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Tavakoly Sany SB, Ahangari H, Rasoulifar A, Salimi M, Jamali J, Tehrani H. Nutrition self-efficacy intervention to improve nutritional status of Iranian older adults. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:22. [PMID: 38308332 PMCID: PMC10837981 DOI: 10.1186/s41043-024-00519-1] [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: 08/26/2023] [Accepted: 01/30/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVES Older adults are a vulnerable group that is at risk of poor nutritional status, which can lead to disease and increase their healthcare costs. Our study aimed to investigate the impact of a self-efficacy intervention on the nutritional status of older adults. METHODS A controlled before and after study was conducted on 110 older adults in the Mashhad, Iran, from 2020 to 2022. Participants were randomly allocated to the intervention (n = 55) and control groups (n = 55). Participants in the intervention group received educational training that was based on the self-efficacy theory. The control group received the routine care. Data collection tools included demographic information questionnaire, Mini Nutritional Assessment Questionnaire, and standard self-efficacy questionnaire. The questionnaires were completed at baseline (before intervention), instantly after the intervention, and at 3-months follow-up by participants in both groups. Data were analyzed using SPSS version 25 and the significance level was considered less than 0.05. RESULTS The Mean of nutritional status in the intervention group, at the baseline, immediately after intervention and 3 months of follow-up were 25.1 ± 2.3, 28.3 ± 5.2 and 27.6 ± 6., respectively. This increase was significant (p < 0.001). Our findings revealed that self-efficacy among participants in the intervention group significantly changed (P < 0.001) across time from baseline through follow-up. There was no significant difference in the mean of self-efficacy and nutritional status in the control group during the study period (P > 0.05). CONCLUSION This current study provided a basis to examine in the effectiveness of such intervention using a properly powered randomized controlled study. Therefore, it can be concluded that self-efficacy interventions are a promising approach to improving the nutritional behaviors of the older adults. TRIAL REGISTRATION IRCT20160619028529N9.
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Affiliation(s)
- Seyedeh Belin Tavakoly Sany
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health, Safety and Environment, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamideh Ahangari
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Rasoulifar
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mitra Salimi
- Management Education District of Mashhad, Mashhad, Iran
| | - Jamshid Jamali
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Tehrani
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Nutritional Status and the Affecting Factors in the Elderly in Gonbad Kavus, Iran. JOURNAL OF RESEARCH DEVELOPMENT IN NURSING AND MIDWIFERY 2021. [DOI: 10.52547/jgbfnm.18.1.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
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Doroudi T, Alizadeh-Khoei M, Kazemi H, Hormozi S, Taati F, Ebrahimi M, Koulivand P, Fakhrzadeh H, Davoudi I, Sharifi F. Comparison of Two Validation Nutrition Tools in Hospitalized Elderly: Full Mini Nutritional Assessment and Short-form Mini Nutritional Assessment. Int J Prev Med 2019; 10:168. [PMID: 32133086 PMCID: PMC6826692 DOI: 10.4103/ijpvm.ijpvm_132_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 05/22/2018] [Indexed: 01/04/2023] Open
Abstract
Background: The aim was to determine validity, reliability, and cutoff of full-mini nutritional assessment (MNA) and MNA-short form (SF) also which one was better for the screening of malnutrition in the Iranian hospitalized elderly. Methods: In this cross-sectional validation study, 96 hospitalized elderly ≥60 years selected from two hospitals in Tehran. Anthropometric measures (body mass index [BMI], mid-arm circumference [MAC], calf circumference [CC], abdomen, and waist skinfold thickness) and laboratory tests (albumin and hemoglobin levels, and red blood cell count were performed. Nutrition tools (full-MNA and MNA-SF), cognition tool (mini-mental state examination, depression scale (Geriatric Depression Scale15 and activities of daily living (ADL) index (Modified Barthel-ADL) were administered. Results: The full-MNA scores were significantly correlated to measures of MAC, BMI, waist, and CC. The MNS-SF scores were significantly related to measures of MAC, waist, and CC. Serum albumin showed a poor correlation with both tools. At cutoff 24 in full-MNA had a sensitivity 75% and specificity 77.8% and the MNA-SF considered 62.5% sensitivity and 65.3% specificity at cutoff 10.50 to detect well-nourished from malnourished subjects. The internal consistencies of both tools were >90%. In exploratory factor analysis, six components found for full-MNA and two components for MNA-SF. Known group validity of full-MNA was reflected significant differences between geriatric patients with expected higher full-MNA scores and patients with expected lower scores (BMI ≥24 vs. BMI <24 or bed ulcer or assisted food intake). Conclusions: It seems the Persian version of full-MNA is more appropriate in comparison to MNA-SF for screening malnutrition in the Iranian hospitalized elderly patients.
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Affiliation(s)
- Taher Doroudi
- Shefa Neuroscience Research Center, Khatam Alanbia Hospital, Tehran, Iran
| | - Mahtab Alizadeh-Khoei
- Department of Gerontology and Geriatric, Medical School, Tehran University of Medical Sciences, Tehran, Iran.,Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadi Kazemi
- Shefa Neuroscience Research Center, Khatam Alanbia Hospital, Tehran, Iran.,Medical School, Shahed University, Tehran, Iran
| | - Sakar Hormozi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Taati
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Ebrahimi
- Department of Internal Medicine, Faculty of Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hossein Fakhrzadeh
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Iran Davoudi
- Shefa Neuroscience Research Center, Khatam Alanbia Hospital, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Psychometric properties of the Persian version of the nutritional form for the elderly (NUFFE) in nursing home residents. Med J Islam Repub Iran 2019; 32:105. [PMID: 30815400 PMCID: PMC6387812 DOI: 10.14196/mjiri.32.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Indexed: 11/18/2022] Open
Abstract
Background: The Nutritional Form for the Elderly (NUFFE) is a newly developed tool. This study aimed to carry out a psychometric evaluation of the Persian version of NUFFE (NUFFE-P) among nursing home residents.
Methods: Nursing home participant’s aged ≥ 60 years (n=97) were enrolled. The inclusion criteria were residency for at least 6 months in the nursing home, and ability to communicate. Exclusion criteria included cognitive impairment, having depressed mood, severe hearing loss, problems in upper and lower extremities also, history of hospital admission during 6 months before enrollment. Anthropometric measures, laboratory tests, three-day food intake, NUFFE-P version, Mini Nutritional Assessment (MNA), Barthel Index (BI) and Geriatric Depression Scale (GDS-15) were assessed. The relationship between the NUFFE-P and MNA scores was considered as concurrent validity.
Results: The Cronbach’s alpha coefficient of NUFFE-P tool was 0.76. The intraclass correlation coefficient for the total score between two raters obtained 0.98 (CI 0.97-0.99). The correlation coefficient between the NUFFE-P and the MNA scores was -0.75 (p<0.01). Four factors were extracted for the NUFFE-P in an exploratory factor analyses. Sensitivity 69.8% and 100% and specificity 75.7% and 85.6% were achieved to detect elderly at medium risk (cutoff=6), and at high risk of under-nutrition (cutoff=11) respectively.
Conclusion: The NUFFE-P has sufficient psychometric properties in nutritional status screening among the Iranian elderly nursing homes residents.
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Serrano-Urrea R, García-Meseguer MJ. Relationships between nutritional screening and functional impairment in institutionalized Spanish older people. Maturitas 2014; 78:323-8. [DOI: 10.1016/j.maturitas.2014.05.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 05/09/2014] [Accepted: 05/23/2014] [Indexed: 10/25/2022]
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Mirarefin M, Sharifi F, Fakhrzadeh H, Amini MR, Ghaderpanahi M, Shoa NZ, Badamchizadeh Z, Tajalizadekhoob Y, Nazari N, Larijani B. Waist circumference and insulin resistance in elderly men: an analysis of Kahrizak elderly study. J Diabetes Metab Disord 2014; 13:28. [PMID: 24495315 PMCID: PMC3929157 DOI: 10.1186/2251-6581-13-28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Accepted: 01/04/2014] [Indexed: 11/25/2022]
Abstract
Background Diagnosis of the metabolic syndrome (MS) is crucial for health care practitioners to identify at risk people for early treatment. Visceral obesity may make unnecessary other laborious measures of insulin resistance. The aim of this study was to see whether waist circumference (WC) can predict insulin resistance as well as MS in a group of Iranian elderly. Methods Out of 94 nondiabetic elderly, thirty three subjects were recognized with MS. MS diagnosis was based on NCEP ATP III (National Cholesterol Education Program Adult Treatment Panel III) and IDF (International Diabetes Federation) definitions. HOMA (Homeostasis Model Assessment) index was used to measure insulin sensitivity. Insulin resistance (IR) was defined as top quartile of HOMA. Results In both sexes, WC and HOMA index were significantly positively correlated. The optimal waist circumference (OWC) cutoff point was 94.5 cm for men and 90.5 cm for women. The high sensitivity (0.80) and specificity (0.84) of WC in males indicates the proportion of IR which is correctly identified and recognizes all non-IR males as such. In regression model only the TG level was associated with WC. But the WC is strongly associated with HOMA-IR. Conclusions While OWC is very likely a good measure to exclude non-IR subjects in our study, determination of optimal WC to identify elderly IR subjects warrants further study in a larger sample of the general population.
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Affiliation(s)
| | | | | | - Mohammad Reza Amini
- Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Bollwein J, Volkert D, Diekmann R, Kaiser MJ, Uter W, Vidal K, Sieber CC, Bauer JM. Nutritional status according to the mini nutritional assessment (MNA®) and frailty in community dwelling older persons: a close relationship. J Nutr Health Aging 2013; 17:351-6. [PMID: 23538658 DOI: 10.1007/s12603-013-0034-7] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE This study investigates the association between MNA results and frailty status in community-dwelling older adults. In addition the relevance of singular MNA items and subscores in this regard was tested. DESIGN Cross-sectional study. SETTING Community-dwelling older adults were recruited in the region of Nürnberg, Germany. PARTICIPANTS 206 volunteers aged 75 years or older without cognitive impairment (Mini Mental State Examination >24 points), 66.0% female. MEASUREMENTS Frailty was defined according to Fried et al. as presence of three, pre-frailty as presence of one or two of the following criteria: weight loss, exhaustion, low physical activity, low handgrip strength and slow walking speed. Malnutrition (<17 points) and the risk of malnutrition (17-23.5 points) were determined by MNA®. RESULTS 15.1% of the participants were at risk of malnutrition, no participant was malnourished. 15.5 % were frail, 39.8% pre-frail and 44.7% non-frail. 46.9% of the frail, 12.2% of the pre-frail and 2.2% of the non-frail participants were at risk of malnutrition (p<0.001). Hence, 90% of those at risk of malnutrition were either pre-frail or frail. For the anthropometric, dietary, subjective and functional, but not for the general MNA subscore, frail participants scored significantly lower than pre-frail (p<0.01), and non-frail participants (p<0.01). Twelve of the 18 MNA items were also significantly associated with frailty (p<0.05). CONCLUSIONS These results underline the close association between frailty syndrome and nutritional status in older persons. A profound understanding of the interdependency of these two geriatric concepts will represent the basis for successful treatment strategies.
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Affiliation(s)
- J Bollwein
- Institute for Biomedicine of Aging, Friedrich-Alexander Universität Erlangen-Nürnberg, Nürnberg, Germany.
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Bollwein J, Volkert D, Diekmann R, Kaiser MJ, Uter W, Vidal K, Sieber CC, Bauer JM. Nutritional status according to the mini nutritional assessment (MNA®) and frailty in community dwelling older persons: a close relationship. J Nutr Health Aging 2013. [PMID: 23538658 DOI: 10.1007/s12603-013-0009-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This study investigates the association between MNA results and frailty status in community-dwelling older adults. In addition the relevance of singular MNA items and subscores in this regard was tested. DESIGN Cross-sectional study. SETTING Community-dwelling older adults were recruited in the region of Nürnberg, Germany. PARTICIPANTS 206 volunteers aged 75 years or older without cognitive impairment (Mini Mental State Examination >24 points), 66.0% female. MEASUREMENTS Frailty was defined according to Fried et al. as presence of three, pre-frailty as presence of one or two of the following criteria: weight loss, exhaustion, low physical activity, low handgrip strength and slow walking speed. Malnutrition (<17 points) and the risk of malnutrition (17-23.5 points) were determined by MNA®. RESULTS 15.1% of the participants were at risk of malnutrition, no participant was malnourished. 15.5 % were frail, 39.8% pre-frail and 44.7% non-frail. 46.9% of the frail, 12.2% of the pre-frail and 2.2% of the non-frail participants were at risk of malnutrition (p<0.001). Hence, 90% of those at risk of malnutrition were either pre-frail or frail. For the anthropometric, dietary, subjective and functional, but not for the general MNA subscore, frail participants scored significantly lower than pre-frail (p<0.01), and non-frail participants (p<0.01). Twelve of the 18 MNA items were also significantly associated with frailty (p<0.05). CONCLUSIONS These results underline the close association between frailty syndrome and nutritional status in older persons. A profound understanding of the interdependency of these two geriatric concepts will represent the basis for successful treatment strategies.
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Affiliation(s)
- J Bollwein
- Institute for Biomedicine of Aging, Friedrich-Alexander Universität Erlangen-Nürnberg, Nürnberg, Germany.
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Dent E, Visvanathan R, Piantadosi C, Chapman I. Nutritional screening tools as predictors of mortality, functional decline, and move to higher level care in older people: a systematic review. J Nutr Gerontol Geriatr 2012; 31:97-145. [PMID: 22607102 DOI: 10.1080/21551197.2012.678214] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This systematic review assessed whether nutritional screening tools (NSTs) predict mortality, functional decline, and move to higher level care in older adults residing in the community or in institutions. In total, 37 prospective studies published between 1999 and 2012 met inclusion criteria and were included in this review. The most commonly used NST in these studies was the Mini Nutritional Assessment (MNA). Comparison of NSTs was limited by variation in follow-up time, lack of uniform definition of functional decline, and biases in many studies. Results of MNA, MNA-Short Form (MNA-SF), and Geriatric Nutrition Risk Index (GNRI) assessments were significantly associated with subsequent mortality, with good negative predictive power (∼0.83), but only modest positive predictive power (PPV∼0.32). MNA-SF and MNA results had a low to moderate association with functional decline (PPV∼0.34). Move to higher level care was less strongly associated with NST scores (PPV∼0.25). Overall, there is evidence that NSTs can predict those at low risk of mortality, functional decline, and, to a lesser extent, move to higher level care in older people.
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Affiliation(s)
- Elsa Dent
- Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
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Kikutani T, Yoshida M, Enoki H, Yamashita Y, Akifusa S, Shimazaki Y, Hirano H, Tamura F. Relationship between nutrition status and dental occlusion in community-dwelling frail elderly people. Geriatr Gerontol Int 2012; 13:50-4. [PMID: 22489562 DOI: 10.1111/j.1447-0594.2012.00855.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM This study aimed to determine the risk of malnutrition in some communities where the frail elderly receive public long-term care insurance. We also clarified the dental problems in those at risk of malnutrition. METHODS A total of 716 frail elderly who lived in eight cities in Japan (240 males and 476 females with a mean age of 83.2±8.6 years) were divided into three groups according to Mini Nutritional Assessment short form results: well nourished, at risk of malnutrition and malnourished. They were also divided into three groups in terms of remaining teeth occlusion and denture occlusion: group A, natural dentition with adequate function; group B, partially or fully edentulous, but maintaining functional occlusion with dentures in either or both jaws; and group C, functionally inadequate occlusion with no dentures. The relationship between nutrition status and dental occlusion was evaluated using logistic regression analysis with sex, age, activities of daily living and cognitive function as covariates. RESULTS The number of participants in each of the groups was as follows: 251 well nourished, 370 at risk of malnutrition and 95 malnourished. When they were divided into just two groups, (i) well nourished and (ii) at risk of malnutrition plus malnourished, in order to study malnutrition risk factors, there were significant relationships between their nutritious status and sex, Barthel index, and occlusion. CONCLUSION This large-scale cross-sectional survey showed that loss of natural teeth occlusion was a risk factor for malnutrition among community-dwelling frail elderly.
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Affiliation(s)
- Takeshi Kikutani
- Division of Oral Rehabilitation, the Nippon Dental University Graduate School of Life Dentistry, Tokyo, Japan
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Geriatric Principles: Evidence-Based Medicine at Its Best. J Am Med Dir Assoc 2012; 13:1-2.e1-2. [DOI: 10.1016/j.jamda.2011.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 10/14/2011] [Indexed: 11/20/2022]
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