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Barbosa MG, Sganzerla D, Buttelli ACK, Teixeira C. Lower quality of life in obese ICU survivors: a multicenter cohort study. Qual Life Res 2024; 33:361-371. [PMID: 37906347 DOI: 10.1007/s11136-023-03523-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 11/02/2023]
Abstract
PURPOSE To compare health-related quality of life (HRQoL) and functional status between obese, underweight, normal-weight, and overweight patients after three months post-intensive care unit (ICU) discharge. METHODS Multicenter cohort study (10 Brazilian ICUs). 1600 ICU survivors (≥ 72 h in the ICU) were included.The main outcomes were HRQoL and functional status assessed three months after the ICU discharge. The secondary outcomes were mortality, hospital readmission, and ICU readmission during the same period. RESULTS Obese patients (median 50.1; IQR 39.6-59.6) had lower HRQoL in the mental component than normal-weight patients (median 53; IQR 45.6-60.1) (p = 0.033). No differences were found between BMI categories regarding the physical component of HRQoL and the Barthel Index (p = 0.355 and 0.295, respectively). Regarding readmissions, 65.1 and 25.1% of patients were readmitted to the hospital and ICU, but there was no difference between the groups (p = 0.870 and 0.220, respectively). Obese patients died less frequently (11.8%) than underweight (30.9%) and normal-weight (19.3%) patients (p < 0.001). CONCLUSION After three months of post-ICU discharge, obese patients had lower HRQoL in the mental component than normal-weight patients. However, obese patients died less than underweight and normal-weight patients.
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Affiliation(s)
- Mirceli Goulart Barbosa
- Post-Graduation Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Sarmento Leite Street, 245, Porto Alegre, 90050-170, Brazil.
| | - Daniel Sganzerla
- UNIMED, Venancio Aires Street, 1040, Porto Alegre, 90040-191, Brazil
| | | | - Cassiano Teixeira
- Post-Graduation Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Sarmento Leite Street, 245, Porto Alegre, 90050-170, Brazil
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Lu L, Liu B, Ma Y. Association of Different Obesity Phenotypes with Sarcopenia in Han Chinese Middle-Aged and Elderly with Type 2 Diabetes Individuals. Diabetes Metab Syndr Obes 2023; 16:841-848. [PMID: 36974328 PMCID: PMC10039658 DOI: 10.2147/dmso.s398475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/09/2023] [Indexed: 03/29/2023] Open
Abstract
PURPOSE To investigate the relationship between different obesity phenotypes and sarcopenia in hospitalized Chinese patients with type 2 diabetes mellitus (T2DM). METHODS This cross-sectional study included 385 men. Anthropometric measurements including applied the determination method of Dual-energy X-ray absorptiometry (DXA) determination of limb skeletal muscle mass index (ASMI) and blood samples were analyzed. The people were divided into four groups according to body mass index (BMI) (≥24kg/m2) and waist circumference (WC) (female ≥85cm, male ≥90cm). Group A (BMI and WC were normal), Group B (BMI was normal and high WC), Group C (high BMI and WC were normal), and Group D (BMI and WC were abnormal). RESULTS The prevalence rates of sarcopenia and abdominal obesity were 32.2% and 74.0%, respectively. The detection rate of lower ASMI decreased gradually from Group A to Group D(74.6% vs 68.3% vs 54.5% vs 51.6%, χ 2 =14.243, P=0.003). Logistic analysis showed that the risk of lower ASMI were decreased by 62.4% (95% CI: 0.149-0.950, P = 0.039) in Group C and 68.8% (95% CI: 0.165-0.593, P = 0.000) in Group D compared with Group A, respectively. The risk of lower ASMI were increased 4.153-fold (95% CI: 2.623-6.576, P = 0.000) in male. Male (OR = 4.065, 95% CI: 2.246-7.356, P = 0.000) and WC (OR = 1.053, 95% CI: 1.004-1.104, P = 0.033) were risk factors for lower ASMI, but the risk of lower ASMI was decreased by 32% (95% CI: 0.5744-0.804, P = 0.000) by elevated BMI in the overweight and obese group (Group C and Group D). CONCLUSION The prevalence of sarcopenia and abdominal obesity was elevated in han Chinese middle-aged and elderly patients with T2DM. Being overweight or obesity as defined by BMI protect against sarcopenia, while abdominal obesity increases the risk of sarcopenia.
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Affiliation(s)
- Lanyu Lu
- Department of Endocrinology and Metabolic Diseases, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
| | - Bowei Liu
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, People’s Republic of China
- Correspondence: Bowei Liu, Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, People’s Republic of China, Tel/Fax +86-335-5908603, Email
| | - Yongfang Ma
- Department of Internal Medicine, Chengde Medical University, Chengde, Hebei, People’s Republic of China
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Zhang A, Li Y, Ma S, Bao Q, Sun J, Cai S, Li M, Su Y, Cheng B, Dong J, Zhang Y, Wang S, Zhu P. Conicity-index predicts all-cause mortality in Chinese older people: a 10-year community follow-up. BMC Geriatr 2022; 22:971. [PMID: 36522628 PMCID: PMC9756661 DOI: 10.1186/s12877-022-03664-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Abdominal obesity (AO) has been regarded as the most dangerous type of obesity. The Conicity-index (C-index) had a high ability to discriminate underlying AO. The purpose of this study was to determine the ability of C-index to predict all-cause mortality among non-cancer Chinese older people. METHODS The participants were residents of the Wanshou Road community in Beijing, China. Receiver operating curve (ROC) curves were used to determine the sensitivity and specificity of the best cut-off values for different anthropometric measures for predicting all-cause mortality. The area under the curve (AUC) of the ROC curves were calculated to compare the relative ability of various anthropometric measures to correctly identify older people in the community where all-cause mortality occurs. Included subjects were grouped according to C-index tertiles. The association between C-index and all-cause mortality was verified using Kaplan-Meier survival analysis and different Cox regression models. RESULTS During a mean follow-up period of 9.87 years, 1821 subjects completed follow-up. The average age was 71.21 years, of which 59.4% were female. The ROC curve results showed that the AUC of the C-index in predicting all-cause mortality was 0.633. Kaplan-Meier survival curves showed a clear dose-response relationship between C-index and all-cause mortality. With the increase of C-index, the survival rate of the study population showed a significant downward trend (P < 0.05). Adjusted for age, gender, hip circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose (FBG), 2-h postprandial blood glucose (2hPG), glycosylated hemoglobin, high-density lipids protein (LDL), triglyceride, serum creatinine, serum uric acid, urine albumin-creatinine ratio (UACR), Mini-Mental State Examination (MMSE), smoking history, and drinking history, COX regression analysis showed that in the model adjusted for all covariates, the risk of all-cause mortality in tertile 3 was 1.505 times that in tertile 1, and the difference was statistically significant. CONCLUSIONS The C-index is an independent risk factor for all-cause mortality in the non-cancer Chinese older people.
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Affiliation(s)
- Anhang Zhang
- grid.414252.40000 0004 1761 8894Medical School of Chinese PLA & Chinese, PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Yingnan Li
- grid.414252.40000 0004 1761 8894Department of Gastroenterology, the Second Medical Center, Chinese PLA General Hospital, Beijing, 100853 China
| | - Shouyuan Ma
- grid.414252.40000 0004 1761 8894Department of Geriatric Cardiology, the Second Medical Center, Chinese PLA General Hospital, Beijing, 100853 China
| | - Qiligeer Bao
- grid.414252.40000 0004 1761 8894Medical School of Chinese PLA & Chinese, PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Jin Sun
- grid.414252.40000 0004 1761 8894Medical School of Chinese PLA & Chinese, PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Shuang Cai
- grid.414252.40000 0004 1761 8894Medical School of Chinese PLA & Chinese, PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Man Li
- grid.414252.40000 0004 1761 8894Medical School of Chinese PLA & Chinese, PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Yongkang Su
- grid.414252.40000 0004 1761 8894Medical School of Chinese PLA & Chinese, PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Bokai Cheng
- grid.414252.40000 0004 1761 8894Medical School of Chinese PLA & Chinese, PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Jing Dong
- grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Yan Zhang
- grid.414252.40000 0004 1761 8894Department of Outpatient, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853 China
| | - Shuxia Wang
- grid.414252.40000 0004 1761 8894Medical School of Chinese PLA & Chinese, PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Ping Zhu
- grid.414252.40000 0004 1761 8894Medical School of Chinese PLA & Chinese, PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
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Ozkok S, Aydin CO, Sacar DE, Catikkas NM, Erdogan T, Bozkurt ME, Kilic C, Karan MA, Bahat G. Sarcopenic obesity versus sarcopenia alone with the use of probable sarcopenia definition for sarcopenia: Associations with frailty and physical performance. Clin Nutr 2022; 41:2509-2516. [PMID: 36219979 DOI: 10.1016/j.clnu.2022.09.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/04/2022] [Accepted: 09/09/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND & AIMS Ageing brings alterations in body composition, as skeletal muscle gradually declines and accumulation of adipose tissue accompanies it. Although sarcopenia (S) and obesity (O) were separately reported to be associated with frailty and poor physical performance, whether they bring more detrimental or favorable effect when they coexist (i.e. sarcopenic obesity; SO) is an issue needs clarification. We aimed to study the associations of SO and S alone with frailty and poor physical performance, by using probable S definition. METHODS This was a retrospective, cross-sectional study including community dwelling older adults who were ≥60 years old and admitted to the outpatient clinic of a tertiary hospital between 2012 and 2020. We measured handgrip strength via hand dynamometer and defined decreased muscle strength as probable S. We performed bioimpedance analysis to evaluate body composition and used fat percentile method to define obesity. We assessed nutritional status via Mini-Nutritional Assessment-Short Form, frailty via FRAIL scale, and physical performance via Timed Up and Go (TUG) test. We examined the associations of four body phenotypes, i.e. non-S non-O, SO, S alone and O alone with frailty and impaired TUG in univariate and multivariate analyses (Model 1). We further performed a head to head analysis of SO vs S to see if one of them was associated more with frailty and impaired TUG (Model 2). RESULTS There were 1366 older adults included in the study (mean age: 74.6 ± 6.9; 68.3% female). The prevalences of non-S non-O, S alone, SO and O alone were 53.5, 7.5, 2.8 and 36.2%, respectively. Multivariate analysis adjusted for age, gender and nutritional status revealed that both SO and S alone were independently associated with frailty and impaired TUG, with SO demonstrating lower odds than S alone (OR = 5.9 and 6.05 for frailty, and 3.9 and 4.4 for TUG, respectively). Head-to-head comparison between SO and S alone in Model 2 showed that two groups did not demonstrate significant difference in terms of the frailty and impaired TUG risk. CONCLUSION Although SO and S groups demonstrated similar risks, obesity accompanying sarcopenia might show a favorable trend in terms of frailty and poor physical performance, compared to sarcopenia alone. Longitudinal studies are needed to reveal whether an obesity paradox exists for frailty and physical performance in older adults.
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Affiliation(s)
- Serdar Ozkok
- Division of Geriatrics, Department of Internal Medicine, Istanbul University, Istanbul Medical School, 34093, Istanbul, Turkey
| | - Caglar Ozer Aydin
- Division of Geriatrics, Department of Internal Medicine, Istanbul University, Istanbul Medical School, 34093, Istanbul, Turkey
| | - Duygu Erbas Sacar
- Division of Geriatrics, Department of Internal Medicine, Istanbul University, Istanbul Medical School, 34093, Istanbul, Turkey
| | - Nezahat Muge Catikkas
- Division of Geriatrics, Department of Internal Medicine, Istanbul University, Istanbul Medical School, 34093, Istanbul, Turkey
| | - Tugba Erdogan
- Division of Geriatrics, Department of Internal Medicine, Istanbul University, Istanbul Medical School, 34093, Istanbul, Turkey
| | - Meris Esra Bozkurt
- Division of Geriatrics, Department of Internal Medicine, Istanbul University, Istanbul Medical School, 34093, Istanbul, Turkey
| | - Cihan Kilic
- Division of Geriatrics, Department of Internal Medicine, Istanbul University, Istanbul Medical School, 34093, Istanbul, Turkey
| | - Mehmet Akif Karan
- Division of Geriatrics, Department of Internal Medicine, Istanbul University, Istanbul Medical School, 34093, Istanbul, Turkey
| | - Gulistan Bahat
- Division of Geriatrics, Department of Internal Medicine, Istanbul University, Istanbul Medical School, 34093, Istanbul, Turkey.
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Gao T, Han S, Mo G, Sun Q, Zhang M, Liu H. A positive association between hunger in childhood and frailty in old age: Findings from the Chinese longitudinal healthy longevity survey. Front Med (Lausanne) 2022; 9:955834. [DOI: 10.3389/fmed.2022.955834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 10/11/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundChildhood hunger not only directly affects the physical and mental health of children and adolescents but also has a long-term negative effect on later health outcomes. In this cross-sectional study, we used a nationally representative Chinese sample to examine the relationship between hunger in childhood and frailty in older adults.Materials and methodsThe data were obtained from the 2018 Chinese Longitudinal Healthy Longevity Survey. The frailty index with 44 health deficits was used to identify frailty. Childhood hunger was measured by the question “Did you often go to bed hungry as a child?” Insurance status was categorized as New Rural Cooperative Medical Scheme (NRCMS), Urban Basic Medical Insurance Scheme (UBMIS), others, and no insurance. Multivariate logistic regression analysis was performed to estimate the adjusted relationship between childhood hunger and frailty.ResultsA total of 7,342 older people aged 65 years and older were analyzed in this study. Older people who experienced childhood hunger were more likely to have frailty than those who did not (OR = 1.13, 95% CI: 1.02–1.26), after adjustment for sociodemographic characteristics, family/social support, socioeconomic status, insurance status, and health behaviors. The association of childhood hunger with frailty was found in the 65–79 years group (OR = 1.21, 95% CI: 1.03–1.43), women (OR = 1.25, 95% CI: 1.08–1.45), individuals with rural residence (OR = 1.16, 95% CI: 1.03–1.31), agricultural work (OR = 1.16, 95% CI: 1.00–1.34), financial dependence (OR = 1.18, 95% CI: 1.02–1.37), and those participating in NRCMS (OR = 1.35, 95% CI: 1.16–1.56). Participants with hunger in childhood who were 80 years or older (OR = 0.80, 95% CI: 0.65–0.98) had lower odds of frailty. NRCMS (OR = 1.42, 95% CI: 1.02–1.98) showed increased odds of childhood hunger-related frailty.ConclusionExposure to hunger during childhood is linked to frailty among older adults, and age, financial support, and insurance status may mediate this relationship. Targeted interventions and policies to address frailty in older adults should be implemented.
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Albrecht BM, Stalling I, Foettinger L, Recke C, Bammann K. Adherence to Lifestyle Recommendations for Bone Health in Older Adults with and without Osteoporosis: Cross-Sectional Results of the OUTDOOR ACTIVE Study. Nutrients 2022; 14:2463. [PMID: 35745193 PMCID: PMC9228189 DOI: 10.3390/nu14122463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 02/06/2023] Open
Abstract
Sustaining good bone health into older age is key for preventing osteoporosis. Bone health is associated with several lifestyle factors. This study investigates older adults' adherence to bone health-promoting lifestyle recommendations dependent on osteoporosis status. Cross-sectional data of 1610 community-dwelling older adults (65-75 years) residing in Bremen, Germany (53.4% female) were included. The Osteoporosis Self-Assessment Tool and self-reported osteoporosis diagnosis were used to classify participants by osteoporosis status (low risk, high risk, diagnosis). Adherence to bone health recommendations regarding calcium and vitamin D intake, sun exposure, alcohol consumption, resistance/weight-bearing exercise, and physical activity were assessed. Descriptive statistics were applied, stratified by sex and osteoporosis status. A total of 91 women (10.6%) and 15 men (2.0%) reported an osteoporosis diagnosis, 457 women (43.2%) and 311 men (41.4%) were classified as having a high risk, and 311 women (36.2%) and 425 men (56.6%) as having a low risk. Adherence to bone health recommendations was high for calcium intake (93.3-100.0%), vitamin D intake (77.8-93.3%), and sun exposure (86.7-97.7%). Lower adherence was observed regarding resistance/weight-bearing exercise (36.3-54.4%), physical activity (14.3-57.7%), and alcohol consumption (40.0-72.4%). In conclusion, tailored prevention strategies are needed that focus on older adults with an osteoporosis diagnosis or who are at high risk.
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Affiliation(s)
- Birte Marie Albrecht
- Institute for Public Health and Nursing Research (IPP), University of Bremen, 28359 Bremen, Germany; (I.S.); (L.F.); (C.R.); (K.B.)
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Shah SA, Safian N, Mohammad Z, Nurumal SR, Wan Ibadullah WAH, Mansor J, Ahmad S, Hassan MR, Shobugawa Y. Factors Associated with Handgrip Strength Among Older Adults in Malaysia. J Multidiscip Healthc 2022; 15:1023-1034. [PMID: 35586078 PMCID: PMC9109974 DOI: 10.2147/jmdh.s363421] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 04/28/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Handgrip strength (HGS) is indicative of overall physical health among older adults. A decrease in HGS may be associated with an increased risk of disease. The aim of this study is to determine the factors associated with HGS among older adults in Malaysia. Patients and Methods One thousand two hundred four (1204) participants from urban and rural areas in Selangor state, Malaysia, were recruited. Sociodemographic and health-related conditions were gathered through a comprehensive face-to-face interview, followed by HGS assessments by a handgrip dynamometer. Subsequently, multiple linear regression was used to test the main association with the HGS. Results A total of 691 participants (57.4%) were male, and 513 (42.6%) were female. Males had a mean HGS of 30.0 (SD 7.53) kg, and females had a mean HGS of 19.4 (SD 5.28) kg. Males' handgrip strength was significantly reduced with increasing age, physically inactive, and diabetes (all at the level p<0.001) after adjusting for social-demographic characteristics and health-related variables. Meanwhile, for females, the HGS was significantly decreased with age (p<0.001), physically inactive (p<0.001) and hypertension (p=0.03). However, female HGS was positively related to BMI (p<0.001). Conclusion The study contributed to a better understanding of factors associated with HGS, and thus, the HGS is recommended as a section in the health evaluation among high-risk older adults as the strategy of disease control and prevention.
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Affiliation(s)
- Shamsul Azhar Shah
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Nazarudin Safian
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Zulkefley Mohammad
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Siti Rohani Nurumal
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Wan Abdul Hannan Wan Ibadullah
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Juliana Mansor
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Saharuddin Ahmad
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Yugo Shobugawa
- Department of Active Aging, Niigata University Graduate School of Medical and Dental Sciences, Niigata, 951-8510, Japan
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Amankwaa I, Nelson K, Rook H, Hales C. Association between body mass index, multi-morbidity and activities of daily living among New Zealand nursing home older adults: a retrospective analysis of nationwide InterRAI data. BMC Geriatr 2022; 22:62. [PMID: 35042475 PMCID: PMC8767739 DOI: 10.1186/s12877-021-02696-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/01/2021] [Indexed: 11/16/2022] Open
Abstract
Background Obesity is a well-established risk factor for multi-morbidity and disability among older adults in the community and acute care settings. However, nursing home residents with body mass index (BMI) below 18.5 kg/m2 and above 25.0 kg/m2 have been understudied. We examined the prevalence of multi-morbidity and disability in activities of daily living (ADL) by BMI category and further investigated the association between BMI, multi-morbidity, and disability of ADL in a large cohort of older adults in nursing homes in New Zealand. Methods A retrospective review of nursing home residents’ data obtained from the New Zealand International Resident Assessment Instrument national dataset from 2015 to 2018. One hundred ninety-eight thousand seven hundred ninety older adults (≥60 years) living in nursing homes were included. BMI was calculated as weight in kilograms (kg) divided by height in meters squared (m2). Multimorbidity was defined as the presence of ≥2 health conditions. The risk of disability was measured by a 4-item ADL self-performance scale. The prevalence ratio (PR) of the association between BMI and multi-morbidity and between BMI and disability in ADL was assessed using Poisson regression with robust variance. Results Of the 198,790 residents, 10.6, 26.6, 11.3 and 5.4% were underweight, overweight, obese, and extremely obese, respectively. 26.4, 31.3 and 21.3% had one, two and three disease conditions, respectively, while 14.3% had four or more conditions. 24.1% could perform only one ADL, and 16.1% could perform none. The prevalence of multi-morbidity increased with increasing BMI, whereas mean disability in ADL decreased with increasing BMI. The risk of multi-morbidity was higher for the overweight (PR, 95%CI: 1.03, 1.02–1.03) and obese (PR, 95% CI: 1.07, 1.06–1.08) compared to normal weight after controlling for age, sex, ethnicity, and region. BMI was inversely associated with mean ADL; β, 95% CI for overweight (− 0.30, − 0.32, − 0.28) and obese − 0.43, − 0.45, − 0.40 compared to normal weight. Conclusion Being underweight was associated with a decline in the performance of ADL in nursing home residents. In contrast, being overweight and obese positively affected functional performance, demonstrating that the obesity paradox plays an important role in this population. The observed associations highlight areas where detection and management of underweight and healthy aging initiatives may be merited.
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El Ghoch M, Pellegrini M. Why should sarcopenic obesity be included in a routine assessment during weight-management programmes? Front Endocrinol (Lausanne) 2022; 13:962895. [PMID: 35937807 PMCID: PMC9354711 DOI: 10.3389/fendo.2022.962895] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/04/2022] [Indexed: 12/25/2022] Open
Affiliation(s)
- Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- *Correspondence: Marwan El Ghoch, ;
| | - Massimo Pellegrini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Sarcopenia risk and associated factors among Chinese community-dwelling older adults living alone. Sci Rep 2021; 11:22219. [PMID: 34782685 PMCID: PMC8593165 DOI: 10.1038/s41598-021-01614-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 09/17/2021] [Indexed: 12/18/2022] Open
Abstract
Sarcopenia, defined as a progressive loss of muscle mass and reduced muscle strength and functional capacity, is common among older adults. This study aimed to assess the proportion of people at risk of sarcopenia and probable sarcopenia among Chinese community-dwelling older adults living alone and to identify the associated factors. A total of 390 older adults were included in this study. Sarcopenia and probable sarcopenia were defined according to the criteria of the Asian Working Group for Sarcopenia 2019. Data on socio-demographic characteristics, health status, health behaviours and lifestyle characteristics, nutritional status, physical activity level, and depressive symptoms were collected. The association between these characteristics and sarcopenia risk was analysed using a multivariate ordinal logistic regression. The proportion of subjects at risk of sarcopenia and probable sarcopenia was found to be 57.7% and 30%, respectively. Older age, being malnourished and being at risk of malnutrition were significantly associated with sarcopenia risk. Being educated to secondary level or above, being overweight or obese and higher physical activity level were associated with decreased sarcopenia risk. Our results showed that older adults living alone were at high risk of developing sarcopenia and probable sarcopenia. These results emphasise the urgent need to initiate aggressive screening and holistic lifestyle therapeutic intervention strategies for this high-risk population.
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Hoseinzadeh-Chahkandak F, Rahimlou M, Salmani F, Ansarifar E, Moodi M, Sharifi F, Zeinali T. Nutrition assessment and geriatric associated conditions among free living elderly people in Birjand, East of Iran: a cross-sectional study. BMC Geriatr 2021; 21:612. [PMID: 34717587 PMCID: PMC8557026 DOI: 10.1186/s12877-021-02518-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/04/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Few data are available on the nutritional status of Iranian geriatric population. The present study aimed to determine the nutritional status of older adults' population in Birjand, East of Iran. METHODS The community-based cohort study was performed on older adults population (60 years and older) living in urban and rural areas of Birjand. The mini nutritional assessment (MNA) questionnaire was used to assess nutritional status. Anthropometric and biochemical evaluation were also performed for all of the participants. RESULTS A total of 1417 geriatric person were enrolled in this study, which, most of them were female (51.9 %). According to MNA tool, most of the participants (73.3 %) had normal nutrition (MNA score ≥ 24). Malnourished (MNA score < 17) and at high risk of malnutrition (MNA score: 17- 23.5) were constituted 0.9 % and 25.8 % of the participants, respectively. Marital status, occupation, period of education and family member were associated with nutritional status. Multiple logistic regression showed that with increase of body mass index (BMI) (OR = 0.96), education years (OR = 0.95), hemoglobin (OR = 0.86) and lymphocyte (OR = 0.98), the odds of malnutrition decreased, but with increase of age the odds (1.03) of malnutrition is also elevated. CONCLUSIONS MNA could successfully forecast the risk of malnutrition and malnourished people. Sociodemographic factors are associated with the nutritional status.
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Affiliation(s)
- Fatemeh Hoseinzadeh-Chahkandak
- Social Determinants of Health Research Center, Department of Public health, School of Health, Birjand University of Medical sciences, Birjand, Iran
| | - Mehran Rahimlou
- Department of Nutrition, School of Medicine, Zanjan University of Medical sciences, Zanjan, Iran
| | - Fatemeh Salmani
- Social Determinants of Health Research Center, Department of Epidemiology and Biostatistics, School of Health, Birjand University of Medical Sciences, Birjand, Iran
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Elham Ansarifar
- Social Determinants of Health Research Center, Department of Public health, School of Health, Birjand University of Medical sciences, Birjand, Iran
| | - Mitra Moodi
- Social Determinants of Health Research Center, Department of Public health, School of Health, Birjand University of Medical sciences, Birjand, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Tayebeh Zeinali
- Social Determinants of Health Research Center, Department of Public health, School of Health, Birjand University of Medical sciences, Birjand, Iran.
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Barcın Güzeldere HK, Aksoy M. Anthropometric measurements and food consumption analysis of older people according to place of residence and gender: A cross-sectional study. Clin Nutr ESPEN 2021; 45:236-244. [PMID: 34620323 DOI: 10.1016/j.clnesp.2021.08.018] [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: 04/15/2021] [Revised: 07/20/2021] [Accepted: 08/17/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND & AIMS The older population across the world is rapidly increasing, raising the importance of a healthy and independent aging process and the factors affecting it. This study aimed to examine the food consumption habits and anthropometric measurements of older people according to their gender and the place of residence. METHODS A total of 121 healthy participants aged over 80 years who lived in rural (n:70) and urban (n:51) areas in the Aegean Region of Turkey were included in the study. A questionnaire was administered to determine the demographic data and nutritional status of the participants. Three-day food consumption was recorded and then analyzed using BeBiS 8.1. The participants' adherence to the Mediterranean diet and their Healthy Eating Index-2015 values were calculated based on their food consumption. The circumferences of the waist, hip, upper-mid arm and calf of the participants were measured by the researcher using an inelastic measuring tape. Weight, fat, muscle, water and basal metabolic rate were measured using the TANITA BC730 body impedance analyzer. RESULTS The mean weight, body mass index, circumferences of waist, hip and upper-mid arm,fat-free mass and basal metabolic rate were higher in the rural men than the urban ones (p < 0.05). The urban women had a higher waist-to-hip ratio than the rural ones (p < 0.05). There were no significant differences in the participants' adherence to the Mediterranean diet and their Healthy Eating Index values according to gender or the region they lived in. Nutrient intake was compared with the daily recommendations in the Turkish Nutrition Guide. It was found that the urban men consumed more carbohydrates, fats, vitamins A and C, and sodium. In contrast, energy, protein, fiber, vitamins E, D, B1, B2, B6 and B12, folic acid, magnesium, calcium, iron and zinc were consumed at lower amounts than recommendations. On the other hand, the rural men consumed more carbohydrates, fats, vitamins A, C and B2, folic acid, sodium and zinc. Similarly, the urban and rural women were found to have a higher intake of carbohydrates, fats, vitamins A and B2 and sodium and lower intake of other nutrients than recommendations. CONCLUSION Old age is one of the most sensitive periods in a person's life cycle. Place of residence during this period may physiologically affect food intake, physical activity, and therefore, anthropometric measurements. Healthcare providers should take into account that place of residence may alter older individuals' nutritional status and anthropometric measurements.
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Affiliation(s)
- Hatice Kübra Barcın Güzeldere
- Istanbul Medeniyet University, Department of Nutrition and Dietetic, Kartal, Istanbul, Turkey; Istanbul Medipol University, Institute of Health Science, Nutrition and Dietetic, Kavacık, Istanbul, Turkey.
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Schrader E, Grosch E, Bertsch T, Sieber CC, Volkert D. Nutritional and Functional Status in Geriatric Day Hospital Patients - MNA Short Form Versus Full MNA. J Nutr Health Aging 2016; 20:918-926. [PMID: 27791222 DOI: 10.1007/s12603-016-0691-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES The aims of this study were to determine the prevalence of malnutrition in patients of a geriatric day hospital using the Mini Nutritional Assessment short form (MNA-SF) and the full MNA, to compare both tools, and to examine the relationship between nutritional and functional status. DESIGN Cross-sectional study. SETTING Geriatric day hospital. PARTICIPANTS 190 patients (72.1% female, median 80 years) aged 65 years or older. MEASUREMENTS In consecutively admitted geriatric day hospital patients nutritional status was assessed by MNA-SF and full MNA, and agreement between both tools calculated by Cohen´s kappa. Basic activities of daily living (ADL), instrumental activities of daily living (IADL) and short physical performance battery (SPPB) were determined and related to MNA categories (Chi2-test, Mann-Whitney-U-test). RESULTS 36.3 % and 44.7% of the patients were at risk of malnutrition, 8.9 % and 5.8 % were malnourished according to MNA-SF and full MNA, respectively. Agreement between both MNA forms was moderate (κ=0.531). No significant associations between MNA-SF and ADL, IADL and SPPB, and between full MNA and SPPB were observed. According to full MNA, the proportion of patients with limitations in ADL and IADL significantly increased with declining nutritional status (ADL: 2.1 vs. 8.2 vs. 18.2 %, p=0.044; IADL: 25.5 vs. 47.1 vs. 54.5 %, p=0.005) with a simultaneous decrease of the proportion of patients without limitations. Well-nourished patients reached significantly higher ADL scores than patients at risk of malnutrition (95 (90-100) vs. 95 (85-100), p=0.005) and significantly higher IADL scores than patients at risk or malnourished (8 (6-8) vs. 7 (5-8) vs. 6 (4-8), p=0.004). CONCLUSION The high prevalence of risk of malnutrition and the observed association between functional status and nutritional status according to full MNA call for routine nutritional screening using this tool in geriatric day hospital patients.
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Affiliation(s)
- E Schrader
- JProf. Dr. Dorothee Volkert, Institut für Biomedizin des Alterns, Friedrich-Alexander-Universität Erlangen-Nürnberg, Kobergerstraße 60, 90408 Nürnberg, Germany; Tel.: +49 911 5302 96150, Fax: +49 911 5302 96151,
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