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Marcos-Delgado A, Yévenes-Briones H, Fernández-Villa T, Martín-Sánchez V, Guallar-Castillón P, Rodríguez-Artalejo F, Lopez-Garcia E. Association between diet quality and malnutrition: pooled results from two population-based studies in older adults. BMC Geriatr 2024; 24:417. [PMID: 38730363 PMCID: PMC11088013 DOI: 10.1186/s12877-024-04984-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/16/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND The role of diet quality on malnutrition in older adults is uncertain, due the paucity of the research conducted and the use of use of screening tools that did not consider phenotypic criteria of malnutrition. OBJECTIVE To evaluate the association of two indices of diet quality, namely the Mediterranean Diet Adherence Screener (MEDAS) and the Alternative Healthy Eating Index (AHEI-2010), with malnutrition among community-dwelling older adults in Spain. METHODS Cross-sectional analysis of data from 1921 adults aged ≥ 60 years from the Seniors-ENRICA-1 (SE-1) study, and 2652 adults aged ≥ 65 years from the Seniors-ENRICA-2 (SE-2) study. Habitual food consumption was assessed through a validated diet history. Malnutrition was defined according to the Global Leadership Initiative on Malnutrition (GLIM) phenotypic criteria. Statistical analyses were performed with logistic regression with adjustment for socioeconomic and lifestyle variables as well as for total energy and protein intake. RESULTS The prevalence of malnutrition in the SE-1 study was 9.5% (95% confidence interval: 8.2 to 10.9) and 11.7% (10.5 to 13.9) in the SE-2. Adherence to the MEDAS score was associated with lower prevalence of malnutrition [pooled odds ratio for high (≥ 9 points) vs. low adherence (< 7 points): 0.64 (0.48-0.84); p-trend < 0.001]. Higher adherence to the AHEI-2010 also showed an inverse association with malnutrition (pooled odds ratio for quartile 4 vs. 1: 0.65 (0.49-0.86); p-trend 0.006). Among the individual components, higher consumption of fish and long-chain n-3 fatty acids in MEDAS and AHEI-2010, and of vegetables and nuts and legumes in AHEI-2010, and lower intake of trans-fat and sugar-sweetened beverages and fruit juice in AHEI-2010 were independently associated with lower odds of malnutrition. CONCLUSION Adherence to high diet-quality patterns was associated with lower frequency of malnutrition among older adults. CLINICAL TRIAL REGISTRY ClinicalTrials.gov identifier: NCT02804672. June 17, 2016.; ClinicalTrials.gov NCT03541135. May 30, 2018.
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Affiliation(s)
- Alba Marcos-Delgado
- Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, León, Spain
- The Research Group in Gene-Environment and Health Interactions, Institute of Biomedicine (IBIOMED), Universidad de León, León, Spain
| | - Humberto Yévenes-Briones
- School of Medicine, Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Avda. Arzobispo Morcillo 2, Madrid, 28029, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Tania Fernández-Villa
- Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, León, Spain
- The Research Group in Gene-Environment and Health Interactions, Institute of Biomedicine (IBIOMED), Universidad de León, León, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Vicente Martín-Sánchez
- Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, León, Spain
- The Research Group in Gene-Environment and Health Interactions, Institute of Biomedicine (IBIOMED), Universidad de León, León, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Pilar Guallar-Castillón
- School of Medicine, Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Avda. Arzobispo Morcillo 2, Madrid, 28029, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- School of Medicine, Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Avda. Arzobispo Morcillo 2, Madrid, 28029, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- School of Medicine, Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Avda. Arzobispo Morcillo 2, Madrid, 28029, Spain.
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain.
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Zügül Y, van Rossum C, Visser M. Prevalence of Undernutrition in Community-Dwelling Older Adults in The Netherlands: Application of the SNAQ 65+ Screening Tool and GLIM Consensus Criteria. Nutrients 2023; 15:3917. [PMID: 37764702 PMCID: PMC10537760 DOI: 10.3390/nu15183917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
The aim of this study was to provide recent data on the prevalence of undernutrition based on screening and diagnosis in Dutch community-dwelling older adults. The data from the 2021 to 2022 examination wave from the Longitudinal Aging Study Amsterdam (n = 1138) and the Dutch National Food Consumption Survey 2019-2021 (n = 607) on community-dwelling men and women aged 65 years and older were used. The prevalence of undernutrition was based on a positive score on the Short Nutritional Assessment Questionnaire 65+ (SNAQ65+) screening tool, a positive diagnosis using the Global Leadership Initiative on Malnutrition (GLIM) criteria and their combination. Of the combined sample (n = 1745), the mean age was 74 (SD 6) years, where 16.7% were aged 80 years or older, 50.5% was female, 56.9% had a high education level, and 30.3% lived alone. The prevalence of undernutrition based on the SNAQ65+ screening in the combined sample was 8.5% (95% CI 7.3-9.9%). In the subgroup of LASA participants with complete data on all GLIM criteria (n = 700), the prevalence of undernutrition was 5.4% based on SNAQ65+ and 7.1% based on GLIM. A positive SNAQ65+ screening followed by a positive GLIM diagnosis resulted in a lower prevalence (3.1%). Being female, older, living alone, receiving formal home care, and having poor self-rated health, poor appetite, or mobility limitations, they were all associated with a higher prevalence, with more than two-fold higher prevalence rates in some subgroups. The results show that currently one out of twelve community-dwelling adults aged 65 years and older is undernourished based on the SNAQ65+ screening, and one out of fourteen is undernourished based on the GLIM diagnosis criteria. Awareness is needed to increase early recognition and treatment in community and primary care, especially among the more vulnerable groups.
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Affiliation(s)
- Yaren Zügül
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Caroline van Rossum
- National Institute for Public Health and the Environment (RIVM), 3721 BA Bilthoven, The Netherlands;
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
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Characterisation of community-dwelling older adults with poor appetite. Eur J Nutr 2023:10.1007/s00394-023-03129-5. [PMID: 36869911 DOI: 10.1007/s00394-023-03129-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/21/2023] [Indexed: 03/05/2023]
Abstract
PURPOSE A poor appetite affects up to 27% of community-dwelling older adults in Europe and is an early predictor of malnutrition. Little is known about the factors associated with poor appetite. The present study, therefore, aims to characterise older adults with poor appetite. METHODS As part of the European JPI project APPETITE, data from 850 participants, aged ≥ 70 years of the Longitudinal Ageing Study Amsterdam (LASA) from 2015/16 were analysed. Appetite during the last week was assessed with a five-point scale and dichotomised into "normal" and "poor". Binary logistic regression was used to examine associations between 25 characteristics from 5 domains-physiological, emotional, cognitive, social, and lifestyle-and appetite. First, domain-specific models were calculated using stepwise backward selection. Second, all variables contributing to poor appetite were combined in a multi-domain model. RESULTS The prevalence of self-reported poor appetite was 15.6%. Fourteen parameters from all five single-domain models contributed to poor appetite and were entered into the multi-domain model. Here, female sex (total prevalence: 56.1%, odds ratio: 1.95 [95% confidence interval 1.10-3.44]), self-reported chewing problems (2.4%, 5.69 [1.88-17.20]), any unintended weight loss in the last 6 months (6.7%, 3.07 [1.36-6.94]), polypharmacy defined as ≥ 5 medications in the past 2 weeks (38.4%, 1.87 [1.04-3.39]), and depressive symptoms (Centre for Epidemiologic Studies Depression Scale without appetite item) (1.12 [1.04-1.21]) were associated with an increased likelihood of having poor appetite. CONCLUSION According to this analysis, older people with the characteristics described above are more likely to have a poor appetite.
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Rodríguez-Mañas L, Murray R, Glencorse C, Sulo S. Good nutrition across the lifespan is foundational for healthy aging and sustainable development. Front Nutr 2023; 9:1113060. [PMID: 36761990 PMCID: PMC9902887 DOI: 10.3389/fnut.2022.1113060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 12/23/2022] [Indexed: 01/26/2023] Open
Abstract
Ensuring healthy lives and promoting wellbeing across the age spectrum are essential to sustainable development. Nutrition is at the heart of the World Health Organization (WHO) Sustainable Development Goals, particularly for Sustainable Development Goal 2/Subgoal 2, which is to End all forms of malnutrition by 2030. This subgoal addresses people of all ages, including targeted groups like young children and older adults. In recent decades, there have been marked advances in the tools and methods used to screen for risk of malnutrition and to conduct nutritional assessments. There have also been innovations in nutritional interventions and outcome measures related to malnutrition. What has been less common is research on how nutritional interventions can impact healthy aging. Our Perspective article thus takes a life-course approach to consider what is needed to address risk of malnutrition and why, and to examine how good nutrition across the lifespan can contribute to healthy aging. We discuss broad-ranging yet interdependent ways to improve nutritional status worldwide-development of nutritional programs and policies, incorporation of the best nutrition-care tools and methods into practice, provision of professional training for quality nutritional care, and monitoring health and economic benefits of such changes. Taken together, our Perspective aims to (i) identify current challenges to meeting these ideals of nutritional care, and to (ii) discover enabling strategies for the improvement of nutrition care across the lifespan. In harmony with the WHO goal of sustainable development, we underscore roles of nutrition to foster healthy human development and healthy aging worldwide.
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Affiliation(s)
- Leocadio Rodríguez-Mañas
- Service of Geriatrics, Getafe University Hospital and CIBER on Frailty and Healthy Aging (CIBERFES), Getafe, Spain,*Correspondence: Leocadio Rodríguez-Mañas,
| | - Robert Murray
- Department of Pediatrics, Emeritus, The Ohio State University College of Medicine, Columbus, OH, United States
| | | | - Suela Sulo
- Abbott Laboratories, Abbott Park, IL, United States
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ten Cate D, Schuurmans MJ, van Eijk J, Bell JJ, Schoonhoven L, Ettema RGA. Factors Influencing Nurses' Behavior in Nutritional Care for Community-Dwelling Older Adults Before, During, and After Hospitalization: A Delphi Study. J Contin Educ Nurs 2022; 53:545-556. [DOI: 10.3928/00220124-20221107-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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Sulo S, Schwander B, Brunton C, Gomez G, Misas JD, Gracia DA, Chavarro-Carvajal DA, Venegas-Sanabria LC, Cano-Gutiérrez C. Nutrition-Focused Care for Community-Living Adults: Healthcare Utilization and Economic Benefits. Value Health Reg Issues 2022; 32:70-77. [PMID: 36099802 DOI: 10.1016/j.vhri.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/08/2022] [Accepted: 08/09/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVES We assessed the impact of a recently reported nutritional quality improvement program (QIP) on healthcare resource utilization and costs for older, community-living adults in Bogotá, Colombia. METHODS The study included 618 community-dwelling, older adults (> 60 years) who were at risk or malnourished and receiving outpatient clinical care. The intervention was a QIP that emphasized nutritional screening, dietary education, lifestyle counseling, 60-day consumption of oral nutritional supplements, and 90-day follow-up. For economic modeling, we performed 90-day budget impact and cost-effectiveness analyses from a Colombian third-party payer perspective. The base-case analysis quantified mean healthcare resource use in the QIP study population. Analysis was based on mean input values (deterministic) and distributions of input parameters (probabilistic). As the deterministic analysis provided a simple point estimate, the cost-effectiveness analysis focused on the probabilistic results informed by 1000 iterations of a Monte-Carlo simulation. RESULTS Results showed that the total use of healthcare resources over 90 days was significantly reduced by > 40% (hospitalizations were reduced by approximately 80%, emergency department visits by > 60%, and outpatient clinical visits by nearly 40%; P < .001). Based on economic modeling, total cost savings of $129 740 or per-patient cost savings of $210 over 90 days could be attributed to the use of nutritional QIP strategies. Total cost savings equated to nearly twice the initial investment for QIP intervention; that is, the per-dollar return on investment was $1.82. CONCLUSIONS For older adults living in the community in Colombia, the use of our nutritional QIP improved health outcomes while lowering costs of healthcare and was thus cost-effective.
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Affiliation(s)
- Suela Sulo
- Abbott Laboratories, Abbott Park, IL, USA.
| | - Bjoern Schwander
- Agency for Health Economic Assessment and Dissemination GmbH, Lörrach, Germany
| | | | | | | | | | | | | | - Carlos Cano-Gutiérrez
- Pontificia Universidad Javeriana, Bogotá, Colombia; Hospital Universitario San Ignacio, Bogotá, Colombia
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Tay W, Quek R, Kaur B, Lim J, Henry CJ. Use of Facial Morphology to Determine Nutritional Status in Older Adults: Opportunities and Challenges. JMIR Public Health Surveill 2022; 8:e33478. [PMID: 35849429 PMCID: PMC9345026 DOI: 10.2196/33478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/03/2022] [Indexed: 11/13/2022] Open
Abstract
Undiagnosed malnutrition is a significant problem in high-income countries, which can reduce the quality of life of many individuals, particularly of older adults. Moreover, it can also inflate the costs of existing health care systems because of the many metabolic complications that it can cause. The current methods for assessing malnutrition can be cumbersome. A trained practitioner must be present to conduct an assessment, or patients must travel to facilities with specialized equipment to obtain their measurements. Therefore, digital health care is a possible way of closing this gap as it is rapidly gaining traction as a scalable means of improving efficiency in the health care system. It allows for the remote monitoring of nutritional status without requiring the physical presence of practitioners or the use of advanced medical equipment. As such, there is an increasing interest in expanding the range of digital applications to facilitate remote monitoring and management of health issues. In this study, we discuss the feasibility of a novel digital remote method for diagnosing malnutrition using facial morphometrics. Many malnutrition screening assessments include subjective assessments of the head and the face. Facial appearance is often used by clinicians as the first point of qualitative indication of health status. Hence, there may be merit in quantifying these subtle but observable changes using facial morphometrics. Modern advancements in artificial intelligence, data science, sensors, and computing technologies allow facial features to be accurately digitized, which could potentially allow these previously intuitive assessments to be quantified. This study aims to stimulate further discussion and discourse on how this emerging technology can be used to provide real-time access to nutritional status. The use of facial morphometrics extends the use of currently available technology and may provide a scalable, easily deployable solution for nutritional status to be monitored in real time. This will enable clinicians and dietitians to keep track of patients remotely and provide the necessary intervention measures as required, as well as providing health care institutions and policy makers with essential information that can be used to inform and enable targeted public health approaches within affected populations.
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Affiliation(s)
- Wesley Tay
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research, Singapore, Singapore
| | - Rina Quek
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research, Singapore, Singapore
| | - Bhupinder Kaur
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research, Singapore, Singapore
| | - Joseph Lim
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research, Singapore, Singapore
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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8
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Kok W, Haverkort E, Algra Y, Mollema J, Hollaar V, Naumann E, de van der Schueren M, Jerković-Ćosić K. The association between polypharmacy and malnutrition(risk) in older people: A Systematic Review. Clin Nutr ESPEN 2022; 49:163-171. [DOI: 10.1016/j.clnesp.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 02/15/2022] [Accepted: 03/05/2022] [Indexed: 11/30/2022]
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Correia MIT, Tappenden KA, Malone A, Prado CM, Evans DC, Sauer AC, Hegazi R, Gramlich L. Utilization and validation of the Global Leadership Initiative on Malnutrition (GLIM): A scoping review. Clin Nutr 2022; 41:687-697. [DOI: 10.1016/j.clnu.2022.01.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/05/2022] [Accepted: 01/20/2022] [Indexed: 12/27/2022]
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10
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Leung DYP, Cheng HL, Tyrovolas S, Tang ASK, Liu JYW, Tse MMY, Lai CKY, Molassiotis A. Magnitude, Temporal Trends, and Inequalities in the DALYs and YLDs of Nutritional Deficiency among Older Adults in the Western Pacific Region: Findings from the Global Burden of Disease Study 1990-2019. Nutrients 2021; 13:nu13124421. [PMID: 34959973 PMCID: PMC8706447 DOI: 10.3390/nu13124421] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/30/2022] Open
Abstract
The population in the Western Pacific region is aging rapidly. Nutritional deficiency is prevalent in older adults; however, information regarding nutritional deficiency in this population is scarce. Using the 2019 Global Burden of Disease (GBD) results, the age-standardized disability-adjusted life years (DALYs) and years of healthy life lost due to disability (YLDs) from nutritional deficiency were estimated between 1990 and 2019 for this population. Average annual percentage change (AAPC) was used to assess temporal trends, and linear mixed-effects models were used to examine socioeconomic and sex inequalities. From 1990 to 2019, the age-standardized DALYs of nutritional deficiency in this population decreased from 697.95 to 290.95 per 100,000, and their age-standardized YLDs decreased from 459.03 to 195.65 per 100,000, with the greatest declines seen in South Korea (AAPCs < −5.0). Tonga had the least decline in DALYs (AAPC = −0.8), whereas Fiji experienced an increase in YLDs (AAPC = 0.1). Being female and having a lower sociodemographic index score was significantly associated with higher age-standardized DALYs and YLDs. The magnitude and temporal trends of the nutritional deficiency burden among older adults varied across countries and sex in the region, indicating that health policies on nutritional deficiency among older adults must be crafted to local conditions.
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Affiliation(s)
- Doris Y. P. Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; (D.Y.P.L.); (H.-L.C.); (S.T.); (A.S.K.T.); (J.Y.W.L.); (M.M.Y.T.); (C.K.Y.L.)
| | - Hui-Lin Cheng
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; (D.Y.P.L.); (H.-L.C.); (S.T.); (A.S.K.T.); (J.Y.W.L.); (M.M.Y.T.); (C.K.Y.L.)
| | - Stefanos Tyrovolas
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; (D.Y.P.L.); (H.-L.C.); (S.T.); (A.S.K.T.); (J.Y.W.L.); (M.M.Y.T.); (C.K.Y.L.)
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, 08007 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Angel S. K. Tang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; (D.Y.P.L.); (H.-L.C.); (S.T.); (A.S.K.T.); (J.Y.W.L.); (M.M.Y.T.); (C.K.Y.L.)
| | - Justina Y. W. Liu
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; (D.Y.P.L.); (H.-L.C.); (S.T.); (A.S.K.T.); (J.Y.W.L.); (M.M.Y.T.); (C.K.Y.L.)
| | - Mimi M. Y. Tse
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; (D.Y.P.L.); (H.-L.C.); (S.T.); (A.S.K.T.); (J.Y.W.L.); (M.M.Y.T.); (C.K.Y.L.)
| | - Claudia K. Y. Lai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; (D.Y.P.L.); (H.-L.C.); (S.T.); (A.S.K.T.); (J.Y.W.L.); (M.M.Y.T.); (C.K.Y.L.)
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; (D.Y.P.L.); (H.-L.C.); (S.T.); (A.S.K.T.); (J.Y.W.L.); (M.M.Y.T.); (C.K.Y.L.)
- Correspondence: ; Tel.: +852-2766-6396
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Kaluźniak-Szymanowska A, Krzymińska-Siemaszko R, Lewandowicz M, Deskur-Śmielecka E, Stachnik K, Wieczorowska-Tobis K. Diagnostic Performance and Accuracy of the MNA-SF against GLIM Criteria in Community-Dwelling Older Adults from Poland. Nutrients 2021; 13:nu13072183. [PMID: 34202898 PMCID: PMC8308417 DOI: 10.3390/nu13072183] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 12/24/2022] Open
Abstract
Up to 28% of elderly residents in Europe are at risk of malnutrition. As uniform diagnostic criteria for malnutrition have not been formulated, in autumn 2018, the Global Leadership Initiative on Malnutrition (GLIM) presented a consensus on its diagnosis. According to the consensus, the diagnosis of malnutrition requires a positive screening test result for the risk of malnutrition, and the presence of at least one etiologic and one phenotypic criterion. This study aimed to assess the diagnostic performance and accuracy of the Mini Nutritional Assessment—Short Form (MNA-SF) against GLIM criteria. The analysis involved 273 community-dwelling volunteers aged ≥ 60 years. All participants were screened for malnutrition with the MNA-SF questionnaire. Next, the GLIM phenotypic and etiologic criteria were assessed in all subjects. Based on the presence of at least one phenotypic and one etiologic criterion, malnutrition was diagnosed in more than one-third of participants (n = 103, 37.7%). According to the MNA-SF, only 7.3% of subjects had malnutrition, and 28.2% were at risk of malnutrition. The agreement between the MNA-SF score and the GLIM criteria were observed in only 22.3% of the population. The sensitivity and specificity of MNA-SF against the GLIM criteria were fair (59.2% and 78.8%, respectively). The area under the curve (AUC) was 0.77, indicating the fair ability of MNA-SF to diagnose malnutrition. Based on the present study results, the best solution may be an optional replacement of the screening tool in the first step of the GLIM algorithm with clinical suspicion of malnutrition.
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Lengelé L, Bruyère O, Beaudart C, Reginster JY, Locquet M. Impact of Malnutrition Status on Muscle Parameter Changes over a 5-Year Follow-Up of Community-Dwelling Older Adults from the SarcoPhAge Cohort. Nutrients 2021; 13:nu13020407. [PMID: 33525324 PMCID: PMC7910934 DOI: 10.3390/nu13020407] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 02/07/2023] Open
Abstract
This study aimed to assess the impact of malnutrition on the 5-year evolution of physical performance, muscle mass and muscle strength in participants from the SarcoPhAge cohort, consisting of community-dwelling older adults. The malnutrition status was assessed at baseline (T0) according to the “Global Leadership Initiatives on Malnutrition” (GLIM) criteria, and the muscle parameters were evaluated both at T0 and after five years of follow-up (T5). Lean mass, muscle strength and physical performance were assessed using dual X-ray absorptiometry, handgrip dynamometry, the short physical performance battery test and the timed up and go test, respectively. Differences in muscle outcomes according to nutritional status were tested using Student’s t-test. The association between malnutrition and the relative 5-year change in the muscle parameters was tested using multiple linear regressions adjusted for several covariates. A total of 411 participants (mean age of 72.3 ± 6.1 years, 56% women) were included. Of them, 96 individuals (23%) were diagnosed with malnutrition at baseline. Their muscle parameters were significantly lower than those of the well-nourished patients both at baseline and after five years of follow-up (all p-values < 0.05), except for muscle strength in women at T5, which was not significantly lower in the presence of malnutrition. However, the 5-year changes in muscle parameters of malnourished individuals were not significantly different than those of well-nourished individuals (all p-values > 0.05).
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Affiliation(s)
- Laetitia Lengelé
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (L.L.); (C.B.); (J.-Y.R.); (M.L.)
| | - Olivier Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (L.L.); (C.B.); (J.-Y.R.); (M.L.)
- Department of Sport Rehabilitation Sciences, University of Liège, 4000 Liège, Belgium
- Physical, Rehabilitation Medicine and Sports Traumatology, SportS2, University Hospital of Liège, 4000 Liège, Belgium
- Correspondence: ; Tel.: +32-43-66-3230
| | - Charlotte Beaudart
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (L.L.); (C.B.); (J.-Y.R.); (M.L.)
| | - Jean-Yves Reginster
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (L.L.); (C.B.); (J.-Y.R.); (M.L.)
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Médéa Locquet
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (L.L.); (C.B.); (J.-Y.R.); (M.L.)
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Cederholm T, Barazzoni R. A year with the GLIM diagnosis of malnutrition - does it work for older persons? Curr Opin Clin Nutr Metab Care 2021; 24:4-9. [PMID: 33323713 DOI: 10.1097/mco.0000000000000710] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW In early 2019, the Global Leadership Initiative on Malnutrition (GLIM) concept was published advocating a two-step procedure, that is, screening followed by confirmation of the malnutrition diagnosis requiring a combination of phenotypic and etiologic criteria. This review summarizes 14 publications that have applied the GLIM criteria in older populations. RECENT FINDINGS Four studies miss data on muscle mass. The mandatory screening appears missing in some studies. Two studies report that criterion validity is fair to good when compared with Subjective Global Assessment as semigold standard. Most studies report strong predictive validity when mortality is used as outcome. Not unexpectedly malnutrition relates strongly to sarcopenia as low muscle mass is a GLIM criterion. Overall, the lack of guidance on how to assess muscle mass and disease burden/inflammation in the original GLIM publication provides uncertainties on how to interpret the results. SUMMARY Fourteen exclusively retrospective studies in older adult cohorts are summarized. In several cases, the data sets are imperfect or incomplete. Still, criterion and predictive validity for GLIM appears well acceptable when applied for older adults. Continuing global implementation efforts are justified. The GLIM consortium needs to provide guidance on assessment of muscle mass and disease burden/inflammation. Moreover, further prospective validation studies are needed to add knowledge for the future GLIM format updates.
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Affiliation(s)
- Tommy Cederholm
- Department of Public Health and Caring Sciences, Uppsala University, Theme Ageing, Karolinska University Hospital, Stockholm, Sweden
| | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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Guigoz Y, Vellas B. Nutritional Assessment in Older Adults : MNA® 25 years of a Screening Tool and a Reference Standard for Care and Research; What Next? J Nutr Health Aging 2021; 25:528-583. [PMID: 33786572 DOI: 10.1007/s12603-021-1601-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A tool to assess nutritional status in older persons was really needed. It took 5 years to design the MNA® (Mini Nutrition Assessment) tool, complete the first validations studies both in Europe and in the U.S. and to publish it. After the full MNA®, the MNA® short form and the self-MNA® have been validated. As well as Chinese and other national MNA® forms. Now more than 2000 clinical research have used the MNA® all over the world from community care to hospital. At least 22 Expert groups included the MNA® in new clinical practice guidelines, national or international registries. The MNA® is presently included in almost all geriatric and nutrition textbook and part of the teaching program for medicine and other health care professional worldwide. The urgent need is to target the frail older adults more likely to have weight loss and poor appetite and to prevent frailty and weight loss in the robust. We present in this paper the review of 25 years of clinical research and practice using the MNA® worldwide.
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Affiliation(s)
- Y Guigoz
- Yves Guigoz, Chemin du Raidillon, CH-1066 Epalinges, Switzerland.
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