Nutritional status of the free-living elderly

Effectiveness of sarcopenia screening markers in predicting out-of-hospital death in the oldest (≥80 years) older

OBJECTIVE

The goal of this investigation was to elucidate the correlation between sarcopenia screening indicators (aspartate transaminase/alanine transaminase (AST/ALT) and creatinine/cystatin C*100 (Cr/CysC*100)) and the risk of out-of-hospital (OFH) death among the very advanced age (≥80 years) population.

METHODS

We conducted a retrospective cohort investigation, involving internal medicine inpatients aged ≥80 years of age, who sought treatment at a teaching hospital in western China. We obtained OFH mortality information from telephonic interviews. Subsequently, we employed Cox proportional hazards models to analyze the links between AST/ALT and Cr/CysC*100 and OFH all-cause mortality among the very advanced age (≥80 years old) population.

RESULTS

In all, we recruited 398 subjects, among which 51.51% were male. The median age of OFH deceased male patients was 85 years, and the same for female patients was 87 years. The total quantity of OFH deaths was 164 (41.21%). Among the oldest male population, those who died OFH exhibited enhanced AST/ALT, relative to those who survived (death vs. survival: 1.5 vs 1.3, P=0.008). However, among the oldest female, there was no difference in AST/ALT between patients who expired OFH, and those who survived. Among the oldest elders (male and female), Cr/CysC*100 did not significantly differ between surviving and OFH deceased patients. Additional analysis involving the Cox proportional hazards model revealed that among the oldest male population, an enhanced AST/ALT denoted an augmented risk of OFH death (hazard ratios (HRs) =1.797, 95%CI: 1.2-2.691). However, Cr/CysC*100 was not correlated with OFH mortality risk. Among the oldest female population, neither AST/ALT nor Cr/CysC*100 was correlated with OFH mortality risk.

CONCLUSIONS

Enhanced AST/ALT was correlated with an augmented OFH mortality risk among the oldest male, but not female population. Alternately, Cr/CysC*100 was not linked to OFH mortality risk among any population.

Relationship Between Oral Hypofunction and Nutritional Status in Patients Treated With Maxillofacial Prostheses

Introduction Patients who have jaw or tongue defects owing to head and neck cancer or congenital disease suffer from oral dysfunction such as speech, swallowing, and mastication. Although maxillofacial prostheses are applied to improve oral functions, their oral functions remain compromised compared to those of patients without jaw or tongue defects. On the other hand, it has been reported that oral hypofunction could lead to malnutrition in the general elderly. However, to date, no reports have evaluated the relationship between oral function and nutritional status in patients with maxillofacial prostheses. In this study, we comprehensively evaluated oral function according to the examination items for oral hypofunction. We assessed which functions were related to nutritional status in patients with jaw defects caused by tumors or congenital diseases who are candidates for maxillofacial prosthetic treatment. Methods Patients who underwent prosthetic treatment at the Department of Maxillofacial Prosthodontics, Aichi-Gakuin University Dental Hospital, between May 2021 and January 2024 and who were doing well were included in the study. Oral function was assessed with seven tests according to the criteria of the Japanese Society of Geriatric Dentistry, and nutritional status was evaluated using the Mini Nutritional Assessment Short-Form (MNA-SF). Patients were classified according to age and type of deficiency. Additionally, the presence or absence of oral hypofunction and malnutrition or risk of malnutrition were assessed. The impact of oral hypofunction tests and defect status on the risk of malnutrition was evaluated using a logistic regression model. Results Oral hypofunction and malnutrition or risk of malnutrition were more frequent in the elderly group by age. Regarding the type of defect, the rate of oral hypofunction and malnutrition or risk of malnutrition was highest in the tongue defect group. Results of the logistic regression analysis indicated that nutritional status was associated with tongue deficiency, tongue-lip motor function, tongue pressure, and swallowing function. Conclusion The nutritional status of maxillofacial prosthetic wearers was associated with oral hypofunction. Particularly, malnutrition and risk of malnutrition were increased with tongue defects and deficiencies in tongue-lip motor function, tongue pressure, and swallowing.

Malnutrition significantly affected centenarian prognoses: A prospective study with 5-year follow-up

BACKGROUND

The world is currently facing a much-needed conundrum, and population aging has become an important worldwide problem. Appropriate nutritional intervention could prolong survival time and reduce mortality rate. However, scarce study has involved the effects of nutrition on survival time in centenarians and evaluated the malnutrition with prognostic nutritional index (PNI) in relation to healthy aging. This prospective study was designed to investigate the effects of malnutrition through PNI assessment on mortality rate and survival time with 5-year follow-up in Chinese centenarians.

METHODS

A household survey was conducted on the centenarians in 18 cities and counties of Hainan province, and malnutrition was evaluated by PNI as an effective tool in 423 centenarians followed up for 5-year.

RESULTS

Prevalence of malnutrition was 19.4%. Body mass index (BMI) was significantly lower and malnutrition was significantly more in the dead group than those in the survival group (all P < 0.05). Multivariate Cox regression analysis indicated that BMI [Hazard ratio (HR): 0.913; 95%CI: 0.854-0.977] negatively affected mortality rate, whereas malnutrition (HR: 2.630; 95%CI:1.474-4.695) positively affected mortality rate in centenarians (all P < 0.05). When BMI was <18.5 kg/m2, malnutrition (HR: 4.401; 95%CI: 1.948-9.943) also positively affected mortality rate (P < 0.05).

CONCLUSIONS

This prospective study with 5-year follow-up demonstrated that malnutrition had positive effect on mortality rate, especially when BMI was lower than 18.5 kg/m2, in Chinese centenarians. In order to reduce mortality rate and prolong survival time, it is essential to pay attention to malnutrition in elderly population.