Comparison of Nutritional Status Between Nursing Home Residents and Community Dwelling Older Adults: a Cross-Sectional Study from Bosnia and Herzegovina

Healthcare and non-healthcare professionals' knowledge about nutrition in older adults: a cross-sectional study

BACKGROUND

Malnutrition frequently affects older adults, increasing their risk for numerous diseases, as well as healthcare costs. Therefore, nutritional assessment and appropriate nutritional support addressed to meet individual nutritional needs and prevent malnutrition and its consequences should be a fundamental part of healthcare for older adults. This study aimed to compare the knowledge of nutrition guidelines for older adults between healthcare and non-healthcare professionals working with older adults.

METHODS

The study was conducted during May and June 2021 using a validated "Knowledge of nutrition guidelines for older adults" questionnaire designed by Andrija Stampar Teaching Institute of Public Health, Croatia. The study participants were recruited from various institutions providing care for older adults in Split-Dalmatia and Dubrovnik-Neretva County. The final convenience sample consisted of 214 participants (163 healthcare professionals and 51 non-healthcare professionals). The obtained results were analyzed using descriptive and inferential statistics. The associations between participants' characteristics and knowledge about the importance of nutrition in disease prevention and treatment, the assessment of nutritional status in older adults, and clinical nutrition were analyzed using multiple linear regression models.

RESULTS

Participants' overall knowledge of nutrition guidelines for older adults was moderate in both groups, with healthcare professionals scoring a median of 7.0 (IQR = 1.0) and non-healthcare professionals scoring a median of 6.0 (IQR = 2.0). Compared to non-healthcare professionals, healthcare professionals had lower knowledge about the importance of nutrition in disease prevention and treatment (β = - 0.16; p = 0.024). No statistically significant differences were found between healthcare and non-healthcare professionals in the level of knowledge about the assessment of nutritional status in older adults (β = - 0.02; p = 0.769) and clinical nutrition (β = 0.08; p = 0.267).

CONCLUSIONS

This study highlights gaps in knowledge regarding dietary guidelines for older adults among healthcare and non-healthcare professionals working with this specific population group. These findings suggest that targeted educational programs might be needed to improve understanding of geriatric nutrition.

Malnutrition and Fall Risk in Older Adults: A Comprehensive Assessment Across Different Living Situations

BACKGROUND

Malnutrition among older adults is associated with numerous adverse effects, including increased morbidity, mortality, prolonged hospital stays, and a heightened risk of falls. This study aims to investigate the prevalence of malnutrition in different groups of older adults using the F-MNA, anthropometry, and s-albumin and the association between nutritional status and fall risk.

METHODS

A total of 228 participants aged 60 years and older were divided into three groups: (1) patients in an internal medicine ward, (2) individuals living in family homes, and (3) residents of care homes. Disease profiles, nutritional status (assessed using the F-MNA and SNAQ), body composition, fall risk, and biochemical markers were evaluated.

RESULTS

The results indicated the highest prevalence of malnutrition among hospitalized individuals. Fall risk was associated with age, calf circumference, the F-MNA, the SNAQ, serum albumin levels, residence in a care home, comorbidities, and the number of medications taken daily. Regression analysis revealed that age, calf circumference, and residence in a care home were independent predictors of fall risk in older adults.

CONCLUSION

Older adults are at significant risk of malnutrition, with the risk notably increasing during hospitalization and long-term stays in care homes. Hospitalized individuals had the poorest nutritional status and were at significant risk of further weight loss, underscoring the importance of post-discharge care and rehabilitation.

Associations of the oral microbiota and Candida with taste, smell, appetite and undernutrition in older adults

Poor taste and smell function are widely thought to contribute to the development of poor appetite and undernutrition in older adults. It has been hypothesized that the oral microbiota play a role as well, but evidence is scarce. In a cross-sectional cohort of 356 older adults, we performed taste and smell tests, collected anthropometric measurements and tongue swabs for analysis of microbial composition (16S rRNA sequencing) and Candida albicans abundance (qPCR). Older age, edentation, poor smell and poor appetite were associated with lower alpha diversity and explained a significant amount of beta diversity. Moreover, a lower Streptococcus salivarius abundance was associated with poor smell identification score, whereas high C. albicans abundance seemed to be associated with poor smell discrimination score. In our population, neither the tongue microbiota, nor C. albicans were associated with poor taste or directly with undernutrition. Our findings do suggest a host-microbe interaction with regard to smell perception and appetite.

Impact of periodontal disease and chewing ability on the quality of life of the elderly in an affluent community

BACKGROUND/PURPOSE

Improvement of the medical and social environment is an important aspect of government policies in assuring the quality of life (QoL) of older adults. However, few studies have appraised the impact and relationship of QoL with clinical factors among elderly individuals in affluent residential areas.

METHODS

A total of 166 older adults from Chang Gung Health and Culture Village were enrolled. Oral health-related QoL was measured using the Geriatric Oral Health Assessment Index. Self-assessed chewing abilities and demographic characteristics were collected by questionnaire. Physical health was scored by activities of daily living (ADL) and instrumental ADL. Mini nutrition assessment questionnaire was used to evaluate the nutritional intake. Multiple linear regression was used to predict risk factors affecting QoL and to examine whether chewing ability was a mediator of oral health-related QoL.

RESULTS

Poor chewing ability was associated with older age (OR = 1.82 for 76-85 years and 3.58 for 86-95 years), sufficient economic status (OR = 5.55) and removable denture-wearing (OR = 7.52). On the other hand, poor chewing ability (OR = 0.11), removable denture-wearing (OR = 0.48), periodontal disease (OR = 0.38) had lower likelihood of good oral health-related QoL. Mediator analyses showed that chewing ability was a mediator for the association between oral health-related QoL and economic status or removable denture-wearing or having more than 20 teeth. Periodontal disease was an independent factor for oral health-related QoL.

CONCLUSION

Among older adults in an affluent community, periodontal disease is an independent risk factor directly related to oral health-related QoL, whereas chewing ability is a mediator between QoL and removable denture-wearing.

Handgrip Strength Cut-Off Values for the Undernutrition Risk Screening among Elderly Men and Women in Bosnia and Herzegovina

OBJECTIVES

To determine the optimal cut-off points of handgrip strength (HGS) to identify the undernutrition risk among individuals older than 65 years of age in Bosnia and Herzegovina.

DESIGN

Cross-sectional study.

SETTING

Towns of Sarajevo, Foca, Rogatica, and Pale in Bosnia and Herzegovina.

PARTICIPANTS

300 community-dwelling older adults and 146 nursing home residents. Comprehensive Geriatric multidimensional assessment (CGA) was carried out to evaluate general health, functional, and cognitive capabilities. Nutritional status and undernutrition risk were assessed by Mini Nutritional Assessment (MNA) and Seniors in the Community: risk evaluation for eating and nutrition, version II (SCREEN II). HGS was measured with a Smedley dynamometer.

RESULTS

According to the classification of nutritional status by MNA, 42% of community-dwelling men and 39% of community-dwelling women were at undernutrition risk. The undernutrition risk was significantly higher among nursing home residing men (89%) and women (78%) (p < 0.001). When nutritional status was assessed by SCREEN II, 100% on nursing home residents, 86% of community-dwelling men and 80% of women were identified as having a high risk for undernutrition. Per MNA, HGS cut-off thresholds were 23.50 kgF (65-74 years) and 19.50 kgF (≥75 years) for men; 15.50 kgF (65-74 years) and 13.50 kgF (≥75 years) for women. Per SCREEN II, cut-points were 28.50 kgF (65-74 years) and 24.50 kgF (≥75 years) for men; 24.50 kgF (65-74 years), 19.50 kgF (≥75 years for women).

CONCLUSION

HGS can be a useful instrument to identify undernutrition risk among the elderly patients. This study provides threshold for men and women older than 65 years of age in Bosnia and Herzegovina.