Validation and Reliability Assessment of the Mini-Nutritional Assessment-Short Form Questionnaire among Older Adults in South India

Chain mediating effect of frailty and depression between nutrition and quality of life in elderly stroke patients

Elderly stroke patients generally have a lower quality of life. This study aimed to investigate the mediating role of frailty and depression in the relationship between nutrition and quality of life in elderly stroke patients. The researcher used the convenience sampling method to select 193 cases of elderly stroke patients who were admitted to the Department of Neurology of a tertiary general hospital in Qingdao from July 2023 to March 2024, and the questionnaires were investigated using the General Information Questionnaire, the Tilburg Frailty Assessment Index Scale (TFI), the Depression Screening Scale (PHQ-9), the Simplified Quality of Life Scale for Stroke Patients (SV-SS-QoL), and the Mini-Nutrition Assessment Scale (MNA-SF). The incidence of malnutrition was 47.2% in elderly stroke patients, whereas the quality of life score was 43.00 (40.00, 47.00), frailty was 6.00 (2.00, 8.00), and depression was 6.00 (4.00, 7.00). The mediating effect analysis showed that the chain mediating effect of frailty and depression on nutrition and quality of life in elderly stroke patients was significant, with a total indirect effect of 0.155, the mediating effect of depression as the mediating variable accounted for 54.2% of the total indirect effect, the mediating effect of frailty as the mediating variable accounted for 25.2% of the total indirect effect, and the chain mediating effect of frailty and depression between nutrition and quality of life of elderly stroke patients accounted for 20.6% of the total indirect effect. It is proven that in elderly stroke patients, depression and frailty have a chain mediating effect on nutrition and quality of life. Healthcare professionals should quickly do nutritional assessments and take the necessary actions to enhance patients' nutritional status, prevent depression and frailty, and enhance their quality of life.

Prevalence of Malnutrition and Associated Factors Among the Elderly With Type 2 Diabetes Using MNA Form

Objective: This study has been conducted to identify the frequency of malnutrition and different factors associated with it among elderly people with Type 2 diabetes. Methods: This cross-sectional study was conducted in the National Institute of Diabetes and Endocrinology (NIDE), DUHS, Karachi, between January 2023 and October 2023. A total of 325 elderly participants aged ≥ 60 years with Type 2 diabetes were included. Mini Nutritional Assessment (MNA) was used for data collection. Results: Nutritional assessment of older diabetic patients according to the MNA revealed that 226 (69.5%) patients were at risk of malnutrition whereas 53 (16.3%) were malnourished. A total of 325 Type 2 diabetic patients were included in the study with a mean age of 65.7 ± 5.5 years, where 135 (41.5%) were male and 190 (58.5%) were female. Older patients (mean age: 65 years) were significantly more malnourished compared to those with normal nutrition (mean age: 62 years; p=0.021). Employed patients were less likely to have the risk of malnutrition as compared to housewives (p=0.005). Patients who had low family income were eight times more likely to be malnourished as compared to those who had better family income (p=0.003). It was also found that patients with low BMI and calf circumference will be more prone to be malnourished as compared to those with high levels of BMI (p=0.003) and calf circumference (p=0.013). Conclusion: The majority of study participants were at risk of malnourishment, with associated factors such as rapid weight loss, poor health status, decline in physical activity, and food intake. Therefore, these findings highlight the importance of tailored interventions for at-risk individuals, including regular screening and nutritional support.

Risk prediction model of physical frailty for a rural older population: a cross-sectional study in Hunan Province, China

Introduction

Physical frailty is a common medical syndrome characterized by low muscle strength, low endurance, and reduced physiological function that leads to significantly negative health outcomes in older adults. This study investigated the risk variables among rural older adults in Hunan Province, China, and developed a physical frailty prediction model to inform policymaking to enhance their health and well-being.

Methods

This study was conducted from July 22 to September 3, 2022. A total of 291 participants were recruited using stratified cluster random sampling from five large villages in Hunan Province. Frailty screening was performed based on the Fatigue, Resistance, Ambulation, Illnesses, and Loss of Weight (FRAIL) scale, Geriatric Depression Scale 15-item version (GDS-15), Falls Efficacy Scale-International (FES-I), and Mini Nutrition Assessment-Short Form (MNA-SF). A logistic regression analysis was performed to identify the predictive factors for physical frailty and develop a physical frailty prediction model based on the area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity, and Youden index.

Results

The physical frailty prevalence among rural older adults in Hunan Province was 21.31% (n = 62). Household income and expenditure [odds ratio (OR): 1.826, 95% confidence interval (CI): 1.142-2.918], physical exercise frequency (OR: 1.669, 95% CI: 1.137-2.451), depressive symptoms (OR: 9.069, 95% CI: 3.497-23.516), and fear of falling (OR: 3.135, 95% CI: 1.689-5.818) were identified as significant predictors of physical frailty in rural older individuals. The AUC for the frailty predictive model was 0.860 (95% CI: 0.805, 0.914). The sensitivity and specificity at the optimal cutoff value were 80.6 and 76.0%, respectively, with a Youden index of 0.566.

Conclusion

The prediction model constructed in this study demonstrated promise as a potential tool for evaluating physical frailty risk in older adults, which can contribute to healthcare providers' screenings for high-risk populations. Further multidimensional and experimental intervention studies should be conducted to prevent the occurrence and delay the progression of physical frailty in older adults.

Malnutrition and other associated factors among the hospitalized elderly in Vietnam: A cross-sectional study

Malnutrition is common among older inpatients and can lead to severe consequences such as disability, assisted living, increased mortality, and prolonged hospital stays. Given the rapidly aging population in Vietnam, limited data is available regarding the nutritional status of the geriatric. This research aimed to determine the prevalence of malnutrition and associated factors among the hospitalized elderly. A prospective observational study with a cross-sectional design was conducted on 108 older inpatients at University Medical Center in Ho Chi Minh City, Vietnam. Patients aged 60 years or older admitted to the hospital were recruited. Malnutrition was assessed using a validated Mini Nutritional Assessment Short Form. Sociodemographic characteristics were measured using interview-administered questionnaires. Data about patients' biochemical parameters were retrieved from records with the newest results. Among 108 hospitalized patients (mean age 74.6 ± 9.8 years; 50% female), 72.2% of patients had malnutrition (n = 78) while 27.8% had normal nutritional status (n = 30). Age group, education level, cohabitation, serum albumin, hand-drip strength, physical inactivity, and frailty were associated with malnutrition. The prevalence of malnutrition in the elderly accounts for a very high proportion. Nutritional status assessment is essential for the elderly; therefore, more attention should be paid to those risk factors in old age health care in order to improve medical outcomes.

Assessment of Nutritional Status among Elderly Hospitalized Patients in Enugu, Nigeria: A Hospital-based Study

Background

The ageing population worldwide presents a significant challenge for healthcare systems, with malnutrition being a common problem among elderly individuals, particularly those hospitalized. Assessing nutritional status is crucial for identifying and addressing malnutrition in this population. This study aimed to assess the prevalence of malnutrition among elderly hospitalized patients in a Nigerian tertiary healthcare setting.

Methodology

This was a hospital-based descriptive and cross-sectional study conducted from March to June 2023, involving 122 patients aged 60 years and above. Demographic data and anthropometric measurements were collected, and the Short-form Mini Nutritional Assessment (MNA-SF) tool was used to assess nutritional status. The reliability of the MNA-SF was assessed using Cronbach's α coefficient and item-to-total score correlations.

Results

The mean MNA score was 14.4 ± 5.3, with 71.3% of participants classified as malnourished, 22.1% at risk of malnutrition, and 6.6% well-nourished. Significant differences were observed in the body mass index (BMI) of nourished, at-risk, and malnourished individuals respectively (23.3 ± 3.6 kg/m2, 22.5 ± 3.8 kg/m2, and 19.6 ± 2.8 kg/m2, p < 0.001). The MNA-SF tool demonstrated acceptable reliability (Cronbach's α coefficient = 0.777), with significant correlations between total MNA scores and most MNA-SF questions.

Conclusion

The high prevalence of malnutrition among elderly hospitalized patients in this Nigerian tertiary hospital emphasizes the importance of implementing routine nutritional screening protocols and targeted nutritional interventions for improved health outcomes among the elderly.

Evaluation of oral health, taste perception, nutritional status and emotional well-being in post-menopausal women

BACKGROUND

In postmenopausal women (PMW), vasomotor symptoms, emotional oscillations and sleep disturbances can affect physiological and psychological functioning. However, the effect of menopause on oral health-related parameters is not been thoroughly studied.

OBJECTIVE

To evaluate oral health, taste perception, eating habits, nutritional status and emotional well-being in PMW compared with a group of young and healthy pre-menopausal women (PrMW).

MATERIALS AND METHODS

Two groups (Group I: PMW and Group II: PrMW) with 30 participants each, participated in the cross-sectional study. The study proforma contained measures of oral health, taste perception, nutritional status and anxiety levels of the women in both groups using validated and previously used tools were designed and implemented. The data were analysed with student t, Mann-Whitney U, and chi-squared tests to evaluate the differences between the two groups.

RESULTS

The cross-sectional study indicates no major differences in oral health, taste perception, nutritional and emotional status between PMW and PrMW. Nonetheless, there was a significant difference in perception of 'front teeth lengthening in size' and change in hot and cold sensations between the groups. Furthermore, the study group with PMW tends to have fewer natural teeth than the reference group.

CONCLUSION

Overall, menopause does not appear to affect oral health, taste perception, nutrition or emotional health. It is suggested that oral health and taste perception, as well as nutritional and emotional status, are associated with gradual aging processes that may or may not be affected by menopause.

Prevalence of sarcopenia and its association with diet and physical activity in older adults with type 2 diabetes: A cross-sectional study

This cross-sectional study explored the prevalence of sarcopenia in older adults with type 2 diabetes and investigated the effects of diet and physical activity on sarcopenia. In total, 577 older adults with diabetes were recruited from a teaching hospital in Taiwan. Diet and physical activity were assessed using self-rated questionnaires, including the Healthy Diet Inventory, the Mini Nutritional Assessment-Short Form, and the International Physical Activity Questionnaire-Short Form. Sarcopenia was defined in accordance with the Asian Working Group for Sarcopenia 2019 guidelines. In total, 51.12% of participants had either possible sarcopenia, sarcopenia, or severe sarcopenia. Participants who were female, old age, prolonged sedentary times, poor nutritional status, and lower level of moderate-to-vigorous physical activity were identified as risk factors for possible to severe sarcopenia. Older adults with diabetes and possible to severe sarcopenia had poor nutrition status and engaged in inadequate physical activity. The findings indicate that sarcopenia may be related to nutrition status and physical activity, especially in older adults with diabetes.

Nutritional Status Predicts Injurious Falls Among Community-Dwelling Older Adults: Does Sex Matter?

The association of poor nutritional status with falls-related injuries other than fractures is unclear. Although there are sex differences in poor nutritional status and the rate of falls-related injuries, whether the impacts of poor nutritional status on falls-related injuries differ by sex is unclear. We investigated whether baseline poor nutritional status predicted injurious falls, fall-related minor injuries, and fractures at 3-year follow-up and whether these relationships differed by sex among community-dwelling older adults (N = 3257). We found that being at risk of malnutrition at baseline significantly predicted injurious falls but not minor injuries and fractures at follow-up. Compared to older males at risk of malnutrition at baseline, females at risk of malnutrition were significantly more likely to have injurious falls and minor injuries later. Being at risk of malnutrition predicted injurious falls, especially among older females. Regular nutritional screenings among older females should be implemented to provide prompt interventions against falls.

The assessment of geriatric malnutrition, geriatric depression and associated co-morbidities among forcibly displaced Myanmar nationals in Bangladesh

OBJECTIVE

To assess the nutritional status and depression of the elderly forcibly displaced Myanmar nationals (FDMN) in Bangladesh and determine the associated factors of geriatric depression (GD).

DESIGN

This was a community-based, cross-sectional study among elderly FDMN. The Mini Nutritional Assessment Short-Form (MNA@-SF) and Geriatric Depression Scale Short-Form (GDS-15 SF) were used to determine malnutrition and GD, respectively.

SETTING

The study was conducted between November 2021 and March 2022 in Kutupalong Refugee Camp, Cox's Bazar, Bangladesh.

PARTICIPANTS

The study participants were elderly FDMN aged ≥ 60 years (n 430).

RESULTS

The mean age and BMI were 71·7(±7·8) years and 21·94(±2·6) kg/m2, respectively. There was a high prevalence of self-reported diabetes mellitus (32·1 %), hypertension (26·7 %), hypotension (20 %), skin diseases (28·4 %) and chronic obstructive pulmonary disease (16·5 %). The prevalence of malnutrition was 25·3 %, and another 29·1 % were at risk. The prevalence of GD was 57·9 %, and co-occurrences of GD and malnutrition were seen in 17·5 % of participants. GD was significantly higher among elderly people with malnutrition (adjusted OR, AOR = 1·71, 95 % CI: 1·01, 2·89). FDMN aged ≥ 80 years were at higher risk of GD (AOR = 1·84, 95 % CI: 1·01, 3·37), and having fewer than five members in the household was an independent predictor of GD. Diabetes mellitus (AOR = 1·95, 95 % CI: 1·24, 3·08) and hypotension (AOR = 2·17, 95 % CI: 1·25, 2·78) were also significantly associated with an increased risk of GD.

CONCLUSION

A high prevalence of GD and malnutrition was observed among elderly FDMN in Bangladesh. The agencies working in Cox's Bazar should focus on geriatric malnutrition and GD for the improvement of the health situation of FDMN in Bangladesh.

The relationships between physical function, nutrition, cognitive function, depression, and sleep quality for facility-dwelling older adults with dynapenia

BACKGROUND

The growing population of older adults worldwide is associated with an extended life expectancy and an increasing proportion of older adults with dynapenia. Most research on dynapenia has involved only populations of older adults living in the community; little research has examined the effects of risk factors on sleep quality among older adults with dynapenia residing in assisted living facilities.

AIM

This study examined the relationships among physical function, nutrition, cognitive function, depression, and sleep quality among older adults with dynapenia residing in assisted living facilities.

METHODS

In this cross-sectional study, data on physical function, nutrition, cognitive function, depression, and sleep quality was collected from 178 older adults with dynapenia residing in assisted living facilities, who were selected using purposive sampling. Descriptive statistical analysis, independent-sample t tests, chi-squared tests, and logistic regression analysis were performed using SPSS 25.0.

RESULTS

The statistical analyses revealed correlations between sleep quality and age (t = 2.37, p < 0.05), level of education (χ2 = 3.85, p < 0.05), grip strength (t = 3.40, p < 0.01), activities of daily living (t = 4.29, p < 0.001), instrumental activities of daily living (t = 2.23, p < 0.001), calf circumference (t = 2.89, p < 0.01), Mini Nutritional Assessment scores (t = 2.29, p < 0.05), Mini Mental State Exam (MMSE) scores (t = 4.50, p < 0.001), and Geriatric Depression Scale (GDS) scores (t = - 4.20, p < 0.001). Calf circumference (OR = 0.8, 95% CI = 0.650.97, p < 0.05), GDS score (OR = 1.42, 95% CI = 1.05-1.92, p < 0.05), and MMSE score (OR = 0.85, 95% CI = 0.73-0.97, p < 0.05) were related to sleep quality among the sample population.

CONCLUSION

Physical function, nutrition, cognitive function, and depression affect the sleep quality of older adults with dynapenia residing in assisted living facilities. Facility nurses must regularly assess these aspects of their patients to ensure that facility-dwelling older adults can maintain their physical function and improve their health to improve the quality of their sleep.

Factors associated with vitamin D deficiency among patients with musculoskeletal disorders seeking physiotherapy intervention: a hospital-based observational study

Background

A considerable number of studies have suggested that there is a strong correlation between 25-hydroxyvitamin D or vitamin D levels and overall health, with reported impacts ranging from mental health and vital organ health to musculoskeletal health. This study aimed to determine the prevalence of 25-hydroxyvitamin D deficiency and identify its associated factors among patients with musculoskeletal disorders (MSDs) currently seeking medical attention.

Methods

A total of 143 patients with MSDs were randomly selected for blood sample collection to measure serum 25-hydroxyvitamin D levels. Descriptive statistics were used to describe the demographic and clinical characteristics of the study participants. Multiple logistic regression analyses were performed to compute the adjusted odds ratio.

Results

Overall, 53.1% of patients had vitamin D deficiency. Vitamin D deficiency was more prevalent among patients with higher body mass index, a bachelor’s degree, lower sun exposure time, and lower serum calcium levels and those living in an urban setting. The multiple logistic regression model suggested that the duration of weekly sun exposure and living location were the independent predictors of vitamin D deficiency.

Conclusion

It is recommended for patients with MSDs to participate in routine physical exercise, consume calcium- and vitamin D-enriched foods, and have regular sun exposure for minimizing the risk of vitamin D deficiency.