1
|
Hou J, Liu Y, Ma Y, Zhang H, Xia N, Li H, Wang Z, Rayan AM, Ghamry M, Mohamed TA. High internal phase Pickering emulsions stabilized by egg yolk-carboxymethyl cellulose as an age-friendly dysphagia food: Tracking the dynamic transition from co-solubility to coacervates. Carbohydr Polym 2024; 342:122430. [PMID: 39048210 DOI: 10.1016/j.carbpol.2024.122430] [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: 04/02/2024] [Revised: 06/17/2024] [Accepted: 06/23/2024] [Indexed: 07/27/2024]
Abstract
Although protein-polysaccharide complexes with different phase behaviors all show potential for stabilizing high internal phase Pickering emulsions (HIPPEs), it is not clarified which aggregation state is more stable and age-friendly. In this study, we investigated and compared the stability and age friendliness of HIPPEs stabilized with egg yolk and carboxymethyl cellulose (EYCMC) in different phase behaviors. The results revealed differences in particle size, aggregation state, charge potential, and stability of secondary and tertiary structures of EYCMC. The behavior of EYCMC at the oil-water interface was mainly divided into three phases: rapid diffusion, permeation, and reorganization. The electrostatic interaction, kinetic hindrance, and depletion attraction were the mechanisms primarily involved in stabilizing HIPPEs by EYCMC. Rheological analysis results indicated that HIPPEs had excellent viscoelasticity, structural recovery properties and yield stress. HIPPEs were used in 3D printing, electronic nose testing, IDDSI testing and in vitro digestive simulations for the elderly, demonstrating a fine appearance, safe consumption and bioaccessibility of β-carotene. Soluble complexes showed the best stability and age friendliness compared to other aggregated forms. This study serves as a foundational source of information for developing innovative foods utilizing HIPPEs.
Collapse
Affiliation(s)
- Jingjie Hou
- College of Food Science, Northeast Agricultural University, Harbin, Heilongjiang 150030, PR China
| | - Yujia Liu
- College of Food Science, Northeast Agricultural University, Harbin, Heilongjiang 150030, PR China
| | - Yunze Ma
- College of Food Science, Northeast Agricultural University, Harbin, Heilongjiang 150030, PR China
| | - Huajiang Zhang
- College of Food Science, Northeast Agricultural University, Harbin, Heilongjiang 150030, PR China.
| | - Ning Xia
- College of Food Science, Northeast Agricultural University, Harbin, Heilongjiang 150030, PR China.
| | - Hanyu Li
- College of Food Science, Northeast Agricultural University, Harbin, Heilongjiang 150030, PR China.
| | - Zhongjiang Wang
- College of Food Science, Northeast Agricultural University, Harbin, Heilongjiang 150030, PR China
| | - Ahmed M Rayan
- Food Technology Department, Faculty of Agriculture, Suez Canal University, Ismailia 41522, Egypt
| | - Mohamed Ghamry
- Food Technology Department, Faculty of Agriculture, Benha University, Moshtohor, 13736, Egypt
| | - Taha Ahmed Mohamed
- Department of Soil Fertility and Plant Nutrition, Soil, Water and Environment Research Institute, Agricultural Research Center, Giza, Egypt
| |
Collapse
|
2
|
Morwani-Mangnani J, Rodriguez-Girondo M, Singh-Povel C, Verlaan S, Beekman M, Slagboom PE. Physical activity and fiber intake beneficial for muscle mass and strength preservation during aging: A comprehensive cross-sectional study in the UK biobank cohort. Exp Gerontol 2024; 193:112474. [PMID: 38815706 DOI: 10.1016/j.exger.2024.112474] [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: 03/05/2024] [Revised: 05/13/2024] [Accepted: 05/27/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Aging triggers intricate physiological changes, particularly in whole-body fat-free mass (FFM) and handgrip strength, affecting overall health and independence. Despite existing research, the broader significance of how muscle health is affected by the intricate interplay of lifestyle factors simultaneously during aging needs more exploration. This study aims to examine how nutrition, physical activity, and sleep impact on FFM and handgrip strength in middle-aged men and women, facilitating future personalized recommendations for preserving muscle health. METHODS The cross-sectional analysis of the UK Biobank involved 45,984 individuals (54 % women) aged 40-70 years with a complete dataset. Multiple linear regression explored determinants of FFM and handgrip strength, considering traditional, socio-demographics, medication use and smoking as covariates, with sex and age (younger and older than 55 years) stratifications. RESULTS In older men and women, higher physical activity beneficially affect both FFM (respectively Β = 3.36 × 10-3, p-value = 1.66 × 10-3; Β = 2.52 × 10-3, p-value = 3.57 × 10-4) and handgrip strength (Β = 6.05 × 10-3, p-value = 7.99 × 10-5, Β = 8.98 × 10-3, p-value = 2.95 × 10-15). Similar results were found in fiber intake for FFM in older men and women (respectively B = 3.00 × 10-2, p-value = 2.76 × 10-5; B = 2.68 × 10-2, p-value = 1.78 × 10-9) and handgrip strength (Β = 3.27 × 10-2, p-value = 1.40 × 10-3; Β = 3.12 × 10-2, p-value = 1.34 × 10-5). Other lifestyle factors influence FFM and handgrip strength differently. Key determinants influencing handgrip strength included higher protein intake, lower water intake, higher alcohol intake, and extended sleep duration whereas mainly higher water intake is associated with higher FFM. CONCLUSIONS In both men and women, the main factors associated with FFM and handgrip strength are physical activity and fiber intake, which may underlie a connection between gut and muscle health. Given the observed complexity of muscle health in the age and sex strata, further longitudinal research is needed to provide personalized lifestyle recommendations.
Collapse
Affiliation(s)
- Jordi Morwani-Mangnani
- Section of Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands.
| | - Mar Rodriguez-Girondo
- Section of Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | | | | | - Marian Beekman
- Section of Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - P Eline Slagboom
- Section of Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| |
Collapse
|
3
|
Nielsen RL, Bornæs O, Iversen E, Strejby Christensen LW, Kallemose T, Jawad B, Rasmussen HH, Munk T, Lund TM, Andersen O, Houlind MB, Leegaard Andersen A, Tavenier J. Growth differentiation factor 15 (GDF15) levels are associated with malnutrition in acutely admitted older adults. Clin Nutr 2024; 43:1685-1693. [PMID: 38879915 DOI: 10.1016/j.clnu.2024.06.005] [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: 04/05/2024] [Revised: 06/01/2024] [Accepted: 06/04/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND AND AIMS The aging process is often accompanied by high risk of malnutrition and elevated levels of growth differentiation factor 15 (GDF15). GDF15 is an increasingly recognized biomarker for regulation of metabolism, but few studies have investigated the connection between GDF15 and malnutrition in older age and how it relates to other features of aging such as decreased appetite and physical function. Therefore, we investigated the associations between GDF15 levels and nutritional status, appetite, and physical function in acutely admitted older adults. METHODS Plasma GDF15 levels were measured using immunoassays in 302 older adults (≥65 years) admitted to the emergency department (ED). Nutritional status was evaluated with the Mini Nutritional Assessment Short-Form (MNA®-SF), appetite was evaluated with the Simplified Nutritional Appetite Questionnaire (SNAQ), and physical function was evaluated with handgrip strength (HGS), 30-s chair stand test (30s-RSS), and gait speed (GS). Associations between GDF15 and each outcome was determined by logistic regression adjusted for age, sex, and C-reactive protein (CRP). RESULTS Each doubling in plasma GDF15 level was associated with an adjusted odds ratio (OR) (95% confidence interval) of 1.59 (1.10-2.29, P = 0.01) for risk of malnutrition compared to normal nutrition and 1.19 (0.85-1.69, P = 0.3)) for malnutrition compared to risk of malnutrition. Each doubling in GDF15 was associated with an adjusted OR of 1.63 (1.21-2.23)) for having poor appetite, 1.46 (1.07-1.99) for having low HGS, 1.74 (1.23-2.51) for having low 30s-RSS, and 1.99 (1.39-2.94) for having low GS. CONCLUSION Among older adults admitted to the ED, higher GDF15 levels were significantly associated with malnutrition, poor appetite, and low physical function independent of age, sex, and CRP.
Collapse
Affiliation(s)
- Rikke Lundsgaard Nielsen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark.
| | - Olivia Bornæs
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark.
| | - Esben Iversen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark.
| | - Louise Westberg Strejby Christensen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark; The Capital Region Pharmacy, Marielundvej 25, 2730 Herlev, Denmark.
| | - Thomas Kallemose
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark.
| | - Baker Jawad
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark.
| | - Henrik Højgaard Rasmussen
- Center for Nutrition and Intestinal Failure, Aalborg University Hospital, Aalborg University, 9220 Aalborg, Denmark; The Dietitians and Nutritional Research Unit, EATEN, Copenhagen University Hospital-Herlev and Gentofte, 2100 Copenhagen, Denmark.
| | - Tina Munk
- The Dietitians and Nutritional Research Unit, EATEN, Copenhagen University Hospital-Herlev and Gentofte, 2100 Copenhagen, Denmark.
| | - Trine Meldgaard Lund
- Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen Ø, Denmark.
| | - Ove Andersen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark; Emergency Department, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark.
| | - Morten Baltzer Houlind
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark; The Capital Region Pharmacy, Marielundvej 25, 2730 Herlev, Denmark; Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen Ø, Denmark.
| | - Aino Leegaard Andersen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark.
| | - Juliette Tavenier
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark.
| |
Collapse
|
4
|
Tey SL, Huynh DTT, Kong ST, Oliver J, Baggs G, Low YL, How CH, Cheong M, Chow WL, Tan NC, Aw TC, Chew STH. Effects of Oral Nutritional Supplement with β-Hydroxy-β-methylbutyrate (HMB) on Biochemical and Hematological Indices in Community-Dwelling Older Adults at Risk of Malnutrition: Findings from the SHIELD Study. Nutrients 2024; 16:2495. [PMID: 39125374 PMCID: PMC11313967 DOI: 10.3390/nu16152495] [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: 06/16/2024] [Revised: 07/18/2024] [Accepted: 07/27/2024] [Indexed: 08/12/2024] Open
Abstract
Malnutrition may result in abnormal biochemical and hematological indices. This planned prespecified analysis investigated the effects of a specialized oral nutritional supplement (ONS) on biochemical and hematological indices in community-dwelling older adults at risk of malnutrition. In the Strengthening Health in ELDerly through nutrition (SHIELD) study, 811 older adults aged 65 years and above took part in this randomized, double-blind, placebo-controlled, multi-center study. Participants were randomly allocated to either a complete and balanced specialized ONS (each serving provides 262 kcal, 10.5 g protein, 7.75 µg vitamin D3, and 0.74 g calcium β-hydroxy-β-methylbutyrate) and dietary counselling (intervention group) or a placebo and dietary counselling (placebo group). Both groups consumed study products twice a day for 180 days. Data were collected at baseline, day 90, and day 180. Blood analysis results at follow-up visits were analyzed using repeated measures analysis of covariance with adjustments for confounders. Overall, when compared with the placebo group, the intervention group showed significantly greater urea (6.0 mmol/L vs. 5.4 mmol/L, p < 0.001), urea to creatinine ratio (4.39 vs. 4.26, p < 0.001), prealbumin (24.9 mg/dL vs. 24.0 mg/dL, p < 0.001), vitamin B12 (480.0 pmol/L vs. 420.1 pmol/L, p < 0.001), and globulin levels (26.8 g/L vs. 26.5 g/L, p = 0.032). The intervention group also had a significantly higher absolute reticulocyte count (62.0 × 103/µL vs. 58.2 × 103/µL, overall p < 0.001) and mean platelet volume (10.0 fL vs. 9.9 fL, overall p = 0.003). Furthermore, significant improvements were seen in total protein at day 90 (71.7 g/L vs. 71.1 g/L, p = 0.017) and in absolute monocyte count at day 90 (0.50 × 103/µL vs. 0.47 × 103/µL, p = 0.009) in the intervention group. In conclusion, daily consumption of a specialized ONS for six months led to significant improvements in biochemical and hematological indices in community-dwelling older adults at risk of malnutrition.
Collapse
Affiliation(s)
- Siew Ling Tey
- Abbott Nutrition Research and Development, Singapore 138668, Singapore; (D.T.T.H.); (S.T.K.); (Y.L.L.)
| | - Dieu Thi Thu Huynh
- Abbott Nutrition Research and Development, Singapore 138668, Singapore; (D.T.T.H.); (S.T.K.); (Y.L.L.)
| | - Sing Teang Kong
- Abbott Nutrition Research and Development, Singapore 138668, Singapore; (D.T.T.H.); (S.T.K.); (Y.L.L.)
| | - Jeffery Oliver
- Abbott Nutrition Research and Development, Columbus, OH 43219, USA; (J.O.); (G.B.)
| | - Geraldine Baggs
- Abbott Nutrition Research and Development, Columbus, OH 43219, USA; (J.O.); (G.B.)
| | - Yen Ling Low
- Abbott Nutrition Research and Development, Singapore 138668, Singapore; (D.T.T.H.); (S.T.K.); (Y.L.L.)
| | - Choon How How
- Care and Health Integration, Changi General Hospital, Singapore 529889, Singapore;
| | - Magdalin Cheong
- Department of Dietetic & Food Services, Changi General Hospital, Singapore 529889, Singapore;
| | - Wai Leng Chow
- Health Services Research, Changi General Hospital, Singapore 529889, Singapore;
| | | | - Tar Choon Aw
- Department of Laboratory Medicine, Changi General Hospital, Singapore 529889, Singapore;
- Duke-NUS Graduate School of Medicine, 8 College Road, Singapore 169857, Singapore;
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore
| | - Samuel Teong Huang Chew
- Duke-NUS Graduate School of Medicine, 8 College Road, Singapore 169857, Singapore;
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore
- Department of Geriatric Medicine, Changi General Hospital, Singapore 529889, Singapore
| |
Collapse
|
5
|
Wang S, Fan X, Zheng X, Xia P, Zou H, Zhang Z, Chen L. Association between Dietary Acid Load and Chronic Kidney Disease in the Chinese Population: A Comprehensive Analysis of the China Health and Nutrition Survey (2009). Nutrients 2024; 16:2461. [PMID: 39125342 PMCID: PMC11314566 DOI: 10.3390/nu16152461] [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: 06/24/2024] [Revised: 07/21/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Dietary acid load (DAL) is closely related to several chronic diseases. However, the link between DAL and chronic kidney disease (CKD) remains scarce and without data from the Chinese populations whose diet is quite different from people in Western countries. METHODS This study evaluated DAL by potential renal acid load (PRAL) and net endogenous acid production (NEAP). We clarified the relationship between DAL and CKD by logistic regression analysis based on data from the China Health and Nutrition Survey (CHNS). RESULTS The final analysis included 7699 individuals, of whom 811 (11.44%) were CKD patients. Although there was no notable link between PRAL and CKD, higher NEAP levels were independently correlated with CKD. As NEAP values rise, so does CKD prevalence. This trend remains highly significant even after adjustments. In subgroup analyses, the relationship between NEAP and CKD was more consistent in the elderly and subjects with a waistline of less than 82 cm and those without diabetes and heart disease. RCS analysis further confirmed the clear linear relationship between the OR of CKD and NEAP score. CONCLUSIONS This study highlighted that higher NEAP was positively correlated with the risk of CKD.
Collapse
Affiliation(s)
- Shurui Wang
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; (S.W.); (H.Z.)
- Department of Nephrology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China; (X.F.); (X.Z.); (P.X.)
| | - Xiaohong Fan
- Department of Nephrology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China; (X.F.); (X.Z.); (P.X.)
| | - Xixi Zheng
- Department of Nephrology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China; (X.F.); (X.Z.); (P.X.)
| | - Peng Xia
- Department of Nephrology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China; (X.F.); (X.Z.); (P.X.)
| | - Haiou Zou
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; (S.W.); (H.Z.)
| | - Zhaofeng Zhang
- Department of Nutrition & Food Hygiene, School of Public Health, Peking University Health Science Center, Haidian District, Beijing 100191, China
| | - Limeng Chen
- Department of Nephrology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China; (X.F.); (X.Z.); (P.X.)
| |
Collapse
|
6
|
Yamaga R, Chikaishi M, Iwasaki T, Tada A, Mizutani S, Amano K, Iwase Y, Taniguchi H. Pilot study on the relationship between oral function or subjective symptoms and appetite. J Oral Rehabil 2024. [PMID: 39054906 DOI: 10.1111/joor.13811] [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: 04/02/2024] [Revised: 07/07/2024] [Accepted: 07/10/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE This pilot study evaluated the relationships between appetite and oral function, and between appetite and the subjective symptoms of decreased oral function. METHODS Seventy-one adult dental clinic patients (22 males, 66.0 ± 14.0 years) participated in this study. A Council on Nutrition Appetite Questionnaire score of ≤28 indicated anorexia, and the Mini Nutritional Assessment Short-form, body mass index and skeletal muscle mass index were used to define subject characteristics. Seven oral function tests and seven subjective symptoms related to oral function were evaluated. The relationship between subject characteristics, oral function tests, subjective symptoms and anorexia was analysed using the chi-square test and univariate and multivariate logistic regression. RESULT There were significant differences between the normal appetite group and the anorexia group for the 10-item Eating Assessment Tool (EAT-10) survey and the question 'Food remains in the oral cavity after eating' (p < .05). Univariate logistic regression found significant differences in the items of masticatory function, the EAT-10 survey and the question 'Food remains in the oral cavity after eating'. Multivariate logistic regression revealed significant differences in masticatory function (AOR 4.35; 95% CI: 1.03-18.35; p = .045) and EAT-10 (AOR 6.27; 95% CI: 1.40-24.02; p = .016). CONCLUSION This pilot study investigated the influence of factors related to oral function on appetite. Relationships were found among poor masticatory function, poor swallowing function and anorexia.
Collapse
Affiliation(s)
- Ryosuke Yamaga
- Department of Dysphagia Rehabilitation, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
- Department of Dentistry for Persons with Disabilities, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
- Yamaga Dental Clinic, Kuwana, Japan
| | - Masato Chikaishi
- Department of Dysphagia Rehabilitation, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
- Department of Dentistry for Persons with Disabilities, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
- Department of Dentistry and Oral-Maxillofacial Surgery, Chikaishi Hospital, Medical Corporation Touhoukai, Gifu, Japan
| | - Toshihiro Iwasaki
- Department of Dysphagia Rehabilitation, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
| | - Akira Tada
- Department of Dysphagia Rehabilitation, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
- Department of Oral Surgery, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
| | - Saki Mizutani
- Department of Dysphagia Rehabilitation, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
- Department of Dentistry for Persons with Disabilities, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
| | - Kota Amano
- Department of Dysphagia Rehabilitation, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
| | - Yoko Iwase
- Department of Dentistry for Persons with Disabilities, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
| | - Hiroshige Taniguchi
- Department of Dysphagia Rehabilitation, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
| |
Collapse
|
7
|
Tang R, Guan B, Xie J, Xu Y, Yan S, Wang J, Li Y, Ren L, Wan H, Peng T, Zeng L. Prediction model of malnutrition in hospitalized patients with acute stroke. Top Stroke Rehabil 2024:1-15. [PMID: 39024192 DOI: 10.1080/10749357.2024.2377521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/30/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVE The prognosis of stroke patients is greatly threatened by malnutrition. However, there is no model to predict the risk of malnutrition in hospitalized stroke patients. This study developed a predictive model for identifying high-risk malnutrition in stroke patients. METHODS Stroke patients from two tertiary hospitals were selected as the objects. Binary logistic regression was used to build the model. The model's performance was evaluated using various metrics including the receiver operating characteristic curve, Hosmer-Lemeshow test, sensitivity, specificity, Youden index, clinical decision curve, and risk stratification. RESULTS A total of 319 stroke patients were included in the study. Among them, 27% experienced malnutrition while in the hospital. The prediction model included all independent variables, including dysphagia, pneumonia, enteral nutrition, Barthel Index, upper arm circumference, and calf circumference (all p < 0.05). The AUC area in the modeling group was 0.885, while in the verification group, it was 0.797. The prediction model produces greater net clinical benefit when the risk threshold probability is between 0% and 80%, as revealed by the clinical decision curve. All p values of the Hosmer test were > 0.05. The optimal cutoff value for the model was 0.269, with a sensitivity of 0.849 and a specificity of 0.804. After risk stratification, the MRS scores and malnutrition incidences increased significantly with escalating risk levels (p < 0.05) in both modeling and validation groups. CONCLUSIONS This study developed a prediction model for malnutrition in stroke patients. It has been proven that the model has good differentiation and calibration.
Collapse
Affiliation(s)
- Rong Tang
- Department of Nursing, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Bi Guan
- Department of Nursing, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Jiaoe Xie
- Department of Neurology, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Ying Xu
- School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Shu Yan
- Medical Affairs Department, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Jianghong Wang
- Department of Neurology, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Yan Li
- Department of Nursing, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Liling Ren
- Department of Neurology, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Haiyan Wan
- Department of Endocrinology, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Tangming Peng
- Department of Neurology, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Liangnan Zeng
- Department of Nursing, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| |
Collapse
|
8
|
Cui G, Zhang S, Zhang X, Li S. Development and validation of a nomogram for predicting anorexia of aging in older people. Appetite 2024; 201:107606. [PMID: 39029530 DOI: 10.1016/j.appet.2024.107606] [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: 05/17/2024] [Revised: 06/24/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Anorexia of aging (AA) is a common geriatric syndrome that seriously endangers the health of older adults. Early identification of populations at risk of AAand the implementation of appropriate intervention measures hold significant public health importance. This study aimed to develop a nomogram for predicting the risk of AA among older people. METHODS We conducted a cross-sectional study involving 2144 community-dwelling older adults to evaluate the AA using the Simplified Nutritional Appetite Questionnaire. We utilized the Least Absolute Shrinkage and Selection Operator (LASSO) and logistic regression analysis to select variables and develop a nomogram prediction model. The predictive performance of the nomogram was evaluated using the Receiver Operating Characteristic (ROC) curves, calibration curves, Decision Curve Analysis (DCA), and internal validation. RESULTS The prevalence of AA among Chinese older adults was 21.7% (95%CI: 20.0%-23.5%). Age, sex, family economic level, smoking status, dysphagia, loneliness, depressive symptoms, living alone, health literacy, life satisfaction, and body mass index have been identified as predictive factors for AA among older people. The nomogram constructed based on these predictive factors showed an area under the curve (AUC) of 0.766 (95%CI: 0.742-0.791), indicating good calibration and discrimination ability. Additionally, the results obtained from the 10-fold cross-validation process confirmed the nomogram's good predictive capabilities. Furthermore, the DCA results showed that the nomogram has clinical utility. CONCLUSION The nomogram constructed in this study serves as an effective tool for predicting anorexia of aging among community-dwelling older adults. Its implementation can help community healthcare workers evaluate the risk of AA in this population and identify high-risk groups.
Collapse
Affiliation(s)
- Guanghui Cui
- Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital, Institute of Integrated Traditional Chinese and Western Medicine, Peking University, Beijing, China
| | - Shengkai Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Xiaochen Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Shaojie Li
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China.
| |
Collapse
|
9
|
Kusama T, Takeuchi K, Kiuchi S, Aida J, Osaka K. The association between objective and subjective oral health conditions and the presence of anorexia of aging among Japanese older Adults 1. Appetite 2024; 198:107332. [PMID: 38582137 DOI: 10.1016/j.appet.2024.107332] [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: 01/04/2024] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/08/2024]
Abstract
Anorexia of aging is a risk factor for malnutrition among older adults. This study aimed to evaluate the association between objective and subjective oral health and anorexia among independent older adults. This cross-sectional study targeted independent older adults aged ≥65 years who participated in the Japan Gerontological Evaluation Study conducted in 2022. The outcome variable was the presence of anorexia, as assessed by the Simplified Nutritional Appetite Questionnaire. Exposure variables were dental status (≥20 teeth, 10-19 teeth with/without dentures, and 0-9 teeth with/without dentures) as objective oral health and oral health-related quality of life measured by five items of the short version of the Oral Impacts on Daily Performances (OIDP) (eating, speaking, smiling, emotional stability, and enjoying with others) as subjective oral health. We fitted the Poisson regression model, including possible confounders, and estimated prevalence ratios (PRs) and 95% confidence intervals. Among 19,787 participants (mean age: 74.6 years [1SD = 6.2], male: 48.5%), 9.0% were classified as having anorexia. After adjusting possible confounders, those with ≤19 teeth had a higher proportion of experiencing anorexia compared to those with ≥20 teeth; however, the association was less pronounced among those with dentures (0-9 teeth with dentures: PR = 1.48 [1.31-1.68], and 0-9 teeth without dentures: PR = 2.08 [1.65-2.63]). Even after adjusting for dental status, each item of OIDP was significantly associated with the presence of anorexia (all p < 0.05). The results showed that both objective and subjective poor oral health were significantly associated with a higher probability of developing anorexia of aging. Therefore, improving both objective and subjective oral health through appropriate dental care could contribute to maintaining appetite in later life.
Collapse
Affiliation(s)
- Taro Kusama
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Miyagi, Japan; Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan
| | - Kenji Takeuchi
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Miyagi, Japan; Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan.
| | - Sakura Kiuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan; Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Miyagi, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan
| |
Collapse
|
10
|
Riddle E, Munoz N, Clark K, Collins N, Coltman A, Nasrallah L, Nishioka S, Scollard T, Simon JR, Moloney L. Prevention and Treatment of Malnutrition in Older Adults Living in Long-Term Care or the Community: An Evidence-Based Nutrition Practice Guideline. J Acad Nutr Diet 2024; 124:896-916.e24. [PMID: 38583584 DOI: 10.1016/j.jand.2024.03.013] [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: 03/13/2024] [Accepted: 03/27/2024] [Indexed: 04/09/2024]
Abstract
Malnutrition in older adults can decrease quality of life and increase risk of morbidities and mortality. Accurate and timely identification of malnutrition, as well as subsequent implementation of effective interventions, are essential to decrease poor outcomes associated with malnutrition in older adults. The Academy of Nutrition and Dietetics Evidence Analysis Center conducted a systematic review of the literature to develop an evidence-based nutrition practice guideline for the prevention and treatment of malnutrition in older adults. The objective of this guideline was to provide evidence-based recommendations to identify, prevent, or treat protein-energy malnutrition in older adults (mean age ≥65 years) living in long-term care and community settings. This guideline provides 11 nutrition recommendations to inform shared decision making among dietitians, members of the health care team, family members or caregivers, and older adults living in long-term care or the community to prevent or treat malnutrition. Topics include dietitian effectiveness, nutrition assessment tools, oral nutrition supplements, food fortification, and home-delivered and congregate meals. Guideline implementation should include consideration of the importance of comprehensive individualized nutrition care for older adults. Future research is needed to address gaps that were identified related to the validity, reliability, and feasibility of nutrition assessment tools, as well as the effectiveness of dietitian interventions on outcomes of interest in older adults living in long-term care and the community.
Collapse
Affiliation(s)
- Emily Riddle
- State University of New York at Oneonta, Oneonta, New York
| | - Nancy Munoz
- Veterans Affairs Southern Nevada Healthcare System, Las Vegas, Nevada
| | | | | | - Anne Coltman
- Commission on Dietetic Registration, Chicago, Illinois
| | - Lamia Nasrallah
- Outpatient Nutrition Services, University of North Carolina Hospitals, Chapel Hill, North Carolina
| | - Shinta Nishioka
- Department of Clinical Nutrition and Food Services, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | | | - Judy R Simon
- Nutrition and Health Promotion Consultant, Easton, Maryland
| | - Lisa Moloney
- Academy of Nutrition and Dietetics, Chicago, Illinois.
| |
Collapse
|
11
|
Ceolin C, De Rui M, Ravelli A, Papa MV, Devita M, Sergi G, Coin A. The potential of cannabinoids in managing cancer-related anorexia in older adults: a systematic review of the literature. J Nutr Health Aging 2024; 28:100299. [PMID: 38917597 DOI: 10.1016/j.jnha.2024.100299] [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: 04/08/2024] [Revised: 06/11/2024] [Accepted: 06/11/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND AND OBJECTIVES Anorexia of aging (AoA) is a prevalent geriatric syndrome characterized by a multifactorial decline in appetite and reduced food intake associated with the aging process. This systematic review aims to investigate the use and outcomes of cannabinoids in addressing AoA, with the goal of providing a comprehensive understanding and discussing their potential integration into daily clinical practice. METHODS A thorough search of databases (Embase Ovid, Scopus, PubMed, Cochrane Library, and Web of Science) identified 6100 studies. After eliminating duplicates and screening titles and abstracts, 25 studies underwent full appraisal. Two reviewers assessed inclusion suitability, and study methodologies were evaluated using the Newcastle-Ottawa Scale (NOS) for observational studies and the modified Jadad Scoring Scale for randomized controlled trials. Ultimately, six studies published between 2002 and 2019, involving 869 participants, were included in the review. RESULTS Out of the 6 fin. l papers selected, 5 were randomized trials, and 1 was a prospective study. Megestrol acetate (800 mg/d) proved to be more effective than dronabinol 2.5 mg twice a day in increasing appetite. Nabilone (at a dosage of 0.5 mg per day) did not show superiority over placebo in alleviating symptoms such as pain, nausea, loss of appetite, and weight. However, with a double dosage followed by 1.0 mg/6 weeks, after eight weeks of treatment, patients recorded a significant increase in calorie intake and carbohydrate consumption compared to the placebo group, with some patients also experiencing substantial weight gain. Regarding delta-9-tetrahydrocannabinol (THC), a weight increase of ≥10% was observed in 17.6% of patients with doses of 5 mg or 10 mg capsules daily, without significant side effects. Additionally, patients treated with THC 2.5 mg reported improved chemosensory perception and increased appetite before meals compared to placebo. No significant side effects were reported in older adults taking cannabinoids. CONCLUSIONS Cannabinoids offer promise in enhancing the quality of life for older individuals with active neoplastic disease. However, to establish comprehensive guidelines, further research with larger sample sizes is essential. Only through this approach can we fully grasp the potential and application of cannabinoids in addressing the nutritional concerns associated with neoplastic diseases.
Collapse
Affiliation(s)
- Chiara Ceolin
- Geriatrics Division, Department of Medicine (DIMED), University of Padua, via Giustiniani 2, 35128 Padova, Italy.
| | - Marina De Rui
- Geriatrics Division, Department of Medicine (DIMED), University of Padua, via Giustiniani 2, 35128 Padova, Italy
| | - Adele Ravelli
- Geriatrics Division, Department of Medicine (DIMED), University of Padua, via Giustiniani 2, 35128 Padova, Italy.
| | - Mario Virgilio Papa
- Geriatrics Division, Department of Medicine (DIMED), University of Padua, via Giustiniani 2, 35128 Padova, Italy.
| | - Maria Devita
- Department of General Psychology (DPG), University of Padua, Via Venezia 8, 35131 Padova, Italy.
| | - Giuseppe Sergi
- Geriatrics Division, Department of Medicine (DIMED), University of Padua, via Giustiniani 2, 35128 Padova, Italy.
| | - Alessandra Coin
- Geriatrics Division, Department of Medicine (DIMED), University of Padua, via Giustiniani 2, 35128 Padova, Italy.
| |
Collapse
|
12
|
Loda I, D’Angelo E, Marzetti E, Kerminen H. Prevention, Assessment, and Management of Malnutrition in Older Adults with Early Stages of Cognitive Disorders. Nutrients 2024; 16:1566. [PMID: 38892503 PMCID: PMC11173938 DOI: 10.3390/nu16111566] [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: 04/29/2024] [Revised: 05/11/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
Malnutrition is common in older adults, and its risk is greater in those living with dementia. Relative to cognitively healthy peers, the prevalence of malnutrition is also increased in individuals with early stages of cognitive disorders owing to pathophysiological, cognitive, and psychosocial changes related to cognitive impairment. Malnutrition is associated with adverse health outcomes, including faster cognitive and functional decline. Here, we provide an overview of the prevention, assessment, and management of malnutrition in older adults, with a special focus on the aspects that are important to consider in individuals with early stages of cognitive disorders. Strategies to prevent malnutrition include systematic screening for malnourishment using validated tools to detect those at risk. If the screening reveals an increased risk of malnutrition, a detailed assessment including the individual's nutritional, medical, and functional status as well as dietary intake should be performed. The management of malnutrition in the early stages of cognitive disorders should be based on the findings of a comprehensive assessment and be personalized according to the individual's specific characteristics. In the article, we also provide an overview of the evidence on vitamin supplements and specific dietary patterns to prevent cognitive decline or attenuate its progression.
Collapse
Affiliation(s)
- Irene Loda
- Scuola di Specialità in Geriatria, Università degli Studi di Brescia, Viale Europa 11, 25123 Brescia, Italy;
| | - Emanuela D’Angelo
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy;
| | - Hanna Kerminen
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy;
- Faculty of Medicine and Health Technology, The Gerontology Research Center (GEREC), Tampere University, Arvo Ylpön katu 34, 33520 Tampere, Finland
| |
Collapse
|
13
|
Rudzińska A, Guzy P, Skowron A, Gąsowski J, Piotrowicz K. Joint interprofessional education of pharmacy and dietetics undergraduates - a scoping review. BMC MEDICAL EDUCATION 2024; 24:557. [PMID: 38778278 PMCID: PMC11110287 DOI: 10.1186/s12909-024-05411-4] [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: 12/15/2023] [Accepted: 04/10/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Interprofessional education (IPE) is an integrative approach that enables collaboration of students of two or more different health professions in aim to acquire skills and competencies related not only to their field of study but also to ensure the standard of care based on collaborative practice. IPE has not yet been explored in relation to collaboration between dietetics-nutrition and pharmacy students, while there is evidence that in many cases nutrition is complementary to pharmacotherapy in the treatment process. AIM The aim of this scoping review was to gather, describe and discuss all relevant literature regarding joint interprofessional training of pharmacy and dietetics-nutrition undergraduates. METHODS We performed a literature search for studies where IPE between dietetics-nutrition and pharmacy students was described. 2204 articles on this topic were identified. After eligibility assessment, 8 articles were included in the review. RESULTS Eight studies were included in the review. Two of these described IPE activities between dietetics and pharmacy students only. The included studies varied in setting, methodology and outcome measures and covered a wide range of topics relevant to clinical practice, such as management of inflammatory bowel diseases, care of the older adults or counselling skills. The most common teaching method was the use of case studies. Some of the included studies did not identify specific learning objectives. The most common way of gathering feedback from participants was through questionnaires and interviews. CONCLUSIONS IPE of pharmacy and dietetics-nutrition students is feasible and may be beneficial in many aspects related to learning. However, there is no well-established model or standard that would facilitate the implementation of such activities in individual educational institutions.
Collapse
Affiliation(s)
- Anna Rudzińska
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, 2 Jakubowskiego St., building I, 5th floor, 30- 688, Kraków, Poland
| | - Piotr Guzy
- Faculty of Pharmacy, Jagiellonian University Medical College, 30-688, Krakow, Poland
| | - Agnieszka Skowron
- Faculty of Pharmacy, Jagiellonian University Medical College, 30-688, Krakow, Poland
| | - Jerzy Gąsowski
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, 2 Jakubowskiego St., building I, 5th floor, 30- 688, Kraków, Poland
| | - Karolina Piotrowicz
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, 2 Jakubowskiego St., building I, 5th floor, 30- 688, Kraków, Poland.
| |
Collapse
|
14
|
Khant Aung Z, Ladyman SR, Brown RSE. Transient loss of satiety effects of leptin in middle-aged male mice. J Neuroendocrinol 2024; 36:e13386. [PMID: 38549242 DOI: 10.1111/jne.13386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 02/08/2024] [Accepted: 03/18/2024] [Indexed: 05/03/2024]
Abstract
Extensive research is undertaken in rodents to determine the mechanism underlying obesity-induced leptin resistance. While body weight is generally tightly controlled in these studies, the effect of age of experimental animals has received less attention. Specifically, there has been little investigation into leptin regulation of food intake in middle-aged animals, which is a period of particular relevance for weight gain in humans. We investigated whether the satiety effects of leptin remained constant in young (3 months), middle-aged (12 months) or aged (18-22 months) male mice. Although mean body weight increased with age, leptin concentrations did not significantly increase in male mice beyond 12 months of age. Exogenous leptin administration led to a significant reduction in food intake in young mice but had no effect on food intake in middle-aged male mice. This loss of the satiety effect of leptin appeared to be transient, with leptin administration leading to the greatest inhibition of food intake in the aged male mice. Subsequently, we investigated whether these differences were due to changes in leptin transport into the brain with ageing. No change in leptin clearance from the blood or transport into the brain was observed, suggesting the emergence of central resistance to leptin in middle age. These studies demonstrate the presence of dynamic and age-specific changes in the satiety effects of leptin in male mice and highlight the requirement for age to be carefully considered when undertaking metabolic studies in rodents.
Collapse
Affiliation(s)
- Zin Khant Aung
- Centre for Neuroendocrinology and Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Sharon R Ladyman
- Centre for Neuroendocrinology and Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Rosemary S E Brown
- Centre for Neuroendocrinology and Department of Physiology, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| |
Collapse
|
15
|
Dericioglu D, Methven L, Clegg ME. Understanding age-related changes: exploring the interplay of protein intake, physical activity and appetite in the ageing population. Proc Nutr Soc 2024:1-13. [PMID: 38557431 DOI: 10.1017/s0029665124002192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Globally, we are currently facing a rapid demographic shift leading to an increase in the proportion of older adults within the population. This raises concerns about the potential increase in age-related diseases and their impact on our ability to provide adequate health and end-of-life care. To apply appropriate interventions, understanding the changes that happen with ageing becomes essential. Ageing is often accompanied by a decrease in appetite and physical activity, which may lead to malnutrition, resulting in decreased muscle mass, physical capabilities and independence. To preserve muscle mass, older adults are advised to increase protein intake and physical activity. However, protein's high satiating effect may cause reduced energy intake. Physical activity is also advised to maintain or enhance older adult's appetite. This review paper aims to discuss appetite-related changes that occur with ageing and their consequences. In particular, it will focus on investigating the relationship between protein intake and physical activity and their impact on appetite and energy intake in the ageing population. Recent studies suggest that physical activity might contribute to maintaining or enhancing appetite in older adults. Nevertheless, establishing a definitive consensus on the satiating effect of protein in ageing remains a work in progress, despite some promising results in the existing literature.
Collapse
Affiliation(s)
- Dilara Dericioglu
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, ReadingRG6 6DZ, UK
- Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading RG6 6EU, UK
| | - Lisa Methven
- Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading RG6 6EU, UK
- Food Research Group, Department of Food and Nutritional Sciences, University of Reading,Whiteknights, Reading RG6 6DZ, UK
| | - Miriam E Clegg
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, ReadingRG6 6DZ, UK
- Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading RG6 6EU, UK
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| |
Collapse
|
16
|
Van Wicklin SA. Fundamentals of Plastic and Aesthetic Nursing: Postoperative Management of Older Adult Patients Undergoing Plastic Surgical Procedures. Pediatr Phys Ther 2024; 44:99-115. [PMID: 38639967 DOI: 10.1097/psn.0000000000000561] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Affiliation(s)
- Sharon Ann Van Wicklin
- Sharon Ann Van Wicklin, PhD, RN, CNOR, CRNFA(E), CPSN-R, PLNC, ISPAN-F, FAORN, FAAN, is Editor in Chief, Plastic and Aesthetic Nursing, and is a Perioperative and Legal Nurse Consultant, Aurora, CO
| |
Collapse
|
17
|
Calcaterra L, Abellan van Kan G, Steinmeyer Z, Angioni D, Proietti M, Sourdet S. Sarcopenia and poor nutritional status in older adults. Clin Nutr 2024; 43:701-707. [PMID: 38320461 DOI: 10.1016/j.clnu.2024.01.028] [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: 11/28/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND & AIMS The association between sarcopenia and malnutrition has been poorly studied in the older population. The purpose of this study is to address the association between sarcopenia, according to different validated definitions, and nutritional status in a large population of community-dwelling older adults. METHODS Observational, cross-sectional study of the Geriatric Frailty Clinic (GFC) for Assessment of Frailty and Prevention of Disability, held by the "Gérontopôle" of the Toulouse University Hospital. Patients aged above 65 years who benefitted from a Dual X-ray Densitometry (DXA) during their assessment at the GFC from June 5th 2013 to January 28th 2020 were included. Sarcopenia was defined according to proposed validated definitions. The Mini Nutritional Assessment (MNA) was used to stratify nutritional status, and identify patients with a poor nutritional status (at risk of malnutrition or malnourished, MNA <24). Multiple logistic regression analyses were performed between MNA and each sarcopenia definition adjusted for confounders. RESULTS Among the 938 patients with DXA data, a total of 809 (86.2 %) subjects were included in the analysis (mean age 81.8 ± 6.9 years, 527 females (65.1 %)). Prevalence of sarcopenia ranged from 12.6 % to 44.9 %, according to various definitions. Overall 244 (30.2 %) of the patients had a poor nutritional status (MNA-score <24), Baumgartner and Newman definitions of sarcopenia were both associated with low MNA-scores (OR = 4.69, CI 3.15-6.98 and OR = 2.30, CI 1.55-3.14, respectively), EWGSOP2 "confirmed sarcopenia" definition was also associated with low MNA-scores (OR = 3.68, CI 2.30-5.89), as well as for the lean mass definition according EWGSOP2 cut-off (OR 5.22 CI 3.52-7.73). Both FNIH and EWGSOP2 "probable sarcopenia" definitions were not associated with the risk of malnutrition. CONCLUSIONS In this study, the prevalence of sarcopenia ranged from 12.6 to 44.9 % according to various definitions. A score of MNA under 24, was associated with almost all of the sarcopenia definitions. This study reinforces the concept that malnutrition and sarcopenia are strictly related. When facing malnutrition in daily clinical practice, body composition should be assessed and the proposed nutritional intervention should be tailored by these results in order to prevent the onset of late-life disability.
Collapse
Affiliation(s)
- L Calcaterra
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France; Division of Subacute Care, IRCCS, Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - G Abellan van Kan
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France.
| | - Z Steinmeyer
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France
| | - D Angioni
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France
| | - M Proietti
- Division of Subacute Care, IRCCS, Istituti Clinici Scientifici Maugeri, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - S Sourdet
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France
| |
Collapse
|
18
|
Demarest-Litchford M, Munoz N, Strange N, Casirati A, Cereda E. The Impact of Malnutrition on Skin Integrity and Wound Healing. Adv Skin Wound Care 2024; 37:126-135. [PMID: 38393703 DOI: 10.1097/asw.0000000000000107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
GENERAL PURPOSE To recognize valuable resources from the Malnutrition Quality Improvement Initiative for acute care patients and malnutrition quality improvement measures for postacute care residents. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant will:1. Distinguish the prevalence of malnutrition among acute care patients.2. Explain the assessment guidelines for identifying malnutrition.3. Identify the resources available for measuring malnutrition quality improvement.
Collapse
|
19
|
Ertuglu L, Ikizler TA. Nutrition Management in Geriatric Patients with CKD. KIDNEY360 2024; 5:310-319. [PMID: 38297445 PMCID: PMC10914191 DOI: 10.34067/kid.0000000000000364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024]
Abstract
Sarcopenia, defined as age-related decline in skeletal muscle mass and functional capacity, is a hallmark nutritional abnormality observed in patients with moderate-to-advanced CKD. Uremic state and associated medical conditions also predispose older patients with CKD to protein-energy wasting, a nutritional abnormality that could include sarcopenia. Prevention of protein and energy depletion and replenishing the already low nutritional reserves elderly patients with CKD should focus on conventional and innovative strategies. This review aims to provide an overview of the mainstay of nutritional therapy in this patient population, such as intake of adequate amounts of protein and energy along with preserving fluid, electrolyte, and mineral balance, and to discuss more innovative interventions to aid these approaches.
Collapse
Affiliation(s)
- Lale Ertuglu
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | | |
Collapse
|
20
|
Bahat G, Ozkok S. The Current Landscape of Pharmacotherapies for Sarcopenia. Drugs Aging 2024; 41:83-112. [PMID: 38315328 DOI: 10.1007/s40266-023-01093-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 02/07/2024]
Abstract
Sarcopenia is a skeletal muscle disorder characterized by progressive and generalized decline in muscle mass and function. Although it is mostly known as an age-related disorder, it can also occur secondary to systemic diseases such as malignancy or organ failure. It has demonstrated a significant relationship with adverse outcomes, e.g., falls, disabilities, and even mortality. Several breakthroughs have been made to find a pharmaceutical therapy for sarcopenia over the years, and some have come up with promising findings. Yet still no drug has been approved for its treatment. The key factor that makes finding an effective pharmacotherapy so challenging is the general paradigm of standalone/single diseases, traditionally adopted in medicine. Today, it is well known that sarcopenia is a complex disorder caused by multiple factors, e.g., imbalance in protein turnover, satellite cell and mitochondrial dysfunction, hormonal changes, low-grade inflammation, senescence, anorexia of aging, and behavioral factors such as low physical activity. Therefore, pharmaceuticals, either alone or combined, that exhibit multiple actions on these factors simultaneously will likely be the drug of choice to manage sarcopenia. Among various drug options explored throughout the years, testosterone still has the most cumulated evidence regarding its effects on muscle health and its safety. A mas receptor agonist, BIO101, stands out as a recent promising pharmaceutical. In addition to the conventional strategies (i.e., nutritional support and physical exercise), therapeutics with multiple targets of action or combination of multiple therapeutics with different targets/modes of action appear to promise greater benefit for the prevention and treatment of sarcopenia.
Collapse
Affiliation(s)
- Gulistan Bahat
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey.
| | - Serdar Ozkok
- Division of Geriatrics, Department of Internal Medicine, Hatay Training and Research Hospital, Hatay, 31040, Turkey
| |
Collapse
|
21
|
Ispoglou T, McCullough D, Windle A, Nair S, Cox N, White H, Burke D, Kanatas A, Prokopidis K. Addressing cancer anorexia-cachexia in older patients: Potential therapeutic strategies and molecular pathways. Clin Nutr 2024; 43:552-566. [PMID: 38237369 DOI: 10.1016/j.clnu.2024.01.009] [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: 11/03/2022] [Revised: 01/04/2024] [Accepted: 01/10/2024] [Indexed: 02/03/2024]
Abstract
Cancer cachexia (CC) syndrome, a feature of cancer-associated muscle wasting, is particularly pronounced in older patients, and is characterised by decreased energy intake and upregulated skeletal muscle catabolic pathways. To address CC, appetite stimulants, anabolic drugs, cytokine mediators, essential amino acid supplementation, nutritional counselling, cognitive behavioural therapy, and enteral nutrition have been utilised. However, pharmacological treatments that have also shown promising results, such as megestrol acetate, anamorelin, thalidomide, and delta-9-tetrahydrocannabinol, have been associated with gastrointestinal and cardiovascular complications. Emerging evidence on the efficacy of probiotics in modulating gut microbiota also presents a promising adjunct to traditional therapies, potentially enhancing nutritional absorption and systemic inflammation control. Additionally, low-dose olanzapine has demonstrated improved appetite and weight management in older patients undergoing chemotherapy, offering a potential refinement to current therapeutic approaches. This review aims to elucidate the molecular mechanisms underpinning CC, with a particular focus on the role of anorexia in exacerbating muscle wasting, and to propose pharmacological and non-pharmacological strategies to mitigate this syndrome, particularly emphasising the needs of an older demographic. Future research targeting CC should focus on refining appetite-stimulating drugs with fewer side-effects, specifically catering to the needs of older patients, and investigating nutritional factors that can either enhance appetite or minimise suppression of appetite in individuals with CC, especially within this vulnerable group.
Collapse
Affiliation(s)
| | | | - Angela Windle
- Department of Nursing and Midwifery, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK; School of Medicine, University of Leeds, Leeds, UK
| | | | - Natalie Cox
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Helen White
- School of Health, Leeds Beckett University, Leeds, UK
| | - Dermot Burke
- School of Medicine, University of Leeds, Leeds, UK
| | | | - Konstantinos Prokopidis
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK; Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK
| |
Collapse
|
22
|
Ma YC, Ju YM, Cao MY, Yang D, Zhang KX, Liang H, Leng JY. Exploring the relationship between malnutrition and the systemic immune-inflammation index in older inpatients: a study based on comprehensive geriatric assessment. BMC Geriatr 2024; 24:19. [PMID: 38178005 PMCID: PMC10768166 DOI: 10.1186/s12877-023-04604-8] [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: 08/18/2023] [Accepted: 12/15/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Malnutrition is a prevalent and major challenge among senior citizens, possibly due to the continual low-grade inflammatory state of the body. A novel inflammatory parameter, the systemic immune-inflammation index (SII), is highly valuable in evaluating and predicting the prognosis of a wide range of diseases. This study aims to explore the significance of the SII in assessing malnutrition in older inpatients. METHODS This retrospective study included 500 senior hospitalized patients who met the inclusion and exclusion criteria from the Comprehensive Geriatric Assessment database of the First Hospital of Jilin University. The Mini-Nutritional Assessment (MNA) questionnaire was used to evaluate the nutritional status of patients. The SII was calculated using complete blood counts, and we performed natural logarithm transformation of the SII [ln(SII)]. Multivariable logistic regression analysis was used to identify the association between ln(SII) and malnutrition. To ensure the stability of the findings, a sensitivity analysis was conducted. RESULTS The 500 patients had a mean age of 77.29 ± 9.85 years, and 68.6% were male. In accordance with the MNA, 30.4% of the patients were malnourished or at risk of malnutrition, and patients in this group had considerably greater levels of ln(SII) than patients with adequate nutrition (P < 0.001). The optimum ln(SII) cutoff value for patients with malnutrition or at risk of malnutrition was 6.46 (SII = 635.87) with 46.7% sensitivity and 80.2% specificity [95% CI: 0.613-0.721, AUC: 0.667, P < 0.001]. Multivariable logistic regression demonstrated that ln(SII) was an independent risk factor for the risk of malnutrition or malnutrition in older individuals (OR 3.984, 95% CI: 2.426-6.543, P < 0.001). Other metrics from the geriatric comprehensive assessment, including body mass index, calf circumference, fat ratio, activities of daily living and instrumental activities of daily living, and geriatric depression scale scores, were also independently correlated with nutritional status. CONCLUSIONS According to our research, a high SII is an independent predictor of older inpatient malnutrition, and the SII aids in screening for malnutrition and may be a potential target for intervention. Comprehensive geriatric assessment parameters such as BMI, calf circumference, fat ratio, activities of daily living and depression were also linked to malnutrition.
Collapse
Affiliation(s)
- Yu-Cen Ma
- Department of Cadre Ward, The First Hospital of Jilin University, Changchun, 130021, China
| | - Yan-Min Ju
- Department of Cadre Ward, The First Hospital of Jilin University, Changchun, 130021, China
| | - Meng-Yu Cao
- Department of Cadre Ward, The First Hospital of Jilin University, Changchun, 130021, China
| | - Di Yang
- Department of Cadre Ward, The First Hospital of Jilin University, Changchun, 130021, China
| | - Ke-Xin Zhang
- Department of Cadre Ward, The First Hospital of Jilin University, Changchun, 130021, China
| | - Hong Liang
- Department of Cadre Ward, The First Hospital of Jilin University, Changchun, 130021, China
| | - Ji-Yan Leng
- Department of Cadre Ward, The First Hospital of Jilin University, Changchun, 130021, China.
| |
Collapse
|
23
|
Aprahamian I, Coats AJ, Morley JE, Klompenhouwer T, Anker SD. Anorexia of aging: An international assessment of healthcare providers' knowledge and practice gaps. J Cachexia Sarcopenia Muscle 2023; 14:2779-2792. [PMID: 37897129 PMCID: PMC10751437 DOI: 10.1002/jcsm.13355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/07/2023] [Accepted: 09/19/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Anorexia of aging is a common geriatric syndrome that includes loss of appetite and/or reduced food intake, with associated undernutrition, unintended weight loss, sarcopenia, functional decline, loss of independence and other adverse health outcomes. Anorexia of aging can have multiple and severe consequences and is often overlooked by healthcare professionals (HCPs). Even more concerningly, clinicians commonly accept anorexia of aging as an inevitable part of 'normal' aging. The aim of this assessment was to identify current gaps in professional knowledge and practice in identifying and managing older persons with anorexia. Results may guide educational programmes to fill the gaps identified and therefore improve patient outcomes. METHODS This international assessment was conducted using a mixed-methods approach, including focus group interviews with subject matter experts and an electronic survey of practicing HCPs. The assessment was led by the Society on Sarcopenia, Cachexia and Wasting Disorders (SCWD) and was supported by in-country collaborating organizations. RESULTS A quantitative survey of 26 multiple-choice questions was completed by physicians, dietitians and other HCPs (n = 1545). Most HCPs (56.8%) recognize a consistent definition of anorexia of aging as a loss of appetite and/or low food intake. Cognitive changes/dementia (91%) and dysphagia (87%) are seen as the biggest risk factors. Most respondents were confident to give nutritional (62%) and physical activity (59.4%) recommendations and engaged caregivers such as family members in supporting older adults with anorexia (80.6%). Most clinicians assessed appetite at each visit (66.7%), although weight is not measured at every visit (41.5%). Apart from the Mini-Nutritional Assessment Short Form (39%), other tools to screen for appetite loss are not frequently used or no tools are used at all (29.4%). A high number of respondents (38.7%) believe that anorexia is a normal part of aging. Results show that treatment is focused on swallowing disorders (78%), dentition issues (76%) and increasing oral intake (fortified foods [75%] and oral nutritional supplements [74%]). Nevertheless, the lack of high-quality evidence is perceived as a barrier to optimal treatment (49.2%). CONCLUSIONS Findings from this international assessment highlight the challenges in the care of older adults with or at risk for anorexia of aging. Identifying professional practice gaps between individual HCPs and team-based gaps can provide a basis for healthcare education that is addressed at root causes, targeted to specific audiences and developed to improve individual and team practices that contribute to improving patient outcomes.
Collapse
Affiliation(s)
- Ivan Aprahamian
- Division of Geriatrics, Department of Internal MedicineJundiaí Medical SchoolJundiaíBrazil
| | | | - John E. Morley
- Division of Geriatrics, Department of MedicineSaint Louis UniversitySt. LouisMissouriUSA
| | | | - Stefan D. Anker
- Department of Cardiology (CVK) of German Heart Center Charité, Institute of Health Center for Regenerative Therapies (BCRT)German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité UniversitätsmedizinBerlinGermany
- Institute of Heart DiseasesWroclaw Medical UniversityWroclawPoland
| | | |
Collapse
|
24
|
Sable-Morita S, Sugiura S, Suzuki H, Fukuoka H, Matsui Y, Arai H. Frailty and visual, auditory, olfactory, and taste senses in older patients visiting a frailty outpatient clinic. Geriatr Gerontol Int 2023; 23:871-876. [PMID: 37789678 DOI: 10.1111/ggi.14674] [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: 03/19/2023] [Revised: 08/05/2023] [Accepted: 09/03/2023] [Indexed: 10/05/2023]
Abstract
AIM Although studies have analyzed the relationship between frailty and human senses, few have comprehensively evaluated and examined their correlations. This study aimed to clarify the relationship between frailty and the senses of sight, hearing, smell, and taste. METHODS The subjects were outpatients at the Locomo Frail Outpatient Clinic. Sensory organ items were evaluated subjectively, and frailty was classified as nonfrail or frail using the Kihon Checklist. Univariate analysis was performed using the presence or absence of frailty as the dependent variable. Logistic regression analysis (forced entry method) was performed for the variables that showed significant differences. RESULTS A total of 269 and 226 participants were assigned to the nonfrail and frail groups, respectively. The frequency of sensory organ impairment was 10.1% for taste, 12.7% for smell, 44.6% for vision, and 58.3% for hearing. Univariate analysis using the presence or absence of frailty as the dependent variable was determined to be significant for years of education, number of medications, Geriatric Depression Scale, Mini-Mental State Examination, Mini Nutritional Assessment-Short Form, grip strength, gait speed, sense of taste, sense of smell, sense of vision, and sense of hearing. Logistic regression analysis using the presence or absence of frailty as the dependent variable, adjusted for age, showed significant correlations with the Geriatric Depression Scale, gait speed, Mini Nutritional Assessment-Short Form, and olfactory impairment. CONCLUSIONS Olfactory impairment had the strongest correlation with frailty. Although the sense of smell decreases with disease and aging, olfactory impairment may be correlated with frailty as a symptom of neurodegenerative diseases. Geriatr Gerontol Int 2023; 23: 871-876.
Collapse
Affiliation(s)
- Sayuri Sable-Morita
- Department of Nursing, National Center for Geriatrics and Gerontology, Obu-shi, Japan
| | - Saiko Sugiura
- Kariya Hearing Clinic, Kariya-shi, Japan
- Department of Otolaryngology, National Center for Geriatrics and Gerontology, Obu-shi, Japan
| | - Hirokazu Suzuki
- Department of Otolaryngology, National Center for Geriatrics and Gerontology, Obu-shi, Japan
| | - Hideki Fukuoka
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto-shi, Japan
| | - Yasumoto Matsui
- Center for Locomo-Frail, National Center for Geriatrics and Gerontology, Obu-shi, Japan
| | - Hidenori Arai
- Office of the President, National Center for Geriatrics and Gerontology, Obu-shi, Japan
| |
Collapse
|
25
|
Chen H, Avgerinou C. Association of Alternative Dietary Patterns with Osteoporosis and Fracture Risk in Older People: A Scoping Review. Nutrients 2023; 15:4255. [PMID: 37836538 PMCID: PMC10574803 DOI: 10.3390/nu15194255] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 10/15/2023] Open
Abstract
PURPOSE Although the Mediterranean diet has been associated with a lower risk of hip fracture, the effect of other dietary patterns on bone density and risk of fracture is unknown. This scoping review aims to investigate the association between adherence to alternative dietary patterns (other than the traditional Mediterranean diet) and osteoporosis or osteoporotic fracture risk in older people. METHODS A systematic search was carried out on three electronic databases (Medline, EMBASE, and Scopus) to identify original papers studying the association between alternative dietary patterns (e.g., Baltic Sea Diet (BSD), modified/alternative Mediterranean diet in non-Mediterranean populations, Dietary Approaches to Stop Hypertension (DASH)) assessed using 'prior' methods (validated scores) and the risk of osteoporotic fracture or Bone Mineral Density (BMD) in people aged ≥50 (or reported average age of participants ≥ 60). Results from the included studies were presented in a narrative way. RESULTS Six observational (four prospective cohort and two cross-sectional) studies were included. There was no significant association between BMD and BSD or DASH scores. Higher adherence to DASH was associated with a lower risk of lumbar spine osteoporosis in women in one study, although it was not associated with the risk of hip fracture in another study with men and women. Higher adherence to aMED (alternative Mediterranean diet) was associated with a lower risk of hip fracture in one study, whereas higher adherence to mMED (modified Mediterranean diet) was associated with a lower risk of hip fracture in one study and had no significant result in another study. However, diet scores were heterogeneous across cohort studies. CONCLUSIONS There is some evidence that a modified and alternative Mediterranean diet may reduce the risk of hip fracture, and DASH may improve lumbar spine BMD. Larger cohort studies are needed to validate these findings.
Collapse
Affiliation(s)
- Huiyu Chen
- Division of Medicine, University College London, London WC1E 6BT, UK;
| | - Christina Avgerinou
- Department of Primary Care and Population Health, University College London, London NW3 2PF, UK
| |
Collapse
|
26
|
Niskanen RT, Reinders I, Wijnhoven HAH, Hyvönen AA, Pols-Vrijmoeth M, Trommel-Bout M, Visser M, Pitkälä KH, Suominen MH, Öhman H, Jyväkorpi SK. The feasibility of a 6-month dietary intervention aiming to increase protein intake among community-dwelling older adults with low habitual protein intake: A secondary analysis of the PROMISS randomised controlled trial. J Hum Nutr Diet 2023; 36:1811-1820. [PMID: 37347495 DOI: 10.1111/jhn.13197] [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: 11/28/2022] [Accepted: 06/05/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND The PROMISS randomised controlled trial showed that personalised dietary advice increased protein intake and improved 400-m walk time and leg strength among community-dwelling older adults with a low habitual protein intake. This secondary analysis describes and further evaluates the methods and feasibility of the model used to carry out dietary intervention in the PROMISS randomised controlled trial. METHODS In total, 185 participants (≥65 years, 54% women) with a habitual low protein intake (<1.0 g/kg adjusted body weight/day) in Finland and the Netherlands received personalised dietary advice and complimentary protein-enriched food products for 6 months with two main objectives: (1) to increase protein intake to ≥1.2 g/kg adjusted body weight/day (energy-neutral) and (2) to include each day a 'high-protein meal' containing ≥ 30-35 g of protein. The feasibility of the model was evaluated by the adoption of the advice, feedback from the participants, and practical experiences by the nutritionists. RESULTS In all, 174 participants (93.5%) completed the intervention. At the 6-month follow-up, 41.8% reached both main objectives of the advice. The participants' general rating for the dietary advice was 8.6 (SD 1.0) (on a scale of 1-10; 10 indicating very good). Sticking to the advice was (very) easy for 79.2% of the participants. The nutritionists perceived the model feasible for the participants except for those with low food intake. CONCLUSIONS The methods used in this model are mainly feasible, well-received and effective in increasing protein intake among community-dwelling older adults with low habitual protein intake.
Collapse
Affiliation(s)
- Riikka T Niskanen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Ilse Reinders
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Aliisa A Hyvönen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Merel Pols-Vrijmoeth
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mariska Trommel-Bout
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kaisu H Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Central Hospital (HUCH), Helsinki, Finland
| | - Merja H Suominen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Central Hospital (HUCH), Helsinki, Finland
| | - Hanna Öhman
- Geriatric Medicine, University of Helsinki (UH) and Helsinki University Central Hospital (HUCH), Helsinki, Finland
| | - Satu K Jyväkorpi
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Central Hospital (HUCH), Helsinki, Finland
| |
Collapse
|
27
|
Dericioglu D, Oldham S, Methven L, Shafat A, Clegg ME. Macronutrients effects on satiety and food intake in older and younger adults: A randomised controlled trial. Appetite 2023; 189:106982. [PMID: 37507052 DOI: 10.1016/j.appet.2023.106982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/07/2023] [Accepted: 07/24/2023] [Indexed: 07/30/2023]
Abstract
Older adults are advised to increase their protein intake to maintain their muscle mass. However, protein is considered the most satiating macronutrient and this recommendation may cause a decrease in total energy intake. To date, satiety studies comparing all three macronutrients have been undertaken in young adults, and it is unclear if the same response is seen in older adults. The objective of this study was to compare the effect of preloads high in protein, fat, and carbohydrate but equal in energy (∼300 kcal) and volume (250 ml) on energy intake, perceived appetite, and gastric emptying in younger and older adults. Twenty older and 20 younger adults completed a single-blinded randomised crossover trial involving three study visits. Participants consumed a standard breakfast, followed by a preload milkshake high in either carbohydrate, fat, or protein. Three hours after the preload, participants were offered an ad libitum meal to assess food intake. Visual analogue scales were used to measure perceived appetite and gastric emptying was measured via the 13C-octanoic acid breath test. There was no significant effect of preload type or age on energy intake either at the ad libitum meal, self-recorded food intake for the rest of the test day or subjective appetite ratings. There was a significant effect of preload type on gastric emptying latency phase and ascension time, and an effect of age on gastric emptying latency and lag phase such that older adults had faster emptying. In conclusion, energy intake, and perceived appetite were not affected by macronutrient content of the preloads in both younger and older adults, but gastric emptying times differed.
Collapse
Affiliation(s)
- Dilara Dericioglu
- Hugh Sinclair Human of Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, RG6 6DZ, UK; Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading, RG6 6EU, UK.
| | - Stephanie Oldham
- Hugh Sinclair Human of Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, RG6 6DZ, UK; Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading, RG6 6EU, UK.
| | - Lisa Methven
- Food Research Group, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, RG6 6DZ, UK; Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading, RG6 6EU, UK.
| | - Amir Shafat
- Physiology, School of Medicine, University of Galway, Galway, H91 W5P7, Ireland.
| | - Miriam E Clegg
- Hugh Sinclair Human of Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, RG6 6DZ, UK; Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading, RG6 6EU, UK.
| |
Collapse
|
28
|
Mhalhel K, Briglia M, Aragona M, Porcino C, Abbate F, Guerrera MC, Laurà R, Krichen Y, Guerbej H, Germanà A, Levanti M, Montalbano G. Nothobranchius as a model for anorexia of aging research: an evolutionary, anatomical, histological, immunohistochemical, and molecular study. Ann Anat 2023; 250:152116. [PMID: 37302430 DOI: 10.1016/j.aanat.2023.152116] [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: 03/23/2023] [Revised: 05/28/2023] [Accepted: 05/29/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Anorexia of aging, defined as a decrease in appetite and a preponderant loss of body weight occurring in late life, is one of the most common diseases affecting older people. The peptide hormone cholecystokinin (Cck) is known to play a key role in regulating food intake and satiety in higher vertebrates. In humans as well as in rats, an increased concentration of Cck was described as the basis of appetite loss in elderly. However, the role of increased plasma Cck concentrations in mediating the age-related decrease in appetite remains to be established. Although in vitro studies are an excellent resource for investigating aging, the use of a model organism that shares and imitates the human physiological processes guarantees a better understanding of the in vivo mechanisms. African annual fishes from the genus Nothobranchius are emerging as a prominent model organism in biogerontology and developmental biology due to their short captive lifespan. Therefore, in the current study, we aimed to investigate the possibility of using the genus Nothobranchius to model the anorexia of aging and their potential contribution to better understanding the pathway by which Cck induce appetite loss in older people providing a comparative/evolutionary localization of the current study model among the aging canonicals models, the morphology of its gastrointestinal tract and its Cck expression pattern. METHODS The comparative/evolutionary investigation was conducted using the NCBI blastp (protein-protein BLAST) and NCBI Tree Viewer. The macroscopic morphology, histological features, ultrastructural organization of Nothobranchius rachovii gastrointestinal tract were investigated using stereomicroscope, Masson's trichrome and alcian blue-PAS staining, and transmission electron microscopy, respectively. The cck expression pattern was studied through immunofluorescence labeling, western blotting, and quantitative RT-PCR. RESULTS The intestine was folded into different segments divided into an anterior intestine made of a rostral intestinal bulb and an intestinal annex of lower diameter, mid and posterior intestine. The gradual transition from the rostral intestinal bulb to the posterior intestine sections's epithelium is characterized by a gradual reduction in the striated muscular bundles, villi height, and goblet mucous cells count. The lining epithelium of the intestinal villi was characterized by a typical brush border enterocytes full of mitochondria. Moreover, Cck expression was detected in scattered intraepithelial cells concentrated in the anterior tract of the intestine. CONCLUSIONS Our study introduces Nothobranchius rachovii as a model for anorexia of aging, giving the first bases on the gastrointestinal tract morphology and cck expression pattern. Future studies on young and elderly Notobranchius can divulge the contribution of cck in the mechanisms of anorexia associated with aging.
Collapse
Affiliation(s)
- Kamel Mhalhel
- Zebrafish Neuromorphology Lab, Department of Veterinary Sciences, University of Messina, Via G. Palatucci snc, 98168 Messina, Italy.
| | - Marilena Briglia
- Zebrafish Neuromorphology Lab, Department of Veterinary Sciences, University of Messina, Via G. Palatucci snc, 98168 Messina, Italy
| | - Marialuisa Aragona
- Zebrafish Neuromorphology Lab, Department of Veterinary Sciences, University of Messina, Via G. Palatucci snc, 98168 Messina, Italy
| | - Caterina Porcino
- Zebrafish Neuromorphology Lab, Department of Veterinary Sciences, University of Messina, Via G. Palatucci snc, 98168 Messina, Italy
| | - Francesco Abbate
- Zebrafish Neuromorphology Lab, Department of Veterinary Sciences, University of Messina, Via G. Palatucci snc, 98168 Messina, Italy
| | - Maria Cristina Guerrera
- Zebrafish Neuromorphology Lab, Department of Veterinary Sciences, University of Messina, Via G. Palatucci snc, 98168 Messina, Italy
| | - Rosaria Laurà
- Zebrafish Neuromorphology Lab, Department of Veterinary Sciences, University of Messina, Via G. Palatucci snc, 98168 Messina, Italy
| | | | - Hamadi Guerbej
- National Institute of Marine Sciences and Technologies, 5000 Monastir, Tunisia
| | - Antonino Germanà
- Zebrafish Neuromorphology Lab, Department of Veterinary Sciences, University of Messina, Via G. Palatucci snc, 98168 Messina, Italy
| | - Maria Levanti
- Zebrafish Neuromorphology Lab, Department of Veterinary Sciences, University of Messina, Via G. Palatucci snc, 98168 Messina, Italy
| | - Giuseppe Montalbano
- Zebrafish Neuromorphology Lab, Department of Veterinary Sciences, University of Messina, Via G. Palatucci snc, 98168 Messina, Italy
| |
Collapse
|
29
|
Delaire L, Courtay A, Humblot J, Aubertin-Leheudre M, Mourey F, Racine AN, Gilbert T, Niasse-Sy Z, Bonnefoy M. Implementation and Core Components of a Multimodal Program including Exercise and Nutrition in Prevention and Treatment of Frailty in Community-Dwelling Older Adults: A Narrative Review. Nutrients 2023; 15:4100. [PMID: 37836384 PMCID: PMC10574358 DOI: 10.3390/nu15194100] [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: 07/31/2023] [Revised: 09/08/2023] [Accepted: 09/18/2023] [Indexed: 10/15/2023] Open
Abstract
Increasing disability-free life expectancy is a crucial issue to optimize active ageing and to reduce the burden of evitable medical costs. One of the main challenges is to develop pragmatic and personalized prevention strategies in order to prevent frailty, counteract adverse outcomes such as falls and mobility disability, and to improve quality of life. Strong evidence reports the effectiveness of exercise interventions to improve various physical parameters and muscle function that are cornerstones of frailty. Other findings also suggest that the interactions between nutrition and physical exercise with or without health behavior promotion prevent the development of frailty. Multimodal programs, including structured exercise, adequate dietary intervention and health behavior promotion, appear increasingly consensual. However, in order for implementation in real-life settings, some pitfalls need to be addressed. In this perspective, structuring and tailoring feasible, acceptable and sustainable interventions to optimize exercise training responses are essential conditions to warrant short, medium and long-term individual benefits. The different components of exercise programs appear to be fairly consensual and effective. However, specific composition of the programs proposed (frequency, intensity, type, time, volume and progressiveness) have to be tailored to individual characteristics and objectives in order to improve exercise responses. The intervention approaches, behavioral strategies and indications for these programs also need to be refined and framed. The main objective of this work is to guide the actions of healthcare professionals and enable them to widely and effectively implement multimodal programs including exercise, nutrition and behavioral strategies in real-life settings.
Collapse
Affiliation(s)
- Leo Delaire
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Aymeric Courtay
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Joannès Humblot
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Mylène Aubertin-Leheudre
- Centre de Recherche de L’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W5, Canada;
- Groupe de Recherche en Activité Physique Adaptée, Département des Sciences de l’Activité Physique, Université du Québec à Montréal (UQÀM), Montréal, QC H2L 2C4, Canada
| | - France Mourey
- Laboratoire CAPS (Cognition, Action, et Plasticité Sensorimotrice), Inserm U1093, UFR STAPS, Université de Bourgogne, Campus Universitaire, BP 27877, 21078 Dijon, France;
| | | | - Thomas Gilbert
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- RESHAPE Research on Healthcare Professionals and Performance, Inserm U1290, Université Claude Bernard Lyon 1, 69008 Lyon, France
| | - Zeinabou Niasse-Sy
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Marc Bonnefoy
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- Inserm U1060-CarMeN, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| |
Collapse
|
30
|
Chan AKY, Tsang YC, Jiang CM, Leung KCM, Lo ECM, Chu CH. Diet, Nutrition, and Oral Health in Older Adults: A Review of the Literature. Dent J (Basel) 2023; 11:222. [PMID: 37754342 PMCID: PMC10528506 DOI: 10.3390/dj11090222] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/07/2023] [Accepted: 09/18/2023] [Indexed: 09/28/2023] Open
Abstract
Diet, nutrition, and oral health are closely linked. Malnutrition is a challenging health concern in older adults that is associated with physical decline affecting their daily activities and quality of life. The aim of this review is to provide an evidence-based summary of the relationship between diet and nutrition and oral health in older adults and its implications. The World Health Organization has declared healthy ageing a priority of its work on ageing. The American Dental Association confirmed the bidirectional relationship between diet and nutrition and oral health. The literature shows that diet and nutrition are related to oral diseases, including dental caries, periodontal diseases, tooth wear, and even oral cancer. Insufficient nutritional intake and poor dietary habits increase the risk of oral diseases, such as dental caries, in older adults. On the other hand, in older adults, poor oral conditions such as periodontal disease may induce pain, infection, and tooth loss, affecting nutritional intake. Surveys have shown that older adults, in particular, those in disadvantaged communities, suffered from nutritional deficiencies or imbalances affecting their oral health. In addition, the current literature shows that malnutrition is associated with frailty, hospitalization, mortality, and morbidity. Good oral health and functional dentition are essential to maintain sufficient nutritional intake among older adults and reduce the risk of malnutrition. Therefore, integrating oral health into general health care service in older adults is imperative to improve their nutritional and oral health status to achieve healthy ageing.
Collapse
Affiliation(s)
| | | | | | | | | | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong 999077, China; (A.K.Y.C.); (Y.C.T.); (C.M.J.); (K.C.M.L.); (E.C.M.L.)
| |
Collapse
|
31
|
Nielsen RL, Bornaes O, Storgaard IK, Kallemose T, Jørgensen LM, Jawad BN, Altintas I, Juul-Larsen HG, Tavenier J, Durhuus JA, Bengaard AKP, Holst JJ, Kolko M, Sonne DP, Breindahl T, Damgaard M, Porrini E, Hornum M, Andersen O, Pedersen MM, Rasmussen HH, Munk T, Lund TM, Jensen PS, Andersen AL, Houlind MB. Appetite stimulation with cannabis-based medicine and methods for assessment of glomerular filtration in older patients with medical illness: A study protocol. Basic Clin Pharmacol Toxicol 2023; 133:237-253. [PMID: 37314893 DOI: 10.1111/bcpt.13914] [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: 02/03/2023] [Revised: 05/05/2023] [Accepted: 06/07/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND AIM Malnutrition in older patients is linked to poor appetite. Cannabis-based medicine may have orexigenic properties in older patients, but this has to our knowledge never been investigated. In older patients, uncertainty applies to the accuracy of estimated glomerular filtration rate (eGFR) based on creatinine, which is crucial for medication prescribing. In older patients with poor appetite, the study aims (1) to assess the efficacy of Sativex® (8.1-mg delta-9-tetrahydrocannabinol [THC] and 7.5-mg cannabidiol [CBD]) to stimulate appetite and (2) to compare the performance of various GFR-estimates and measured-GFR (mGFR) for determining gentamicin clearance utilizing population pharmacokinetic (popPK) modelling methods. METHODS AND OBJECTIVES This study is composed of two substudies. Substudy 1 is an investigator-initiated single-center, double-blinded, randomized, placebo-controlled, superiority, cross-over study. Substudy 1 will recruit 17 older patients with poor appetite, who will also be invited to substudy 2. Substudy 2 is a single-dose pharmacokinetics study and will recruit 55 patients. Participants will receive Sativex® and placebo in substudy 1 and gentamicin with simultaneous measurements of GFR in substudy 2. The primary endpoints are as follows: Substudy 1-the difference in energy intake between Sativex® and placebo conditions; substudy 2- the accuracy of different eGFR equations compared to mGFR. The secondary endpoints include safety parameters, changes in the appetite hormones, total ghrelin and GLP-1 and subjective appetite sensations, and the creation of popPK models of THC, CBD, and gentamicin.
Collapse
Affiliation(s)
- R L Nielsen
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - O Bornaes
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - I K Storgaard
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - T Kallemose
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - L M Jørgensen
- Emergency Department, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - B N Jawad
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - I Altintas
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Emergency Department, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - H G Juul-Larsen
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - J Tavenier
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - J A Durhuus
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Cellular and Molecular Medicine, Center for Healthy Aging, Copenhagen, Denmark
| | - A K P Bengaard
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - J J Holst
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M Kolko
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
| | - D P Sonne
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Pharmacology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - T Breindahl
- Department of Clinical Biochemistry, North Denmark Regional Hospital, Hjørring, Denmark
| | - M Damgaard
- Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - E Porrini
- Laboratory of Renal Function (LFR), Faculty of Medicine, University of La Laguna, La Laguna, Spain
| | - M Hornum
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Nephrology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - O Andersen
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Emergency Department, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - M M Pedersen
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - H H Rasmussen
- Center for Nutrition and Intestinal Failure, Aalborg University Hospital, Aalborg University, Aalborg, Denmark
- The Dietitians and Nutritional Research Unit, EATEN, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - T Munk
- The Dietitians and Nutritional Research Unit, EATEN, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - T M Lund
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - P S Jensen
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Orthopeadic Surgery, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - A L Andersen
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M B Houlind
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
- The Hospital Pharmacy, Herlev, Denmark
| |
Collapse
|
32
|
Vaudin A, Dean W, Chen J, Sahyoun NR. Service Awareness Among Older Adults Experiencing Barriers to Food and Eating. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:564-574. [PMID: 37389500 DOI: 10.1016/j.jneb.2023.04.005] [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: 08/04/2022] [Revised: 04/06/2023] [Accepted: 04/24/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVE To explore (1) the services older adults use to address the barriers to food access they face and (2) how they found out about these services. DESIGN Semistructured, basic descriptive qualitative in-person interviews. SETTING Senior center and participants' homes. PARTICIPANTS A convenience sample of 24 older adults recruited from suburban and urban settings. Primarily Black females, living alone, and able to leave home without help. PHENOMENON OF INTEREST Financial and nonfinancial barriers to food access, awareness of services available. ANALYSIS Codes were assigned to portions of the text in which participants described how they learned about a service. These codes were categorized into one of the 3 larger themes that emerged: (1) intentionally sought by the participant, (2) intentional outreach by the service, and (3) encounters in daily life and environment. RESULTS Most connections to services were made through encounters in participants' daily life and environment; for example, word of mouth from family, friends or neighbors; connection through other services; referral from health care professionals; and seeing the service in their neighborhood. CONCLUSIONS AND IMPLICATIONS Robust social networks, medical screening, and referral may promote awareness of food assistance services. Future research and outreach should target those who are most isolated.
Collapse
Affiliation(s)
- Anna Vaudin
- Department of Nutrition and Food Science, University of Maryland College Park, College Park, MD
| | - Wesley Dean
- Department of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark
| | - Jie Chen
- Department of Health Policy and Management, School of Public Health, University of Maryland College Park, College Park, MD
| | - Nadine R Sahyoun
- Department of Nutrition and Food Science, University of Maryland College Park, College Park, MD.
| |
Collapse
|
33
|
Pourhassan M, Cederholm T, Donini LM, Poggiogalle E, Schwab U, Nielsen RL, Andersen AL, Małgorzewicz S, Volkert D, Wirth R. Severity of Inflammation Is Associated with Food Intake in Hospitalized Geriatric Patients-A Merged Data Analysis. Nutrients 2023; 15:3079. [PMID: 37513497 PMCID: PMC10385000 DOI: 10.3390/nu15143079] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 06/29/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
The extent to which inflammation impacts food intake remains unclear, serving as a key risk factor for malnutrition as defined by the Global Leadership Initiative on Malnutrition (GLIM). To address this, we analyzed a large, merged dataset of geriatric hospitalized patients across Europe. The study included 1650 consecutive patients aged ≥65 year from Germany, Italy, Finland, Denmark, and Poland. Nutritional intake was assessed using the first item of the Mini Nutritional Assessment Short Form; C-reactive protein (CRP) levels were measured using standard procedures. In total (age 79.6 ± 7.4 year, 1047 females), 23% exhibited moderate to severe inflammation, and 12% showed severe inflammation; 35% showed moderate reductions in food intake, and 28% were considered malnourished. Median CRP levels differed significantly between patients with severe, moderate, and no decrease in food intake. Among patients with a CRP level of 3.0-4.99 mg/dL, 19% experienced a severe decrease in food intake, while 66% experienced moderate to severe decreases. Regression analysis revealed that inflammation was the most prominent risk factor for low food intake and malnutrition, surpassing other factors such as age, gender, infection, and comorbidity. A CRP level of ≥3.0 mg/dL is associated with reduced food intake during last 3 months in two thirds of hospitalized geriatric patients and therefore indicative for a high risk of malnutrition.
Collapse
Affiliation(s)
- Maryam Pourhassan
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, 44625 Herne, Germany
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, 75122 Uppsala, Sweden
- Theme Inflammation & Aging, Karolinska University Hospital, 14186 Stockholm, Sweden
| | - Lorenzo M Donini
- Department of Experimental Medicine, University of Rome "Sapienza", 00185 Rome, Italy
| | - Eleonora Poggiogalle
- Department of Experimental Medicine, University of Rome "Sapienza", 00185 Rome, Italy
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70210 Kuopio, Finland
| | - Rikke Lundsgaard Nielsen
- Department of Clinical Research, ACUTE-CAG, Copenhagen University Hospital, 2650 Hvidovre, Denmark
| | - Aino Leegaard Andersen
- Department of Clinical Research, ACUTE-CAG, Copenhagen University Hospital, 2650 Hvidovre, Denmark
| | - Sylwia Małgorzewicz
- Department of Clinical Nutrition, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Dorothee Volkert
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, 90403 Nuremberg, Germany
| | - Rainer Wirth
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, 44625 Herne, Germany
| |
Collapse
|
34
|
Chen LK. Unveiling the hidden epidemic: Anorexia of aging and nutritional decline in older adults. Arch Gerontol Geriatr 2023; 111:105064. [PMID: 37210787 DOI: 10.1016/j.archger.2023.105064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec 2, Shih-Pai Road, Taipei, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan.
| |
Collapse
|
35
|
Russell P, Thompson C, Mangoni AA. Rational Prescribing and Deprescribing of Antihypertensive Medications in Older People, a Three-Part Narrative Review, Part 3. Sr Care Pharm 2023; 38:168-178. [PMID: 37185147 DOI: 10.4140/tcp.n.2023.168] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
What happens when you stop? This is the third of a three-part series on antihypertensive medication use in older people. In the first, we reviewed the importance of better blood pressure (BP) control, even in older people with hypertension. In the second, we discussed the limitations of the evidence favoring intensive therapy for some older people. For older people with advanced frailty or those with a limited life expectancy, medications taken for BP can actually be a source of morbidity. Guidelines encourage clinical judgment and rational prescribing. Sometimes the best action is to stop prescribing. De-prescribing of medical therapy is now considered good practice for a range of medications for suitable patients; should this include antihypertensives? In part three of this three-part series, we will review some of the evidence available thus far, demonstrating de-intensification of antihypertensive medications is not a new idea. We will offer a guide to identifying the most suitable patients for de-prescribing: cognitive impairment, frailty, when circumstances change, or when BP is (too) well-controlled. This is an area of equipoise and needs more research. There is a path forward that we hope to illuminate.
Collapse
Affiliation(s)
- Patrick Russell
- 1 Department of Internal Medicine, Royal Adelaide Hospital, Adelaide, South Australia
| | - Campbell Thompson
- 2 University of Adelaide, Department of Medicine, Royal Adelaide Hospital, Adelaide, South Australia
| | - Arduino A Mangoni
- 3 Department of Clinical Pharmacology, Flinders University and Flinders Medical Centre, Bedford Park, South Australia
| |
Collapse
|
36
|
Siefkas AC, Millar CL, Dufour AB, Kiel DP, Jacques PF, Hannan MT, Sahni S. Dairy Food Intake Is Not Associated With Frailty in Adults From the Framingham Heart Study. J Acad Nutr Diet 2023; 123:729-739.e1. [PMID: 36108932 PMCID: PMC10652358 DOI: 10.1016/j.jand.2022.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/30/2022] [Accepted: 09/07/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Nutrients, including protein, calcium, and fat may be associated with risk of frailty, yet specific contributions from whole dairy foods rich in these nutrients remain understudied. OBJECTIVE To determine associations between dairy intake (milk, yogurt, cheese, total (milk + yogurt + cheese), low-fat and high-fat dairy, and servings per week) and frailty onset and frailty phenotype components. DESIGN Prospective cohort study. All dairy intake exposures (servings per week) were assessed via a food frequency questionnaire. PARTICIPANTS AND SETTING Participants (aged 33 to 86 years) from the Framingham Offspring Study who were not frail at baseline (1998-2001) completed a food frequency questionnaire and had 1 or 2 follow-up frailty assessments (2005-2008 and 2011-2014) were included. MAIN OUTCOME MEASURES Frailty was defined as the presence of ≥3 Fried frailty phenotype components: unintentional weight-loss, exhaustion, slowness (gait speed), weakness (grip strength), and low physical activity. Individuals with zero to two components were considered nonfrail. STATISTICAL ANALYSES PERFORMED Repeated measures logistic regression estimated odds ratios and 95% CIs for frailty onset. Logistic (exhaustion and weight loss) and linear regression (gait speed, grip strength, and physical activity) estimated the association between baseline dairy intake and each frailty component at follow-up, adjusting for baseline values for age, sex, energy intake (residual analysis), current smoking, and multivitamin use. Models were further adjusted for health status in a secondary analysis. RESULTS Mean baseline age ± SD was 61 ± 9 years (range = 33 to 87 years), and 54% were women. Of 2,550 nonfrail individuals at baseline, 8.8% (2005-2008) and 13.5% (2011-2014) became frail. Higher yogurt intake was associated with decreased odds of frailty (odds ratio 0.96, 95% CI 0.93 to 0.99; P = 0.02). Each additional serving of yogurt (β ± SE) .004 ± .001; P < 0.01) and low-fat dairy (β ± SE) .001 ± .0006; P = 0.04) was associated with significantly faster follow-up gait speed. Dietary intakes of high-fat dairy were associated with increased odds of frailty (odds ratio 1.02, 95% CI 1.00 to 1.04; P = 0.05), but the P value was of borderline significance. No associations were observed for other dairy foods. After adjusting for health status, the associations of high-fat dairy and yogurt with frailty became nonsignificant, although the magnitudes of the associations did not change. The association between yogurt and gait speed decreased in magnitude after adjusting for health status (β ± SE) .002 ± .001; P = 0.01). CONCLUSIONS Dietary intakes of yogurt were modestly associated with reduced frailty onset and dietary intakes of high-fat dairy had a borderline association with increased odds of frailty, but other dairy food intakes showed no association in this study of healthy adults. Some dairy food intakes were modestly associated with follow-up gait speed. However, effect sizes were small, and the clinical importance of these associations remains undetermined.
Collapse
Affiliation(s)
- Anna C Siefkas
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Courtney L Millar
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Alyssa B Dufour
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Douglas P Kiel
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Paul F Jacques
- Nutritional Epidemiology Program, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts; Friedman School of Nutrition, Tufts University, Boston, Massachusetts
| | - Marian T Hannan
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Shivani Sahni
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
| |
Collapse
|
37
|
Rajado AT, Silva N, Esteves F, Brito D, Binnie A, Araújo IM, Nóbrega C, Bragança J, Castelo-Branco P. How can we modulate aging through nutrition and physical exercise? An epigenetic approach. Aging (Albany NY) 2023. [DOI: https:/doi.org/10.18632/aging.204668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Affiliation(s)
- Ana Teresa Rajado
- Algarve Biomedical Center, Research Institute (ABC-RI), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Algarve Biomedical Center (ABC), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
| | - Nádia Silva
- Algarve Biomedical Center, Research Institute (ABC-RI), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Algarve Biomedical Center (ABC), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
| | - Filipa Esteves
- Algarve Biomedical Center, Research Institute (ABC-RI), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Algarve Biomedical Center (ABC), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
| | - David Brito
- Algarve Biomedical Center, Research Institute (ABC-RI), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Algarve Biomedical Center (ABC), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
| | - Alexandra Binnie
- Algarve Biomedical Center, Research Institute (ABC-RI), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Algarve Biomedical Center (ABC), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Department of Critical Care, William Osler Health System, Etobicoke, Ontario, Canada
| | - Inês M. Araújo
- Algarve Biomedical Center, Research Institute (ABC-RI), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Algarve Biomedical Center (ABC), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Champalimaud Research Program, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Clévio Nóbrega
- Algarve Biomedical Center, Research Institute (ABC-RI), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Algarve Biomedical Center (ABC), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Champalimaud Research Program, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - José Bragança
- Algarve Biomedical Center, Research Institute (ABC-RI), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Algarve Biomedical Center (ABC), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Champalimaud Research Program, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Pedro Castelo-Branco
- Algarve Biomedical Center, Research Institute (ABC-RI), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Algarve Biomedical Center (ABC), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Champalimaud Research Program, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | | |
Collapse
|
38
|
Rajado AT, Silva N, Esteves F, Brito D, Binnie A, Araújo IM, Nóbrega C, Bragança J, Castelo-Branco P. How can we modulate aging through nutrition and physical exercise? An epigenetic approach. Aging (Albany NY) 2023; 15:3191-3217. [PMID: 37086262 DOI: 10.18632/aging.204668] [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: 01/23/2023] [Accepted: 03/11/2023] [Indexed: 04/23/2023]
Abstract
The World Health Organization predicts that by 2050, 2.1 billion people worldwide will be over 60 years old, a drastic increase from only 1 billion in 2019. Considering these numbers, strategies to ensure an extended "healthspan" or healthy longevity are urgently needed. The present study approaches the promotion of healthspan from an epigenetic perspective. Epigenetic phenomena are modifiable in response to an individual's environmental exposures, and therefore link an individual's environment to their gene expression pattern. Epigenetic studies demonstrate that aging is associated with decondensation of the chromatin, leading to an altered heterochromatin structure, which promotes the accumulation of errors. In this review, we describe how aging impacts epigenetics and how nutrition and physical exercise can positively impact the aging process, from an epigenetic point of view. Canonical histones are replaced by histone variants, concomitant with an increase in histone post-translational modifications. A slight increase in DNA methylation at promoters has been observed, which represses transcription of previously active genes, in parallel with global genome hypomethylation. Aging is also associated with deregulation of gene expression - usually provided by non-coding RNAs - leading to both the repression of previously transcribed genes and to the transcription of previously repressed genes. Age-associated epigenetic events are less common in individuals with a healthy lifestyle, including balanced nutrition, caloric restriction and physical exercise. Healthy aging is associated with more tightly condensed chromatin, fewer PTMs and greater regulation by ncRNAs.
Collapse
Affiliation(s)
- Ana Teresa Rajado
- Algarve Biomedical Center, Research Institute (ABC-RI), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Algarve Biomedical Center (ABC), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
| | - Nádia Silva
- Algarve Biomedical Center, Research Institute (ABC-RI), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Algarve Biomedical Center (ABC), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
| | - Filipa Esteves
- Algarve Biomedical Center, Research Institute (ABC-RI), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Algarve Biomedical Center (ABC), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
| | - David Brito
- Algarve Biomedical Center, Research Institute (ABC-RI), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Algarve Biomedical Center (ABC), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
| | - Alexandra Binnie
- Algarve Biomedical Center, Research Institute (ABC-RI), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Algarve Biomedical Center (ABC), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Department of Critical Care, William Osler Health System, Etobicoke, Ontario, Canada
| | - Inês M Araújo
- Algarve Biomedical Center, Research Institute (ABC-RI), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Algarve Biomedical Center (ABC), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Champalimaud Research Program, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Clévio Nóbrega
- Algarve Biomedical Center, Research Institute (ABC-RI), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Algarve Biomedical Center (ABC), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Champalimaud Research Program, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - José Bragança
- Algarve Biomedical Center, Research Institute (ABC-RI), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Algarve Biomedical Center (ABC), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Champalimaud Research Program, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Pedro Castelo-Branco
- Algarve Biomedical Center, Research Institute (ABC-RI), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Algarve Biomedical Center (ABC), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve Campus Gambelas, Faro 8005-139, Portugal
- Champalimaud Research Program, Champalimaud Centre for the Unknown, Lisbon, Portugal
| |
Collapse
|
39
|
Agostini D, Gervasi M, Ferrini F, Bartolacci A, Stranieri A, Piccoli G, Barbieri E, Sestili P, Patti A, Stocchi V, Donati Zeppa S. An Integrated Approach to Skeletal Muscle Health in Aging. Nutrients 2023; 15:nu15081802. [PMID: 37111021 PMCID: PMC10141535 DOI: 10.3390/nu15081802] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
A decline in muscle mass and function represents one of the most problematic changes associated with aging, and has dramatic effects on autonomy and quality of life. Several factors contribute to the inexorable process of sarcopenia, such as mitochondrial and autophagy dysfunction, and the lack of regeneration capacity of satellite cells. The physiologic decline in muscle mass and in motoneuron functionality associated with aging is exacerbated by the sedentary lifestyle that accompanies elderly people. Regular physical activity is beneficial to most people, but the elderly need well-designed and carefully administered training programs that improve muscle mass and, consequently, both functional ability and quality of life. Aging also causes alteration in the gut microbiota composition associated with sarcopenia, and some advances in research have elucidated that interventions via the gut microbiota-muscle axis have the potential to ameliorate the sarcopenic phenotype. Several mechanisms are involved in vitamin D muscle atrophy protection, as demonstrated by the decreased muscular function related to vitamin D deficiency. Malnutrition, chronic inflammation, vitamin deficiencies, and an imbalance in the muscle-gut axis are just a few of the factors that can lead to sarcopenia. Supplementing the diet with antioxidants, polyunsaturated fatty acids, vitamins, probiotics, prebiotics, proteins, kefir, and short-chain fatty acids could be potential nutritional therapies against sarcopenia. Finally, a personalized integrated strategy to counteract sarcopenia and maintain the health of skeletal muscles is suggested in this review.
Collapse
Affiliation(s)
- Deborah Agostini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Marco Gervasi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Fabio Ferrini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Alessia Bartolacci
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Alessandro Stranieri
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Giovanni Piccoli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Elena Barbieri
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Piero Sestili
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Antonino Patti
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy
| | - Vilberto Stocchi
- Department of Human Science for Promotion of Quality of Life, Università Telematica San Raffaele, 00166 Rome, Italy
| | - Sabrina Donati Zeppa
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| |
Collapse
|
40
|
Kim N, Kim GS, Won CW, Lee JJ, Park MK, Shin J, Kim M. Two-year longitudinal associations between nutritional status and frailty in community-dwelling older adults: Korean Frailty and Aging Cohort Study. BMC Geriatr 2023; 23:216. [PMID: 37020292 PMCID: PMC10074647 DOI: 10.1186/s12877-023-03903-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/20/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Korea is expected to become a super-aged society in 2026, and improving nutritional status, which is directly related to health problems, is therefore important for increasing healthy life expectancy. Frailty is the most complex phenotype of aging, and leads to adverse health outcomes, disability, poor quality of life, hospitalization, and mortality. Malnutrition is a major risk factor for frailty syndrome. This study aimed to investigate the incidence of pre-frailty or frailty in the second wave (T2, 2018-2019) according to general characteristics and nutritional status in the first wave (T1, 2016-2017); and examine the longitudinal association of nutritional status in T1 and the incidence of pre-frailty or frailty in T2 among older adults living in a community. METHODS A secondary data analysis was performed using the Korean Frailty and Aging Cohort Study (KFACS). Participants comprised 1125 community-dwelling older Korean adults aged 70-84 years (mean age: 75.03 ± 3.56 years; 53.8% males). Frailty was assessed using the Fried frailty index, and nutritional status was assessed using the Korean version of the Mini Nutritional Assessment Short-Form and blood nutritional biomarkers. Binary logistic regression was used to identify longitudinal associations between the nutritional status at T1 and pre-frailty or frailty at T2. RESULTS Over the two-year follow-up period, 32.9% and 1.7% of the participants became pre-frail and frail, respectively. After the potential confounders were adjusted (sociodemographic, health behaviors, and health status characteristics), pre-frailty or frailty had a significant longitudinal association with severe anorexia (adjusted odds ratio [AOR], 4.17; 95% confidence interval [CI], 1.05-16.54), moderate anorexia (AOR, 2.31; 95% CI, 1.46-3.64), psychological stress or acute disease (AOR, 2.61; 95% CI, 1.26-5.39), and body mass index (BMI) less than 19 (AOR, 4.11; 95% CI, 1.20-14.04). CONCLUSIONS Anorexia, psychological stress, acute disease, and low BMI are the most significant longitudinal risk factors for pre-frailty or frailty in older adults. As nutritional risk factors may be preventable or modifiable, it is important to develop interventions targeting the same. Community-based health professionals in health-related fields should recognize and manage these indicators appropriately to prevent frailty among older adults living in the community.
Collapse
Affiliation(s)
- Namhee Kim
- Wonju College of Nursing, Yonsei University, Wonju, Republic of Korea
| | - Gwang Suk Kim
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, 50-1, Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, 26, Kyungheedae-Ro, Dongdaemun-Gu, Seoul, 02447, Republic of Korea.
| | - Jae Jun Lee
- Department of Nursing, Graduate School of Yonsei University, Seoul, Republic of Korea
| | - Min Kyung Park
- Department of Nursing, Graduate School of Yonsei University, Seoul, Republic of Korea
| | - Jinhee Shin
- College of Nursing, Woosuk University, Jeollabuk-Do, Republic of Korea
| | - Miji Kim
- Department of Biomedical Science and Technology, East-West Medical Research Institute, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| |
Collapse
|
41
|
Prokopidis K, Giannos P, Reginster JY, Bruyere O, Petrovic M, Cherubini A, Triantafyllidis KK, Kechagias KS, Dionyssiotis Y, Cesari M, Ibrahim K, Scott D, Barbagallo M, Veronese N. Sarcopenia is associated with a greater risk of polypharmacy and number of medications: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2023; 14:671-683. [PMID: 36781175 PMCID: PMC10067503 DOI: 10.1002/jcsm.13190] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/10/2023] [Accepted: 01/16/2023] [Indexed: 02/15/2023] Open
Abstract
Polypharmacy in older adults is associated with multiple negative consequences that may affect muscular function, independently from the presence of medical conditions. The aim of this systematic review and meta-analysis was to investigate the association of sarcopenia with polypharmacy and higher number of medications. A systematic literature search of observational studies using PubMed, Web of Science, Scopus and Cochrane Library databases was conducted from inception until June 2022. To determine if sarcopenia is associated with a higher risk of polypharmacy and increased number of medications, a meta-analysis using a random-effects model was used to calculate the pooled effects (CRD42022337539). Twenty-nine studies were included in the systematic review and meta-analysis. Sarcopenia was associated with a higher prevalence of polypharmacy (odds ratio [OR]: 1.65, 95% confidence interval [CI] [1.23, 2.20], I2 = 84%, P < 0.01) and higher number of medications (mean difference: 1.39, 95% CI [0.59, 2.19], I2 = 95%, P < 0.01) compared with individuals without sarcopenia. Using meta-regression, a high variance was observed due to different populations (i.e., community-dwelling, nursing home residents, inpatients, outpatients) for both outcomes of polypharmacy (r = -0.338, SE = 0.1669, 95% CI [-0.67, -0.01], z = -2.03, P = 0.04) and number of medications (r = 0.589, SE = 0.2615, 95% CI [0.08, 1.10], z = 2.25, P = 0.02). This systematic review and meta-analysis reported a significantly increased risk of polypharmacy and higher number of medications in people with sarcopenia compared with individuals without this condition. Future research should clarify whether the specificity and number of medications is a direct contributor in accelerating the progression of muscle wasting and dysfunction contributing to sarcopenia in older adults.
Collapse
Affiliation(s)
- Konstantinos Prokopidis
- Department of Musculoskeletal Biology, Institute of Life Course and Medical SciencesUniversity of LiverpoolLiverpoolUK
- Society of Meta‐research and Biomedical InnovationLondonUK
| | - Panagiotis Giannos
- Society of Meta‐research and Biomedical InnovationLondonUK
- Department of Life Sciences, Faculty of Natural SciencesImperial College LondonLondonUK
| | - Jean Yves Reginster
- WHO Collaborating Center for Epidemiology of Musculoskeletal Health and AgingLiègeBelgium
- Division of Public Health, Epidemiology and Health EconomicsUniversity of LiègeLiègeBelgium
| | - Olivier Bruyere
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo‐Skeletal Health and AgeingUniversity of LiègeLiègeBelgium
| | - Mirko Petrovic
- Section of Geriatrics, Department of Internal Medicine and PaediatricsGhent UniversityGhentBelgium
| | - Antonio Cherubini
- Geriatria, Accettazione Geriatrica e Centro di Ricerca per l'Invecchiamento, IRCCS INRCAAnconaItaly
| | - Konstantinos K. Triantafyllidis
- Society of Meta‐research and Biomedical InnovationLondonUK
- Department of Nutrition and DieteticsHomerton University Hospital Foundation TrustLondonUK
| | - Konstantinos S. Kechagias
- Society of Meta‐research and Biomedical InnovationLondonUK
- Department of Metabolism, Digestion and Reproduction, Faculty of MedicineImperial College LondonLondonUK
| | - Yannis Dionyssiotis
- Medical School, Spinal Cord Injury Rehabilitation Clinic, General University Hospital PatrasUniversity of PatrasPatrasGreece
| | - Matteo Cesari
- Department of Clinical Sciences and Community HealthUniversity of MilanMilanItaly
- Geriatric UnitIRCCS Istituti Clinici Scientifici MaugeriMilanItaly
| | - Kinda Ibrahim
- Academic Geriatric Medicine, Faculty of Medicine, University Hospital SouthamptonUniversity of SouthamptonSouthamptonUK
- Applied Research Collaboration Wessex, The National Institute of Health and Care Research (NIHR)University of SouthamptonSouthamptonUK
| | - David Scott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition SciencesDeakin UniversityBurwoodVictoriaAustralia
- Department of Medicine, School of Clinical Sciences at Monash HealthMonash UniversityClaytonVictoriaAustralia
| | - Mario Barbagallo
- Department of Internal Medicine and GeriatricsUniversity of PalermoPalermoItaly
| | - Nicola Veronese
- Department of Internal Medicine and GeriatricsUniversity of PalermoPalermoItaly
| | | |
Collapse
|
42
|
Gaussens L, González-Bautista E, Bonnefoy M, Briand M, Tavassoli N, De Souto Barreto P, Rolland Y. Associations between Vitality/Nutrition and the Other Domains of Intrinsic Capacity Based on Data from the INSPIRE ICOPE-Care Program. Nutrients 2023; 15:nu15071567. [PMID: 37049408 PMCID: PMC10096560 DOI: 10.3390/nu15071567] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/19/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND The vitality domain of intrinsic capacity (IC) represents the synthesis of biological interactions and metabolism. As part of the Integrated Care for Older People (ICOPE) program developed by the World Health Organization (WHO), vitality focuses on the nutritional status of older adults. The objective of this work was to describe the vitality domain of IC in community-dwelling older people and to examine the associations of the vitality components (appetite loss and weight loss) with the other IC domains assessed within the framework of ICOPE. METHODS Cross-sectional data were obtained between January 2020 and February 2022 through the INSPIRE-ICOPE-Care program, a real-life ICOPE implementation initiative developed in the Occitania region of France. Participants were men and women aged 60 and older, looking for primary care services within the French healthcare system. RESULTS Appetite loss was reported by 14.0% (2013) of the participants, and weight loss by 12.4% (1788). A total of 863 participants (6.01%) declaring weight loss also suffered from appetite loss. In total, 2910 participants (20.27%) screened positive for the domain of vitality. Appetite loss was significantly associated with positive screenings for the domains of cognition (OR = 2.14 [1.84;2.48]), vision (OR = 1.51 [1.28;1.79]), hearing (OR = 1.18 [1.01;1.37]), psychology (OR = 3.95 [3.46;4.52]), and locomotion 'OR = 2.19 [1.91;2.51]). We found significant associations of weight loss with the IC domains of cognition (OR = 1.65 [1.42;1.93]), psychology (OR = 1.80 [1.56;2.07]), locomotion (OR = 1.64 [1.41;1.91]), vision (OR = 1.24 [1.04;1.47]), and hearing (OR = 1.32 [1.12;1.55]). People reporting simultaneous appetite and weight loss showed higher odds of screening positive for psychological (OR = 5.33 [4.53;6.27]) and locomotion impairments (OR = 3.38 [2.88;3.98]). CONCLUSIONS Appetite and weight loss are common among older people and are related to other potential IC impairments, especially psychological and locomotion. Further studies are needed to explore the longitudinal associations of vitality with the incidence of clinically meaningful declines in the other IC domains.
Collapse
Affiliation(s)
- Luc Gaussens
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, 31300 Toulouse, France
| | - Emmanuel González-Bautista
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, 31300 Toulouse, France
| | - Marc Bonnefoy
- Service de Médecine Gériatrique, CHU Lyon, Groupement Hospitalier Sud, 69495 Pierre-Bénite, France
| | - Marguerite Briand
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, 31300 Toulouse, France
| | - Neda Tavassoli
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, 31300 Toulouse, France
| | - Philipe De Souto Barreto
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, 31300 Toulouse, France
- CERPOP UMR 1295, University of Toulouse III, Inserm, UPS, 31062 Toulouse, France
| | - Yves Rolland
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, 31300 Toulouse, France
- CERPOP UMR 1295, University of Toulouse III, Inserm, UPS, 31062 Toulouse, France
| |
Collapse
|
43
|
Neville CE, Young IS, Kee F, Hogg RE, Scott A, Burns F, Woodside JV, McGuinness B. Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA): health assessment protocol, participant profile and patterns of participation. BMC Public Health 2023; 23:466. [PMID: 36899371 PMCID: PMC9999338 DOI: 10.1186/s12889-023-15355-x] [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: 08/22/2022] [Accepted: 03/01/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND The Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA) is a prospective, longitudinal study of a representative cohort of older adults living in Northern Ireland, United Kingdom. Its aim is to explore the social, behavioural, economic and biological factors of ageing and how these factors change as people age. The study has been designed to maximize comparability with other international studies of ageing thereby facilitating cross-country comparisons. This paper provides an overview of the design and methodology of the health assessment which was carried out as part of Wave 1. METHODS Three thousand, six hundred and fifty five community dwelling adults, aged 50 years and over participated in the health assessment as part of Wave 1 of NICOLA. The health assessment included a battery of measurements across various domains that addressed key indicators of ageing namely: physical function, vision and hearing, cognitive function, and cardiovascular health. This manuscript describes the scientific rationale for the choice of assessments, provides an overview of the core objective measures carried out in the health assessment and describes the differences in characteristics of participants who took part in the health assessment compared to those who did not take part. RESULTS The manuscript highlights the importance of incorporating objective measures of health in population based studies as a means of complementing subjective measures and as a way to advance our understanding of the ageing process. The findings contextualize NICOLA as a data resource within Dementias Platform UK (DPUK), the Gateway to Global Ageing (G2G) and other existing networks of population based longitudinal studies of ageing. CONCLUSION This manuscript can help inform design considerations for other population based studies of ageing and facilitate cross-country comparative analysis of key life-course factors affecting healthy ageing such as educational attainment, diet, the accumulation of chronic conditions (including Alzheimer's disease, dementia and cardiovascular disease) as well as welfare and retirement policies.
Collapse
Affiliation(s)
- Charlotte E Neville
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Science, Queen's University Belfast, Grosvenor Road, BT12 6BJ, Belfast, United Kingdom.
| | - Ian S Young
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Science, Queen's University Belfast, Grosvenor Road, BT12 6BJ, Belfast, United Kingdom
| | - Frank Kee
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Science, Queen's University Belfast, Grosvenor Road, BT12 6BJ, Belfast, United Kingdom.
| | - Ruth E Hogg
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Science, Queen's University Belfast, Grosvenor Road, BT12 6BJ, Belfast, United Kingdom
| | - Angela Scott
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Science, Queen's University Belfast, Grosvenor Road, BT12 6BJ, Belfast, United Kingdom
| | - Frances Burns
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Science, Queen's University Belfast, Grosvenor Road, BT12 6BJ, Belfast, United Kingdom
| | - Jayne V Woodside
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Science, Queen's University Belfast, Grosvenor Road, BT12 6BJ, Belfast, United Kingdom
| | - Bernadette McGuinness
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Science, Queen's University Belfast, Grosvenor Road, BT12 6BJ, Belfast, United Kingdom
| |
Collapse
|
44
|
Garnsey MR, Smith AC, Polivkova J, Arons AL, Bai G, Blakemore C, Boehm M, Buzon LM, Campion SN, Cerny M, Chang SC, Coffman K, Farley KA, Fonseca KR, Ford KK, Garren J, Kong JX, Koos MRM, Kung DW, Lian Y, Li MM, Li Q, Martinez-Alsina LA, O'Connor R, Ogilvie K, Omoto K, Raymer B, Reese MR, Ryder T, Samp L, Stevens KA, Widlicka DW, Yang Q, Zhu K, Fortin JP, Sammons MF. Discovery of the Potent and Selective MC4R Antagonist PF-07258669 for the Potential Treatment of Appetite Loss. J Med Chem 2023; 66:3195-3211. [PMID: 36802610 DOI: 10.1021/acs.jmedchem.2c02012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The melanocortin-4 receptor (MC4R) is a centrally expressed, class A GPCR that plays a key role in the regulation of appetite and food intake. Deficiencies in MC4R signaling result in hyperphagia and increased body mass in humans. Antagonism of MC4R signaling has the potential to mitigate decreased appetite and body weight loss in the setting of anorexia or cachexia due to underlying disease. Herein, we report on the identification of a series of orally bioavailable, small-molecule MC4R antagonists using a focused hit identification effort and the optimization of these antagonists to provide clinical candidate 23. Introduction of a spirocyclic conformational constraint allowed for simultaneous optimization of MC4R potency and ADME attributes while avoiding the production of hERG active metabolites observed in early series leads. Compound 23 is a potent and selective MC4R antagonist with robust efficacy in an aged rat model of cachexia and has progressed into clinical trials.
Collapse
Affiliation(s)
| | - Aaron C Smith
- Pfizer, Incorporated, Groton, Connecticut 06340, United States
| | - Jana Polivkova
- Pfizer, Incorporated, Groton, Connecticut 06340, United States
| | - Autumn L Arons
- Pfizer, Incorporated, Cambridge, Massachusetts 02139, United States
| | - Guoyun Bai
- Pfizer, Incorporated, Groton, Connecticut 06340, United States
| | | | - Markus Boehm
- Pfizer, Incorporated, Cambridge, Massachusetts 02139, United States
| | - Leanne M Buzon
- Pfizer, Incorporated, Groton, Connecticut 06340, United States
| | - Sarah N Campion
- Pfizer, Incorporated, Groton, Connecticut 06340, United States
| | - Matthew Cerny
- Pfizer, Incorporated, Groton, Connecticut 06340, United States
| | - Shiao-Chi Chang
- Pfizer, Incorporated, Cambridge, Massachusetts 02139, United States
| | - Karen Coffman
- Pfizer, Incorporated, Groton, Connecticut 06340, United States
| | | | - Kari R Fonseca
- Pfizer, Incorporated, Cambridge, Massachusetts 02139, United States
| | - Kristen K Ford
- Pfizer, Incorporated, Groton, Connecticut 06340, United States
| | - Jeonifer Garren
- Pfizer, Incorporated, Cambridge, Massachusetts 02139, United States
| | - Jimmy X Kong
- Pfizer, Incorporated, Cambridge, Massachusetts 02139, United States
| | - Martin R M Koos
- Pfizer, Incorporated, Groton, Connecticut 06340, United States
| | - Daniel W Kung
- Pfizer, Incorporated, Groton, Connecticut 06340, United States
| | - Yajing Lian
- Pfizer, Incorporated, Groton, Connecticut 06340, United States
| | - Monica M Li
- Pfizer, Incorporated, Cambridge, Massachusetts 02139, United States
| | - Qifang Li
- Pfizer, Incorporated, Groton, Connecticut 06340, United States
| | | | | | - Kevin Ogilvie
- Pfizer, Incorporated, Groton, Connecticut 06340, United States
| | - Kiyoyuki Omoto
- Pfizer, Incorporated, Cambridge, Massachusetts 02139, United States
| | - Brian Raymer
- Pfizer, Incorporated, Cambridge, Massachusetts 02139, United States
| | - Matthew R Reese
- Pfizer, Incorporated, Groton, Connecticut 06340, United States
| | - Tim Ryder
- Pfizer, Incorporated, Groton, Connecticut 06340, United States
| | - Lacey Samp
- Pfizer, Incorporated, Groton, Connecticut 06340, United States
| | | | | | - Qingyi Yang
- Pfizer, Incorporated, Cambridge, Massachusetts 02139, United States
| | - Kaicheng Zhu
- Pfizer, Incorporated, Groton, Connecticut 06340, United States
| | | | | |
Collapse
|
45
|
Characterisation of community-dwelling older adults with poor appetite. Eur J Nutr 2023:10.1007/s00394-023-03129-5. [PMID: 36869911 DOI: 10.1007/s00394-023-03129-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/21/2023] [Indexed: 03/05/2023]
Abstract
PURPOSE A poor appetite affects up to 27% of community-dwelling older adults in Europe and is an early predictor of malnutrition. Little is known about the factors associated with poor appetite. The present study, therefore, aims to characterise older adults with poor appetite. METHODS As part of the European JPI project APPETITE, data from 850 participants, aged ≥ 70 years of the Longitudinal Ageing Study Amsterdam (LASA) from 2015/16 were analysed. Appetite during the last week was assessed with a five-point scale and dichotomised into "normal" and "poor". Binary logistic regression was used to examine associations between 25 characteristics from 5 domains-physiological, emotional, cognitive, social, and lifestyle-and appetite. First, domain-specific models were calculated using stepwise backward selection. Second, all variables contributing to poor appetite were combined in a multi-domain model. RESULTS The prevalence of self-reported poor appetite was 15.6%. Fourteen parameters from all five single-domain models contributed to poor appetite and were entered into the multi-domain model. Here, female sex (total prevalence: 56.1%, odds ratio: 1.95 [95% confidence interval 1.10-3.44]), self-reported chewing problems (2.4%, 5.69 [1.88-17.20]), any unintended weight loss in the last 6 months (6.7%, 3.07 [1.36-6.94]), polypharmacy defined as ≥ 5 medications in the past 2 weeks (38.4%, 1.87 [1.04-3.39]), and depressive symptoms (Centre for Epidemiologic Studies Depression Scale without appetite item) (1.12 [1.04-1.21]) were associated with an increased likelihood of having poor appetite. CONCLUSION According to this analysis, older people with the characteristics described above are more likely to have a poor appetite.
Collapse
|
46
|
Großschädl F, Schoberer D, Eglseer D, Lohrmann C, Everink I, Gordon AL, Schols JMGA, Bauer S. Obesity and its associated factors in older nursing home residents in three European countries-Secondary data analyses from the "International Prevalence Measurement of Care Quality". Int J Older People Nurs 2023; 18:e12530. [PMID: 36840619 DOI: 10.1111/opn.12530] [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: 09/22/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND The prevalence of obesity has risen in recent decades and reached epidemic proportions worldwide. The proportion of those living with obesity is also increasing in nursing homes. This could impact the nursing care required, equipment and facilities provided, and morbidity in these settings. Limited evidence exists on clinical consequences of obesity in nursing home residents and their care. OBJECTIVE Therefore, the aim was to examine the rate and associated factors of obesity (BMI ≥30; class I (BMI 30.0-34.9 kg/m2 ), class II (BMI 35.0-39.9 kg/m2 ), and class III (BMI >40.0 kg/m2 )) amongst older nursing home residents in European countries. METHODS We analysed data from 21,836 people who reside in nursing homes in Austria, the Netherlands, and the United Kingdom. They participated in the "International Prevalence Measurement of Care Quality", a cross sectional study between 2016 and 2019, where trained nurses interviewed the residents, reviewed care records, and conducted clinical examinations. A tested and standardised questionnaire comprised questions on demographic data, measured BMI, medical diagnosis according to ICD-10, and care dependency. Descriptive and logistic regression analyses were performed. RESULTS Obesity rates were highest in Austria (17.1%) and lowest in the UK (13.0%) (p = .006). Residents with obesity were younger and less likely to be care dependent or living with dementia and had more often diabetes mellitus, endocrine, metabolic, and skin diseases compared to residents without obesity (p < .05). Most obese residents had obesity class I. Therefore, two subgroups were built (class I vs. class II + III). Residents with obesity class II + III were more frequently care dependent for mobility, getting dressed and undressed, and personal hygiene compared to residents with class I (p < .05). CONCLUSIONS This study identified several factors that are associated with obesity amongst older nursing home residents in selected European countries. IMPLICATIONS FOR PRACTICE The division into obesity classes is important for planning targeted care according to the individual needs of nursing home residents.
Collapse
Affiliation(s)
| | - Daniela Schoberer
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
| | - Doris Eglseer
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
| | - Christa Lohrmann
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
| | - Irma Everink
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Adam L Gordon
- Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Derby, UK.,East Midlands Academic Health Sciences Network Patient Safety Collaborative, Nottingham, UK.,NIHR Applied Research Collaboration - East Midlands (ARC-EM), Nottingham, UK
| | - Jos M G A Schols
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Silvia Bauer
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
| |
Collapse
|
47
|
Huang T, Chen X, Chen D, Yu B, He J, Yan H, Luo Y, Zheng P, Chen H, Huang Z. Eugenol promotes appetite through TRP channels mediated-CaMKK2/AMPK signaling pathway. Phytother Res 2023. [PMID: 36762415 DOI: 10.1002/ptr.7768] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/22/2022] [Accepted: 01/29/2023] [Indexed: 02/11/2023]
Abstract
Eugenol is a major component of clove oil. A recent study found that inhalation of eugenol promoted the appetite of mice. However, whether oral ingestion of eugenol promoted appetite is unclear and its mechanism await study. Here, mice were divided into four treatments (n = 20) and fed a basal diet supplemented with 0%, 0.005%, 0.01% and 0.02% eugenol for 4 weeks. In addition, mice (n = 7) were injected intraperitoneally with 3 mg/kg body weight eugenol. Our data showed that feeding mice with 0.01% and 0.02% eugenol promoted their appetite. In addition, the short-term intraperitoneal injection of eugenol enhanced the feed intake in mice within 1 h. Further studies found that dietary eugenol increased orexigenic factors expression and decreased anorexigenic factors expression in mice. We then carried out N38 cell experiments to explore the transient receptor potential (TRP) channels-dependent mechanism of eugenol in promoting appetite. We found that eugenol activated the TRP channels mediated-CaMKK2/AMPK signaling pathway in the hypothalamus and N38 cells. Besides, the inhibition of TRPV1 and AMPK eliminated the upregulation of eugenol on the agouti-related protein level in N38 cells. In conclusion, the study suggested that eugenol promotes appetite through TRPV1 mediated-CaMKK2/AMPK signaling pathway.
Collapse
Affiliation(s)
- Tengteng Huang
- Key Laboratory for Animal Disease-Resistance Nutrition of China Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, Sichuan, People's Republic of China
| | - Xiaoling Chen
- Key Laboratory for Animal Disease-Resistance Nutrition of China Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, Sichuan, People's Republic of China
| | - Daiwen Chen
- Key Laboratory for Animal Disease-Resistance Nutrition of China Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, Sichuan, People's Republic of China
| | - Bing Yu
- Key Laboratory for Animal Disease-Resistance Nutrition of China Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, Sichuan, People's Republic of China
| | - Jun He
- Key Laboratory for Animal Disease-Resistance Nutrition of China Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, Sichuan, People's Republic of China
| | - Hui Yan
- Key Laboratory for Animal Disease-Resistance Nutrition of China Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, Sichuan, People's Republic of China
| | - Yuheng Luo
- Key Laboratory for Animal Disease-Resistance Nutrition of China Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, Sichuan, People's Republic of China
| | - Ping Zheng
- Key Laboratory for Animal Disease-Resistance Nutrition of China Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, Sichuan, People's Republic of China
| | - Hong Chen
- College of Food Science, Sichuan Agricultural University, Yaan, Sichuan, People's Republic of China
| | - Zhiqing Huang
- Key Laboratory for Animal Disease-Resistance Nutrition of China Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, Sichuan, People's Republic of China
| |
Collapse
|
48
|
Abstract
Fatigue is defined as a symptom leading to the inability to continue functioning at the expected activity level. It is a highly prevalent symptom, challenging to frame into monodimensional pathophysiological mechanisms. As a result, fatigue is often underestimated in the clinical setting and is wrongly considered an unavoidable consequence of ageing. Several potential mechanisms responsible for fatigue have been proposed, including sleep patterns, autonomic nervous system abnormalities and biological complexity. Inflammation and mitochondrial dysfunction are among the most promising mechanisms through which malnutrition may cause fatigue. Not surprisingly, fatigue is highly prevalent in inflammatory conditions (e.g. COVID-19 infection). The nutritional status may also represent a critical factor in the development and presentation of fatigue, which may mimic the exhaustion of the individual's metabolic reserves. For example, the insufficient dietary intake of energy and proteins may determine the catabolism of body fat and muscles, disrupt the homeostatic balance and cause the onset of fatigue. It is necessary to conduct research on fatigue. By characterising its pathophysiological mechanisms, it will be possible to (1) support the design and development of targeted interventions, (2) improve the quality of life of many persons by acting on the symptom and (3) reduce the direct and indirect costs of a burdening condition typical of advancing age. In the present review, we provide an overview of the role that nutrition may play as a determinant of fatigue in older people, also in the context of the COVID-19 pandemic.
Collapse
|
49
|
Raffin J, Rolland Y, Parini A, Lucas A, Guyonnet S, Vellas B, de Souto Barreto P. Association between physical activity, growth differentiation factor 15 and bodyweight in older adults: A longitudinal mediation analysis. J Cachexia Sarcopenia Muscle 2023. [PMID: 36999490 PMCID: PMC10067491 DOI: 10.1002/jcsm.13152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 09/10/2022] [Accepted: 11/27/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Late-life aging is often associated with appetite reduction and weight loss. Physical activity (PA) may prevent these processes, but the molecular mechanisms involved remain elusive. The present study investigated the putative mediating aspect of growth differentiation factor 15 (GDF-15), a stress signalling protein involved in aging, exercise and appetite control, on the association between PA and late-life-associated weight loss. METHODS One thousand eighty-three healthy adults (63.8% women) aged 70 years and over who participated in the Multidomain Alzheimer Preventive Trial were included. Bodyweight (kg) and PA levels (square root of metabolic equivalent of task-min/week) were assessed repeatedly from baseline to the 3-year visit, whereas plasma GDF-15 (pg/mL) was measured at the 1-year visit. Multiple linear regressions were performed to test the association between first-year mean PA level, 1-year visit GDF-15 concentration and subsequent bodyweight changes. Mediation analyses were used to investigate whether GDF-15 mediated the association between first-year mean PA levels and consecutive bodyweight changes. RESULTS Multiple regression analyses demonstrated that higher first-year mean PA levels significantly predicted lower GDF-15 and bodyweight at 1 year (B = -2.22; SE = 0.79; P = 0.005). In addition, higher 1-year visit GDF-15 levels were associated with faster subsequent bodyweight loss (Time × GDF-15 interaction B = -0.0004; SE = 0.0001; P = 0.003). Mediation analyses confirmed that GDF-15 mediated the association between first-year mean PA levels and subsequent bodyweight changes (mediated effect ab = 0.0018; bootstrap SE = 0.001; P < 0.05) and revealed that mean PA had no direct effect on subsequent bodyweight changes (c' = 0.006; SE = 0.008; P > 0.05). CONCLUSIONS This study suggests that GDF-15 may be one of the molecules mediating the link between PA and late-life weight loss, but mechanistic studies are necessary to further support the present findings.
Collapse
Affiliation(s)
- Jérémy Raffin
- Gérontopôle de Toulouse, Institut du VieillissementCentre Hospitalo‐Universitaire de ToulouseToulouseFrance
| | - Yves Rolland
- Gérontopôle de Toulouse, Institut du VieillissementCentre Hospitalo‐Universitaire de ToulouseToulouseFrance
- CERPOP UMR 1295, University of Toulouse III, Inserm, UPSToulouseFrance
| | - Angelo Parini
- Institute of Metabolic and Cardiovascular Diseases, UMR1048Toulouse Cedex 4France
- Paul Sabatier UniversityToulouse Cedex 9France
| | - Alexandre Lucas
- Institute of Metabolic and Cardiovascular Diseases, UMR1048Toulouse Cedex 4France
- Paul Sabatier UniversityToulouse Cedex 9France
| | - Sophie Guyonnet
- Gérontopôle de Toulouse, Institut du VieillissementCentre Hospitalo‐Universitaire de ToulouseToulouseFrance
- CERPOP UMR 1295, University of Toulouse III, Inserm, UPSToulouseFrance
| | - Bruno Vellas
- Gérontopôle de Toulouse, Institut du VieillissementCentre Hospitalo‐Universitaire de ToulouseToulouseFrance
- CERPOP UMR 1295, University of Toulouse III, Inserm, UPSToulouseFrance
| | - Philipe de Souto Barreto
- Gérontopôle de Toulouse, Institut du VieillissementCentre Hospitalo‐Universitaire de ToulouseToulouseFrance
- CERPOP UMR 1295, University of Toulouse III, Inserm, UPSToulouseFrance
| | | |
Collapse
|
50
|
Nishioka S, Wakabayashi H. Interaction between malnutrition and physical disability in older adults: is there a malnutrition-disability cycle? Nutr Rev 2023; 81:191-205. [PMID: 35831980 DOI: 10.1093/nutrit/nuac047] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Malnutrition and physical disability are urgent issues in super-aging societies and the 2 phenomena are closely linked in older adults. Both conditions have common underlying causes, including physiological changes due to aging and burdens imposed by disease or injury. Accordingly, a concept of the malnutrition-disability cycle was generated and a comprehensive literature search was performed. There was insufficient evidence to prove an interrelationship between malnutrition and physical disabilities, because of the study design and poor quality, among other factors. However, some evidence exists for the interaction between low body mass index and swallowing disorders, and the effects of some malnutrition and disability components. This review provides the rationale for this interaction, the concept of a malnutrition-disability cycle is proposed, and the available evidence is critically appraise.
Collapse
Affiliation(s)
- Shinta Nishioka
- is with the Department of Clinical Nutrition and Food Services, Nagasaki Rehabilitation Hospital, Nagasaki City, Nagasaki, Japan
| | - Hidetaka Wakabayashi
- is with the Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan
| |
Collapse
|