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AlFehaidi AAAHZ, Khan SHU, Abdelrahman RA, Ahel NT, Shine P, De Ramos MD, Skairjeh NM, Khan SA, Al-Saadi RK. Predictors of malnutrition among older residents in Qatari long-term care facilities: a retrospective study. BMC Nutr 2024; 10:23. [PMID: 38303045 PMCID: PMC10835922 DOI: 10.1186/s40795-024-00827-z] [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: 08/15/2023] [Accepted: 01/16/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Malnutrition is a prevalent issue among older adults in long-term care facilities and is associated with adverse health outcomes and increased healthcare costs. Identifying the predictors of malnutrition in this population is crucial for developing effective intervention strategies. This study aimed to explore the factors contributing to malnourishment among older individuals living in long-term care facilities in Qatar. METHODS This cross-sectional study included 75 older adults from two long-term care facilities (Rumailah Hospital and Enaya Specialized Care Center) in Qatar. Baseline characteristics, including age, sex, length of stay, mortality, weight, body mass index, co-morbidities, and laboratory parameters, were assessed. Data were analyzed using the most recent version of the SPSS software, version 29. Predictors of malnutrition and mortality were identified using logistic regression analysis. RESULTS Of the 75 older individuals included in the study, 85% (64) were malnourished. The average age of the participants was 74.89 years, with a standard deviation of 10.21. Of all participants, approximately 61% (46) were males, and 39% (29) were females. Most malnourished older adults were classified as either at "moderate (29.69%)" or "severe risk (37.50%)," according to the Geriatric Nutritional Risk Index. Malnourished participants experienced a significant percentage of weight change within 3 months (14.01 ± 7.89); the only statistically significant predictor of malnutrition was the percentage of weight change within 3 months with an odds ratio (OR) of 4.8 (confidence interval [CI] 1.56-14.75) and p-value of 0.006. Statistically significant predictors of mortality were malnutrition (OR 24.84, CI 1.09-564) and age (OR 1.07, CI 1.00-1.14). CONCLUSIONS A significant predictor of malnutrition in older adults identified in this study was the sudden and recent change in weight, which can be employed to detect individuals at risk early and guide tailored interventions. Malnutrition is a significant predictor of mortality. Employing a multidimensional strategy to tackle malnutrition can improve outcomes for the older individuals.
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Affiliation(s)
- Al Anoud Ali H Z AlFehaidi
- Department of Dietetics & Nutrition, Rumailah Hospital, Hamad Medical Corporation, Al Khaleej Street, Doha, P.O. Box: 3050, Qatar.
| | - Shafi Hashmath Ulla Khan
- Department of Geriatrics & Long-Term Care, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Rana Albdeljubbar Abdelrahman
- Department of Dietetics & Nutrition, Rumailah Hospital, Hamad Medical Corporation, Al Khaleej Street, Doha, P.O. Box: 3050, Qatar
| | - Nesreen Talal Ahel
- Department of Dietetics & Nutrition, Rumailah Hospital, Hamad Medical Corporation, Al Khaleej Street, Doha, P.O. Box: 3050, Qatar
| | - Pavithra Shine
- Department of Dietetics & Nutrition, Rumailah Hospital, Hamad Medical Corporation, Al Khaleej Street, Doha, P.O. Box: 3050, Qatar
| | - Monica Doroja De Ramos
- Department of Dietetics & Nutrition, Rumailah Hospital, Hamad Medical Corporation, Al Khaleej Street, Doha, P.O. Box: 3050, Qatar
| | - Nisreen Mazin Skairjeh
- Department of Dietetics & Nutrition, Rumailah Hospital, Hamad Medical Corporation, Al Khaleej Street, Doha, P.O. Box: 3050, Qatar
| | - Shakeel Ahmad Khan
- Department of Dietetics & Nutrition, Rumailah Hospital, Hamad Medical Corporation, Al Khaleej Street, Doha, P.O. Box: 3050, Qatar
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Salmi R, Närhi T, Suominen A, Suominen AL, Lahti S. Oral health-related quality of life among home-dwelling older people with and without domiciliary care. Gerodontology 2023; 40:340-347. [PMID: 36178113 DOI: 10.1111/ger.12659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 03/21/2022] [Accepted: 03/28/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim was to compare oral health-related quality of life (OHRQoL) between home-dwelling older people with and without domiciliary care when adjusted for gender, education, use of dental services and removable dental prostheses. BACKGROUND OHRQoL of home-dwelling older people with and without domiciliary care is a neglected area of research, with few studies having been conducted. MATERIALS AND METHODS A secondary analysis was conducted on the Finnish Health 2011 interview data. Home-dwelling participants (age ≥ 70) with or without domiciliary care were included (n = 758). OHRQoL was measured with the Oral Health Impact Profile questionnaire (OHIP-14) calculating three outcomes: prevalence of at least one impact reported: "occasionally," "fairly often" or "very often" (OFoVo), severity as mean sum score and mean of the seven OHIP-14 dimensions. These were evaluated by use of domiciliary care using logistic and negative binomial regression analyses. RESULTS Domiciliary care clients tended to have poorer OHRQoL than non-clients (severity mean 4.33 vs 4.11, P = .057), especially men (6.71 vs 4.15, P = .027), and reported more psychological discomfort than non-clients (mean 1.10 vs 0.82, P = .039). The use of removable dental prostheses was the strongest predictor (OR 2.84, P < .001) of poor OHRQoL. CONCLUSION Domiciliary care clients tended to report poorer OHRQoL, especially with regard to psychological discomfort dimension than non-clients. Thus, support of oral hygiene and regular utilisation of oral health services should be part of domiciliary care among older people to enhance OHRQoL.
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Affiliation(s)
- Riikka Salmi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, University of Turku, Turku, Finland
| | - Timo Närhi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, University of Turku, Turku, Finland
- City of Turku, Welfare Division, Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
- Public Health Evaluation and Projection Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Satu Lahti
- Department of Community Dentistry, University of Turku, Turku, Finland
- Centre for Population Health, University of Turku and Turku University Hospital, Turku, Finland
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Prognostic Association Between Frailty and Post-Arrest Health Outcomes in Patients Receiving Home Care: A Population-Based Retrospective Cohort Study. Resuscitation 2023; 187:109766. [PMID: 36931455 DOI: 10.1016/j.resuscitation.2023.109766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/22/2023] [Accepted: 03/02/2023] [Indexed: 03/17/2023]
Abstract
AIM To evaluate the association between frailty and post-cardiac arrest survival, functional decline, and cognitive decline, among patients receiving home care METHODS: Frailty was measured using the Clinical Frailty Scale (CFS) and a valid frailty index. We used multivariable logistic regression to measure the association between frailty and post-arrest outcomes after adjusting for age, sex, and arrest setting. Functional independence and cognitive performance were measured using the interRAI ADL Long-Form and Cognitive Performance Scale, respectively. We conducted sub-group analytics of in-hospital and out-of-hospital arrests RESULTS: Our cohort consisted of 7,901 home care clients; most patients arrested out-of-hospital (55.4%) and were 75 years or older (66.3%). Most of the cohort was classified as frail (94.2%), with a CFS score of 5 or greater. The 30-day survival rate was higher for in-hospital (26.6%) than out-of-hospital cardiac arrests (5.2%). Most patients who survived to discharge had declines in post-arrest functional independence (65.8%) and cognitive performance (46.5%). A one-point increase in the CFS decreased the odds of 30-day survival by 8% (aOR=0.92; 95%CI = 0.87-0.97). A 0.1 unit increase in the frailty index reduced 30-day survival odds by 9% (aOR = 0.91; 95%CI = 0.86-0.96). The frailty index was associated with declines in functional independence (OR = 1.16; 95%CI = 1.02-1.31) and cognitive performance (OR = 1.24; 95%CI = 1.09-1.42), while the CFS was not. CONCLUSION Frailty is associated with cardiac arrest survival and post-arrest cognitive and functional status in patients receiving home care. Post-cardiac arrest cognitive and functional status are best predicted using more comprehensive frailty indices.
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Savela RM, Välimäki T, Kiljunen O, Nykänen I, Koponen S, Suominen AL, Schwab U. Assessing Social Inequalities in Older Family Caregivers' Frailty Conditions, Comorbidity, and Cognitive Functioning: A Cross-sectional Study. Gerontol Geriatr Med 2023; 9:23337214231214082. [PMID: 38143876 PMCID: PMC10748589 DOI: 10.1177/23337214231214082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/06/2023] [Accepted: 10/23/2023] [Indexed: 12/26/2023] Open
Abstract
We aimed to assess the social inequalities in older family caregivers' frailty conditions, comorbidity, and cognitive functioning. A cross-sectional study was conducted. Study participants were recruited in 2019 in Finland. First, cognitive functioning was assessed with a Mini-Mental State Examination, comorbidity with the modified Functional Comorbidity Index, and frailty conditions were evaluated using the abbreviated Comprehensive Geriatric Assessment. Study participants were also interviewed on socioeconomic factors. The social inequalities in these health outcomes were assessed using the Independent Samples t-test, Pearson Chi-square test, and Binary Logistic Regression Analysis. Family caregivers' (n = 125) mean age was 74, and 73% had frailty conditions. Family caregivers' social inequalities in frailty conditions were linked to their older age and the lowest caregiving cash benefit. Family caregivers' low educational attainment was also the main factor predicting their minor cognitive impairment. Family caregivers' social determinants of health should be fully assessed in their health assessment, policies, and programs to ensure healthy aging for both family caregivers and care recipients in the future.
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Affiliation(s)
| | | | | | | | | | - Anna Liisa Suominen
- University of Eastern Finland, Kuopio, Finland
- Kuopio University Hospital, Kuopio, Finland
| | - Ursula Schwab
- University of Eastern Finland, Kuopio, Finland
- Kuopio University Hospital, Kuopio, Finland
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Hutchins-Wiese H, Argeros G, Walsh SE. Frailty and Nutrition Risk Predict Falls and Emergency Department Visits in Home-Delivered Meal Clients. J Nutr Gerontol Geriatr 2023; 42:1-14. [PMID: 36649214 DOI: 10.1080/21551197.2023.2167030] [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: 01/18/2023]
Abstract
Home-delivered meal programs improve health outcomes for older adults who are homebound, yet some clients need additional services and support to maintain independence. This study sought to identify program clients at the highest risk for adverse outcomes. Nutrition risk and Frailty Index scores were used to predict client-reported falls, emergency department visits, and hospitalizations over a six-month period for 258 Meals on Wheels clients in one Midwestern community. A multivariate binomial logistic regression model adjusting for both Frailty Index and nutrition risk scores with age, gender, poverty, and race accounted for 13.2% of the variation in falls and 22% of the variation in emergency department visits. Neither study variable was predictive of hospitalizations. Nutrition risk and Frailty Index scores, together, produced a more robust picture of client risk than with either score alone; these tools could be used by service providers to prioritize additional support services.
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Affiliation(s)
| | - Grigoris Argeros
- Department of Sociology, Anthropology, and Criminology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Sarah E Walsh
- School of Health Sciences, Eastern Michigan University, Ypsilanti, Michigan, USA
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Kiljunen O, Kankkunen P, Välimäki T. Identification of Contributing Factors of Falls and Non-Fall Accidents Among Home Care Clients: A Retrospective Study Using Incident Reports. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2022. [DOI: 10.1177/10848223221134095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
To prevent falls and other accidents among home care clients, it is essential to gather high-quality information on the factors contributing to the accidents. Incident reporting systems are used in home care units to generate information for risk management. This study aimed to explore the contributing factors of falls and non-fall accidents among home care clients and to evaluate the accuracy of the information on contributing factors gained from the incident reporting system. An existing dataset was used—safety incident reports concerning accidents involving home care clients. The incident reports (n = 323) were stored in the social- and health care organization’s incident reporting database from 2018 to 2020. The free-text narratives describing factors contributing to the event’s occurrence were analyzed using inductive content analysis, and the frequencies of the main category codes were recorded. The results were then compared with the frontline managers’ analyses of the narratives, where the managers used the classification of contributing factors provided by the system. According to incident reports, intrinsic (person-specific), behavior-related and extrinsic (environment-related) factors contributed to accidents among home care clients. Intrinsic and behavior-related factors were reported more often than extrinsic factors. The classified information on contributing factors did not correspond in all respects to the descriptions in the incident reports. To ensure high-quality information for safety management, incident reporting tools must be appropriate for use in the home care context. Both the reporter of an adverse event and the individual responsible for analyzing the report play essential roles in identifying contributing factors of accidents.
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Affiliation(s)
- Outi Kiljunen
- University of Eastern Finland, Department of Nursing Science, Kuopio, Finland
| | - Päivi Kankkunen
- University of Eastern Finland, Department of Nursing Science, Kuopio, Finland
| | - Tarja Välimäki
- University of Eastern Finland, Department of Nursing Science, Kuopio, Finland
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Louise Finlay S. Frailty: an overview of concepts, risk factors, assessment tools and interventions. Nurs Older People 2022; 34:35-42. [PMID: 35791827 DOI: 10.7748/nop.2022.e1394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 06/15/2023]
Abstract
Frailty is a distinctive health state and a life-limiting syndrome seen in older people and in those living with multiple long-term conditions. It is likely that every nurse will encounter patients living with frailty in their clinical practice, even more so if they work in older people's nursing. People living with frailty are more vulnerable than others to stressors and insults due to a decline in their physiological reserve and function. There are tools that can be used to assess people's frailty or risk of frailty and interventions that can be used to prevent or reduce frailty. This article describes frailty and explains how to assess, prevent and reduce it. The article also outlines the relationship between frailty and coronavirus disease 2019 and the frailty trajectory at the end of life.
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Chin YR, Lee HY. Long-term Monitoring of Changes in Blood Pressure, Blood Glucose, and Total Cholesterol Levels among Frail Older Individuals Receiving Home Health Care Nursing in South Korea. J Community Health Nurs 2021; 38:13-23. [PMID: 33682551 DOI: 10.1080/07370016.2021.1869424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study identified changes in blood pressure, blood glucose, and cholesterol levels in frail elderly adults who received home health care nursing over 8 years in Korea. Secondary data extracted from nursing records (2010-2018) of a public health center were analyzed using a mixed model of repeated measure. Study participants were elderly people (n = 499) with a mean age of 81.9 ± 5.56 years. Systolic and diastolic blood pressure decreased by 8.97 and 15.78 mmHg, and by 2.92 and 5.01 mmHg, respectively, at 4-year and 8-year monitoring. This demonstrates that home health care nursing is effective and has both short- and long-term benefits.
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Affiliation(s)
- Young-Ran Chin
- Department of Nursing, Chungwoon University, Gongju, Republic of Korea
| | - Hyo Young Lee
- Department of Health Administration, Dongseo University, Busan, Korea
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9
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Huang Y, Guo X, Du J, Liu Y. Associations Between Intellectual and Social Activities With Frailty Among Community-Dwelling Older Adults in China: A Prospective Cohort Study. Front Med (Lausanne) 2021; 8:693818. [PMID: 34381799 PMCID: PMC8350036 DOI: 10.3389/fmed.2021.693818] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/25/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Frailty is one of the most important global health challenges. We aimed to examine the associations between frequency of intellectual and social activities and frailty among community-dwelling older adults in China. Methods: This is a prospective analysis of older adults (aged ≥60 years) who had intellectual and social activity data and were free of frailty from the national representative China Health and Retirement Longitudinal Study (CHARLS). The exposure was frequency of intellectual and social activities. Frailty was measured by the frailty index (FI) and defined as FI ≥ 0.25. Frailty incidents were followed up for 2 years. We estimated the relative risks (RRs) with 95% confidence intervals (CIs) using log-linear binominal regression adjusting for potential confounders. Results: We documented 655 frailty cases over the past 2 years. Participants who had frequent intellectual activities had a lower frailty risk compared with participants who did not have intellectual activity (adjusted RR = 0.65, 95%CI = 0.47–0.90). The adjusted RRs were 0.51 (95%CI = 0.33–0.77) for participants who did not have a slip or a fall accident and 1.06 (95%CI = 0.65–1.75) for participants who had experienced slip and fall accidents (P = 0.01 for interaction). Having frequent social activities was not associated with a significant decrease in frailty risk compared with participants who did not have social activity (adjusted RR = 0.93, 95%CI = 0.78–1.12). Conclusions: This observational study showed that having frequent intellectual activities was associated with a decreased frailty risk. The association was likely to be stronger in participants without a slip or a fall accident. Randomized controlled trials are needed to confirm this observational finding.
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Affiliation(s)
- Yafang Huang
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| | - Xiangyu Guo
- School of Pharmaceutical Sciences, Capital Medical University, Beijing, China
| | - Juan Du
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| | - Yanli Liu
- Department of General Practice, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Leão LL, Engedal K, Monteiro-Junior RS, Tangen GG, Krogseth M. Malnutrition Is Associated With Impaired Functional Status in Older People Receiving Home Care Nursing Service. Front Nutr 2021; 8:684438. [PMID: 34195219 PMCID: PMC8236523 DOI: 10.3389/fnut.2021.684438] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/10/2021] [Indexed: 12/23/2022] Open
Abstract
Objective: This study aimed to explore the magnitude and significance of associations among nutritional status, functional status, comorbidities, age, and gender in older adults receiving assistance from the in-home nursing care service. Method: In this cross-sectional study, 210 home-dwelling persons 65 years or older who received in-home nursing care service were evaluated. Demographic variables, nutritional status, comorbidities, and the dependency levels of activities of daily living were analyzed. To assess the correlation among the factors that influence nutritional status, a theoretical model was developed and adjusted using the path analysis model. Results: The primary finding is that functional status is directly associated with nutritional status (β = 0.32; p < 0.001) and severity of comorbidities is indirectly associated with nutritional status (β = −0.07; p < 0.017). Conclusion: The elicited outcomes in this study reinforce the concept that nutritional status is linked with functional status in older adults receiving in-home care nursing service.
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Affiliation(s)
- Luana Lemos Leão
- Graduate Program of Health Sciences, State University of Montes Claros, Montes Claros, Brazil
| | - Knut Engedal
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Renato Sobral Monteiro-Junior
- Graduate Program of Health Sciences, State University of Montes Claros, Montes Claros, Brazil.,Graduate Program of Medicine (Neurology/Neuroscience), Federal Fluminense University, Rio de Janeiro, Brazil
| | - Gro Gujord Tangen
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Maria Krogseth
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.,Old Age Psychiatry Research Network, Telemark Hospital Trust and Vestfold Hospital Trust, Tønsberg, Norway.,Department of Nursing and Health Sciences, University of South-Eastern Norway, Drammen, Norway
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Pizzonia M, Giannotti C, Carmisciano L, Signori A, Rosa G, Santolini F, Caffa I, Montecucco F, Nencioni A, Monacelli F. Frailty assessment, hip fracture and long-term clinical outcomes in older adults. Eur J Clin Invest 2021; 51:e13445. [PMID: 33131066 DOI: 10.1111/eci.13445] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/19/2020] [Accepted: 10/27/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND The primary aim of the study was determining the validation of the modified 19-item Frailty Index (mFI-19), based on the standard procedure for creating a frailty index scoring in the accumulation deficit theory of Rockwood and comparing it with the gold standard comprehensive geriatric assessment (CGA) in old age patients with hip fracture. As a secondary aim, we compared prognostic accuracies of mFI-19 and CGA in predicting long-term mortality after surgery. MATERIALS AND METHODS A total of 364 older patients with hip fractures, each a candidate for surgery, were consecutively enrolled. All were subjected to CGA and mFI-19 at baseline and time to death (years from hip surgery) were collected prospectively. RESULTS Mean patient age was 86.5 (SD: 5.65) years. The most common clinical phenotype (77%) was frail. Both CGA and mFI-19 performed similarly in predicting long-term mortality (Harrell's C-index: 0.66 and 0.68, respectively). CONCLUSIONS The mFI-19 was validated, compared to the gold standard CGA, based on a systematic process for creating a frailty index in relation to the accumulation deficit. This is one of few prospective studies addressing long-term mortality in older adults with hip fractures, invoking a methodologically robust frailty screening assessment.
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Affiliation(s)
| | - Chiara Giannotti
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Geriatrics Clinic, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy
| | - Luca Carmisciano
- DISSAL, Department of Health Science, University of Genoa, Genoa, Italy
| | - Alessio Signori
- DISSAL, Department of Health Science, University of Genoa, Genoa, Italy
| | - Gianmarco Rosa
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Geriatrics Clinic, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy
| | - Federico Santolini
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Orthopaedic and Trauma Unit, Department of Emergency, Hospital Policlinic San Martino, Genoa, Italy
| | - Irene Caffa
- Geriatrics Clinic, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy
| | - Fabrizio Montecucco
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Geriatrics Clinic, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy
| | - Alessio Nencioni
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Geriatrics Clinic, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy
| | - Fiammetta Monacelli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Geriatrics Clinic, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy
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12
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Yeung SSY, Chan JHY, Chan RSM, Sham A, Ho SC, Woo J. Predictive Value of the GLIM Criteria in Chinese Community-Dwelling and Institutionalized Older Adults Aged 70 Years and Over. J Nutr Health Aging 2021; 25:645-652. [PMID: 33949632 DOI: 10.1007/s12603-021-1610-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The Global Leadership Initiative on Malnutrition (GLIM) has recently published criteria for classifying malnutrition. This study investigated the associations between malnutrition and adverse outcomes, and identified which component(s) of the GLIM criteria is/are risk factor(s) of adverse outcomes in Chinese older adults. DESIGN A prospective cohort study of Chinese older adults in a healthy ageing study. SETTING Participants' place of residence. PARTICIPANTS Community-dwelling and institutionalized Chinese older adults aged ≥70 years living in Hong Kong. MEASUREMENTS Malnutrition at baseline was classified according to selected GLIM criteria. Adverse outcomes including poor self-rated health, functional limitation (Barthel Index), falls, frailty (FRAIL scale), hospitalization and mortality were assessed after a 3-year follow-up. Associations between malnutrition and components of selected GLIM criteria (weight loss, low body mass index (BMI), low muscle mass and disease burden) and each adverse outcome were examined using adjusted binary logistic regression and Cox proportional hazards model. Odds ratio (OR) or hazard ratio (HR) and 95% confidence interval (CI) are presented. RESULTS Data of 1576 community-dwelling (45.5% female, 78.1±6.5 years) and 427 institutionalized (69.6% female, 85.5±6.4 years) older adults were included at baseline. Among community-dwelling older adults, malnutrition was associated with frailty (n=899, OR: 2.44, 95% CI: 1.05-5.70) and mortality (n=1007, HR: 1.37, 95% CI: 1.12-1.66). No association was found for other outcomes. Among institutionalized older adults, malnutrition was not associated with any outcomes. Low BMI and low muscle mass were risk factors of frailty; while weight loss was a risk factor of mortality in community-dwelling older adults. Weight loss and disease burden were risk factors of mortality among institutionalized older adults. CONCLUSION The association between malnutrition and frailty and mortality was observed in community but not in institutional settings. Further studies are required to draw more definitive conclusions on the use of GLIM criteria in institutional settings.
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Affiliation(s)
- S S Y Yeung
- Dr. Suey S.Y. Yeung, Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, N.T., Hong Kong. Tel: +852 3505 2190; Fax: +852 26379215;
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Velázquez-Alva MC, Irigoyen-Camacho ME, Cabrer-Rosales MF, Lazarevich I, Arrieta-Cruz I, Gutiérrez-Juárez R, Zepeda-Zepeda MA. Prevalence of Malnutrition and Depression in Older Adults Living in Nursing Homes in Mexico City. Nutrients 2020; 12:E2429. [PMID: 32823579 PMCID: PMC7468927 DOI: 10.3390/nu12082429] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/08/2020] [Accepted: 08/11/2020] [Indexed: 01/12/2023] Open
Abstract
This study evaluated the association between nutritional status, depressive symptoms, and the number of prescription drugs taken by older adults living in nursing homes in Mexico City. In a cross-sectional study, 262 participants were subjected to anthropometric and nutritional (Mini Nutritional Assessment (MNA)) evaluations; additionally, their depression (Geriatric Depression Scale (GDS)) and functional status were assessed. Multiple logistic regression was used for identifying factors associated with the risk of malnutrition/malnourishment. The mean age of participants was 83.1 ± 8.6 years. A total of 59.9% and 21.1% were at risk of malnutrition and malnourished, respectively. With respect to depression, 27.9% of the participants had mild depression, while 11.4% showed severe depression. An inverse correlation between MNA evaluations and depression scores was found (Spearman's ρ = -0.4624, p < 0.001); residents with a better nutritional status had lower depression scores. Individuals with depressive symptoms were approximately five times more likely to be at risk of malnutrition or malnourished (OR = 5.82, 95% CI = 2.27-14.89) than individuals without depression. Residents taking three or more prescription drugs daily (OR = 1.83, 95% CI = 1.27-2.63, p < 0.001) were more likely to be at risk of malnutrition or malnourished. In summary, poor nutritional status was associated with depression, while the intake of numerous prescription drugs was associated with being at risk of malnutrition or malnourished.
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Affiliation(s)
- María Consuelo Velázquez-Alva
- Health Care Department, Metropolitan Autonomous University, Unit Xochimilco, Mexico City 04960, Mexico; (M.C.V.-A.); (M.F.C.-R.); (I.L.); (M.A.Z.-Z.)
| | - María Esther Irigoyen-Camacho
- Health Care Department, Metropolitan Autonomous University, Unit Xochimilco, Mexico City 04960, Mexico; (M.C.V.-A.); (M.F.C.-R.); (I.L.); (M.A.Z.-Z.)
| | - María Fernanda Cabrer-Rosales
- Health Care Department, Metropolitan Autonomous University, Unit Xochimilco, Mexico City 04960, Mexico; (M.C.V.-A.); (M.F.C.-R.); (I.L.); (M.A.Z.-Z.)
| | - Irina Lazarevich
- Health Care Department, Metropolitan Autonomous University, Unit Xochimilco, Mexico City 04960, Mexico; (M.C.V.-A.); (M.F.C.-R.); (I.L.); (M.A.Z.-Z.)
| | - Isabel Arrieta-Cruz
- Department of Basic Research, National Institute of Geriatrics, Ministry of Health, Mexico City 10200, Mexico;
| | - Roger Gutiérrez-Juárez
- Department of Biomedical Sciences, School of Medicine, Faculty of High Studies Zaragoza, National Autonomous University of Mexico, Mexico City 09230, Mexico;
| | - Marco Antonio Zepeda-Zepeda
- Health Care Department, Metropolitan Autonomous University, Unit Xochimilco, Mexico City 04960, Mexico; (M.C.V.-A.); (M.F.C.-R.); (I.L.); (M.A.Z.-Z.)
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14
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Llano PMPD, Lange C, Sequeira CADC, Jardim VMDR, Castro DSP, Santos F. Factors associated with frailty syndrome in the rural elderly. Rev Bras Enferm 2020; 72:14-21. [PMID: 31826186 DOI: 10.1590/0034-7167-2017-0079] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 07/19/2018] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE determine the prevalence and factors associated with frailty syndrome (FS) in the elderly in the rural population of Pelotas. METHOD Quantitative, analytical, transversal study conducted with 820 elderly subjects registered in the Family Health Strategy (FHS) in the rural area in the municipality of Pelotas, from July to October 2014. RESULTS among those evaluated, 43.41% showed FS. These factors were consolidated as associated with the condition: low income (PR: 1.54, p ≤ 0.001), low educ. level (PR: 1.45, p ≤ 0.001), nutritional status (obesity) (PR:1.89, p ≤ 0.001), physical inactivity (PR:1.93, p = 0.003), cognitive deficit (PR:2.07, p = 0.005), and poor self-perceived health (PR: 8.21, p ≤ 0.001). CONCLUSION the findings may contribute effectively to the establishment of prevention and screening measures for frailty among the elderly by health professionals, especially nurses, aiming to prevent the occurrence of the syndrome and adverse and undesirable outcomes.
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Affiliation(s)
| | - Celmira Lange
- Universidade Federal de Pelotas. Pelotas, Rio Grande do Sul, Brazil
| | | | | | | | - Fernanda Santos
- Universidade Federal de Pelotas. Pelotas, Rio Grande do Sul, Brazil
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15
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Tuuliainen E, Nihtilä A, Komulainen K, Nykänen I, Hartikainen S, Tiihonen M, Suominen AL. The association of frailty with oral cleaning habits and oral hygiene among elderly home care clients. Scand J Caring Sci 2019; 34:938-947. [DOI: 10.1111/scs.12801] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 11/13/2019] [Indexed: 01/11/2023]
Affiliation(s)
- Eveliina Tuuliainen
- Public Health Center Oral Health Care ServicesKuopio Finland
- Institute of Dentistry University of Eastern Finland Kuopio Finland
| | - Annamari Nihtilä
- Institute of Dentistry University of Eastern Finland Kuopio Finland
- Chief Dentist, Social and Health Services Espoo Finland
| | - Kaija Komulainen
- Institute of Dentistry University of Eastern Finland Kuopio Finland
| | - Irma Nykänen
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - Sirpa Hartikainen
- Kuopio Research Centre of Geriatric Care School of Pharmacy Faculty of Health Sciences University of Eastern Finland Kuopio Finland
| | - Miia Tiihonen
- Kuopio Research Centre of Geriatric Care School of Pharmacy Faculty of Health Sciences University of Eastern Finland Kuopio Finland
| | - Anna Liisa Suominen
- Institute of Dentistry Department of Oral and Maxillofacial Diseases Kuopio University Hospital Kuopio Finland
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16
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Ultrasound Muscle Assessment and Nutritional Status in Institutionalized Older Adults: A Pilot Study. Nutrients 2019; 11:nu11061247. [PMID: 31159255 PMCID: PMC6627854 DOI: 10.3390/nu11061247] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 05/26/2019] [Accepted: 05/29/2019] [Indexed: 01/10/2023] Open
Abstract
Muscle thickness, measured by ultrasonography, has been investigated for nutritional assessment in older adults, however the associations between muscle ultrasound parameters in the lower limb and nutritional status have not been studied. The aim of this study was to investigate the relationship between muscle thickness echo intensity (EI), and nutritional status in home care residents. A cross sectional study was conducted involving 19 older adults from a home care in Malaga (Spain). We evaluated lower leg muscles by ultrasound, anthropometric data, physical function (measured by gait speed and the Short Physical Performance Battery), strength (handgrip and knee extensors strength) and nutritional status across the Mini-Nutritional Assessment Short-Form (MNA-SF). We found that muscle thickness assessed by ultrasonography independently predicts nutritional status by MNA-SF and after adjusting for handgrip strength or age and sex. As secondary findings, we found relations between strength, functional capacity and the MNA-SF test. These results suggest that lower leg muscle ultrasound parameters could be used as a low-cost objective method for muscle evaluation in nutritional assessment in older adults.
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