Altered Eating Attitudes in Nursing Home Residents and Its Relationship with their Cognitive and Nutritional Status

Prevalence, associated factors, and impact of vitamin B12 deficiency in older medical inpatients

PURPOSE

This retrospective cohort study aims to explore the prevalence of vitamin B12 deficiency in older hospitalized adults and identify key factors associated with this deficiency, as well as its impact on frailty and functional decline.

METHODS

Data were collected from older adults (≥65 years) sequentially admitted to the Internal Medicine Department of a tertiary university hospital. Clinical and laboratory characteristics, including age, sex, somatometric data, cause of admission, past medical history, chronic medication use, and laboratory tests, were recorded. Frailty and functional status were assessed using the Fried Frailty Scale (FFS), Clinical Frailty Scale (CFS), Barthel Index, and Katz Index. Vitamin B12 levels on admission were categorised as deficient (<200 pg/ml), borderline (200-300 pg/ml), normal (300-999 pg/ml), and high (≥1000 pg/ml).

RESULTS

A total of 894 patients were included. The median age was 83 years and 487 (54.5%) were females. The prevalence of vitamin B12 deficiency was found in 9.1%, while 17.3% of the sample had borderline levels. Multivariate analysis identified polypharmacy (≥5 drugs), low albumin levels/Geriatric Nutritional Risk Index (GNRI), and nursing home residency as independent factors associated with low B12 levels. Multivariate analyses showed that B12 deficiency was significantly associated with higher frailty rates and lower functional status.

CONCLUSION

Vitamin B12 deficiency is prevalent among hospitalized older patients and is significantly associated with increased frailty and reduced functional status. These findings underscore the importance of routine screening for B12 deficiency in this vulnerable population to improve clinical outcomes and quality of life.

Reliability and validity of Chinese version of the Simplified Nutritional Appetite Questionnaire (SNAQ) in community-dwelling old people

OBJECTIVE

To investigate the reliability and validity of the Chinese version of simplified nutritional appetite questionnaire (SNAQ).

METHODS

The SNAQ was translated and back-translated for the study population. We surveyed 122 community-dwelling residents aged ≥60 years in Beijing's residential communities. Participants underwent face-to-face surveys including the SNAQ, mini-nutritional assessment short-form (MNA-SF), FRAIL scale, Sarcopenia-Five (SCAR-F), 15-item Geriatric Depression Scale (GDS-15), 7-item Generalized Anxiety Disorder (GAD-7), 8-item Oral Frailty Index (OFI-8), 10-item Eating Assessment Tool (EAT-10), and Mini-Mental State Examination (MMSE). Cronbach's alpha was used to measure the internal consistency and the relationship between individual items. The construct validity was verified using the KMO-Bartlett. Concurrent validity was established to validate measures of the same constructs.

RESULTS

Cronbach's alpha measured the internal consistency of the questionnaire at 0.694. The split-half reliability stood at 0.725. The construct validity of the SNAQ was confirmed using a KMO-Bartlett value of 0.648 (P <0.001). The MNA-SF, as validation benchmark, has a correlation coefficient of 0.345 (P =0.001).

CONCLUSION

The Chinese version of the SNAQ has good reliability and validity for older adults in community settings.

Eating Difficulties among Older Adults with Dementia in Long-Term Care Facilities: A Scoping Review

This paper reports a scoping review of the literature on eating difficulties among older adults with dementia in long-term care facilities to identify key concepts, methods of measuring outcomes, interventions, and related factors. A scoping review was performed using the bibliographic databases PubMed, CINAHL, PsycINFO, and Cochrane Library. A combination of keywords and subject headings related to eating or feeding difficulties was used. Inclusion criteria were limited to materials published in English. A total of 1070 references were retrieved, of which 39 articles were selected after applying the inclusion and exclusion criteria. Articles that met the criteria were published between 1987 and 2020. "Eating disabilities" have been defined as problems related to choosing food and/or the ability to get food to one's mouth, chew, and swallow. Interventions for eating difficulties described in the literature include spaced retrieval training, Montessori training, and feeding skill training. Intrapersonal, interpersonal, and environmental factors related to eating difficulties were identified. This scoping review will provide direct care workers, nursing educators, and administrators with an overview of eating performance and a broad understanding of eating difficulties for older adults with dementia in long-term care facilities.