1
|
O'Brien L, Wilkinson TJ, Frampton C, Gearry RB, Wall C. A systematic review and meta-analysis of the dietary fiber menu provision and consumption for older adults living in residential care facilities. Am J Clin Nutr 2024; 120:431-441. [PMID: 38851635 DOI: 10.1016/j.ajcnut.2024.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 05/12/2024] [Accepted: 05/23/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Older adults living in residential care facilities are commonly given laxatives to treat constipation; however, these may not always provide full relief, and side effects include diarrhea. Dietary fiber effectively prevents constipation, and international guidelines recommend 25 g/d for optimal laxation. Older adults in residential care rely on the facility menu to provide their nutritional requirements, including adequate dietary fiber. Little is known about how much dietary fiber is provided and consumed. OBJECTIVES We aimed to determine the provision and consumption of dietary fiber for older adults living in residential care facilities. METHODS We systematically searched available literature for studies reporting the analysis of residential care menus and meals consumed by residents aged over 65 y. A meta-analysis was performed on the studies that provided the mean amount of dietary fiber provided and consumed by residents. A random effect model was applied due to the heterogeneity of study methodologies. RESULTS The literature search yielded 4406 publications, but only 28 studies were eligible for our meta-analysis. The study sample comprised 4817 residents. The mean amount of fiber provided to residents was 21.4 g/d [standard error (SE): 1.2; 95% confidence interval: 18.8, 24.2 g/d], the mean amount of fiber consumed by residents was 15.8 g/d (SE: 0.6; 95% confidence interval: 14.7, 16.9 g/d). CONCLUSIONS Older adults living in care facilities are provided with dietary fiber below the recommended guidelines. Compounding this is that residents consume much less than what is provided and do not meet the recommendations for dietary fiber consumption. There is scope to improve dietary fiber provision, promote consumption to residents to aid laxation, and potentially reduce laxative use and the unwanted side effects of diarrhea. This trial was registered at PROSPERO as CRD42023427265.
Collapse
Affiliation(s)
- Leigh O'Brien
- Department of Medicine, University of Otago, Christchurch, New Zealand.
| | - Tim J Wilkinson
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Chris Frampton
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Richard B Gearry
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Catherine Wall
- Department of Medicine, University of Otago, Christchurch, New Zealand
| |
Collapse
|
2
|
Chen Q, Shen J, Gao Y, Wang XX, Jia QY, Li M. Nutritional status of the older adults in nursing homes: A cross-sectional study. J Clin Nurs 2024; 33:2640-2648. [PMID: 38185924 DOI: 10.1111/jocn.16978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 11/14/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024]
Abstract
AIM AND OBJECTIVES To investigate the nutritional status of older adults in nursing homes in Chongqing, China, compare and analyse the differences in the physical condition, cognitive function and social-related factors of older adults with different nutritional statuses. BACKGROUND Malnurtition in the older people has become a priority concer, and the incidence and factors associated with malnutrition vary somewhat by healthcare setting. In Chongqing ,China, there is lack of research on malnutrition of the older people in nursing homes. Here, we investigated the incidence of malnutrition and analysed the associated factors. DESIGN A cross-sectional study. METHODS From January to April 2023, a cross-sectional survey was conducted in three nursing homes in Chongqing, China. Participants completed a series of questionnaires, including the Demographic Information Questionnaire which included age, gender, education level, previous occupation, marital status and other information. The survey also included validated non-demographic instruments [Short-Form Mini-Nutritional Assessment (MNA-SF), Barthel Index (BI) and Mini-mental State Examination (MMSE)] to identify related impact factors. The Guidelines for cross-sectional studies were used in this study (Data S1). RESULTS 209 older adults aged 60 and over participated in this study, of whom 121 were women and 88 were men. The average (SD) age of the participants was 84.7 (6.3) years. Of the participants, 46.4% were classified as well nourished. About 39.2% were at risk of malnutrition and 14.4% were malnourished. Compared to those who were well nourished, those who were malnourished or at risk of becoming malnourished were more likely to suffer from comorbidities, polypharmacy, a higher risk of falling, ADL dependence and to receive more nutritional interventions. However, there are no significant differences after adjustment for age, education level, previous occupation, marital status, length of stay, and type of health care payment. CONCLUSION Malnutrition is a common problem among older adults innursing homes in Chongqing, China. There are certain differences in physical conditions and nutritional interventions among older adults withdifferent nutritional status. PUBLIC CONTRIBUTION This study suggests that the problem of malnutrition is very prominent in nursing homes in Chongqing, China. Cognitive impairment, impaired activities of daily living, fall risk and nutritional intervention need to be prevalent in older adults with (risk of) malnutrition.
Collapse
Affiliation(s)
- Qiu Chen
- Chongqing Emergency Medical Center, Chongqing University Central Hospital, Chongqing, China
| | - Jun Shen
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Gao
- Chongqing Emergency Medical Center, Chongqing University Central Hospital, Chongqing, China
| | - Xin Xia Wang
- University of Wollongong, Wollongong, New South Wales, Australia
| | - Qian Ying Jia
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Miao Li
- Chongqing Medical University, Chongqing, China
| |
Collapse
|
3
|
Abeywickrama HM, Uchiyama M, Sumiyoshi T, Okuda A, Koyama Y. The role of zinc on nutritional status, sarcopenia, and frailty in older adults: a scoping review. Nutr Rev 2024; 82:988-1011. [PMID: 37550266 PMCID: PMC11163457 DOI: 10.1093/nutrit/nuad094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Zinc (Zn) deficiency, malnutrition, sarcopenia, and frailty are prevalent among older adults and are prominent factors contributing to disability and mortality. OBJECTIVE This scoping review was conducted to aid understanding of the extent and types of research addressing the role of Zn in nutritional status, sarcopenia, and frailty, among older individuals. METHOD A systematic search was performed in August 2022 of 3 electronic databases (PubMed, Web of Science, and ProQuest) using predefined search terms. The review was conducted referring to the Arksey and O'Malley framework and PRISMA-ScR. RESULTS The search retrieved 16 018 records, and a total of 49 studies were included in this review after the screening. Of those, 30 were based on dietary Zn intake, 18 on tissue Zn levels, and 1 on both. Most studies were based on cross-sectional data from community-dwelling older adults. Studies addressing the associations between Zn status and individual anthropometric and sarcopenia-related variables reported inconsistent results. However, most studies reported inverse associations between malnutrition, frailty, and Zn status. CONCLUSION There was more consistent evidence of the relationship of Zn status with malnutrition, sarcopenia, and frailty rather than with individual nutritional parameters. Validated screening and assessment tools and criteria and prospective studies are required to elucidate the relationship of Zn with sarcopenia and frailty in the older population.
Collapse
Affiliation(s)
| | - Mieko Uchiyama
- Department of Nursing, Graduate School of Health Sciences, Niigata University, Niigata, Japan
| | - Tomoko Sumiyoshi
- Department of Nursing, Graduate School of Health Sciences, Niigata University, Niigata, Japan
| | - Akiko Okuda
- Department of Medical Technology, Graduate School of Health Sciences, Niigata University, Niigata, Japan
| | - Yu Koyama
- Department of Nursing, Graduate School of Health Sciences, Niigata University, Niigata, Japan
| |
Collapse
|
4
|
Lavriša Ž, Pravst I. Nutritional Challenges in Nursing Homes: Pilot Study on Macronutrient Intake and Status of Vitamins D and B12. Nutrients 2024; 16:1495. [PMID: 38794733 PMCID: PMC11124101 DOI: 10.3390/nu16101495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/07/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
Older adults living in nursing homes (NH) are considered a population group that could be at risk in terms of nutrition, even more so than their community-dwelling peers. Evidence on the nutritional status of NH residents is scarce, as they are commonly excluded from population-based dietary studies. This is also the case in Slovenia. In the presented pilot study, we assessed the intake of macronutrients as well as the intake and status of vitamin D and vitamin B12 on a sample of NH and NH daycare center users to explore the need for a larger representative study. The pilot study included 37 participants from three Slovenian NH (20 participants) and their daycare centers (17 participants). Daycare centers offer daytime care services for older adults, where users are also provided with major meals during their stay. Intakes of energy and nutrients were estimated by three 24 h dietary records. Fasting blood samples were collected for the assessment of vitamin D and vitamin B12 status. Over 90% of the participants had daily energy and protein intakes below recommendations (reference values: energy intake: males 2100 kcal and females 1700 kcal; protein intake > 1 g/kg body mass). The males' median daily intakes of vitamin D were 1.7 µg (1.5 µg females), and 2.3 µg for vitamin B12 (2.0 µg females). None of the participants had adequate vitamin D intake (>20 µg), and 92.3% males and 87.5% females had inadequate vitamin B12 intake (<4 µg). The prevalence of vitamin D deficiency (serum 25-OH-D conc. < 30 nmol/L) was 100% among NH residents and 53% among NH daycare center users. The prevalence of vitamin B12 deficiency was found in 20% of NH residents. The study results highlighted that certain nutrients might be critical in this population, especially among NH residents; however, a more thorough investigation with the inclusion of other important markers of nutritional status should be performed on a larger, representative sample to support the development and implementation of appropriate public health interventions.
Collapse
Affiliation(s)
- Živa Lavriša
- Nutrition and Public Health Research Group, Nutrition Institute, Koprska ulica 98, SI-1000 Ljubljana, Slovenia;
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia
| | - Igor Pravst
- Nutrition and Public Health Research Group, Nutrition Institute, Koprska ulica 98, SI-1000 Ljubljana, Slovenia;
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia
- VIST–Faculty of Applied Sciences, Gerbičeva cesta 51A, SI-1000 Ljubljana, Slovenia
| |
Collapse
|
5
|
Araújo MPD, Nobre TTX, Rosendo CWF, de Lima FAS, Nunes VMDA, Torres GDV. Loss of Muscle Mass and Vulnerability in Institutionalized Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:426. [PMID: 36612746 PMCID: PMC9819833 DOI: 10.3390/ijerph20010426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/06/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
This study aimed to evaluate the association between muscle mass and vulnerability in institutionalized older adults. A cross-sectional study was carried out in eight philanthropic Long-Term Care Facilities (LTCF) located in the metropolitan area of Natal, Rio Grande do Norte, Brazil. The participants were individuals aged 60 years or older who were present in the institutions at the time of data collection. To assess muscle mass, the calf circumference was categorized into loss of muscle mass (<31 cm) and preserved muscle mass (≥31 cm). The vulnerability was assessed by The Vulnerable Elders Survey (VES-13). Of the 250 older adults evaluated, 46.1% presented loss of muscle mass, which was associated with the presence of physical limitation, vulnerability, and age group (p < 0.05). The presence of vulnerability was the main factor contributing to loss of muscle mass (R2 = 8.8%; B = 0.781; 95% CI 0.690−0.884; p < 0.001). Loss of muscle mass is associated with disability in institutionalized older adults.
Collapse
Affiliation(s)
| | - Thaiza Teixeira Xavier Nobre
- College of Health Sciences of Trairi, Federal University of Rio Grande do Norte (UFRN), Santa Cruz 59200-000, RN, Brazil
| | | | | | | | | |
Collapse
|
6
|
The use of herbs and spices in sodium-reduced meals enhances saltiness and is highly accepted by the elderly. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2022.104789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
7
|
Fonseca-Pérez D, Arteaga-Pazmiño C, Maza-Moscoso CP, Flores-Madrid S, Álvarez-Córdova L. Food insecurity as a risk factor of sarcopenic obesity in older adults. Front Nutr 2022; 9:1040089. [PMID: 36337623 PMCID: PMC9630347 DOI: 10.3389/fnut.2022.1040089] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/03/2022] [Indexed: 12/02/2022] Open
Abstract
Sarcopenic obesity is characterized by the loss of muscle strength, mass and muscle functionality and increased adipose tissue (obesity) according to different criteria and cut-off points. The prevalence of sarcopenic obesity among older adults is growing worldwide, and many factors are involved in its development. Diet and food security have been described as the main contributors to the development of obesity and sarcopenia. Food insecurity consists of limited or uncertain access to adequate and nutritious foods. This narrative review aims to summarize the existing data on food insecurity as a risk factor for sarcopenic obesity in the elderly.
Collapse
Affiliation(s)
- Diana Fonseca-Pérez
- Carrera de Nutrición y Dietética, Instituto de Investigación e Innovación en Salud Integral (ISAIN), Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Cecilia Arteaga-Pazmiño
- Carrera de Nutrición y Dietética, Facultad de Ciencias Médicas, Universidad de Guayaquil, Guayaquil, Ecuador
| | | | - Sara Flores-Madrid
- Carrera de Nutrición y Dietética, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador
| | - Ludwig Álvarez-Córdova
- Carrera de Nutrición y Dietética, Instituto de Investigación e Innovación en Salud Integral (ISAIN), Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
- Carrera de Nutrición y Dietética, Facultad de Ciencias de la Vida, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador
| |
Collapse
|
8
|
Nutritional intake and malnutrition in institutionalised and non-institutionalised older adults. Br J Nutr 2022; 128:921-931. [PMID: 34583786 DOI: 10.1017/s0007114521003925] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Malnutrition (synonym: undernutrition) is prevalent among older adults, which may be partly related to changes in dietary intake, but evidence on the link between malnutrition and diet is scarce. The aims of this study were to estimate the association between energy/nutrients intake and malnutrition, and to characterise nutritional inadequacy in institutionalised and non-institutionalised older adults. A national survey was conducted including a Portuguese representative sample of nursing home (NH) residents (n 563) and community-dwellers (n 837) aged ≥ 65 years. Data included socio-demographic characteristics, self-reported health, loneliness feelings, nutritional status (Mini Nutritional Assessment®) and dietary intake (two non-consecutive 24-h recalls). A higher energy intake was associated with lower odds of malnutrition risk (being 'at risk of malnutrition' or 'malnourished') in both settings, but only significant among NH residents after adjusting for confounders (NH: OR = 0·66, 95 % CI 0·50, 0·86; community: OR = 0·64, 95 % CI 0·37, 1·10). The intake of carbohydrates, fat, fibre, vitamin C, Na, K and Mg was inversely associated with malnutrition risk in NH residents, and protein, fat, vitamin B6, folates, Na, K, Ca and Mg intake in community-dwellers. After additional adjustment for total energy, only Na and Mg intake of community-dwellers remained significantly associated. The prevalence of inadequate nutrient intake was generally higher for the malnutrition risk group, which was particularly evident among community-dwellers. The effect of dietary intake on nutritional status seems more dependent on total energy and carbohydrates intake in institutionalised elders, whereas among community-dwellers protein and some micronutrients appear to have a greater impact.
Collapse
|
9
|
Gregorič M, Hristov H, Blaznik U, Koroušić Seljak B, Delfar N, Pravst I. Dietary Intakes of Slovenian Adults and Elderly: Design and Results of the National Dietary Study SI.Menu 2017/18. Nutrients 2022; 14:nu14173618. [PMID: 36079875 PMCID: PMC9460239 DOI: 10.3390/nu14173618] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 11/16/2022] Open
Abstract
Incomparable and insufficiently detailed information on dietary intakes are common challenges associated with dietary assessment methods. Being a European Union country, Slovenia is expected to conduct national food consumption studies in line with harmonised EU Menu methodology. The present study aimed to describe the methodology and protocols in the Slovenian nationally representative dietary survey SI.Menu 2017/18, and to assess population dietary habits with respect to food consumption and energy and macronutrient intakes. While the study targeted various population groups, this report is focused on adults. A representative sample of participants was randomly selected from the Central Register of Population according to sex, age classes and place of residency, following a two-stage stratified sampling procedure. Information on food consumption was collected with two non-consecutive 24-h dietary recalls using a web-based Open Platform for Clinical Nutrition (OPEN) software. Data were complemented with a food propensity questionnaire to adjust for usual intake distribution. Altogether, 364 adults (18–64 years) and 416 elderlies (65–74 years) were included in the data analyses. Study results highlighted that observed dietary patterns notably differ from food-based dietary guidelines. Typical diets are unbalanced due to high amounts of consumed meat and meat products, foods high in sugar, fat and salt, and low intake of fruits and vegetables and milk and dairy products. Consequently, the energy proportion of carbohydrates, proteins, and to some extent, free sugars and total fats, as well as intake of dietary fibre and total water deviates from the reference values. Age and sex were significantly marked by differences in dietary intakes, with particularly unfavourable trends in adults and men. Study results call for adoption of prevention and public health intervention strategies to improve dietary patterns, taking into account population group differences. In addition, all developed protocols and tools will be useful for further data collection, supporting regular dietary monitoring systems and trend analyses.
Collapse
Affiliation(s)
- Matej Gregorič
- Health Survey and Health Promotion Centre, National Institute of Public Health, Trubarjeva Cesta 2, SI-1000 Ljubljana, Slovenia
- Correspondence: ; Tel.: +386-1-2441-496
| | - Hristo Hristov
- Nutrition Institute, Tržaška Cesta 40, SI-1000 Ljubljana, Slovenia
| | - Urška Blaznik
- Health Survey and Health Promotion Centre, National Institute of Public Health, Trubarjeva Cesta 2, SI-1000 Ljubljana, Slovenia
| | - Barbara Koroušić Seljak
- Computer Systems Department, Jožef Stefan Institute, Jamova Ulica 39, SI-1000 Ljubljana, Slovenia
| | - Nataša Delfar
- Health Data Centre, National Institute of Public Health, Trubarjeva Cesta 2, SI-1000 Ljubljana, Slovenia
| | - Igor Pravst
- Nutrition Institute, Tržaška Cesta 40, SI-1000 Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia
- VIST-Faculty of Applied Sciences, Gerbičeva Cesta 51A, SI-1000 Ljubljana, Slovenia
| |
Collapse
|
10
|
Jyväkorpi Satu K, Suominen Merja H, Strandberg Timo E, Salminen K, Niskanen Riikka T, Roitto HM, Saarela Riitta KT, Pitkälä Kaisu H. Dietary fat intake and quality in long-term care residents in two cohorts assessed 10 years apart. BMC Nutr 2022; 8:31. [PMID: 35413879 PMCID: PMC9006457 DOI: 10.1186/s40795-022-00524-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 04/06/2022] [Indexed: 12/13/2022] Open
Abstract
Abstract
Purpose
To describe and compare detailed dietary fat intake, fat quality and associative factors between two measuring points 10 years apart of residents living in long-term care facilities, and to reflect how fat composition and fat quality corresponds to current nutrition recommendations.
Methods
In 2007 long-term care residents (n = 374) of 25 assisted-living facilities and nursing homes and in 2017–18 long-term care residents (n = 486) of 17 respective facilities in Helsinki metropolitan area were recruited for this study. Information on the residents’ heights, demographic information and use of calcium and vitamin D supplementation were retrieved from medical records. Residents’ clinical assessment included Clinical Dementia Rating (CDR), the Mini Nutritional Assessment (MNA) and questionnaire related to nutrition care. Participants’ energy and fat intake were determined from 1--2-day food diaries kept by the ward nurses, and fat quality indicators calculated.
Results
Age, gender distribution, MNA score or body mass index did not differ between the two cohorts. Residents’ cognitive status, subjective health and mobility were poorer in 2017 compared to 2007. Total fat and saturated fatty acid (SFA) intakes were higher and fat quality indicators lower in the 2017 cohort residents than in the 2007 cohort residents. Sugar intake, male gender, eating independently, eating larger amounts and not having dry mouth predicted higher SFA intake in the 2017 cohort.
Conclusions
The fat quality in long-term care residents in our study worsened in spite of official recommendations between the two measurement points.
Collapse
|
11
|
Uršulin-Trstenjak N, Dodlek Šarkanj I, Sajko M, Vitez D, Živoder I. Determination of the Personal Nutritional Status of Elderly Populations Based on Basic Foodomics Elements. Foods 2021; 10:2391. [PMID: 34681440 PMCID: PMC8535163 DOI: 10.3390/foods10102391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/01/2021] [Accepted: 10/06/2021] [Indexed: 01/10/2023] Open
Abstract
Nutritional status is a series of related parameters collected using different available methods. In order to determine the nutritional status of elderly populations and ensure nutritional support based on an individual approach, the implementation of the increasingly used foodomics approach is available; this approach plays a key role in personalized diets and in the optimization of diets for a population group, such as an elderly population. The Mini Nutritional Assessment (MNA) method and the Nottingham Screening Tool (NST) form were used on 50 users in a home for the elderly in northwest Croatia. A loss of body mass (BM) was statistically significantly higher for those who had the following: decreased food intake in the last week and users who had complete and partial feeding autonomy. Additionally, the obtained data on drug intake, fluid, individual nutrients, and physical activity are based on an individual approach. The available documentation provides insight into nutritional values and food preparation in an attempt to satisfy a holistic approach in the evaluation of exposure while trying to achieve as many elements of foodomics as possible.
Collapse
Affiliation(s)
- Natalija Uršulin-Trstenjak
- Department of Food Technology, University Center Koprivnica, University North, Trg dr. Žarka Dolinara 1, 48000 Koprivnica, Croatia;
- Department of Nursing, University Center Varaždin, University North, Jurja Križanića 31b, 42000 Varaždin, Croatia; (M.S.); (I.Ž.)
| | - Ivana Dodlek Šarkanj
- Department of Food Technology, University Center Koprivnica, University North, Trg dr. Žarka Dolinara 1, 48000 Koprivnica, Croatia;
| | - Melita Sajko
- Department of Nursing, University Center Varaždin, University North, Jurja Križanića 31b, 42000 Varaždin, Croatia; (M.S.); (I.Ž.)
| | - David Vitez
- County Hospital Čakovec, I.G.Kovačića 1e, 40000 Čakovec, Croatia;
| | - Ivana Živoder
- Department of Nursing, University Center Varaždin, University North, Jurja Križanića 31b, 42000 Varaždin, Croatia; (M.S.); (I.Ž.)
| |
Collapse
|
12
|
González-Fernández M, Perez-Nogueras J, Serrano-Oliver A, Torres-Anoro E, Sanz-Arque A, Arbones-Mainar JM, Sanz-Paris A. Masseter Muscle Thickness Measured by Ultrasound as a Possible Link with Sarcopenia, Malnutrition and Dependence in Nursing Homes. Diagnostics (Basel) 2021; 11:1587. [PMID: 34573928 PMCID: PMC8469670 DOI: 10.3390/diagnostics11091587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/06/2021] [Accepted: 08/30/2021] [Indexed: 01/13/2023] Open
Abstract
Sarcopenia is a progressive and generalized loss of skeletal muscle mass and strength. It is frequently associated with malnutrition and dependence in nursing homes. Masticatory muscle strength could be the link between sarcopenia, malnutrition and dependence. We aimed to study the relation between sarcopenia, malnutrition and dependence with masseter muscle thickness measured by ultrasound. A cross-sectional study was realized, with 464 patients from 3 public nursing homes in Zaragoza (Spain). The diagnosis of sarcopenia was assessed according to the European Working Group on Sarcopenia in Older People 2 criteria, malnutrition by the Mini Nutritional Assessment (MNA) and the Global Leadership Initiative on Malnutrition (GLIM) criteria and functional capacity by the Barhel Index and the texture diet. Masseter muscle thickness (MMT) was measured by ultrasound. The median age was 84.7 years, and 70% of the participants were women. Sarcopenia was confirmed in 39.2% of patients, malnutrition in 26.5% (risk 47.8%), total dependence in 37.9% and diet texture was modified in 44.6%. By logistic regression, once the model was adjusted for age, sex, Barthel index and texture diet, our analyses indicated that each 1 mm decrease in MMT increased the risk of sarcopenia by ~57% (OR: 0.43), the risk of malnutrition by MNA by ~63% (OR: 0.37) and the risk of malnutrition by GLIM by ~34% (OR: 0.66). We found that MMT was reduced in sarcopenic, malnourished and dependent patients, and it could be the common point of a vicious cycle between sarcopenia and malnutrition. Further studies are needed to establish causality.
Collapse
Affiliation(s)
| | | | | | | | | | - Jose M. Arbones-Mainar
- Instituto de Investigación Sanitaria Aragon (IIS-Aragon), 50007 Zaragoza, Spain;
- Adipocyte and Fat Biology Laboratory (AdipoFat), Translational Research Unit, Instituto Aragones de Ciencias de la Salud (IACS), University Hospital Miguel Servet, 50007 Zaragoza, Spain
- Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Alejandro Sanz-Paris
- Nutrition Department, University Hospital Miguel Servet, 50007 Zaragoza, Spain;
- Instituto de Investigación Sanitaria Aragon (IIS-Aragon), 50007 Zaragoza, Spain;
| |
Collapse
|
13
|
Salminen K, Willman M, Kautiainen H, Pitkälä K, Roitto HM, Suominen M. Temporal trends in nutrition intake among older long-term care residents. Clin Nutr 2021; 40:3793-3797. [PMID: 34134002 DOI: 10.1016/j.clnu.2021.04.048] [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: 01/13/2021] [Revised: 04/09/2021] [Accepted: 04/30/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND & AIMS The temporal trends in protein and other nutrient intakes among older long-term care residents have not been studied. The aim of this study was to explore the changes in energy, protein, and other nutrient intakes between 2007 and 2017-8 in two cross-sectional samples of older long-term care residents in the Helsinki metropolitan area. We also studied how the residents' disability and stage of cognition modified the association between observation year and protein intake (g/body weight kg). METHODS Two cross-sectional samples were collected in 2007 (n = 350) and 2017-8 (n = 476) in long-term care settings. Residents' nutrient intake was determined by a one- or two-day food record. Residents' disability was determined by the Clinical Dementia Rating (CDR) "personal care" question and stage of cognition was determined by the CDR "memory" item. RESULTS There was no significant difference in energy intake between the observation years. Carbohydrates, total protein, and protein (g/body weight kg) intakes were significantly lower in 2017-8 than in 2007. Fat intake was higher in 2017-8 than in 2007. In 2017-8, the intake of some vitamins and minerals was lower (thiamine, calcium) but some higher (vitamins A, D, C, E) compared to 2007. Residents' disability (p = 0.049) and observation year (p = 0.037) were significantly associated with protein intake (g/body weight kg), but the interaction was not significant (p = 0.35). Furthermore, residents' stage of cognition was not associated with protein intake (p = 0.22) but observation year was (p < 0.001). The interaction was not significant (p = 0.30). CONCLUSIONS Whereas the energy intake remained at the same level in the observation years, the ratio of macronutrient intake changed in an unfavorable way. The intake of protein and some vitamins were lower whereas the relative proportion of fat was higher in 2017-8 compared to 2007. As long-term care residents become more disabled in the future, more attention should be paid to diet quality.
Collapse
Affiliation(s)
- Karoliina Salminen
- University of Helsinki, Department of General Practice and Primary Health Care, Helsinki, Finland, POB 20, 00014, Helsinki, Finland; Vantaa Social Welfare and Health Care, Kielotie 11 A, 01300 Vantaa, Finland.
| | - Mirjami Willman
- University of Helsinki, Department of Food and Nutrition, Agnes Sjöbergin Katu 2 00014 Helsinki, Finland
| | - Hannu Kautiainen
- University of Helsinki, Department of General Practice and Primary Health Care, Helsinki, Finland, POB 20, 00014, Helsinki, Finland
| | - Kaisu Pitkälä
- University of Helsinki, Department of General Practice and Primary Health Care, Helsinki, Finland, POB 20, 00014, Helsinki, Finland; Helsinki University Hospital, Unit of Primary Health Care, Tukholmankatu 8 B, Biomedicum 2 B, 00290 Helsinki, Finland
| | - Hanna-Maria Roitto
- University of Helsinki, Department of General Practice and Primary Health Care, Helsinki, Finland, POB 20, 00014, Helsinki, Finland; Department of Social Services and Health Care, Geriatric Clinic, Helsinki Hospital, Lääkärinkatu 8, 00250 Helsinki, Finland
| | - Merja Suominen
- University of Helsinki, Department of General Practice and Primary Health Care, Helsinki, Finland, POB 20, 00014, Helsinki, Finland
| |
Collapse
|
14
|
Mozo-Alonso F, Novalbos-Ruiz JP, Duran-Alonso JC, Rodríguez-Martin A. Nutritional Status of Non-Institutionalized Adults Aged over 65. Study of Weight and Health in Older Adults (PYSMA). Nutrients 2021; 13:1561. [PMID: 34066337 PMCID: PMC8148168 DOI: 10.3390/nu13051561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND A significant increase in the prevalence of malnourishment, obesity, and sarcopenic obesity has been observed in developed countries over the last few decades. In Spain, this especially happens in populations over 65 who are not institutionalized. Differences in lifestyle, medication, and economic capacity partially explain this increase. OBJECTIVE To study the nutritional status of a population of 65 year-olds and subjects who are not institutionalized, in the Cádiz region (Spain). METHODS Observational, transversal study carried out on 2621 subjects who are 65 years old and over, with a direct weight and height measurement, in 150 pharmacy offices from 44 locations. A mobile application was designed for homogeneous data collection in all the pharmacy offices. The data required from all subjects was gender, age, postal code, social security contribution regime, if the patient lives alone, type of food consumed as the main meals, level of physical activity, polypharmacy, weight, and height. RESULTS The prevalence of overweight and obesity amounts to 82.2% of the population (43.2% overweight and 39% obese). We found an inverse relationship between the prevalence of overweight and obesity with carrying out physical activity and having full dinners. CONCLUSION We identify the need to reinforce the messages to the elderly aimed at maintaining adequate physical activity and assessing the quality and quantity of dinners, as well as reducing, as much as possible, the treatments that may lead to weight gain.
Collapse
Affiliation(s)
- Felipe Mozo-Alonso
- Colegio Oficial Farmacéuticos de Cádiz, Calle Isabel la Católica, 22. Cádiz, 11004 Cádiz, Spain;
| | | | - Juan C. Duran-Alonso
- Hospital Juan Grande, Glorieta Félix Rdguez, de la Fuente, Jerez de la Frontera, 11408 Cádiz, Spain;
| | | |
Collapse
|
15
|
Valente A, Jesus J, Breda J, Dinis A, Correia A, Godinho J, Oliveira T, Garagarza C. Dietary Advice in Hemodialysis Patients: Impact of a Telehealth Approach During the COVID-19 Pandemic. J Ren Nutr 2021; 32:319-325. [PMID: 34147308 PMCID: PMC8098055 DOI: 10.1053/j.jrn.2021.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 04/18/2021] [Accepted: 04/25/2021] [Indexed: 12/27/2022] Open
Abstract
Objective The purpose of this study was to assess the effect of a telehealth-delivered nutritional intervention via telephone in maintenance hemodialysis (HD) patients during the coronavirus outbreak. Methods This was a multicenter, observational, prospective, and longitudinal study of 156 patients undergoing maintenance HD from 15 dialysis units conducted during the COVID-19 pandemic. We assigned patients to receive dietary counseling through a phone call, according to their biochemical and nutritional parameters. Dry weight, intradialytic weight gain percentage (%IDWG), body mass index, potassium, phosphorus, calcium, calcium/phosphorus product, normalized protein catabolic rate, albumin, and hemoglobin were recorded at baseline and 1 month after nutrition counseling. Results The prevalence of hyperkalemia and hyperphosphatemia decreased significantly after dietary advice. A statistically significant reduction in serum potassium and phosphorus levels was observed in patients receiving counseling for hyperkalemia and hyperphosphatemia. In addition, there was a statistically significant decrease in the prevalence of hypophosphatemia. We also observed a significant decrease in %IDWG, although no statistically significant differences were detected in patients with high %IDWG. The data demonstrated statistically significant differences in potassium and phosphorus values when the person receiving the phone contact was the patient or the caregiver. The main statistically significant differences in hypophosphatemia %IDWG were only observed when contact was made directly with the patient. No differences were observed when the contact was made through nursing homes. Conclusion Our results suggest that telehealth-delivered dietary interventions can improve the clinical and nutritional parameters of HD patients. Consequently, this strategy may be effective for promoting continuous nutritional monitoring in these patients, in particular when conducting a face-to-face option is not crucial.
Collapse
Affiliation(s)
- Ana Valente
- Nutrition Department, Nephrocare, Lisbon, Portugal.
| | - Joana Jesus
- Nutrition Department, Nephrocare, Lisbon, Portugal
| | - Joana Breda
- Nutrition Department, Nephrocare, Lisbon, Portugal
| | - Ana Dinis
- Nutrition Department, Nephrocare, Lisbon, Portugal
| | | | | | | | | |
Collapse
|
16
|
Cao Y, Lu Q, Zhuang B, Zhang L, Wang Y, Jin S, Xiao S, Jin S, Zheng B, Sun Y. The prevalence of sarcopenia and relationships between dietary intake and muscle mass in head and neck cancer patients undergoing radiotherapy: A longitudinal study. Eur J Oncol Nurs 2021; 53:101943. [PMID: 34281789 DOI: 10.1016/j.ejon.2021.101943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 03/08/2021] [Accepted: 03/11/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE Our study aims to investigate dietary intake characteristics and their association with skeletal muscle mass in head and neck cancer patients treated with radiotherapy. METHODS From March 2017 to August 2018, patients with head and neck cancer who received radiotherapy at our affiliated hospital were enrolled. Dietary intake was assessed through 24-hr dietary recall and skeletal muscle mass was evaluated by bioelectrical impedance analysis at three-time points. Appendicular skeletal muscle mass was adjusted for height squared defined sarcopenia and correlated with dietary intake by generalized estimating equations (GEE). RESULTS This study sample comprised 287 patients [median age: 54 years; 187 (65.2%) men]. Median dietary intake at post-treatment was 14.95 kcal/kg/day energy and 0.63 g/kg/day protein. Skeletal muscle mass decreased significantly in all patients. The prevalence of sarcopenia increased from 24.4% before treatment to 46.7% at the end of treatment. Exploratory univariate GEE analysis revealed that radiotherapy time-point, male-gender, age ≥60 and decreased dietary energy intake significantly impacted on muscle loss represented by the appendicular skeletal muscle index. After controlling covariates, dietary energy intake was only positively associated with muscle loss in women (P = 0.013, 95% CI = 0.003-0.027) but not in men (P = 0.788, 95% CI = -0.007-0.009). CONCLUSION While the loss in skeletal muscle is more prevalent in men receiving radiotherapy, the effects of dietary energy intake were only associated with women. A prospective randomized clinical trial is required to identify the appropriate amount of dietary energy supplement by gender in cancer patients treated with radiotherapy.
Collapse
Affiliation(s)
- Yiwei Cao
- Division of Medical & Surgical Nursing, School of Nursing, Peking University, #38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Qian Lu
- Division of Medical & Surgical Nursing, School of Nursing, Peking University, #38 Xueyuan Road, Haidian District, Beijing, 100191, China.
| | - Bing Zhuang
- Division of Medical & Surgical Nursing, School of Nursing, Peking University, #38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Lichuan Zhang
- Division of Medical & Surgical Nursing, School of Nursing, Peking University, #38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yujie Wang
- Division of Medical & Surgical Nursing, School of Nursing, Peking University, #38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Shuai Jin
- Division of Medical & Surgical Nursing, School of Nursing, Peking University, #38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Shaowen Xiao
- Department of Radiation Oncology, Key Laboratory of Carcinogenesis and Translational Research, Peking University Cancer Hospital & Institute, #52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Sanli Jin
- Division of Medical & Surgical Nursing, School of Nursing, Peking University, #38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Baomin Zheng
- Department of Radiation Oncology, Key Laboratory of Carcinogenesis and Translational Research, Peking University Cancer Hospital & Institute, #52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Yan Sun
- Department of Radiation Oncology, Key Laboratory of Carcinogenesis and Translational Research, Peking University Cancer Hospital & Institute, #52 Fucheng Road, Haidian District, Beijing, 100142, China.
| |
Collapse
|
17
|
Kirk B, Iuliano S, Daly RM, Duque G. Effects of protein supplementation on muscle wasting disorders: A brief update of the evidence. Australas J Ageing 2020; 39 Suppl 2:3-10. [PMID: 33095495 DOI: 10.1111/ajag.12853] [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: 07/09/2020] [Revised: 07/30/2020] [Accepted: 08/05/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To examine the effects of protein supplementation on muscle mass, strength and function in individuals at risk of muscle wasting disorders. METHODS A narrative overview of the literature based on a PubMed search. RESULTS Increasing protein intake beyond the recommended dietary intake may prevent or attenuate muscle loss in people at risk of muscle wasting disorders; however, there is inconsistent evidence for any benefits on muscle strength or physical function. This is likely due to the significant heterogeneity and bias regarding baseline demographics, basal protein/energy intakes and protein supplement type, dose, timing and compliance. CONCLUSION Protein supplementation attenuates muscle loss in some populations at increased risk of muscle wasting, but there is no consistent evidence to support benefits on muscle strength or physical function. Further randomised controlled trials are needed that focus on whether there is an optimal type, dose and timing of protein intake, and potential interaction with other nutrients.
Collapse
Affiliation(s)
- Ben Kirk
- Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, St Albans, Melbourne, Vic., Australia.,Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Melbourne, Vic., Australia
| | - Sandra Iuliano
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Melbourne, Vic., Australia.,Department of Endocrinology, University of Melbourne/Austin Health, Heidelberg, Vic., Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Vic., Australia
| | - Gustavo Duque
- Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, St Albans, Melbourne, Vic., Australia.,Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Melbourne, Vic., Australia
| |
Collapse
|
18
|
Donnelly R, Wei C, Morrison-Koechl J, Keller H. The effect of blue dishware versus white dishware on food intake and eating challenges among residents living with dementia: a crossover trial. BMC Res Notes 2020; 13:353. [PMID: 32703270 PMCID: PMC7379787 DOI: 10.1186/s13104-020-05195-y] [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: 03/20/2020] [Accepted: 07/17/2020] [Indexed: 11/15/2022] Open
Abstract
Objective Residents living with dementia (RLWD) often experience changes in their visual perception, which could reduce food intake. Inadequate food intake is known to cause malnutrition, which increases the risk of hospitalization, morbidity, and mortality. This study evaluated the effectiveness of using blue dishware compared to white dishware to improve food intake and mitigate eating challenges among 18 RLWD (mean age 84.6 ± 7.9 years, 72.2% female). Results A within-within person crossover design determined differences in food intake and eating challenges between blue and white dishware conditions. Five participants responded to the blue dishware and increased their average food intake by ≥ 10%. Responders were not different from non-responders in terms of demographic or health characteristics. The proportion of eating challenges experienced was not significantly different between the blue and white dishware conditions. Percent food intake was significantly greater at lunch (83.5 ± 19.0%) compared to dinner (75.8 ± 22.1%; p < 0.0001), regardless of dishware condition. However, there were no significant differences for food intake between the dishware conditions, even after matching food choices. Promoting food intake and reducing eating challenges in RLWD likely needs multi-component interventions targeting meal quality, meal access, and mealtime experience. Trial registration ClincialTrials.gov Identifier: NCT04298788. Retrospectively registered: 6 March 2020, https://clinicaltrials.gov/ct2/show/NCT04298788?term=NCT04298788&draw=2&rank=1.
Collapse
Affiliation(s)
- Rachael Donnelly
- University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - Cindy Wei
- University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | | | - Heather Keller
- University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada. .,Schlegel-University of Waterloo Research Institute for Aging, 250 Laurelwood Drive, Waterloo, ON, N2J 0E2, Canada.
| |
Collapse
|
19
|
Vural Z, Avery A, Kalogiros DI, Coneyworth LJ, Welham SJM. Trace Mineral Intake and Deficiencies in Older Adults Living in the Community and Institutions: A Systematic Review. Nutrients 2020; 12:nu12041072. [PMID: 32294896 PMCID: PMC7230219 DOI: 10.3390/nu12041072] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/05/2020] [Accepted: 04/08/2020] [Indexed: 12/31/2022] Open
Abstract
The global population is ageing with many older adults suffering from age-related malnutrition, including micronutrient deficiencies. Adequate nutrient intake is vital to enable older adults to continue living independently and delay their institutionalisation, as well as to prevent deterioration of health status in those living in institutions. This systematic review investigated the insufficiency of trace minerals in older adults living independently and in institutions. We examined 28 studies following a cross-sectional or cohort design, including 7203 older adults (≥60) living independently in 13 Western countries and 2036 living in institutions in seven Western countries. The estimated average requirement (EAR) cut-off point method was used to calculate percentage insufficiency for eight trace minerals using extracted mean and standard deviation values. Zinc deficiency was observed in 31% of community-based women and 49% of men. This was higher for those in institutional care (50% and 66%, respectively). Selenium intakes were similarly compromised with deficiency in 49% women and 37% men in the community and 44% women and 27% men in institutions. We additionally found significant proportions of both populations showing insufficiency for iron, iodine and copper. This paper identifies consistent nutritional insufficiency for selenium, zinc, iodine and copper in older adults.
Collapse
Affiliation(s)
- Zeynep Vural
- Nutrition and Dietetics, Division of Food, School of Biosciences, University of Nottingham, Sutton Bonington, Loughborough, Leicestershire LE12 5RD, UK; (Z.V.); (A.A.); (L.J.C.)
| | - Amanda Avery
- Nutrition and Dietetics, Division of Food, School of Biosciences, University of Nottingham, Sutton Bonington, Loughborough, Leicestershire LE12 5RD, UK; (Z.V.); (A.A.); (L.J.C.)
| | - Dimitris I. Kalogiros
- School of Mathematical Sciences, University of Nottingham, University Park, Nottingham NG7 2RD, UK;
| | - Lisa J. Coneyworth
- Nutrition and Dietetics, Division of Food, School of Biosciences, University of Nottingham, Sutton Bonington, Loughborough, Leicestershire LE12 5RD, UK; (Z.V.); (A.A.); (L.J.C.)
| | - Simon J. M. Welham
- Nutrition and Dietetics, Division of Food, School of Biosciences, University of Nottingham, Sutton Bonington, Loughborough, Leicestershire LE12 5RD, UK; (Z.V.); (A.A.); (L.J.C.)
- Correspondence:
| |
Collapse
|
20
|
Salminen KS, Suominen MH, Kautiainen H, Pitkälä KH. Associations between Nutritional Status, Frailty and Health-Related Quality of Life among Older Long-Term Care Residents in Helsinki. J Nutr Health Aging 2020; 24:319-324. [PMID: 32115614 PMCID: PMC7064461 DOI: 10.1007/s12603-019-1320-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 11/05/2019] [Indexed: 01/03/2023]
Abstract
OBJECTIVES The aim of this study was to examine how nutritional status modifies the association between frailty and health-related quality of life (HRQoL) among older nursing home residents. We also investigated how residents' energy intake is linked to frailty score. DESIGN AND PARTICIPANTS A total of 486 older (> 65 years of age) nursing home residents living in Helsinki, Finland were included to this cross-sectional study. METHODS We collected data on the residents' background information, HRQoL by 15D, nutritional status by Mini Nutritional Assessment (MNA), frailty status (Fried's phenotype criteria; pre-frail: 1-2 criteria and frail: 3-5) and energy intake (one- or two-day food records). RESULTS The frail residents were more often malnourished and had lower HRQoL than those in the prefrail group. Energy and protein intakes were significantly lower among frail women than prefrail women. Energy intake was linearly associated with frailty points. When residents in the frail and prefrail groups were divided according to their nutritional status, both nutritional status and frailty were associated with HRQoL, but there was no interaction. CONCLUSIONS Both nutritional status and frailty were associated with HRQoL, and lower energy intake indicated a higher frailty score. An adequate energy intake may promote residents' HRQoL and prevent frailty in long-term care.
Collapse
Affiliation(s)
- K S Salminen
- K.S. Salminen, Department of General Practice and Primary Health Care, University of Helsinki, Finland. POB 20, FIN-00014 University of Helsinki, Finland.
| | | | | | | |
Collapse
|
21
|
Energy Intake and Severity of Dementia Are Both Associated with Health-Related Quality of Life among Older Long-Term Care Residents. Nutrients 2019; 11:nu11102261. [PMID: 31546994 PMCID: PMC6835645 DOI: 10.3390/nu11102261] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 09/17/2019] [Accepted: 09/18/2019] [Indexed: 01/01/2023] Open
Abstract
Our aim was to investigate how energy intake modifies the association of the stage of dementia with health related quality of life (HRQoL) among institutionalized older people. A cross-sectional sample of 538 older long-term care residents with dementia in Helsinki, Finland were assessed with HRQoL (15D), energy intake (from one to two days), and the stage of dementia by the clinical dementia rating (CDR) scale. The energy intakes were standardized by z-scores to include both men and women in the same analyses. Severity of dementia was associated with HRQoL (15D index in CDR 0.5–1: 0.65 (0.11), CDR 2: 0.60 (0.10), CDR 3: 0.52 (0.10)). When the three groups of dementia severity were divided according to their energy intake quartiles, there was an association between the HRQoL and the stage of dementia (p < 0.001) and energy intake (p = 0.013); however, no interaction was observed (p = 0.30). While partial correlation analysis showed that energy intake correlated with HRQoL among residents with very mild/mild or moderate dementia, this was not observed among those with severe dementia. In moderate dementia, the dimensions of mobility and usual activities correlated significantly with higher energy intake. Both energy intake and severity of dementia are associated with HRQoL.
Collapse
|