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Pradana AA, Chiu HL, Lin CJ, Lee SC. Prevalence of frailty in Indonesia: a systematic review and meta-analysis. BMC Geriatr 2023; 23:778. [PMID: 38012546 PMCID: PMC10680226 DOI: 10.1186/s12877-023-04468-y] [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: 03/30/2023] [Accepted: 11/08/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Frailty increases the risks of hospitalization, injury, fall, psychological disorders, and death in older adults. Accurate estimation of the prevalence of frailty is crucial for promoting health in these individuals. Therefore, this study was conducted to estimate the prevalence of frailty and prefrailty in older adults residing in Indonesia. METHODS In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, six electronic databases were searched (without any language restriction) for relevant articles from inception to February 2023. Studies on the prevalence of frailty and prefrailty in older adults (age ≥ 60 years) residing in Indonesia were included in the analysis. A random-effects model was selected a priori because of the expected high degree of heterogeneity in the study, followed by sensitivity analysis, subgroup analysis, and meta-regression. The protocol of this review study was registered in the PROSPERO database (CRD42022381132). RESULTS A total of 79 studies were identified, of which 20 were finally included in the analysis. The pooled prevalence of frailty and prefrailty in older adults in Indonesia was 26.8% and 55.5%, respectively. The pooled prevalence of frailty and prefrailty was 37.9% and 44.8% in nursing homes, 26.3% and 61.4% in hospitals, and 21.1% and 59.6% in community settings, respectively. Furthermore, the pooled prevalence of frailty and prefrailty was 21.6% and 64.3%, 18.7% and 62%, and 27.8% and 59.8% in studies using the Frailty Index-40, FRAIL, and Fried Frailty Phenotype questionnaires, respectively. However, the parameters did not vary significantly across measurement tools or study settings. Publication bias was not detected while the year of data collection influenced the heterogeneity between the studies. CONCLUSIONS To the best of our knowledge, this study is the first meta-analysis to report the prevalence of frailty and prefrailty in older adults residing in Indonesia. The gradual increase in the number of older adults with frailty or prefrailty in Indonesia is concerning. Therefore, the government, private sectors, health-care professionals, and the community must jointly design effective strategies and policies to address this problem.
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Affiliation(s)
- Anung Ahadi Pradana
- STIKes Mitra Keluarga, Bekasi-Indonesia, Indonesia
- International PhD Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Huei-Ling Chiu
- International PhD Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Chen-Ju Lin
- Department of Rehabilitation Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
| | - Shu-Chun Lee
- International PhD Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan.
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan.
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Dobarrio-Sanz I, Chica-Pérez A, Martínez-Linares JM, López-Entrambasaguas OM, Fernández-Sola C, Hernández-Padilla JM. Experiences of poverty amongst low-income older adults living in a high-income country: A qualitative study. J Adv Nurs 2023; 79:4304-4317. [PMID: 37357429 DOI: 10.1111/jan.15750] [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: 02/25/2023] [Revised: 05/12/2023] [Accepted: 06/10/2023] [Indexed: 06/27/2023]
Abstract
AIM To understand the experience of low-income older adults living in poverty in a high-income country. DESIGN A qualitative study based on Gadamer's hermeneutic phenomenology. METHODS A convenience sample of twenty-seven low-income older adults were interviewed in-depth between September 2021 and January 2022. Fleming's method for conducting phenomenological qualitative studies was followed and ATLAS.ti software was used for data analysis. RESULTS Three main themes were extracted from the analysis: (i) 'living in the shadow of poverty', (ii) 'unprotected by the 'social shield' of the welfare state' (iii) 'the struggle to attain good health'. CONCLUSION Living in poverty affects all spheres of life. Older adults living in poverty feel excluded from social support policies and laws. This has a negative impact on the older adults' mental health and can lead to social isolation. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Nursing interventions to promote health amongst older adults living in poverty should include an assessment of the patient's social determinants and a focus on increasing social participation. Older people living in poverty experience difficulties accessing formal social support so nurses should implement patient navigation interventions that aim to help them overcome the complexities of the system. Nursing interventions to improve mental health amongst older adults living in poverty are much needed. IMPACT Living in poverty increases older adults' vulnerability. Older adults living in poverty suffer from mental health issues as they live under constant pressure to meet their basic needs and lack formal social support. These findings are important for nurses, who play a pivotal role in the design, implementation and evaluation of policies and interventions that promote health equity. REPORTING METHOD The study has been conducted following the COREQ guidelines. PATIENT OR PUBLIC CONTRIBUTION There has been no public or patient involvement in the design or development of the study.
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Affiliation(s)
- Iria Dobarrio-Sanz
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
| | | | | | | | - Cayetano Fernández-Sola
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago, Chile
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Morris JN, Howard EP, Schachter E, Burney S, Laytham A, Fialova D, Hoogendijk EO, Liperoti R, van Hout HPJ, Vetrano DL. Cognitive Change Among Nursing Home Residents: CogRisk-NH Scale Development to Predict Decline. J Am Med Dir Assoc 2023; 24:1405-1411. [PMID: 37517808 DOI: 10.1016/j.jamda.2023.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVES Examine cognitive changes over time among nursing home residents and develop a risk model for identifying predictors of cognitive decline. DESIGN Using secondary analysis design with Minimum Data Set data, cognitive status was based on the Cognitive Performance Scale (CPS). SETTING AND PARTICIPANTS Baseline and 7 quarterly follow-up analyses of US and Canadian interRAI data (N = 1,257,832) were completed. METHODS Logistic regression analyses identified predictors of decline to form the CogRisk-NH scale. RESULTS At baseline, about 15% of residents were cognitively intact (CPS = 0), and 11.2% borderline intact (CPS = 1). The remaining more intact, with mild impairment (CPS = 2), included 15.0%. Approximately 59% residents fell into CPS categories 3 to 6 (moderate to severe impairment). Over time, increasing proportions of residents declined: 17.1% at 6 months, 21.6% at 9 months, and 34.0% at 21 months. Baseline CPS score was a strong predictor of decline. Categories 0 to 2 had 3-month decline rates in midteens, and categories 3 to 5 had an average decline rate about 9%. Consequently, a 2-submodel construction was employed-one for CPS categories 0 to 2 and the other for categories 3 to 5. Both models were integrated into a 6-category risk scale (CogRisk-NH). CogRisk-NH scale score distribution had 15.9% in category 1, 26.84% in category 2, and 36.7% in category 3. Three higher-risk categories (ie, 4-6) represented 20.6% of residents. Mean decline rates at the 3-month assessment ranged from 4.4% to 28.3%. Over time, differentiation among risk categories continued: 6.9% to 38.4.% at 6 months, 11.0% to 51.0% at 1 year, and 16.2% to 61.4% at 21 months, providing internal validation of the prediction model. CONCLUSIONS AND IMPLICATIONS Cognitive decline rates were higher among residents in less-impaired CPS categories. CogRisk-NH scale differentiates those with low likelihood of decline from those with moderate likelihood and, finally, much higher likelihood of decline. Knowledge of resident risk for cognitive decline enables allocation of resources targeting amenable factors and potential interventions to mitigate continuing decline.
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Affiliation(s)
- John N Morris
- Hebrew SeniorLife, The Hinda and Arthur Marcus Institute for Aging Research, Boston, MA, USA
| | - Elizabeth P Howard
- Hebrew SeniorLife, The Hinda and Arthur Marcus Institute for Aging Research, Boston, MA, USA; Connell School of Nursing, Boston College, Chestnut Hill, MA, USA.
| | | | - Sharran Burney
- Connell School of Nursing, Boston College, Chestnut Hill, MA, USA
| | - Anna Laytham
- Connell School of Nursing, Boston College, Chestnut Hill, MA, USA
| | - Daniela Fialova
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Charles University, Prague, Czech Republic; Department of Geriatrics and Gerontology, 1(st) Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Emiel O Hoogendijk
- Department of General Practice and Department of Epidemiology & Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, the Netherlands
| | - Rosa Liperoti
- Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, Rome, Italy
| | - Hein P J van Hout
- Amsterdam University Medical Center, Departments of General Practice and Medicine for Older Persons, Vrije Universiteit, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Davide Liborio Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden
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Miladitiya A, Juniarto AZ, Nugrohowati AK, Winarni TI. The Role of Body Mass Index, Advanced Age, and Low Educational Attainment in Mild Cognitive Impairment among the Older Adult Population: A Study in a Rural Area in Indonesia. J Nutr Gerontol Geriatr 2023; 42:144-160. [PMID: 37610863 DOI: 10.1080/21551197.2023.2249835] [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: 08/25/2023]
Abstract
This study evaluated the prevalence of mild cognitive impairment (MCI) and factors associated with MCI among older adults in a rural area of Indonesia. This cross-sectional study was conducted in a rural area of East Java, Indonesia. Four hundred and twenty-seven older adults aged ≥60 years were included in the study. MCI was assessed using the Brain Health Test Cognitive Tool. Data related to possible risk factors were obtained using semi-structured questionnaires. The indirect body mass index was determined based on ulnar length. The prevalence of MCI was 12.9%. Being underweight (<18.5 kg/m2) (odds ratio [OR], 2.42; 95% confidence interval [CI], 1.17-4.97; p = 0.016), requiring assistance to manage money or medications (OR, 2.72; 95% CI, 1.02-7.23; p = 0.045), age ≥70 years (OR, 2.50; 95% CI, 1.11-5.60; p = 0.026), and having an educational attainment of ≤6 years (OR, 4.92; 95% CI, 1.92-12.60; p = 0.001) were significantly associated with MCI. In this Indonesian older adult population, underweight people who had an educational attainment of <6 years, those aged ≥70 years, and those who needed assistance to manage money or medications were more likely to have MCI.
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Affiliation(s)
- Aulia Miladitiya
- Magister of Nutrition, Faculty of Medicine, Universitas Diponegoro, Semarang, Central Java, Indonesia
| | - Achmad Zulfa Juniarto
- Department of Biology, Faculty of Medicine, Universitas Diponegoro, Semarang, Central Java, Indonesia
| | - Annta Kern Nugrohowati
- Clinical Nutrition Department, Diponegoro National Hospital, Semarang, Central Java, Indonesia
| | - Tri Indah Winarni
- Department of Anatomy, Faculty of Medicine, Universitas Diponegoro, Semarang, Central Java, Indonesia
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Coelho-Júnior HJ, Calvani R, Tosato M, Landi F, Picca A, Marzetti E. Protein intake and physical function in older adults: A systematic review and meta-analysis. Ageing Res Rev 2022; 81:101731. [PMID: 36087703 DOI: 10.1016/j.arr.2022.101731] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/24/2022] [Accepted: 09/05/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND The present study explored cross-sectional and longitudinal associations between protein intake and physical function in older adults. METHODS We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated the association between protein intake and measures of physical function in older adults. Cross-sectional, case-control, and longitudinal cohort studies that investigated the association between protein intake and physical function as a primary or secondary outcome in people aged 60 + years were included. Studies published in languages other than English, Italian, Portuguese, or Spanish were excluded. Studies were retrieved from MEDLINE, SCOPUS, EMBASE, CINAHL, AgeLine, and Food Science Source databases through January 31, 2022. A pooled effect size was calculated based on standard mean differences (SMD), MD, log odds ratio (OR) and Z-score.. RESULTS Twenty-two cross-sectional studies examined a total of 11,332 community-dwellers, hospitalized older adults, and elite senior athletes with a mean age of approximately 75 years. The pooled analysis indicated that a protein intake higher than the recommended dietary allowance (RDA) was significantly associated with higher Short Physical Performance Battery (SPPB) scores (SMD: 0.63, 95% CI: 0.27, 0.99, P-value: 0.0006), faster walking speed, greater lower-limb (SMD: 0.22, 95% CI: 0.04, 0.40, P-value: 0.02) and isometric handgrip strength (Z-score: 0.087, 95% CI: 0.046-0.128, P-value: 0.0001), and better balance (SMD: 0.33, 95% CI: 0.05, 0.62, P-value: 0.02). Nine longitudinal studies investigated 12,424 community-dwelling and native older adults with a mean age of approximately 85 years. A protein intake higher than the current RDA was not associated with lower decline in either isometric handgrip strength (logOR: 0.99, 95% CI: 0.97-1.02, P-value= 0.67) or walking speed (logOR: 0.92, 95% CI: 0.77-1.10, P-value= 0.35). CONCLUSIONS A protein intake higher than the RDA is cross-sectionally associated with better physical performance and greater muscle strength in older adults. However, a high consumption of proteins does not seem to prevent physical function decline over time.
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Affiliation(s)
- Hélio José Coelho-Júnior
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.
| | - Riccardo Calvani
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.
| | - Matteo Tosato
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Francesco Landi
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Anna Picca
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Emanuele Marzetti
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
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Chen L, Arai H, Assantachai P, Akishita M, Chew ST, Dumlao LC, Duque G, Woo J. Roles of nutrition in muscle health of community-dwelling older adults: evidence-based expert consensus from Asian Working Group for Sarcopenia. J Cachexia Sarcopenia Muscle 2022; 13:1653-1672. [PMID: 35307982 PMCID: PMC9178363 DOI: 10.1002/jcsm.12981] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/15/2022] [Indexed: 12/29/2022] Open
Abstract
General muscle health declines with age, and in particular, sarcopenia-defined as progressive loss of muscle mass and strength/physical performance-is a growing issue in Asia with a rising population of community-dwelling older adults. Several guidelines have addressed early identification of sarcopenia and management, and although nutrition is central to treatment of sarcopenia, there are currently few guidelines that have examined this specifically in the Asian population. Therefore, the Asian Working Group for Sarcopenia established a special interest group (SIG) comprising seven experts across Asia and one from Australia, to develop an evidence-based expert consensus. A systematic literature search was conducted using MEDLINE on the topic of muscle health, from 2016 (inclusive) to July 2021, in Asia or with relevance to healthy, Asian community-dwelling older adults (≥60 years old). Several key topics were identified: (1) nutritional status: malnutrition and screening; (2) diet and dietary factors; (3) nutritional supplementation; (4) lifestyle interventions plus nutrition; and (5) outcomes and assessment. Clinical questions were developed around these topics, leading to 14 consensus statements. Consensus was achieved using the modified Delphi method with two rounds of voting. Moreover, the consensus addressed the impacts of COVID-19 on nutrition, muscle health, and sarcopenia in Asia. These statements encompass clinical expertise and knowledge across Asia and are aligned with findings in the current literature, to provide a practical framework for addressing muscle health in the community, with the overall aim to encourage and facilitate broader access to equitable care for this target population.
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Affiliation(s)
- Liang‐Kung Chen
- Center for Healthy Longevity and Aging SciencesNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
- Center for Geriatrics and GerontologyTaipei Veterans General HospitalTaipeiTaiwan
- Taipei Municipal Gan‐Dau HospitalTaipeiTaiwan
| | - Hidenori Arai
- National Center for Geriatrics and GerontologyObuJapan
| | | | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Samuel T.H. Chew
- Department of Geriatric MedicineChangi General Hospital, SingHealthSingapore
| | | | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS)The University of Melbourne and Western HealthMelbourneVictoriaAustralia
| | - Jean Woo
- Chinese University of Hong KongHong Kong
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Dewiasty E, Agustina R, Saldi SRF, Pramudita A, Hinssen F, Kumaheri M, de Groot LCPGM, Setiati S. Malnutrition Prevalence and Nutrient Intakes of Indonesian Community-Dwelling Older Adults: A Systematic Review of Observational Studies. Front Nutr 2022; 9:780003. [PMID: 35284453 PMCID: PMC8912970 DOI: 10.3389/fnut.2022.780003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/31/2022] [Indexed: 11/15/2022] Open
Abstract
Background Malnutrition and inadequate nutrient intake are associated with functional decline, frailty, and bad clinical outcomes among community-dwelling older adults. Despite the growing proportion of the elderly population in Indonesia, data on the prevalence of malnutrition and adequacy of macronutrient and micronutrient intakes among Indonesian older adults are scattered and vary between studies. Therefore, our study aims to obtain data on malnutrition prevalence, level and distribution of nutrient intakes, and prevalence of macronutrient and micronutrient inadequacies in Indonesian community-dwelling older adults. Methods We carried out a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and registered in PROSPERO. A systematic electronic database search of MEDLINE, CENTRAL, EMBASE, ProQuest, HINARI, IMSEAR, GARUDA, and Indonesian Publication Index was undertaken. Additional searches were conducted in gray literature sources, hand-searching, retrospective searching, and personal communication with authors of the relevant publication. Observational studies presenting the malnutrition prevalence of habitual dietary intakes of older adults (60 years or older) were included. The risk of bias of studies was assessed using the Joanna Briggs Institute critical appraisal form. Sex-specific mean (and standard deviation) habitual macronutrient and a selection of micronutrients (calcium, vitamin D, and vitamin B12) intakes were extracted from each article to calculate the percentage of older people who were at risk for inadequate micronutrient intakes using a proxy of estimated average requirement (EAR) cut-point method, which is calculated from the national guideline of recommended dietary allowance (RDA). Prevalence of malnutrition, based on body mass index (BMI) categories and mini-nutritional assessment (MNA) criteria. and the population at risk of malnutrition were presented descriptively. Results Nine studies retrieved from electronic databases and gray literature were included in the pooled systematic analysis. According to BMI criteria, the underweight prevalence ranged from 8.0 to 26.6%. According to the MNA, the prevalence of malnutrition ranged from 2.1 to 14.6%, whereby the prevalence of at risk of malnutrition amounted to 18–78%. Our systematic review identified a high prevalence of nutrient inadequacies, most markedly for protein, calcium, vitamin D, and vitamin B12. Conclusion We signal a high risk of malnutrition along with poor macronutrients and micronutrients intakes among Indonesian community-dwelling older adults. These findings provide important and robust evidence on the magnitude of malnutrition and nutrient inadequacy concerns that call for appropriate nutrition, as well as public health policies and prompt intervention. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018102268.
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Affiliation(s)
- Esthika Dewiasty
- Department of Internal Medicine, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
- *Correspondence: Esthika Dewiasty ; ;
| | - Rina Agustina
- Department of Nutrition, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Human Nutrition Research Center, Indonesian Medical Education and Research Center, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Siti Rizny F. Saldi
- Department of Internal Medicine, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Arvin Pramudita
- Department of Internal Medicine, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Fenna Hinssen
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Meutia Kumaheri
- Department of Internal Medicine, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | | | - Siti Setiati
- Department of Internal Medicine, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Center of Clinical Epidemiology and Evidence-Based Medicine, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Ong PA, Annisafitrie FR, Purnamasari N, Calista C, Sagita N, Sofiatin Y, Dikot Y. Dementia Prevalence, Comorbidities, and Lifestyle Among Jatinangor Elders. Front Neurol 2021; 12:643480. [PMID: 34367043 PMCID: PMC8345013 DOI: 10.3389/fneur.2021.643480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 06/22/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Research on dementia prevalence and the potentially related risk factors from Indonesia is scarce. We sought to identify the prevalence of dementia, health risk factors, and lifestyle in Jatinangor elders. Methods: A total of 686 participants completed questionnaires on lifestyle, health risk factors, and cognitive and functional tests from September 2013 to December 2013. We determined the prevalence of dementia; and the associations between health, leisure activities, dietary pattern, and dementia were analyzed using logistic regression. Results: The prevalence of dementia was 29.15%. The risk factors differed between age groups. Those aged 60–74 years and who have a lower education level, lower occupational attainment, and less active intellectual and recreational activities were associated with higher dementia risk. Those aged > 75 years living in a rural area and who take less fruit were associated with a higher risk of dementia. Conclusions: The prevalence of dementia in Jatinangor is high. The identified modifiable risk factors are a potential target for intervention and valuable for designing public health policies.
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Affiliation(s)
- Paulus Anam Ong
- Department of Neurology, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Febby Rosa Annisafitrie
- Department of Neurology, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Novita Purnamasari
- Department of Neurology, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Chandra Calista
- Department of Neurology, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Noveline Sagita
- Department of Neurology, Immanuel Hospital, Maranatha Christian University, Bandung, Indonesia
| | - Yulia Sofiatin
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Yustiani Dikot
- Department of Neurology, Faculty of Medicine, Achmad Yani University, Bandung, Indonesia
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9
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Rizka A, Indrarespati A, Dwimartutie N, Muhadi M. Frailty among Older Adults Living in Nursing Homes in Indonesia: Prevalence and Associated Factors. Ann Geriatr Med Res 2021; 25:93-97. [PMID: 33975423 PMCID: PMC8272998 DOI: 10.4235/agmr.21.0033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 05/07/2021] [Indexed: 11/21/2022] Open
Abstract
Background Frailty syndrome is a predictor of all-cause mortality among older adults living in nursing homes. However, data on the prevalence of frailty among individuals living in nursing homes, particularly in middle-income countries, are limited. Thus, this study aimed to determine the prevalence of frailty and identify its associated factors among older adults living in nursing homes in Indonesia. Methods This cross-sectional study of older adults living in six nursing homes in Indonesia was conducted between May and December 2019. Data on demographic characteristics, physical activity (Physical Activity Scale for the Elderly), cognitive status (Abbreviated Mental Test), nutritional status (Mini Nutritional Assessment Short-Form), depression (Geriatric Depression Scale), comorbidity, frailty state (Cardiovascular Health Study criteria), dietary pattern (24-hour food recall), handgrip strength, and gait speed were evaluated. Bivariate and multivariate analyses were performed to identify factors independently associated with frailty. Results This study recruited a total of 214 participants with a mean age of 73.68±4.30 years. The prevalence rates of frailty and malnutrition were 46.5% and 58%, respectively. The results showed that physical frailty was associated with malnutrition (odds ratio=4.23; 95% confidence interval, 1.730–10.380). Conclusion Frailty was prevalent and strongly associated with malnutrition among older adults living in nursing homes in Indonesia.
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Affiliation(s)
- Aulia Rizka
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta Indonesia
| | - Andika Indrarespati
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
| | - Noto Dwimartutie
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta Indonesia
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Muth AK, Park SQ. The impact of dietary macronutrient intake on cognitive function and the brain. Clin Nutr 2021; 40:3999-4010. [PMID: 34139473 DOI: 10.1016/j.clnu.2021.04.043] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/19/2021] [Accepted: 04/23/2021] [Indexed: 12/20/2022]
Abstract
Macronutrients - carbohydrates, fats, and proteins - supply the nutrients required for optimal functioning. Inadequate intake compromises both physical and brain health. We synthesized research on macronutrients from whole meals on cognitive function in healthy adults and identified underlying mechanisms. Intake of simple carbohydrates ('sugars') is consistently associated with decreased global cognition whereas consumption of complex carbohydrates correlates with successful brain aging and improved memory both in the short- and long-term. Saturated fatty acid intake correlates with decreased memory and learning scores whereas omega-3 intake correlates positively with memory scores. Protein intake boosts executive function and working memory when task-demands are high. Individual differences affecting the macronutrient-cognition relationship are age, physical activity, and glucose metabolism. Neural correlates reflect findings on cognitive functions: cortical thickness and cerebral amyloid burden correlate with sugar intake, inflammatory status and cerebral glucose metabolism correlate with fatty acid intake. Key mechanisms by which dietary macronutrients affect the brain and cognition include glucose and insulin metabolism, neurotransmitter actions, and cerebral oxidation and inflammation. In conclusion, macronutrient intake affects cognitive function both acutely and in the long-term, involving peripheral and central mechanisms. A healthy diet supports brain integrity and functionality, whereas inadequate nutrition compromises it. Studying diet can be key to nutritional recommendations, thereby improving the landscape of mental health and healthy brain aging.
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Affiliation(s)
- Anne-Katrin Muth
- Department of Decision Neuroscience and Nutrition, German Institute of Human Nutrition (DIfE), Potsdam-Rehbrücke, Germany; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Neuroscience Research Center, 10117, Berlin, Germany.
| | - Soyoung Q Park
- Department of Decision Neuroscience and Nutrition, German Institute of Human Nutrition (DIfE), Potsdam-Rehbrücke, Germany; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Neuroscience Research Center, 10117, Berlin, Germany; Deutsches Zentrum für Diabetes, Neuherberg, Germany.
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11
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Bortone I, Sardone R, Lampignano L, Castellana F, Zupo R, Lozupone M, Moretti B, Giannelli G, Panza F. How gait influences frailty models and health-related outcomes in clinical-based and population-based studies: a systematic review. J Cachexia Sarcopenia Muscle 2021; 12:274-297. [PMID: 33590975 PMCID: PMC8061366 DOI: 10.1002/jcsm.12667] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/30/2020] [Accepted: 12/16/2020] [Indexed: 12/20/2022] Open
Abstract
Aging is often associated with a decline in physical function that eventually leads to loss of autonomy in activities of daily living (ADL). Walking is a very common ADL, important for main determinants of quality of life in older age, and it requires the integration of many physiological systems. Gait speed has been described as the 'sixth vital sign' because it is a core indicator of health and function in aging and disease. We reviewed original studies up to June 2020 that assessed frailty in both longitudinal and cross-sectional observational studies, paying particular attention to how gait is measured in older population and how the gait parameter adopted may influence the estimated frailty models and the health-related outcomes of the various studies (i.e. clinical, cognitive, physical, and nutritional outcomes). Eighty-five studies met the search strategy and were included in the present systematic review. According to the frailty tools, more than 60% of the studies used the physical phenotype model proposed by Fried and colleagues, while one-third referred to multi-domain indexes or models and only 5% referred to other single-domain frailty models (social or cognitive). The great heterogeneity observed in gait measurements and protocols limited the possibility to directly compare the results of the studies and it could represent an important issue causing variability in the different outcome measures in both clinical-and population-based settings. Gait appeared to be an indicator of health and function also in frail older adults, and different gait parameters appeared to predict adverse health-related outcomes in clinical, cognitive, and physical domains and, to a lesser extent, in nutritional domain. Gait has the potential to elucidate the common basic mechanisms of cognitive and motor decline. Advances in technology may extend the validity of gait in different clinical settings also in frail older adults, and technology-based assessment should be encouraged. Combining various gait parameters may enhance frailty prediction and classification of different frailty phenotypes.
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Affiliation(s)
- Ilaria Bortone
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Rodolfo Sardone
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Luisa Lampignano
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Fabio Castellana
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Roberta Zupo
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Madia Lozupone
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense OrgansUniversity of Bari Aldo MoroBariItaly
| | - Biagio Moretti
- Orthopaedics and Trauma Unit, Department of Basic Medicine, Neuroscience, and Sense OrgansUniversity of Bari Aldo MoroBariItaly
| | - Gianluigi Giannelli
- Scientific DirectionNational Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Francesco Panza
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense OrgansUniversity of Bari Aldo MoroBariItaly
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Guigoz Y, Vellas B. Nutritional Assessment in Older Adults : MNA® 25 years of a Screening Tool and a Reference Standard for Care and Research; What Next? J Nutr Health Aging 2021; 25:528-583. [PMID: 33786572 DOI: 10.1007/s12603-021-1601-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A tool to assess nutritional status in older persons was really needed. It took 5 years to design the MNA® (Mini Nutrition Assessment) tool, complete the first validations studies both in Europe and in the U.S. and to publish it. After the full MNA®, the MNA® short form and the self-MNA® have been validated. As well as Chinese and other national MNA® forms. Now more than 2000 clinical research have used the MNA® all over the world from community care to hospital. At least 22 Expert groups included the MNA® in new clinical practice guidelines, national or international registries. The MNA® is presently included in almost all geriatric and nutrition textbook and part of the teaching program for medicine and other health care professional worldwide. The urgent need is to target the frail older adults more likely to have weight loss and poor appetite and to prevent frailty and weight loss in the robust. We present in this paper the review of 25 years of clinical research and practice using the MNA® worldwide.
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Affiliation(s)
- Y Guigoz
- Yves Guigoz, Chemin du Raidillon, CH-1066 Epalinges, Switzerland.
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Widagdo TM, Rianto N, Restyandito, Kurniawan E. Correlates of visuospatial ability among older people in Indonesia. Indian J Community Med 2021; 46:614-617. [PMID: 35068720 PMCID: PMC8729291 DOI: 10.4103/ijcm.ijcm_526_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 04/03/2021] [Indexed: 11/07/2022] Open
Abstract
Introduction: The Indonesian elderly population keeps increasing. Aging is related with degeneration process, one of which is a decrease in cognitive function, including visuospatial ability. This is the first study on the visuospatial ability of Indonesian older people. Objective: This research aimed to assess the visuospatial ability and its correlation with sex, age, education, and general cognitive function among older people in Indonesia. Subjects and Methods: The research subjects were older people aged ≥60 years with Mini-Mental State Examination (MMSE) score ≥24. The visuospatial ability was assessed using Wechsler Adult Intelligence Scale-Revised (WAIS-R) Block Design Test (BDT). Regression analysis was performed to reveal the correlation of sex, age, education, and global cognitive function with visuospatial ability. Results: Sixty older people participated in this research, with an average age of 68.08 ± 6.24, mean MMSE score of 27.43 ± 1.71, and mean WAIS-R BDT score of 27.8 ± 7.27. The female and older individuals tended to have lower scores. Subjects with higher education and global cognitive function had higher WAIS-R BDT scores. Regression analysis showed that age and sex did not have significant effect, but education and global cognitive function had positive effect on visuospatial ability. Conclusion: There is a significant correlation between education and global cognitive function with visuospatial ability among older people in Indonesia.
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Malnutrition, low diet quality and its risk factors among older adults with low socio-economic status: a scoping review. Nutr Res Rev 2020; 34:107-116. [PMID: 32727634 DOI: 10.1017/s0954422420000189] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Low socio-economic status (SES) is often associated with various health-related problems. Therefore, the present paper aims to review the available literature to identify the prevalence of malnutrition, prevalence of poor diet quality and its associated risk factors among older adults with low SES. A literature search was performed using four databases, namely PubMed, Google Scholar, Springer and Science Direct. The search terms used were 'diet quality', 'nutritional status', 'dietary intake', 'overweight', 'obesity', 'underweight', 'older people' and 'low socioeconomic status (SES)'. The overall prevalence of undernutrition among older adults with low SES worldwide was in the range of 28·9 to 48 %, while overnutrition was reported to be between 8·1 to 28·2 %. In Asia, the prevalence of undernourished older adults ranged from 3 to 64·9 %, while 2·5 to 32·8 % were overnourished. Most of the studies (60 %) included in the present review used BMI as the tool to identify malnutrition, but none of the nutritional screening tools were considered to be the 'gold standard'. For dietary assessment, FFQ and multiple 24 h dietary recall improved the estimation of individual dietary intake. Risk factors for poor diet quality included financial hardship, functional limitation, sex, place of residence, smoking and oral health. Poor nutritional status, especially lack of good-quality diet, and thinness are prevalent among older adults with low SES. Hence, it is important to establish nutrition-related programmes and intervention studies among this group of individuals for improving their health status and quality of life.
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Kim JM, Bae YJ. Mineral Intake Status of Community-Dwelling Elderly from Urban and Rural Areas of South Korea: A Cross-Sectional Study Based on Korean National Health and Nutrition Examination Survey, 2013~2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103415. [PMID: 32422923 PMCID: PMC7277109 DOI: 10.3390/ijerph17103415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 05/12/2020] [Accepted: 05/12/2020] [Indexed: 01/06/2023]
Abstract
We aimed to evaluate the intake of minerals (calcium, phosphorous, sodium, and potassium) in the urban and rural elderly and explore the adequacy of intake and food sources for each mineral using nationwide big data. The study used data from the Korea National Health and Nutrition Examination Survey (KNHANES) between 2013 and 2016. We analyzed 5292 elderly individuals that were aged 65 years and older (2271 men, 3021 women). Daily calcium, phosphorous, sodium, and potassium intake, and they were analyzed using the 24-h dietary recall method. Additionally, the adequacy of intake and food sources for each mineral was analyzed. Blood triglyceride level was significantly higher in rural elderly than in urban elderly. The intake of calcium and potassium per 1000 kcal of energy intake was significantly lower in the rural elderly, and the proportion of participants with calcium intake below the Estimated Average Requirement was significantly higher in the rural elderly than in the urban elderly. The intake of calcium, phosphorous, and potassium in the rural elderly was lower than that in the urban elderly. These results can be used as basic data when making social and environmental policies for the health of the elderly and when providing targeted dietary education for the management of chronic diseases for the elderly.
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Affiliation(s)
- Ji-Myung Kim
- Food and Nutrition Major, Division of Food Science and Culinary Arts, Shinhan University, Uijeongbu, Gyeonggi 11644, Korea;
| | - Yun-Jung Bae
- Major in Food and Nutrition, Division of Food Science and Biotechnology, Korea National University of Transportation, Jeungpyeong 27909, Korea
- Correspondence:
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Eating Habits in Older Adults: Compliance with the Recommended Daily Intakes and Its Relationship with Sociodemographic Characteristics, Clinical Conditions, and Lifestyles. Nutrients 2020; 12:nu12020446. [PMID: 32053923 PMCID: PMC7071317 DOI: 10.3390/nu12020446] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 01/25/2023] Open
Abstract
Background: Older people have different nutritional requirements from those of the general population; in particular, they need a lower energy intake, higher protein content to preserve muscle mass, and a greater supply of vitamins and minerals to maintain good bone health. The objective of this study is to evaluate the degree of compliance with nutritional recommendations, and its relationship with sociodemographic characteristics, clinical conditions, and lifestyles in older people residing in the Spanish Mediterranean. METHODS Cross-sectional study with 341 people over 60 years old. Participants were selected using a snowball strategy. A validated food intake frequency questionnaire for older populations was used to determine the daily food intake. This evaluation was carried out at two time points from which the average nutrient intake was obtained. Sociodemographic, clinical, and lifestyle variables were obtained from an ad hoc elaborated questionnaire. RESULTS Compliance with dietary intakes was low, by deficiency, such as in vitamin D, where none of the participating subjects met the requirements, and iodine, where the compliance rate did not exceed 20%, or by excess, such as with monounsaturated fatty acids, fiber, iron, B vitamins, vitamin E, and vitamin C. People with better blood pressure, cholesterol, and glucose levels observed a higher degree of compliance with the recommended intakes. Living in rural areas, being divorced, or being illiterate negatively influence meeting the recommended intakes of certain nutrients. Increased physical activity was associated with an increased compliance with Kcal recommendations, cholesterol, and vitamin B2 intake. CONCLUSION this study highlights the importance of accurately knowing the dietary intakes in the older population, and what factors, such as lifestyles or sociodemographic characteristics, may predispose to better or worse compliance with the recommendations.
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Obesity Is Less Frequently Associated with Cognitive Impairment in Elderly Individuals: A Cross-Sectional Study in Yogyakarta, Indonesia. Nutrients 2020; 12:nu12020367. [PMID: 32019161 PMCID: PMC7071195 DOI: 10.3390/nu12020367] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 12/16/2022] Open
Abstract
Obesity is one of the factors associated with cognitive impairment. However, obesity may differently affect cognitive function in different age groups, and scarce data are available from low- and middle-income countries. This cross-sectional study aimed to identify the association between obesity and cognitive impairment among 143 elderly individuals in Yogyakarta. We recorded the sociodemographic factors and some comorbidities, also measured the body mass index as a parameter of obesity, cognitive function using Montreal Cognitive Assessment—Indonesia, mood condition and depression status using geriatric depression scale-short form, as well as the daily life function using Activity of Daily Living and Instrumental Activity of Daily Living. After adjustment for the sociodemographic and comorbidities, we found that subjects with older age were more likely to have cognitive impairment (odds ratio [OR] 3.544, 95%CI: 1.36–9.22, p < 0.01) and compared with elderly individuals with normal weight, obese elderly individuals were 40% less likely to have cognitive impairment (OR 0.604, 95%CI: 0.39–0.95, p < 0.05). This study suggests that obesity in elderly individuals is less frequently associated with cognitive impairment. These findings support the reverse causation mechanism related to body mass index (BMI) and cognitive impairment in low/middle-income countries.
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Fitrina K, Fahmi B, Supriyati S. Community engagement strategy for healthy diet in urban community: A phenomenological study. BIO WEB OF CONFERENCES 2020. [DOI: 10.1051/bioconf/20202805001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Unhealthy diet is the risk factors for non-communicable diseases with limited intervention in Indonesia. Environmental change interventions are known to be effective in encouraging changes in healthy diet. However, community engagement is needed to ensure the adoption of the behaviour. This study seeks to identify the strategy to engage urban community in healthy diet intervention. Qualitative research with phenomenological approach was conducted in Yogyakarta, Indonesia. Samples were selected among citizens of Yogyakarta city with the age range from 19 yr old to 65 yr old. The informants consist of lay persons, cadres and stakeholders. Data from 87 respondents were collected through 7 focus group discussions and 2 in-depth interviews. Strategies to engage community in healthy eating interventions consists of 3 main themes: i) intervention’s characteristics, ii) information characteristics and iii) the information channel. The intervention’s expected characteristics are aimed at various ages, using family approach through stakeholder support and collaboration and by increasing cadre’s capacity and providing opportunity to manage funding. Information characteristics are accessible, valid, up to date and personal. Information can be disseminated through virtual and non-virtual media. Community engagement strategies in healthy eating interventions should be segmented, strengthening the role of family and easily accessible.
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Surendran S, Aji AS, Ariyasra U, Sari SR, Malik SG, Tasrif N, Yani FF, Lovegrove JA, Sudji IR, Lipoeto NI, Vimaleswaran KS. A nutrigenetic approach for investigating the relationship between vitamin B12 status and metabolic traits in Indonesian women. J Diabetes Metab Disord 2019; 18:389-399. [PMID: 31890664 PMCID: PMC6914754 DOI: 10.1007/s40200-019-00424-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 07/09/2019] [Indexed: 12/24/2022]
Abstract
PURPOSE Adverse effects of maternal vitamin B12 deficiency have been linked to major clinical outcomes, including increased body mass index and gestational diabetes, however, less is known about vitamin B12 nutrition in non-pregnant women. Hence, the aim of the present study was to explore the relationships between metabolic traits and vitamin B12 status in a cohort of healthy Indonesian women and to investigate whether these relationships were modified by dietary intake using a genetic approach. METHODS A total of 117 Minangkabau women (aged 25-60 years), from the city of Padang, West Sumatra underwent anthropometric, biochemical, dietary intake analysis and genetic tests. Genetic risk scores (GRS) based on nine vitamin B12 associated single nucleotide polymorphisms (SNPs) (B12-GRS) and nine metabolic SNPs (metabolic-GRS) were constructed. RESULTS The B12-GRS and metabolic-GRS had no effect on vitamin B12 (P > 0.160) and metabolic traits (P > 0.085). However, an interaction was observed between the B12-GRS and dietary fibre intake (g) on glycated haemoglobin (HbA1C) levels (P interaction = 0.042), where among those who consumed a low fibre diet (4.90 ± 1.00 g/day), individuals carrying ≥9 risk alleles for vitamin B12 deficiency had significantly higher HbA1C levels (P = 0.025) compared to those carrying ≤8 risk alleles. CONCLUSION Our study showed a significant impact of the B12-GRS on HbA1C concentrations through the influence of a dietary factor, however, our study failed to provide evidence for an impact of metabolic-GRS on lowering B12 concentrations. Further replication studies utilizing larger sample sizes are needed to confirm our findings.
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Affiliation(s)
- S. Surendran
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - A. S. Aji
- Department of Biomedical Science, Faculty of Medicine, Andalas University, Padang, West Sumatra Indonesia
| | - U. Ariyasra
- Department of Biomedical Science, Faculty of Medicine, Andalas University, Padang, West Sumatra Indonesia
| | - S. R. Sari
- Department of Biomedical Science, Faculty of Medicine, Andalas University, Padang, West Sumatra Indonesia
| | - S. G. Malik
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - N. Tasrif
- Public Health Department, Faculty of Medicine, Andalas University, Padang, Indonesia
| | - F. F. Yani
- Department of Child Health, Faculty of Medicine, Andalas University, Padang, Indonesia
| | - J. A. Lovegrove
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading, UK
- Institute for Cardiovascular and Metabolic Research (ICMR), University of Reading, Reading, UK
| | - I. R. Sudji
- Biomedical Laboratory, Faculty of Medicine, Andalas University, Padang, Indonesia
| | - N. I. Lipoeto
- Department of Nutrition, Faculty of Medicine, Andalas University, Padang, Indonesia
| | - Karani Santhanakrishnan Vimaleswaran
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading, UK
- Institute for Cardiovascular and Metabolic Research (ICMR), University of Reading, Reading, UK
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Abe T, Kitamura A, Seino S, Yokoyama Y, Amano H, Taniguchi Y, Nishi M, Narita M, Ikeuchi T, Tomine Y, Fujiwara Y, Shinkai S. Differences in the Prevalence of and Factors Associated with Frailty in Five Japanese Residential Areas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203974. [PMID: 31635223 PMCID: PMC6843904 DOI: 10.3390/ijerph16203974] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/14/2019] [Accepted: 10/15/2019] [Indexed: 12/29/2022]
Abstract
This study aimed to examine area differences in the prevalence of and factors associated with frailty. This cross-sectional study included metropolitan (eastern and western areas), suburban (districts A and B), and rural areas of Japan (n = 9182, woman 50.9%). Frailty was defined by using a standardized questionnaire comprising three subcategories (fall, nutritional status, and social activities). The prevalence of frailty in the five areas was 14.2% to 30.6% for men and 11.5% to 21.4% for women. The areas with a high frailty prevalence had a significantly lower nutritional status or social activity, or both. Compared to the western metropolitan area, among men, the multivariable-adjusted prevalence ratio (APR) of frailty was significantly higher in the eastern metropolitan area and lower in suburban district A, and among women, the eastern metropolitan and rural areas had significantly higher APRs. Area-stratified multiple Poisson regression analysis showed that age, bone and joint disease, and a subjective economic status were associated with frailty in most areas and that some factors were area-specific, i.e., living alone (for men living in metropolitan areas) and underweight (for women living in suburban areas). The frailty prevalence differed by area, even after multivariable adjustment. Area-specific characteristics and factors associated with frailty may result in area differences.
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Affiliation(s)
- Takumi Abe
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan.
- Japan Society for the Promotion of Science, Tokyo 102-0083, Japan.
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan.
| | - Satoshi Seino
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan.
| | - Yuri Yokoyama
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan.
| | - Hidenori Amano
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan.
| | - Yu Taniguchi
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba 305-0053, Japan.
| | - Mariko Nishi
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan.
| | - Miki Narita
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan.
| | - Tomoko Ikeuchi
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan.
| | - Yui Tomine
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan.
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan.
| | - Shoji Shinkai
- Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan.
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Aging, Mastication, and Malnutrition and Their Associations with Cognitive Disorder: Evidence from Epidemiological Data. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s40496-019-0220-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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