1
|
Liu J, Zhu Y, Tan JK, Ismail AH, Ibrahim R, Hassan NH. Factors Associated with Frailty in Older Adults in Community and Nursing Home Settings: A Systematic Review with a Meta-Analysis. J Clin Med 2024; 13:2382. [PMID: 38673654 PMCID: PMC11050860 DOI: 10.3390/jcm13082382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Frailty is a globally recognized issue. However, there is a lack of evidence exploring factors associated with frailty among older residents in community and nursing-home settings. Methods: To explore the prevalence and factors associated with frailty among older adults in community and nursing-home settings, we conducted a systematic search following the PRISMA guidelines across Web of Science, MEDLINE, EMBASE, PubMed, and Cochrane databases up until January 2024, selecting 38 studies which encompassed 150,642 participants. Results: Our findings showed higher frailty prevalence in nursing homes compared to communities. Frailty was significantly associated with sociodemographic (living alone, poor self-reported health), physiological (poor sleep, low activity of daily living), behavioral (physical inactivity) and disease (chronic conditions, depression) factors in both community and nursing-home settings. Conclusions: There are numerous factors associated with frailty in older adults in nursing-home and community settings. These factors underscore the significance of promptly identifying high-risk individuals and devising appropriate interventions to mitigate frailty among them.
Collapse
Affiliation(s)
- Jia Liu
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
| | - Yuezhi Zhu
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (Y.Z.); (J.K.T.)
| | - Jen Kit Tan
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (Y.Z.); (J.K.T.)
| | - Azera Hasra Ismail
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
| | - Roszita Ibrahim
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
| | - Nor Haty Hassan
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
| |
Collapse
|
2
|
Chen Q, Shen J, Gao Y, Wang XX, Jia QY, Li M. Nutritional status of the older adults in nursing homes: A cross-sectional study. J Clin Nurs 2024. [PMID: 38185924 DOI: 10.1111/jocn.16978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 11/14/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024]
Abstract
AIM AND OBJECTIVES To investigate the nutritional status of older adults in nursing homes in Chongqing, China, compare and analyse the differences in the physical condition, cognitive function and social-related factors of older adults with different nutritional statuses. BACKGROUND Malnurtition in the older people has become a priority concer, and the incidence and factors associated with malnutrition vary somewhat by healthcare setting. In Chongqing ,China, there is lack of research on malnutrition of the older people in nursing homes. Here, we investigated the incidence of malnutrition and analysed the associated factors. DESIGN A cross-sectional study. METHODS From January to April 2023, a cross-sectional survey was conducted in three nursing homes in Chongqing, China. Participants completed a series of questionnaires, including the Demographic Information Questionnaire which included age, gender, education level, previous occupation, marital status and other information. The survey also included validated non-demographic instruments [Short-Form Mini-Nutritional Assessment (MNA-SF), Barthel Index (BI) and Mini-mental State Examination (MMSE)] to identify related impact factors. The Guidelines for cross-sectional studies were used in this study (Data S1). RESULTS 209 older adults aged 60 and over participated in this study, of whom 121 were women and 88 were men. The average (SD) age of the participants was 84.7 (6.3) years. Of the participants, 46.4% were classified as well nourished. About 39.2% were at risk of malnutrition and 14.4% were malnourished. Compared to those who were well nourished, those who were malnourished or at risk of becoming malnourished were more likely to suffer from comorbidities, polypharmacy, a higher risk of falling, ADL dependence and to receive more nutritional interventions. However, there are no significant differences after adjustment for age, education level, previous occupation, marital status, length of stay, and type of health care payment. CONCLUSION Malnutrition is a common problem among older adults innursing homes in Chongqing, China. There are certain differences in physical conditions and nutritional interventions among older adults withdifferent nutritional status. PUBLIC CONTRIBUTION This study suggests that the problem of malnutrition is very prominent in nursing homes in Chongqing, China. Cognitive impairment, impaired activities of daily living, fall risk and nutritional intervention need to be prevalent in older adults with (risk of) malnutrition.
Collapse
Affiliation(s)
- Qiu Chen
- Chongqing Emergency Medical Center, Chongqing University Central Hospital, Chongqing, China
| | - Jun Shen
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Gao
- Chongqing Emergency Medical Center, Chongqing University Central Hospital, Chongqing, China
| | - Xin Xia Wang
- University of Wollongong, Wollongong, New South Wales, Australia
| | - Qian Ying Jia
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Miao Li
- Chongqing Medical University, Chongqing, China
| |
Collapse
|
3
|
Development of a protein energy malnutrition screening tool for older Thais in public residential homes. Public Health Nutr 2022; 25:565-577. [PMID: 34620259 PMCID: PMC9991796 DOI: 10.1017/s1368980021004250] [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: 11/06/2022]
Abstract
OBJECTIVE This study aimed to develop and validate protein energy malnutrition (PEM) screening tool for older adults in public residential homes, and to test its practicality. DESIGN This cross-sectional study consisted of two phases: tool development/validation and tool practicality evaluation. In Phase 1, the questionnaire was developed based on literature review and tested for content validity. Older residents were interviewed using this questionnaire to identify potential PEM risk factors. A 24-h recall was used to collect dietary data, and body composition and serum albumin were measured. In Phase 2, practicality of new PEM screening tool was evaluated by intended users. Data were analysed by χ2 test, Fisher's exact test, t-test, Mann-Whitney U test and multiple logistic regression. Akaike Information Criterion (AIC) was used to estimate the best fit model. SETTING Four public residential homes in central region, Thailand. PARTICIPANTS 249 older residents residing in public residential homes and eight intended users. RESULTS 26·9 % had PEM (serum albumin <3·5 g/dl). According to multiple logistic regression and AIC values, PEM predictors were having pressure ulcer, experiencing significant weight loss and taking ≥ 9 types of medicine daily. These predictors were included in PEM screening tool. Regarding the tool performance test, area under the ROC curve was 0·8 (P < 0·001) with sensitivity and specificity of 83·9 and 45·5 %, respectively. For its practicality, eight intended users reported that it was useful and easy to use. CONCLUSIONS New screening tool may be capable of identifying PEM in older residents, and further testing is required before being recommended for use.
Collapse
|
4
|
Lee JE. Current status of foodservice nutrition management and effects of welfare facility support for the elderly in Cheongju City. Nutr Res Pract 2022; 16:527-536. [PMID: 35919287 PMCID: PMC9314197 DOI: 10.4162/nrp.2022.16.4.527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/07/2021] [Accepted: 12/09/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Joo-Eun Lee
- Department of Food and Nutrition, Center for Social Welfare Foodservice Management, Seowon University, Cheongju 28674, Korea
| |
Collapse
|
5
|
Vieira BLDC, Morais LPD, Vargas-Ferreira F, Guimarães MRC, Mattos FF, Vargas AMD. Use and need of removable dental prostheses in an institutionalized Brazilian elderly population: a cross-sectional study. Braz Oral Res 2021; 35:e134. [PMID: 34932663 DOI: 10.1590/1807-3107bor-2021.vol35.0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 07/05/2021] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to assess the use and need of conventional removable prostheses (total and partial) and their associated factors among institutionalized elders. A cross-sectional study was conducted with 1003 elderly people living in non-profit private long-term care institutions in Belo Horizonte, Brazil. Inclusion criteria required a minimum Mini Mental State of Examination (MMSE) score of 21. After the test, 191 individuals were included. Oral examination and interviews were conducted to identify participants' use (throughout the day/every day) and need (do not have/have but do not use) of removable dental prostheses. Socioeconomic health indicators and behaviours were collected from institutional records and via interviews. Bivariate analysis was performed using chi-square test (p<0.05). Poisson regression with robust variance was used in multivariate analysis. Most elders were female (76.4%) and independent in their daily activities (56.5%). Elderly men (PR 1.26) and those whose dental visit was more than one year ago (PR 1.38) showed higher need of dental prostheses. Elderly women (PR 1.68) and individuals with morbidities (PR 1.33) had higher prostheses use. This study demonstrates how socio-demographic characteristics, health indicators, and oral health services impact the use and need of dental prostheses among elders and how these can contribute to public oral health policy development.
Collapse
Affiliation(s)
- Bruno Luís de Carvalho Vieira
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Social and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | - Larissa Pereira de Morais
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Social and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | - Fabiana Vargas-Ferreira
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Social and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | - Mirna Rodrigues Costa Guimarães
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Social and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | - Flávio Freitas Mattos
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Social and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | - Andréa Maria Duarte Vargas
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Social and Preventive Dentistry, Belo Horizonte, MG, Brazil
| |
Collapse
|
6
|
The Nutritional Status of Long-Term Institutionalized Older Adults Is Associated with Functional Status, Physical Performance and Activity, and Frailty. Nutrients 2021; 13:nu13113716. [PMID: 34835971 PMCID: PMC8619061 DOI: 10.3390/nu13113716] [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: 09/06/2021] [Revised: 10/15/2021] [Accepted: 10/21/2021] [Indexed: 11/16/2022] Open
Abstract
Among older adults living in long-term nursing homes (LTNHs), maintaining an adequate functional status and independence is a challenge. Whilst a poor nutritional status is a potential risk factor for a decreased function in this population, its role is not fully understood. Here, using a transversal multicenter study of 105 older adults living in 13 LTNHs, we analyzed the associations between nutritional status, as measured by the Mini Nutritional Assessment (MNA), and the parameters of functional status, physical performance, physical activity, and frailty as well as comorbidity and body composition. The MNA scores were positively correlated with the Barthel Index, handgrip strength, Short Physical Performance Battery (SPPB) scores, absolute muscle power, and Assessment of Physical Activity in Frail Older People (APAFOP) scores and were negatively correlated with dynamic balance and frailty. In a multiple linear regression model controlling for gender and age, the APAFOP score (β = 0.386), BMI (β = 0.301), and Barthel Index (β = 0.220) explained 31% of the variance in the MNA score. Given the observed close relationship between the MNA score and functional status, physical performance and activity, and frailty, interventions should jointly target improvements in both the nutritional status and functional status of LTNH residents. Strategies designed and implemented by interdisciplinary professional teams may be the most successful in improving these parameters to lead to better health and quality of life.
Collapse
|
7
|
de Oliveira LFS, Wanderley RL, de Medeiros MMD, de Figueredo OMC, Pinheiro MA, Rodrigues Garcia RCM, Almeida LDFDD, Cavalcanti YW. Health-related quality of life of institutionalized older adults: Influence of physical, nutritional and self-perceived health status. Arch Gerontol Geriatr 2020; 92:104278. [PMID: 33069111 DOI: 10.1016/j.archger.2020.104278] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/28/2020] [Accepted: 10/01/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Institutionalized older adults have higher risks of diseases and worse health-related quality of life (HRQoL) than noninstitutionalized. OBJECTIVE To evaluate the influence of physical state, nutritional status and self-perceived general health and oral health on the quality of life of institutionalized older adults in two Brazilian cities. METHODS A multicenter cross-sectional study was conducted in 17 homes for the aged of two Brazilian cities. Six trained researchers interviewed 344 older adults. The performance of activities of daily living (Katz scale) and frailty status (Fried scale) were applied to evaluate the physical state. The Mini Nutritional Assessment Short-Form (MNA-SF®) and the body composition were used to screening the nutritional status. A hand dynamometer was used to measure the dominant hand grip strength. The 12-Item Short Form Survey for self-perceived health (SF-12) was used to determine the HRQoL. A Likert scale was used to assess the general and oral health self-perception. Multiple Poisson regression model was applied to analyze the data (α = 0.05). RESULTS The mean (SD) score of the SF-12 was 60.89 (14.50) points. The factors associated with the highest SF-12 score were being able to walk, being nonfrail, being normal nourished, taking fewer medications, having greater dominant hand grip strength and higher self- perceived general health (p < 0.05). CONCLUSION Better HRQoL in institutionalized older adults was associated with better physical state, nutritional status and self-perceived general health.
Collapse
Affiliation(s)
- Luiz Fabrício Santos de Oliveira
- Graduate Program in Dentistry, Department of Social Medicine and Dentistry, Federal University of Paraíba (Universidade Federal da Paraíba), João Pessoa, Paraíba, Brazil
| | - Rayssa Lucena Wanderley
- Graduate Program in Dentistry, Department of Social Medicine and Dentistry, Federal University of Paraíba (Universidade Federal da Paraíba), João Pessoa, Paraíba, Brazil
| | - Mariana Marinho Davino de Medeiros
- Graduate Program in Dentistry, Department of Clinical Dentistry, Dental Prosthesis Area, State University of Campinas (Universidade Estadual de Campinas), Piracicaba, São Paulo, Brazil
| | - Olívia Maria Costa de Figueredo
- Graduate Program in Dentistry, Department of Clinical Dentistry, Dental Prosthesis Area, State University of Campinas (Universidade Estadual de Campinas), Piracicaba, São Paulo, Brazil
| | - Mayara Abreu Pinheiro
- Graduate Program in Dentistry, Department of Clinical Dentistry, Dental Prosthesis Area, State University of Campinas (Universidade Estadual de Campinas), Piracicaba, São Paulo, Brazil
| | - Renata Cunha Matheus Rodrigues Garcia
- Graduate Program in Dentistry, Department of Clinical Dentistry, Dental Prosthesis Area, State University of Campinas (Universidade Estadual de Campinas), Piracicaba, São Paulo, Brazil
| | - Leopoldina de Fátima Dantas de Almeida
- Graduate Program in Dentistry, Department of Social Medicine and Dentistry, Federal University of Paraíba (Universidade Federal da Paraíba), João Pessoa, Paraíba, Brazil
| | - Yuri Wanderley Cavalcanti
- Graduate Program in Dentistry, Department of Social Medicine and Dentistry, Federal University of Paraíba (Universidade Federal da Paraíba), João Pessoa, Paraíba, Brazil.
| |
Collapse
|
8
|
Medeiros MMD, Pinheiro MA, Figueredo OMC, Oliveira LFS, Wanderley RL, Cavalcanti YW, Rodrigues Garcia RCM. Masticatory function in nursing home residents: Correlation with the nutritional status and oral health–related quality of life. J Oral Rehabil 2020; 47:1511-1520. [DOI: 10.1111/joor.13096] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 08/25/2020] [Accepted: 09/10/2020] [Indexed: 12/13/2022]
Affiliation(s)
| | - Mayara Abreu Pinheiro
- Department of Prosthodontics and Periodontology Piracicaba Dental School University of Campinas São Paulo Brazil
| | - Olívia Maria Costa Figueredo
- Department of Prosthodontics and Periodontology Piracicaba Dental School University of Campinas São Paulo Brazil
| | | | | | | | | |
Collapse
|