropometric measures, respiratory function testing and blood samples. DISCUSSION A longitudinal study of people of advanced age is underway in New Zealand. The health status of a population based sample of older people will be established and predictors of successful ageing determined.
Collapse
Affiliation(s)
- Karen J Hayman
- Department of General Practice and Primary Healthcare, University of Auckland, Private Bay, 92109, Auckland, New Zealand
| | - Ngaire Kerse
- Department of General Practice and Primary Healthcare, University of Auckland, Private Bay, 92109, Auckland, New Zealand
| | - Lorna Dyall
- Te Kupenga Hauora, Department of Māori Studies, University of Auckland, Auckland, New Zealand
| | - Mere Kepa
- Te Kupenga Hauora, Department of Māori Studies, University of Auckland, Auckland, New Zealand
| | - Ruth Teh
- Department of General Practice and Primary Healthcare, University of Auckland, Private Bay, 92109, Auckland, New Zealand
| | - Carol Wham
- Institute of Food, Nutrition and Human Health, Massey University, Auckland, New Zealand
| | - Valerie Wright-St Clair
- School of Rehabilitation & Occupation Studies, Auckland University of Technology, Auckland, New Zealand
| | - Janine Wiles
- Department of Community Health, University of Auckland, Auckland, New Zealand
| | - Sally Keeling
- Dept of Medicine, University of Otago, Christchurch, New Zealand
| | - Martin J Connolly
- Freemasons’ Department of Geriatric Medicine, University of Auckland, Auckland, New Zealand
| | - Tim J Wilkinson
- Dept of Medicine, University of Otago, Christchurch, New Zealand
| | - Simon Moyes
- Department of General Practice and Primary Healthcare, University of Auckland, Private Bay, 92109, Auckland, New Zealand
| | - Joanna B Broad
- Freemasons’ Department of Geriatric Medicine, University of Auckland, Auckland, New Zealand
| | - Santosh Jatrana
- Alfred Deakin Research Institute, Deakin University, Sydney, Australia
| |
Collapse
|
41
|
Nicklett EJ, Semba RD, Simonsick EM, Szanton S, Bandeen-Roche K, Ferrucci L, Guralnik JM, Fried LP. Diet quality and social support: factors associated with serum carotenoid concentrations among older disabled women (the Women's Health and Aging Study). J Nutr Health Aging 2012; 16:511-8. [PMID: 22659988 PMCID: PMC3475721 DOI: 10.1007/s12603-012-0031-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE This study investigated the relationship between social support (including instrumental support, emotional support, social interaction, social space, and family networks) and diet quality, as indicated by serum carotenoid levels. DESIGN AND METHODS The sample consisted of participants in the Women's Health and Aging Study with longitudinal carotenoid data (n=325). We performed regression analyses using baseline indicators of social support and changes in social support to determine whether baseline levels and/or change in levels of social support predict changes in serum carotenoid levels. Social support changes were measured over 1 year from baseline to follow-up round 1. Carotenoid level changes were established from follow-up round 1 to round 2. To determine whether or not regression to the mean was driving these results, we performed an analysis that included baseline and change levels of social support indicators. RESULTS At baseline, the frequency of leaving one's home was associated with a decrease in carotenoid levels. Leaving one's home more frequently predicted an increase in carotenoid levels and attending fewer activities predicted a decrease in carotenoid levels. IMPLICATIONS In older, community-resident disabled women, baseline levels of social support did not consistently predict diet quality. However, change in social support predicted both positive and negative change in diet quality and thus provides supportive evidence that social activity and family interaction may play meaningful roles in the maintenance of diet quality among functionally compromised older women. Further research is necessary to more fully understand the impact of multiple forms of social supports on the diet quality of older adults.
Collapse
Affiliation(s)
- E J Nicklett
- Johns Hopkins University, Center on Aging and Health, Baltimore, MD 21231, USA.
| | | | | | | | | | | | | | | |
Collapse
|
42
|
Lambert M, Van Hulst A, O'Loughlin J, Tremblay A, Barnett TA, Charron H, Drapeau V, Dubois J, Gray-Donald K, Henderson M, Lagacé G, Low NC, Mark S, Mathieu MÈ, Maximova K, McGrath JJ, Nicolau B, Pelletier C, Poirier P, Sabiston C, Paradis G. Cohort profile: the Quebec adipose and lifestyle investigation in youth cohort. Int J Epidemiol 2011; 41:1533-44. [PMID: 21785124 DOI: 10.1093/ije/dyr111] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Marie Lambert
- Département de pédiatrie, Université de Montréal, Montréal, Québec, Canada.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Content Validation of a Standardized Language Diagnosis by Certified Specialists in Gerontological Nutrition. ACTA ACUST UNITED AC 2011; 111:561-6. [DOI: 10.1016/j.jada.2011.01.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Accepted: 02/11/2010] [Indexed: 11/21/2022]
|
44
|
Early determinants for the development of undernutrition in an older general population: Longitudinal Aging Study Amsterdam. Br J Nutr 2011; 106:708-17. [DOI: 10.1017/s0007114511000717] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Undernutrition may be an important modifiable risk factor for poor clinical outcomes in older individuals. To achieve earlier detection or prevention of undernutrition, more information is needed about risk factors for the development of undernutrition in community-dwelling older individuals. The objective was to identify early determinants of incident undernutrition in a prospective population-based study. Baseline data (1992–3) on socio-economic, psychological, medical, functional, lifestyle and social factors of 1120 participants aged 65–85 years of the Longitudinal Aging Study Amsterdam were used. Undernutrition, defined as a BMI < 20 kg/m2 or self-reported involuntary weight loss ≥ 5 % in the last 6 months, was assessed every 3 years during a 9-year follow-up period. Cox proportional-hazards regression analysis was used to investigate the association between early determinants at baseline and incident undernutrition. In 9 years, 156 participants (13·9 %) developed undernutrition. In univariate analyses, female sex, depressive symptoms, anxiety symptoms, multiple chronic diseases, high medication use (women), poor appetite, no alcohol use v. light alcohol use, loneliness, not having a partner, limitations in performing normal activities due to a health problem, low physical performance (participants aged < 75 years) and reporting difficulties walking stairs (participants aged < 75 years) were statistically significantly associated with incident undernutrition. In a multivariate model, poor appetite and reporting difficulties walking stairs (participants aged < 75 years) remained early determinants. The results of the present study can be used to identify subgroups of older individuals with increased risk of undernutrition and to identify modifiable determinants for the purpose of prevention of undernutrition.
Collapse
|
45
|
German L, Kahana C, Rosenfeld V, Zabrowsky I, Wiezer Z, Fraser D, Shahar DR. Depressive symptoms are associated with food insufficiency and nutritional deficiencies in poor community-dwelling elderly people. J Nutr Health Aging 2011; 15:3-8. [PMID: 21267514 DOI: 10.1007/s12603-011-0005-9] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
UNLABELLED Depression is associated with nutritional deterioration in older persons and is highly prevalent among people of low socioeconomic status (LSES). OBJECTIVES To determine the prevalence of depressive symptoms and food insufficiency, and to examine the relationship between dietary intake, food insufficiency and depression, in LSES community dwelling elderly. DESIGN Cross-sectional study. SETTING Lod, a town in the central Israel. PARTICIPANTS Community-dwelling welfare recipients aged 60 to 92. MEASUREMENTS Depression was assessed by 15-item Geriatric Depression Scale (GDS-short version), using a score ≥ 10 as the cut off point for clinically important depressive symptoms. Dietary intake was evaluated using a 24-hour dietary recall. Food insufficiency was defined by participants reporting that they did not have enough food to eat " sometimes " or " often " . RESULTS This study reports on 112 persons aged 60 years and above (27.1% men). The prevalence of depression in this population was 47%; 25% of the study sample was classified as " food insufficient " . Macronutrients intake was similar for depressed and non-depressed persons, except for polyunsaturated fats which was lower among the depressed group (7.9 ± 4.9 vs.11.0 ± 7.5 g/day in the non-depressed, p=0.03). Vitamins and minerals intake was lower than recommended for both groups; vitamin E intake was associated with depression. In regression models controlling for confounding variables, an increase of 1 mg in vitamin E intake and 1 gram in polyunsaturated fatty acids (PUFA) intake was associated with lower risk for depression (OR=0.73, p=0.008 and OR=0.86, p=0.007 respectively) Participants who reported food insufficiency were 10 times more likely to be depressed compared with those who reported sufficient food. CONCLUSIONS Given the evaluated adverse association between depressive symptoms and food insufficiency, more efforts are needed to guarantee adequate food intake, particularly foods rich in vitamin E and PUFA, in poor elderly people. Further studies are needed to clarify the temporal relationship between the emotional and nutritional domains in this vulnerable population.
Collapse
Affiliation(s)
- Larissa German
- Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, PO Box 653, Beer-Sheva 84105, Israel.
| | | | | | | | | | | | | |
Collapse
|
46
|
Anyanwu UO, Sharkey JR, Jackson RT, Sahyoun NR. Home food environment of older adults transitioning from hospital to home. J Nutr Gerontol Geriatr 2011; 30:105-121. [PMID: 21598161 DOI: 10.1080/21551197.2011.566525] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Only anecdotal information is known about foods available in the home of hospital-discharged older adults. This study describes the home food environment of this population and examines associations between health/nutrition risk factors and ability to shop and prepare meals. Data were collected from 512 hospital-discharged older adults residing in 6 U.S. states; food available within the home was assessed. Most households had a variety of food present; however, 20% of households lacked fresh fruit, 15% lacked fresh vegetables, and 35% had no fresh meat. About 35% of participants reported an inability to both prepare meals and shop for food. Among those unable to do both activities, the prevalence of depressive symptoms, food-related anxiety, and poor self-rated health was significantly (p < 0.01) higher than those able to do both activities. Homebound older adults may face additional challenges to recuperation from illness based on inability to prepare meals, regardless of availability of food following hospital discharge.
Collapse
Affiliation(s)
- Ucheoma O Anyanwu
- Department of Nutrition and Food Science, University of Maryland, College Park, Maryland, USA.
| | | | | | | |
Collapse
|
47
|
Payette H, Gueye NR, Gaudreau P, Morais JA, Shatenstein B, Gray-Donald K. Trajectories of physical function decline and psychological functioning: the Quebec longitudinal study on nutrition and successful aging (NuAge). J Gerontol B Psychol Sci Soc Sci 2010; 66 Suppl 1:i82-90. [PMID: 21135071 DOI: 10.1093/geronb/gbq085] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Decline of physical function with age is associated with substantial health consequences. Physical and psychological functioning is linked, but the temporal nature of this association remains unclear. METHODS Three-year follow-up data from men and women (n = 1,741), aged 68-82 years, in the longitudinal study on nutrition and successful aging (NuAge; Québec, Canada) were used. Growth curve modeling was performed to examine trajectories of a global physical performance score across time as conditioned by cognition and depression. RESULTS Significant decline in physical function was observed (p < .0001). Rate of decline in physical performance score was accelerated in the older participants (>77 years; age(2): p < .01) but not affected by slight decline in cognition or depression. Yet, people with lower cognition level and more depressive symptoms show lower physical capacity throughout the entire follow-up period (p < .0001). CONCLUSIONS Physical function significantly declined over 3 years, in particular in the oldest group. A subtle decline in psychological health paralleled decline in physical function but did not accelerate it.
Collapse
Affiliation(s)
- Hélène Payette
- Research Center on Aging, Health and Social Services Center-University Institute of Geriatrics of Sherbrooke, Sherbrooke, Québec, Canada.
| | | | | | | | | | | |
Collapse
|
48
|
Abstract
ABSTRACTThe purpose of this study was to determine the extent to which functional ability was associated with dietary intake in community-living seniors with some activity limitation. In this cross-sectional survey, 145 seniors were recruited from 15 recreation, day programs or seniors' apartment complexes. Dietary intake was assessed with a food frequency questionnaire and evaluated for adequacy with a Diet Score. An Activity Score was derived from 15 questions on basic and instrumental activities of daily living. Demographic, health, psychosocial, functional and behavioural factors that could influence diet intake were measured with standardized, validated scales. Diet Score was significantly and positively associated with income, hearing, education, satisfaction with use of time, number of medications and age. Activity Score, the belief that health affects activity level, shopping behaviour and smoking were negatively and significantly associated with Diet Score. Many factors influence the dietary intake of seniors, including extent of functional limitations. This analysis suggests that the most dependent seniors living in the community consume better diets than those seniors with few limitations; this finding is probably a result of informal and formal support services for these functionally dependent seniors.
Collapse
|
49
|
Anthropometric Indices and Their Correlates in Cognitively-Intact and Elderly Canadians with Dementia. Can J Aging 2010. [DOI: 10.1017/s0714980800012307] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
RÉSUMÉLes mesures anthropométriques reflètent l'état nutritionnel. Cette recherche a examiné les données provenant de Canadien(ne)s âgé(e)s ayant participé à la première phase de l'Étude sur la santé et le vieillissement au Canada (CSHA-1). Le poids et la taille furent mesurés chez 1 464 personnes vivant dans la communauté et 963 individus en institution. Les sujets institutionnalisés avaient un poids corporel inférieur à ceux vivant en communauté (59,1 ± 13,8 kg. vs. 65,1 ± 14,1 kg.); ils étaient plus petits (160,4 ± 10.1 cm vs. 162,6 ± 10 cm), et leur IMC étaient plus bas (23,3 ± 5,0 vs. 24,6 ± 4,5) (p< .001). Les valeurs anthropométriques furent plus basses chez les femmes, et diminuaient progressivement avec l'âge. Les Québécois avaient une taille plus petite et un poids corporel inférieur à ceux des Canadiens vivant ailleurs. Les mesures anthropométriques ont diminué suivant le diagnostic cognitif, en allant de normal, à «deficit cognitif sans démence» (CIND), à dément; les participants atteints de la démence de type Alzheimer avaient les poids corporels les plus bas. Les facteurs associés au poids corporel étaient différents parmi les participants vivant dans la communauté et en institution.
Collapse
|
50
|
Jürschik P, Torres J, Solá R, Nuin C, Botigué T, Lavedán A. High Rates of Malnutrition in Older Adults Receiving Different Levels of Health Care in Lleida, Catalonia: An Assessment of Contributory Factors. ACTA ACUST UNITED AC 2010; 29:410-22. [DOI: 10.1080/01639366.2010.521043] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Pilar Jürschik
- a Department of Nursing , University of Lleida , Lleida , Spain
| | - Joan Torres
- a Department of Nursing , University of Lleida , Lleida , Spain
- b Epidemiology Department of Health and Welfare , Generalitat de Catalunya , Lleida
| | - Román Solá
- c Department of Experimental Medicine , University of Lleida
- d Department of Surgery , Universitary Hospital Arnau de Vilanova , Lleida , Spain
| | - Carmen Nuin
- a Department of Nursing , University of Lleida , Lleida , Spain
| | - Teresa Botigué
- a Department of Nursing , University of Lleida , Lleida , Spain
| | - Ana Lavedán
- e Universitary Hospital Arnau de Vilanova , Lleida , Spain
| |
Collapse
|