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Bardon LA, Corish CA, Lane M, Bizzaro MG, Loayza Villarroel K, Clarke M, Power LC, Gibney ER, Dominguez Castro P. Ageing rate of older adults affects the factors associated with, and the determinants of malnutrition in the community: a systematic review and narrative synthesis. BMC Geriatr 2021; 21:676. [PMID: 34863118 PMCID: PMC8642873 DOI: 10.1186/s12877-021-02583-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 10/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malnutrition negatively impacts on health, quality of life and disease outcomes in older adults. The reported factors associated with, and determinants of malnutrition, are inconsistent between studies. These factors may vary according to differences in rate of ageing. This review critically examines the evidence for the most frequently reported sociodemographic factors and determinants of malnutrition and identifies differences according to rates of ageing. METHODS A systematic search of the PubMed Central and Embase databases was conducted in April 2019 to identify papers on ageing and poor nutritional status. Numerous factors were identified, including factors from demographic, food intake, lifestyle, social, physical functioning, psychological and disease-related domains. Where possible, community-dwelling populations assessed within the included studies (N = 68) were categorised according to their ageing rate: 'successful', 'usual' or 'accelerated'. RESULTS Low education level and unmarried status appear to be more frequently associated with malnutrition within the successful ageing category. Indicators of declining mobility and function are associated with malnutrition and increase in severity across the ageing categories. Falls and hospitalisation are associated with malnutrition irrespective of rate of ageing. Factors associated with malnutrition from the food intake, social and disease-related domains increase in severity in the accelerated ageing category. Having a cognitive impairment appears to be a determinant of malnutrition in successfully ageing populations whilst dementia is reported to be associated with malnutrition within usual and accelerated ageing populations. CONCLUSIONS This review summarises the factors associated with malnutrition and malnutrition risk reported in community-dwelling older adults focusing on differences identified according to rate of ageing. As the rate of ageing speeds up, an increasing number of factors are reported within the food intake, social and disease-related domains; these factors increase in severity in the accelerated ageing category. Knowledge of the specific factors and determinants associated with malnutrition according to older adults' ageing rate could contribute to the identification and prevention of malnutrition. As most studies included in this review were cross-sectional, longitudinal studies and meta-analyses comprehensively assessing potential contributory factors are required to establish the true determinants of malnutrition.
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Affiliation(s)
- Laura A Bardon
- School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland.
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland.
| | - Clare A Corish
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Meabh Lane
- School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland
| | - Maria Gabriella Bizzaro
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Katherine Loayza Villarroel
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Michelle Clarke
- School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
| | - Lauren C Power
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Eileen R Gibney
- School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
| | - Patricia Dominguez Castro
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
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Kalfoss M, Abudayya A, Cvancarova Småstuen M. The relationship of existential well - being to identity, religious coping, mental and general health among Norwegian aging women. J Women Aging 2020; 34:140-154. [PMID: 33297890 DOI: 10.1080/08952841.2020.1819178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The aim of this study was to explore the relationship of existential spirituality to identity processing, religious coping and mental and general health among younger and older aged women in Norway. Participant's included 120 women aged 31-91 who took part in a postal survey. Results showed that both accommodative and balancing identity processes were associated with existential well -being among both the younger and older aged. Among the younger - aged, mental health was also significantly associated with existential well-being, Moreover, among the older aged, religious coping in the form of discontent, was found to be associated with existential well-being.
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Affiliation(s)
- Mary Kalfoss
- Faculty of Health Sciences, VID Specialized University, Oslo, Norway
| | - Abdallah Abudayya
- Faculty of Health Sciences, VID Specialized University, Oslo, Norway
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Saeed A, Fisher J, Mitchell-Smith Z, Brown LJE. "You've Got to Be Old to Go There": Psychosocial Barriers and Facilitators to Social Eating in Older Adults. THE GERONTOLOGIST 2020; 60:628-637. [PMID: 32413143 DOI: 10.1093/geront/gnz121] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Social eating is associated with a range of physical and mental health benefits for older adults. Previous research has identified some of the practical barriers that may limit social eating, such as cost and access to public transport. However, little is known about the psychosocial issues that can affect older adults' engagement with social eating. This study examines psychosocial barriers and facilitators to attending community-based social eating opportunities for older adults. DESIGN AND METHODS Forty-two older people aged between 59 and 89 years living in Manchester, UK, participated in semi-structured interviews or focus groups about their experiences and perceptions of social eating opportunities. Interview transcripts were analyzed using inductive thematic analyses. As there are known gender differences in relation to attitudes and behaviors relating to food and social activities, a framework analysis was applied to explore how these themes were differentially expressed by gender. RESULTS Four themes were identified that related to the importance of (a) offering more than food; (b) participants' social identity; (c) taking the first step; and (d) embarrassment and self-consciousness about physical health. Gender differences related to perceptions of the relevance and attractiveness of social eating, and the role of social support. DISCUSSION AND IMPLICATIONS This study improves our understanding of older adults' social eating experiences and highlights clear strategies by which social eating opportunities could be made more attractive, accessible, and acceptable to older adults.
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Affiliation(s)
- Anisa Saeed
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Science Centre, UK
| | - Jenny Fisher
- Department Social Care and Social Work, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, UK
| | - Zinnia Mitchell-Smith
- Department Social Care and Social Work, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, UK
| | - Laura J E Brown
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Science Centre, UK
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Type of Care and Living Situation Are Associated with Nutritional Care but Not Nutritional Status of Older Persons Receiving Home Care. Healthcare (Basel) 2020; 8:healthcare8030296. [PMID: 32854303 PMCID: PMC7551165 DOI: 10.3390/healthcare8030296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/17/2020] [Accepted: 08/21/2020] [Indexed: 12/03/2022] Open
Abstract
Nutritional care and nutritional status may differ in older persons receiving informal (IC) or professional (PC) home care and further depend on the living situation, but little is known in this regard. In this analysis of a cross-sectional multicenter study, type of care, living situation, and nutritional care were enquired in 353 older adults (≥65) receiving IC or PC, living either with partner (LP), with others (LO) or alone (LA), and the nutritional status was determined by BMI and MNA®. For IC receivers, food shopping (IC-LP 94%, IC-LO 96%, IC-LA 92%) and warm meals (IC-LP 89%, IC-LO 90%, IC-LA 71%) were mainly provided by relatives, whereas 47% of PC-LA prepared warm meals by themselves and 22% received meals on wheels. Thirteen percent were underweight, 13% malnourished, and 57% at risk of malnutrition without differences between the groups. Adjusted odds ratios (OR) of being malnourished were also not different (IC-LP 2.2 [95% CI 0.5–9.7], IC-LO 1.4 [0.3–6.6], IC-LA 1.4 [0.3–6.6]) compared to PC-LA. In conclusion, provision of nutritional care obviously differed according to the type of care and living situation, whereas nutritional status does not seem to be affected by these aspects. More research is clearly needed in this field.
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Aure CF, Kluge A, Moen A. Promoting dietary awareness: Home-dwelling older adults' perspectives on using a nutrition application. Int J Older People Nurs 2020; 15:e12332. [PMID: 32597570 DOI: 10.1111/opn.12332] [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: 11/19/2019] [Revised: 04/21/2020] [Accepted: 06/12/2020] [Indexed: 02/02/2023]
Abstract
AIMS AND OBJECTIVES This study investigated older adults' experiences of using the Appetitus app with support from healthcare professionals. BACKGROUND Good nutrition status is important for good health when ageing. However, as undernutrition remains a prevalent and persistent problem among older adults, the study explored whether technology affords innovative support for nutritional self-care among older adults. DESIGN The study was explorative and qualitative in approach. METHODS Appetitus was developed as a tablet-based application to prevent and alleviate undernutrition among older adults. Eighteen home-dwelling older adults used the app for 8 weeks. Older adults received home care, and local healthcare professionals introduced the app and gave support during the study. RESULTS Appetitus served as a source of inspiration and a reminder of available, relevant food options. Appetitus encouraged some participants to eat or drink more by the end of the day while others became more aware of selecting food options to ensure sufficient protein, energy and fluids. However, some participants made no active effort to change their diet despite feedback from the app that suggested they did not eat or drink enough. Technical support from healthcare professionals facilitated participants' use of the app and tablet. Some participants also received more specific nutritional follow-up that helped to make their experience of using the app more meaningful. CONCLUSION Older adults' awareness about the importance of keeping a diet that helps prevent undernutrition was reinforced through the use of Appetitus and discussing nutrition with healthcare professionals. IMPLICATION FOR PRACTICE The findings affirm feasibility of using technology in nutritional interventions enhancing self-care among older adults.
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Affiliation(s)
- Caroline Farsjø Aure
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Anders Kluge
- Department of Education, Faculty of Educational Sciences, University of Oslo, Oslo, Norway
| | - Anne Moen
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
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Chatindiara I, Sheridan N, Kruger M, Wham C. Eating less the logical thing to do? Vulnerability to malnutrition with advancing age: A qualitative study. Appetite 2020; 146:104502. [DOI: 10.1016/j.appet.2019.104502] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/02/2019] [Accepted: 10/28/2019] [Indexed: 12/16/2022]
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Abstract
The objective of this narrative review was to provide an update on oral and nasal vitamin B12 (cobalamin) therapy in elderly patients. Relevant articles were identified by 'PubMed' and 'Scholar Google' search from January 2010 to July 2018 and through hand search of relevant reference articles. Additional studies were obtained from references of identified studies, the 'Cochrane Library' and the 'ISI Web of Knowledge'. Data retrieved from international meetings were also used, as was information retrieved from commercial sites on the web and data from 'CARE B12' research group. For oral vitamin B12 therapy, four prospective randomized controlled trials, eight prospective studies, one systematic and four reviews fulfilled our inclusion criteria. The studies included mainly or exclusively elderly patients (≥65-year-olds). In all of the studies, the mean age of the patients was at least 70 years except for two. The present review documents that oral vitamin B12 replacement at 1000 μg daily proved adequate to cure vitamin B12 deficiency, with a good safety profile. The efficacy was particularly marked when considering the noticeable improvement in serum vitamin B12 levels and haematological parameters, such as haemoglobin level, mean erythrocyte cell volume and reticulocyte count. The effect of oral cobalamin treatment in patients presenting with severe neurological manifestations has not yet been adequately documented. For nasal vitamin B12, only a few preliminary studies were available. We conclude that oral vitamin B12 is an effective alternative to intramuscular vitamin B12 injections in elderly patients. Oral vitamin B12 treatment avoids the discomfort, inconvenience and cost of monthly injections.
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Affiliation(s)
- E Andrès
- Department of Internal Medicine, Diabetes and Metabolic Diseases, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - A-A Zulfiqar
- Department of Geriatrics, CHRU de Rouen, Rouen, France
| | - T Vogel
- Department of Geriatrics and Internal Medicine, Universitaires de Strasbourg, Strasbourg, France
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Avgerinou C, Bhanu C, Walters K, Croker H, Liljas A, Rea J, Bauernfreund Y, Kirby-Barr M, Hopkins J, Appleton A, Kharicha K. Exploring the Views and Dietary Practices of Older People at Risk of Malnutrition and Their Carers: A Qualitative Study. Nutrients 2019; 11:E1281. [PMID: 31195731 PMCID: PMC6627873 DOI: 10.3390/nu11061281] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/10/2019] [Accepted: 06/03/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND While malnutrition is an important cause of morbidity and mortality in older people, it is commonly under-recognised. We know little on the views of community-dwelling older people and their carers regarding the management of malnutrition. The aim of the study was: (a) to explore views and dietary practices of older people at risk of malnutrition and their carers; (b) to identify gaps in knowledge, barriers and facilitators to healthy eating in later life; (c) to explore potential interventions for malnutrition in primary care. METHODS A qualitative study was performed using semi-structured interviews with participants recruited from four general practices and a carers' focus group in London. Community-dwelling people aged ≥75, identified as malnourished or at risk of malnutrition (n = 24), and informal carers of older people (n = 9) were interviewed. Data were analysed using thematic analysis. RESULTS Older people at risk of malnutrition rarely recognise appetite or weight loss as a problem. Commonly held perceptions include that being thin is healthy and 'snacking' is unhealthy. Changes in household composition, physical or mental health conditions and cognitive impairment can lead to inadequate food intake. Most carers demonstrate an awareness of malnutrition, but also a lack of knowledge of what constitutes a nutritious diet. Although older people rarely seek any help, most would value advice from their GP/practice nurse, a dietitian or another trained professional. CONCLUSION Older people at risk of malnutrition and their carers lack knowledge on nutritional requirements in later life but are receptive to intervention. Training for health professionals in delivering tailored dietary advice should be considered.
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Affiliation(s)
- Christina Avgerinou
- Department of Primary Care and Population Health, University College London, London, NW3 2PF, UK.
| | - Cini Bhanu
- Department of Primary Care and Population Health, University College London, London, NW3 2PF, UK.
| | - Kate Walters
- Department of Primary Care and Population Health, University College London, London, NW3 2PF, UK.
| | - Helen Croker
- Health Behaviour Research Centre, University College London, London WC1E 6BT, UK.
| | - Ann Liljas
- Department of Primary Care and Population Health, University College London, London, NW3 2PF, UK.
| | - Jennifer Rea
- Department of Primary Care and Population Health, University College London, London, NW3 2PF, UK.
| | - Yehudit Bauernfreund
- Department of Primary Care and Population Health, University College London, London, NW3 2PF, UK.
| | | | - Jane Hopkins
- Patient and Public Involvement Representative, London, UK.
| | - Amber Appleton
- Department of Primary Care and Population Health, University College London, London, NW3 2PF, UK.
| | - Kalpa Kharicha
- Department of Primary Care and Population Health, University College London, London, NW3 2PF, UK.
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Where would you like to eat? A formative evaluation of mixed-reality solitary meals in virtual environments for older adults with mobility impairments who live alone. Food Res Int 2019; 117:30-39. [DOI: 10.1016/j.foodres.2018.02.051] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 02/16/2018] [Accepted: 02/20/2018] [Indexed: 11/21/2022]
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Abstract
This study aimed at investigating the prevalence and factors associated with living alone among older persons in Uganda. A secondary analysis of the 2010 Uganda National Household Survey (UNHS) data was conducted. A complementary log-log regression model was used to estimate the association between living alone and demographic, socio-economic and health factors. Nearly one out of ten (9%) older persons lived alone in Uganda. Living alone was associated with being divorced / separated (OR 18.5, 95% CI: 10.3–33.3), being widowed (OR 8.8, 95% CI: 5.1–15.2), advanced age (OR 2.1, 95% CI: 1.4–3.2), residence in western region (OR 0.6, 95% CI: 0.3–0.93), poor wealth status (OR 0.3, 95% CI: 0.2–06), receiving remittances (OR 1.6, 95% CI: 1.1–2.3) and being disabled (OR 1.6, 95% CI: 1.2–2.1). Living alone among older persons did not vary by gender.
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Kobayashi S, Asakura K, Suga H, Sasaki S. Living status and frequency of eating out-of-home foods in relation to nutritional adequacy in 4,017 Japanese female dietetic students aged 18-20 years: A multicenter cross-sectional study. J Epidemiol 2017; 27:287-293. [PMID: 28190656 PMCID: PMC5463022 DOI: 10.1016/j.je.2016.07.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 07/15/2016] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Living status (e.g., living with family or alone) may affect dietary habits. We compared nutritional adequacy according to living status and the frequency of eating out-of-home foods in young Japanese women. METHODS Female dietetic students (aged 18-20 years; n = 4,017) participated in a cross-sectional multicenter study, which was conducted in 85 dietetic schools in 35 of 47 prefectures in Japan. Habitual dietary intake was assessed with a validated diet history questionnaire. Nutritional adequacy was determined based on the Dietary Reference Intakes for Japanese, 2015, for two goals: preventing non-communicable chronic disease (a tentative dietary goal for preventing lifestyle-related diseases [DG] that tracks five nutrients) and avoiding insufficient intake of mainly vitamins and minerals (estimated average requirement [EAR] that tracks 14 nutrients). RESULTS Women living with their family were less likely to meet DG nutrient levels, but more likely to meet EAR nutrient levels compared with those living alone. In contrast, women living alone had more inadequate nutrients with EAR and fewer nutrients with not-meeting DG than those living with families. A higher frequency of eating out-of-home was significantly associated with a higher prevalence of not-meeting DG nutrient levels only in the women living with their family. CONCLUSIONS The prevalence of nutritional adequacy varied based on living status. In addition, women living with their family and those with a high frequency of eating out-of-home foods had the highest prevalence of not-meeting DG. Effective ways of improving dietary quality among young Japanese women differ by living status.
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Affiliation(s)
- Satomi Kobayashi
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Keiko Asakura
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan; Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan
| | - Hitomi Suga
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan; Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Liu LK, Guo CY, Lee WJ, Chen LY, Hwang AC, Lin MH, Peng LN, Chen LK, Liang KY. Subtypes of physical frailty: Latent class analysis and associations with clinical characteristics and outcomes. Sci Rep 2017; 7:46417. [PMID: 28397814 PMCID: PMC5387710 DOI: 10.1038/srep46417] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 03/15/2017] [Indexed: 12/23/2022] Open
Abstract
Frailty is a well-recognized geriatric syndrome with various definitions and conceptual frameworks. This study aimed to use latent class analysis to discover potential subtypes of pre-frail and frail older people. Data from the I-Lan Longitudinal Aging Study (ILAS), a community-based cohort study was used for analysis. Latent class analysis was applied to characterize classes or subgroups with different frailty phenotypes among ILAS participants targeting older adults aged 65 and above, capable of completing a 6-meter walk, without severe major or life threatening diseases, and not institutionalized. Latent class analysis identified three distinct subgroups with different frailty phenotypes: non-mobility-type (weight loss and exhaustion), mobility-type frailty (slowness and weakness), and low physical activity. Comparing these groups with the robust group, people with mobility-type frailty had poorer body composition, worse bone health, poorer cognitive function, lower survival (hazard ratio: 6.82, p = 0.019), and poorer overall health outcomes (hazard ratio: 1.67, p = 0.040). People in the non-mobility-type group had poorer bone health and more metabolic serum abnormalities. In conclusion, mobility-type frailty was a better predictor of adverse outcomes. However, further investigation is needed to evaluate how these phenotypic subgroups may help in predicting prognosis or in developing interventions.
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Affiliation(s)
- Li-Kuo Liu
- Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd., Taipei 11217, Taiwan
| | - Chao-Yu Guo
- Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan.,Institute of Public Health, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan
| | - Wei-Ju Lee
- Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan.,Department of Family Medicine, Taipei Veterans General Hospital, Yuanshan Branch, No. 386 Rongguang Rd., Yuanshan Township, Yilan County 264, Taiwan
| | - Liang-Yu Chen
- Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd., Taipei 11217, Taiwan.,Institute of Public Health, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan
| | - An-Chun Hwang
- Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd., Taipei 11217, Taiwan.,Institute of Public Health, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan
| | - Ming-Hsien Lin
- Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd., Taipei 11217, Taiwan
| | - Li-Ning Peng
- Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd., Taipei 11217, Taiwan.,Institute of Public Health, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan
| | - Liang-Kung Chen
- Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd., Taipei 11217, Taiwan
| | - Kung-Yee Liang
- Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan.,Institute of Public Health, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan
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Kalfoss MH, Low G, Halvorsrud L. Identity Processes Among Older Norwegians Living in Urban and Rural Areas. West J Nurs Res 2017; 40:701-724. [PMID: 28322656 DOI: 10.1177/0193945916687514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Guided by the Identity Process Theory, we examined whether 424 Norwegians 60+ years of age would attribute their physical and mental functioning to their health (identity assimilation), to aging itself (identity accommodation), or to both (identity balance). We were also interested in the effect of these attribution styles upon depressive symptoms. Secondary data from the 2004 World Health Organization Quality of Life OLD Group Norwegian Field Study were analyzed using General Linear Model Regression and subsequent Path Analyses. Attributing physical functioning to health as opposed to aging had a negligible effect on depressive symptoms among both study groups. Attributing mental functioning to aging worsened depressive symptoms among rural participants. Attributing mental functioning to health was associated with more positive perceptions of psychosocial loss among urban participants. Positivity toward psychosocial loss lessened depressive symptoms and factors affecting those perceptions differed among rural versus urban participants. Adapting to functional changes in older age is a complex process affecting depressive symptoms.
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Affiliation(s)
| | - Gail Low
- 2 University of Alberta, Edmonton, Canada
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van der Pols-Vijlbrief R, Wijnhoven HAH, Visser M. Perspectives on the Causes of Undernutrition of Community-Dwelling Older Adults: A Qualitative Study. J Nutr Health Aging 2017; 21:1200-1209. [PMID: 29188880 DOI: 10.1007/s12603-017-0872-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Undernutrition is a major health concern particularly in vulnerable older adults. The present study aimed to reveal the causes of undernutrition as reported by community-dwelling older adults. DESIGN Twenty-five semi-structured interviews and two focus group discussions were performed and analyzed. SETTING Community-dwelling. PARTICIPANTS Older adults. MEASUREMENTS A questionnaire on demographics, Short Nutritional Assessment Questionnaire 65+ and interviews on the potential causes of undernutrition. RESULTS 33 older adults agreed to participate in the interviews and focus groups. Our findings indicate that a wide variety of causes of undernutrition, both modifiable and non-modifiable, were mentioned by the older adults. Many modifiable causes of undernutrition were reported in the mental, social or food and appetite theme, such as poor food quality provided by meal services, the inability to do groceries, loneliness and mourning. Non-modifiable causes included, forgetfulness, aging, surgery and hospitalization. CONCLUSIONS This study provides guidance to better understand the underlying causes of undernutrition from an older adult's perspective. The modifiable causes provide specific direction towards practical implications that might decrease or prevent undernutrition. Non-modifiable causes should raise awareness of an increased risk of undernutrition by health professionals in primary and secondary care, caregivers and family members.
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Affiliation(s)
- R van der Pols-Vijlbrief
- Rachel van der Pols-Vijlbrief, Department of Health Sciences and the EMGO+ Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands, E-mail address: ; Telephone number: +31 (0)20 59 83 701; Fax number: +31 (0)20 59 86 940
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Lyngroth AL, Hernes SMS, Madsen BO, Söderhamn U, Grov EK. Nutritional screening of patients at a memory clinic - association between patients’ and their relatives’ self-reports. J Clin Nurs 2016; 25:760-8. [DOI: 10.1111/jocn.13093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2015] [Indexed: 01/27/2023]
Affiliation(s)
| | - Susanne Miriam Sørensen Hernes
- Department of Clinical Science, University of Bergen and Department of Geriatrics and Internal Medicine; Sorlandet Hospital Arendal; Arendal Stoa Norway
| | - Bengt-Ove Madsen
- The Memory Clinic; Sorlandet Hospital Arendal; Arendal Stoa Norway
| | - Ulrika Söderhamn
- Faculty of Health and Sports Sciences; University of Agder; Grimstad Norway
| | - Ellen Karine Grov
- Department of Nursing and Health
Promotion; Oslo and Akershus University of Applied Sciences; Oslo Norway
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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]
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Söderhamn U, Sundsli K, Cliffordson C, Dale B. Psychometric properties of Antonovsky’s 29-item Sense of Coherence scale in research on older home-dwelling Norwegians. Scand J Public Health 2015; 43:867-74. [DOI: 10.1177/1403494815598863] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2015] [Indexed: 11/15/2022]
Abstract
Aim: The aim of this study was to test the homogeneity and construct validity of the Sense of Coherence 29-item scale (SOC-29) among older home-dwelling Norwegians. Methods: A postal questionnaire, consisting of background variables, five health-related questions, the SOC-29, and three other instruments measuring mental health, self-care ability, and risk for undernutrition, was sent to 6033 home-dwelling older people (65+ years) in southern Norway. A total of 2069 participants were included. Homogeneity was assessed with Cronbach’s alpha coefficient and item-to-total correlations. The construct validity was assessed with “the known-groups technique,” a linear stepwise regression analysis with SOC score serving as the dependent variable and with confirmatory factor analysis. Results: With a Cronbach’s alpha coefficient of 0.91 and statistically significant item-to-total correlations, the SOC-29 was found to be homogeneous. Construct validity was supported because the SOC-29 could separate known groups with expected high and low scores. The factors that could predict SOC were mental health, self-care ability, feeling lonely, being active, and chronic disease or handicap. Evidence of construct validity was displayed in a confirmatory factor analysis that confirmed SOC-29 as one theoretical construct with the three dimensions, comprehensibility, manageability, and meaningfulness. Conclusions: The Norwegian version of the SOC-29 is a reliable and valid instrument for use in research among older people. The results confirm that SOC has a particularly strong relationship with mental health and self-care ability.
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Affiliation(s)
- Ulrika Söderhamn
- Center for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
| | - Kari Sundsli
- Department of Social Welfare and Occupational therapy, Diakonhjemmet University College, Sandnes, Norway
| | | | - Bjørg Dale
- Center for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
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Dale B, Söderhamn U. Nutritional self-care among a group of older home-living people in rural Southern Norway. J Multidiscip Healthc 2015; 8:67-74. [PMID: 25670905 PMCID: PMC4315559 DOI: 10.2147/jmdh.s75521] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Older home-living people are an at-risk group for undernutrition, particularly those who are living alone. Lack of knowledge about healthy dietary habits, altered taste sensation, and declined health status are shown to be some of the factors related to undernutrition. The aims of this study were to explore how a small group of older people in Southern Norway perceived their nutritional self-care. Methods An exploratory qualitative approach, combined with a simple self-report questionnaire, was used. Five persons living in rural areas in Southern Norway, who in a former study were screened and found to be at risk for undernutrition, participated. Qualitative data assessed by means of individual self-care talks in the persons’ own homes were analyzed using directed content analysis. A simple self-report questionnaire containing demographic variables, two health-related questions, and the Nutritional Form For the Elderly (NUFFE-NO) instrument was filled out at baseline and 6 months after the self-care talks. Results The qualitative data showed that the participants had adequate knowledge about healthy and nutritious diets. They were aware of and motivated to adapt their diet to their current state of health and to perform the necessary actions to maintain an optimal nutritional status and nutritional self-care. Conclusion Older people living at home are a diverse group. However, this study showed that they may have sufficient knowledge, willingness, and ability to perform nutritional self-care, even if they live alone and have several chronic illnesses and impaired health.
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Affiliation(s)
- Bjørg Dale
- Centre for Caring Research - Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
| | - Ulrika Söderhamn
- Centre for Caring Research - Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
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Ghosh S, Bandyopadhyay S, Bhattacharya S, Misra R, Das S. Quality of life of older people in an urban slum of India. Psychogeriatrics 2014; 14:241-6. [PMID: 25495086 DOI: 10.1111/psyg.12073] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 07/21/2014] [Accepted: 08/18/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this study was to examine different domains of quality of life (QOL) and their relationship to sociodemographic characteristics among older people in an urban slum in India. MATERIALS AND METHODS A cross-sectional study was conducted (n = 120). Selected individuals were interviewed, and their QOL was assessed by the World Health Organization Quality of Life-BREF questionnaire. Statistical analysis was then performed. RESULTS Of those included in the study population, 61.7% were men, all were Hindus, 46.7% were members of the general caste, 19.2% were illiterate, 35% were unemployed, and 72.5% lived with their joint family (i.e. extended family). Mean scores in each domain studied did not significantly differ between the sexes, age groups, castes, and family types. Subjects with more education, who were married, and with greater income had significantly better QOL scores. Mean scores were also better in certain domains among persons who had their own income and who resided with their children. CONCLUSION Having low education, being single, lacking personal income, and not living with their children significantly reduced QOL in the elderly subjects. Attention should be given to these factors to help elderly individuals age in a healthy manner.
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Affiliation(s)
- Somenath Ghosh
- Department of Community Medicine, Burdwan Medical College and Hospital, Burdwan, India
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John BK, Bullock M, Brenner L, McGaw C, Scolapio JS. Nutrition in the elderly. Frequently asked questions. Am J Gastroenterol 2013; 108:1252-66; quiz 1267. [PMID: 23711624 DOI: 10.1038/ajg.2013.125] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2012] [Accepted: 04/02/2013] [Indexed: 12/11/2022]
Affiliation(s)
- Bijo K John
- Division of Gastroenterology, Department of Internal Medicine, University of Florida College of Medicine, Jacksonville, FL 32209, USA
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Sundsli K, Espnes GA, Söderhamn O. Being old and living alone in urban areas: the meaning of self-care and health on the perception of life situation and identity. Psychol Res Behav Manag 2013; 6:21-7. [PMID: 23847434 PMCID: PMC3704551 DOI: 10.2147/prbm.s46329] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Living alone in urban areas when getting old is an important and necessary field for research as the growth of the urban population worldwide increases, and due to the fact that people live longer. How older people manage their self-care and health, and how this might influence their identity and life situation may be very important to understand when planning for a new, upcoming older generation. The aim of this study was to elucidate the meaning of self-care and health for the perception of life situation and identity among single-living older individuals in urban areas in southern Norway. METHODS A phenomenological-hermeneutic approach inspired by Ricoeur was applied. Nine single-living older persons in urban areas, 70-82 years of age, and identified to be in good health were interviewed. The interviews were audiotaped, transcribed verbatim, and analyzed using a phenomenological-hermeneutic method. RESULTS Strength and a time dimension characterized the meaning of self-care and health for the perception of life situation and identity as narrated by the group of single-living older individuals in urban areas in southern Norway. The informants were, as older individuals, caring, autonomous, and robust characters, who had gone through difficult times in life, and in a resilient way moved towards a new future. They valued and were grateful for what they had learned in their lives and could go forward and still experience and explore. CONCLUSION Self-care is significant in the perception of life situation and identity among single urban older people in this study, and characterized by strength, temporality, gratitude, autonomy, and natality. Society needs to acknowledge the strengths and capabilities of older people to a greater extent.
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Affiliation(s)
- Kari Sundsli
- Department of Social Work and Health Science, Norwegian University of Science and Technology, Trondheim
- Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
| | - Geir Arild Espnes
- Research Centre for Health Promotion and Resources, Norwegian University of Science and Technology, Trondheim, Norway
| | - Olle Söderhamn
- Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
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Tomstad ST, Söderhamn U, Espnes GA, Söderhamn O. Nutritional self-care in two older Norwegian males: a case study. Clin Interv Aging 2013; 8:609-20. [PMID: 23807843 PMCID: PMC3686329 DOI: 10.2147/cia.s45458] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Knowledge about how to support nutritional self-care in the vulnerable elderly living in their own homes is an important area for health care professionals. The aim of this case study was to evaluate the effects of nutritional intervention by comparing perceived health, sense of coherence, self-care ability, and nutritional risk in two older home-dwelling individuals before, during, and after intervention and to describe their experiences of nutritional self-care before and after intervention. METHODS A study circle was established to support nutritional self-care in two older home-dwelling individuals (≥65 years of age), who participated in three meetings arranged by health professionals over a period of six months. The effects of this study circle were evaluated using the Nutritional Form For the Elderly, the Self-care Ability Scale for the Elderly (SASE), the Appraisal of Self-care Agency scale, the Sense of Coherence (SOC) scale, and responses to a number of health-related questions. Qualitative interviews were performed before and after intervention to interpret the changes that occurred during intervention. RESULTS A reduced risk of undernutrition was found for both participants. A higher total score on the SASE was obtained for one participant, along with a slightly stronger preference for self-care to maintain sufficient food intake, was evident. For the other participant, total score on the SASE decreased, but the SOC score improved after intervention. Decreased mobility was reported, but this did not influence his food intake. The study circle was an opportunity to express personal views and opinions about food intake and meals. CONCLUSION An organized meeting place for dialogue between older home-dwelling individuals and health care professionals can stimulate the older person's engagement, consciousness, and learning about nutritional self-care, and thereby be of importance in reducing the risk of undernutrition.
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Affiliation(s)
- Solveig T Tomstad
- Department of Social Work and Health Science, Faculty of Social Sciences and Technology Management, Norwegian University of Science and Technology, Trondheim, Norway.
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Abstract
Background: Estimates of health problems of the elderly in developing countries are required from time to time to predict trends in disease burden and plan health care for the elderly. Developing countries have a poor track record of equitable distribution of health care. Marginalized groups living in urban slums and rural villages have poor penetration of health services. Aims: To identify the geriatric health problems in samples drawn from a slum and a village, and also to explore any gender and urban–rural difference morbidity. Subject and Methods: A community-based cross-sectional study was carried out by house to house survey of all people aged over 60 years in an urban slum and a village in the field practice area of a teaching hospital. The total elderly population in these two areas was 407, with an almost equal representation from urban slum and rural area. Information (most of them self-reported) was collected in a pre-tested instrument, which has been used earlier in a World Health Organization multicentric study in India. Categorical variables were summarized by percentages. Associations were explored with odds ratio (OR) and 95% confidence intervals (CIs). Results: Female elders outnumbered the male elders; widows outnumbered widowers. Tobacco use was very high at 58.97% (240/407). Visual impairment (including uncorrected presbyopia) was the most common handicap with prevalence of 83.29% (339/407), with males more affected than females (OR = 2.52, 95% CI 1.32-4.87). Uncorrected hearing impairment was also common. Urinary complaints were also more common in males (OR = 1.68, 95% CI = 0.93-3.04). More rural elders were living alone than their urban counterpart (OR = 2.87, 95% CI 1.23-6.86). History of weight loss was higher in the rural areas, while tendency to obesity was higher in the urban areas. An appreciable number 29.2% (119/407) had unoperated cataract. Prevalence of hypertension was 30.7% (125/407); 12% (49/407) had diabetes; 7.6% (31/407) gave history of ischemic heart disease, males more than females (OR = 3.75, 95% CI 1.62-8.82). A large proportion, 32.6%, (133/407) had dental problems. Almost half of the population gave history of depression. Conclusion: A large number of unmet health needs, such as unoperated cataract, uncontrolled hypertension, uncorrected hearing impairment and tobacco use, exist in marginalized groups. Health interventions for these are needed in developing countries. Preventive services such as tobacco cessation campaigns among the elderly should also get priority.
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Affiliation(s)
- Rp Thakur
- Department of Community Medicine, Burdwan Medical College, Burdwan, West Bengal, India
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Tomstad ST, Söderhamn U, Espnes GA, Söderhamn O. Lived experiences of self-care among older, home-dwelling individuals identified to be at risk of undernutrition. J Multidiscip Healthc 2012; 5:319-27. [PMID: 23271914 PMCID: PMC3526862 DOI: 10.2147/jmdh.s38474] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction In a society where most older people live in their own homes, it may be expected of older individuals to exercise their potential to take care of themselves in daily life. Nutrition is a central aspect of self-care, and groups of older, home-dwelling people are at risk of undernutrition. Aim The aim of this study was to describe the lived experiences of self-care and features that influence health and self-care among older, home-dwelling individuals identified to be at risk of undernutrition. Methods Qualitative interviews were performed with eleven home-dwelling individuals who had been identified as being at risk of undernutrition. The interviews were recorded, transcribed verbatim, and analyzed with a descriptive phenomenological method. Findings Self-care as a lived experience among older, home-dwelling individuals identified to be at risk of undernutrition is about being aware of food choices and making decisions about taking healthy steps or not. In the presence of health problems, the appetite often decreases. Being able to take care of oneself in daily life is important, as is receiving help when needing it. Working at being physically and socially active and engaged may stimulate the appetite. Having company at meals is important and missed when living alone. Being present and taking each day by day, as well as considering oneself in the light of past time and previous experiences and looking ahead, is central, even when having fears for the future and the end of life. Conclusion Health care professionals should be aware of these findings in order to support self-care in older people, and they should pay attention to the social aspects at meals.
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Affiliation(s)
- Solveig T Tomstad
- Department of Social Work and Health Science, Norwegian University of Science and Technology, Trondheim, Norway ; Centre for Caring Research - Southern Norway, University of Agder, Grimstad, Norway
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Söderhamn U, Dale B, Sundsli K, Söderhamn O. Nutritional screening of older home-dwelling Norwegians: a comparison between two instruments. Clin Interv Aging 2012; 7:383-91. [PMID: 23049250 PMCID: PMC3459573 DOI: 10.2147/cia.s35986] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background It is important to obtain knowledge about the prevalence of nutritional risk and associated factors among older home-dwelling people in order to be able to meet nutritional challenges in this group in the future and to plan appropriate interventions. The aim of this survey was to investigate the prevalence of home-dwelling older people at nutritional risk and to identify associated factors using two different nutritional screening instruments as self-report instruments. Methods This study had a cross-sectional design. A postal questionnaire, including the Norwegian versions of the Nutritional Form for the Elderly (NUFFE-NO) and Mini Nutritional Assessment – Short Form (MNA-SF), background variables, and health-related questions was sent to a randomized sample of 6033 home-dwelling older people in southern Norway. A total of 2106 (34.9%) subjects were included in the study. Data were analyzed using descriptive statistics and logistic regression analyses. Results When using the NUFFE-NO and MNA-SF, 426 (22.3%) and 258 (13.5%) older persons, respectively, were identified to be at nutritional risk. The risk of undernutrition increased with age. Several predictors for being at risk of undernutrition, including chronic disease/handicap and receiving family help, as well as protective factors, including sufficient food intake and having social contacts, were identified. Conclusion Health professionals must be aware of older people’s vulnerability to risk of undernutrition, perform screening, and have a plan for preventing under-nutrition. For that purpose, MNA-SF and NUFFE-NO can be suggested for screening older people living at home.
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Affiliation(s)
- Ulrika Söderhamn
- Centre for Caring Research-Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway.
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Söderhamn U, Dale B, Sundsli K, Tomstad ST, Söderhamn O. Psychometric testing of the Norwegian version of the Nutritional Form For the Elderly among older home-dwelling people. J Multidiscip Healthc 2012; 5:121-8. [PMID: 22791993 PMCID: PMC3392698 DOI: 10.2147/jmdh.s32502] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Nutritional screening instruments need to be evaluated in terms of reliability and validity and being able to demonstrate sensitivity and specificity for use in clinical practice and research. The aims of this study were to test the reliability and validity of the Norwegian version of the Nutritional Form For the Elderly (NUFFE-NO) in a sample of older home-dwelling people, and to use the short form of the Mini Nutritional Assessment (MNA-SF) as a standard. Methods A postal questionnaire, including the two instruments, background variables, and health-related questions, was sent to 6033 home-dwelling older people (65+ years) in southern Norway. In total, 2106 persons responded and were included. Data were analyzed statistically regarding homogeneity, concurrent and construct validity, sensitivity, and specificity of NUFFE-NO. Results A Cronbach’s alpha coefficient of 0.71 and significant item-to-total correlations were obtained as measures of homogeneity. Concurrent validity was assessed by a correlation coefficient of −0.37 (P < 0.001) between NUFFE-NO and MNA-SF. NUFFE-NO could separate known nutritional at-risk groups as a measure of construct validity. A cut-off point of ≥4 for identification of older people at nutritional risk was found for NUFFE-NO with MNA-SF as a standard. Conclusion NUFFE-NO shows adequate psychometric properties regarding homogeneity and construct validity. MNA-SF was not found to be the most suitable standard to use, because a low correlation coefficient was obtained as a measure of concurrent validity and a lower cut-off point was found compared with another study using the Mini Nutritional Assessment (MNA®) as a standard for NUFFE-NO. The obtained cut-off point of ≥4 is not recommended for use in practice or research, because many false positive nutritional at-risk persons would then be identified. Further studies with suitable design have to be performed among older home-dwelling people using the MNA as a standard.
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Affiliation(s)
- Ulrika Söderhamn
- Center for Caring Research, Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
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