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Vialaret J, Vignon M, Hirtz C, Badiou S, Baptista G, Fichter L, Dupuy AM, Maceski AM, Fayolle M, Brousse M, Cristol JP, Jeandel C, Lehmann S. Use of dried blood spots for monitoring inflammatory and nutritional biomarkers in the elderly. Clin Chem Lab Med 2024; 62:881-890. [PMID: 37999931 DOI: 10.1515/cclm-2023-0312] [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: 03/27/2023] [Accepted: 11/01/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES Blood microsampling, particularly dried blood spots (DBSs), is an attractive minimally-invasive approach that is well suited for home sampling and predictive medicine associated with longitudinal follow-up of the elderly. However, in vitro diagnostic quantification of biomarkers from DBS poses a major challenge. Clinical mass spectrometry can reliably quantify blood proteins in various research projects. Our goal here was to use mass spectrometry of DBS in a real-world clinical setting and compared it to the standard immunoassay method. We also sought to correlate DBS mass spectrometry measurements with clinical indices. METHODS A clinical trial of diagnostic equivalence was conducted to compare conventional venous samples quantified by immunoassay and DBSs quantified by mass spectrometry in an elderly population. We assayed three protein biomarkers of nutritional and inflammatory status: prealbumin (transthyretin), C-reactive protein, and transferrin. RESULTS The analysis of DBSs showed satisfactory variability and low detection limits. Statistical analysis confirmed that the two methods give comparable results at clinical levels of accuracy. In conclusion, we demonstrated, in a real-life setting, that DBSs can be used to measure prealbumin, CRP and transferrin, which are commonly used markers of nutritional status and inflammation in the elderly. However, there was no correlation with patient frailty for these proteins. CONCLUSIONS Early detection and regular monitoring of nutritional and inflammatory problems using DBS appear to be clinically feasible. This could help resolve major public health challenges in the elderly for whom frailty leads to serious risks of health complications.
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Affiliation(s)
- Jérôme Vialaret
- LBPC-PPC, Univ Montpellier, CHU Montpellier, INM INSERM, Montpellier, France
| | - Margaux Vignon
- LBPC-PPC, Univ Montpellier, CHU Montpellier, INM INSERM, Montpellier, France
| | - Christophe Hirtz
- LBPC-PPC, Univ Montpellier, CHU Montpellier, INM INSERM, Montpellier, France
| | - Stéphanie Badiou
- Department of Biochemistry and Hormonology, Univ Montpellier, CHU Montpellier, INSERM, Montpellier, France
| | - Gregory Baptista
- Centre de gérontologie clinique Antonin-Balmès, Univ Montpellier, CHU Montpellier, Montpellier, France
| | - Laura Fichter
- LBPC-PPC, Univ Montpellier, CHU Montpellier, INM INSERM, Montpellier, France
| | - Anne-Marie Dupuy
- Department of Biochemistry and Hormonology, Univ Montpellier, CHU Montpellier, INSERM, Montpellier, France
| | | | - Martin Fayolle
- LBPC-PPC, Univ Montpellier, CHU Montpellier, INM INSERM, Montpellier, France
- Department of Biochemistry and Hormonology, Univ Montpellier, CHU Montpellier, INSERM, Montpellier, France
| | - Mehdi Brousse
- LBPC-PPC, Univ Montpellier, CHU Montpellier, INM INSERM, Montpellier, France
- Department of Biochemistry and Hormonology, Univ Montpellier, CHU Montpellier, INSERM, Montpellier, France
| | - Jean-Paul Cristol
- Department of Biochemistry and Hormonology, Univ Montpellier, CHU Montpellier, INSERM, Montpellier, France
| | - Claude Jeandel
- Centre de gérontologie clinique Antonin-Balmès, Univ Montpellier, CHU Montpellier, Montpellier, France
| | - Sylvain Lehmann
- LBPC-PPC, Univ Montpellier, CHU Montpellier, INM INSERM, Montpellier, France
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Bice EM, Galek KE, Ward M. Dysphagia and Diets in Skilled Nursing Facilities When Patient's Health Status Changes: The Role of Imaging. J Am Med Dir Assoc 2024; 25:381-386. [PMID: 38109943 DOI: 10.1016/j.jamda.2023.11.008] [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: 07/26/2023] [Revised: 11/06/2023] [Accepted: 11/06/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVES Research suggests that clinical decision making for assessing and treating patients with swallowing dysfunction varies significantly, and decisions may harm patients. The study aimed to investigate clinical practice of speech-language pathologists (SLPs) assessing and treating swallowing in skilled nursing facilities (SNFs). DESIGN Retrospective review of 120 medical records of patients recommended for a flexible endoscopic evaluation of swallowing (FEES). SETTING AND PARTICIPANTS 120 SNF patients. METHODS Records from 25 SNFs were reviewed to determine which patients were receiving swallowing therapy, their diet level pre- and post-FEES, and if they received prior imaging studies. Recordings of FEES were assigned severity ratings based on the Dynamic Imaging Grade of Swallowing Toxicity-FEES scores to determine the relationship between diet and liquid recommendations before and after FEES, how often patients consume a modified diet in the absence of dysphagia, percentage of patients without dysphagia receiving swallowing treatment, percentage of patients receiving alternative means of nutrition without dysphagia, and the percentage of patients with a feeding tube without an imaging assessment. RESULTS Chi-square tests revealed no agreement between pre- and postimaging diet levels. Ordinal regressions indicated preimaging diets did not fit the DIGEST severity rating model; however, investigators found a good fit with postimaging diet recommendations. Descriptive statistics indicated that 67% of the patients receiving a modified solid and/or liquid did not have dysphagia. Treatment was provided to 100% of the patients without dysphagia. Sixty-one percent of patients with feeding tubes had no dysphagia. Forty-five percent of NPO (nothing by mouth) patients had imaging during their acute stay. CONCLUSIONS AND IMPLICATIONS The results strongly suggest that the practice of continuing acute care diet recommendations in a SNF increases cost and may negatively impact patient quality of life. The practice may also lead to negative health consequences. A new imaging assessment is required to inform treatment when medical status changes.
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Affiliation(s)
- Ed M Bice
- IOPI Medical, LLC, Woodinville, WA, USA.
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Ma C, Yu B, Fan Y, Jia P, Yang S. Exploring Interrelationships between Mental Health Symptoms and Cognitive Impairment in Aging People Living with HIV in China. Dement Geriatr Cogn Disord 2024; 53:19-28. [PMID: 38232713 DOI: 10.1159/000536056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 12/29/2023] [Indexed: 01/19/2024] Open
Abstract
INTRODUCTION Mental health symptoms and cognitive impairment are highly prevalent and intertwined among aging people living with HIV (PLWH). This study aimed to assess the interrelationships and strength of connections between individual mental health symptoms and cognitive impairment. We sought to identify specific symptoms linking mental health and cognitive impairment in aging PLWH. METHODS Participants in the Sichuan Older People with HIV Infections Cohort Study (SOHICS) were recruited between November 2018 and April 2021 in China. Mental health symptoms, including depression and anxiety, were assessed by the Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder-7 (GAD-7), respectively. Cognitive impairment was assessed by the Montreal Cognitive Assessment-Basic (MoCA-B). Partial correlation networks were used to depict the interrelationships between mental health symptoms and cognitive impairment, and bridge strength was used to identify specific symptoms linking mental health and cognitive impairment. RESULTS Of the 1,587 recruited participants with a mean age of 63.0 years old, 47.0% had mild or severe cognitive impairment. Network analysis revealed that cognitive function, visual perception, and problem-solving task of the MoCA-B were negatively correlated with appetite, energy, and motor of the PHQ-9, respectively. Based on their interrelationships, problem-solving task and motor acted as bridge symptoms. CONCLUSION Problem-solving task and motor may be potential intervention targets to reduce the overall risk of mental health symptoms and cognitive impairment. Future research could assess the feasibility and effectiveness of specific interventions designed for the two symptoms of aging PLWH.
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Affiliation(s)
- Chunlan Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Bin Yu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China
- Sichuan Research Center of Sexual Sociology and Sex Education, Chengdu, China
| | - Yunzhe Fan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Peng Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China
- Hubei Luojia Laboratory, Wuhan, China
- School of Public Health, Wuhan University, Wuhan, China
- Renmin Hospital, Wuhan University, Wuhan, China
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
- Department of Clinical Medical College, Affiliated Hospital of Chengdu University, Chengdu, China
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Wei C, Zhang X, Dong M, Lei B, Zhao J, Xi X, Zhao S, Zhou B. Risk Factors for Postoperative Knee Stiffness in Patients with Anteromedial Knee Osteoarthritis Undergoing Unicompartmental Knee Arthroplasty with Cemented Prostheses: A Short-Term, Retrospective, Case-Control Study. Med Sci Monit 2023; 29:e942440. [PMID: 38006202 PMCID: PMC10685645 DOI: 10.12659/msm.942440] [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: 09/05/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND The present study was performed to determine the potential risk factors for postoperative knee stiffness in patients with anteromedial knee osteoarthritis undergoing unicompartmental knee arthroplasty with cemented prostheses. MATERIAL AND METHODS This retrospective cohort study evaluated patients with anteromedial knee osteoarthritis who underwent medial unicompartmental knee arthroplasty at our hospital between May 2017 and May 2020. The patients were divided into 2 groups according to their prognosis: those who experienced knee stiffness after undergoing unicompartmental knee arthroplasty and those who did not. The factors associated with stiffness after UKA were identified using univariate analysis. Frequencies are used to express categorical variables, while mean±SD is used to express continuous variables. The t test and chi-square test were used. A multivariate logistic regression model was built to identify the risk factors for postoperative stiffness. RESULTS We included 590 knees in the study after unicompartmental knee arthroplasty. The overall incidence of postoperative stiffness in unicompartmental knee arthroplasty surgery was 10.17%. In terms of the radiological measurements, varus deformity (70.34% vs 29.66%) and tibial component posterior slope angle (4.8±2.0 vs 4.6±2.0, P<0.001) were significantly differences between the 2 groups. Four independent risk factors for stiffness after unicompartmental knee arthroplasty were identified: age (95% CI, 1.022-1.048), varus deformity (95% CI, 1.186-1.192), tibial component posterior slope angle (95% CI, 0.550-0.870), and preoperative maximum flexion (95% CI, 0.896-0.923). CONCLUSIONS The overall incidence of postoperative knee stiffness in patients with anteromedial knee osteoarthritis undergoing unicompartmental knee arthroplasty with cemented prostheses was 10.17%, which was at a moderate level compared to patients with other diseases undergoing unicompartmental knee arthroplasty. Four independent risk factors were identified: age, varus deformity, preoperative maximum flexion, and tibial component posterior slope angle. Awareness these risk factors might help surgeons prevent the occurrence of postoperative knee stiffness in patients with UKA.
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Affiliation(s)
- Congcong Wei
- Department of Joint Surgery, No. 215 Hospital of Shaanxi Nuclear Industry, Xianyang, Shaanxi, PR China
| | - Xihan Zhang
- Department of Joint Surgery, No. 215 Hospital of Shaanxi Nuclear Industry, Xianyang, Shaanxi, PR China
| | - Mingming Dong
- Department of Geriatrics, No. 215 Hospital of Shaanxi Nuclear Industry, Xianyang, Shaanxi, PR China
| | - Boyi Lei
- Department of Joint Surgery, No. 215 Hospital of Shaanxi Nuclear Industry, Xianyang, Shaanxi, PR China
| | - Jiangbo Zhao
- Department of Joint Surgery, No. 215 Hospital of Shaanxi Nuclear Industry, Xianyang, Shaanxi, PR China
| | - Xiangdong Xi
- Department of Joint Surgery, No. 215 Hospital of Shaanxi Nuclear Industry, Xianyang, Shaanxi, PR China
| | - Shuai Zhao
- Department of Joint Surgery, No. 215 Hospital of Shaanxi Nuclear Industry, Xianyang, Shaanxi, PR China
| | - Baigang Zhou
- Department of Joint Surgery, No. 215 Hospital of Shaanxi Nuclear Industry, Xianyang, Shaanxi, PR China
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Dou L, Peng Y, Zhang B, Yang H, Zheng K. Immune Remodeling during Aging and the Clinical Significance of Immunonutrition in Healthy Aging. Aging Dis 2023:AD.2023.0923. [PMID: 37815906 DOI: 10.14336/ad.2023.0923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/23/2023] [Indexed: 10/12/2023] Open
Abstract
Aging is associated with changes in the immune system and the gut microbiota. Immunosenescence may lead to a low-grade, sterile chronic inflammation in a multifactorial and dynamic way, which plays a critical role in most age-related diseases. Age-related changes in the gut microbiota also shape the immune and inflammatory responses. Nutrition is a determinant of immune function and of the gut microbiota. Immunonutrion has been regarded as a new strategy for disease prevention and management, including many age-related diseases. However, the understanding of the cause-effect relationship is required to be more certain about the role of immunonutrition in supporting the immune homeostasis and its clinical relevance in elderly individuals. Herein, we review the remarkable quantitative and qualitative changes during aging that contribute to immunosenescence, inflammaging and microbial dysbiosis, and the effects on late-life health conditions. Furthermore, we discuss the clinical significance of immunonutrition in the treatment of age-related diseases by systematically reviewing its modulation of the immune system and the gut microbiota to clarify the effect of immunonutrition-based interventions on the healthy aging.
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Affiliation(s)
- Lei Dou
- Department of Geriatrics, Tongji Hospital, Tongji Medical college, Huazhong University of Science and Technology, Wuhan 430030, China
- Department of Surgery, Tongji Hospital, Tongji Medical college, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yang Peng
- Department of Geriatrics, Tongji Hospital, Tongji Medical college, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Bin Zhang
- Department of Surgery, Tongji Hospital, Tongji Medical college, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Huiyuan Yang
- Department of Surgery, Tongji Hospital, Tongji Medical college, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Kai Zheng
- Department of Geriatrics, Tongji Hospital, Tongji Medical college, Huazhong University of Science and Technology, Wuhan 430030, China
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Khan J, Chattopadhyay A, Shaw S. Assessment of nutritional status using anthropometric index among older adult and elderly population in India. Sci Rep 2023; 13:13015. [PMID: 37563173 PMCID: PMC10415320 DOI: 10.1038/s41598-023-39167-6] [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: 11/22/2022] [Accepted: 07/20/2023] [Indexed: 08/12/2023] Open
Abstract
Malnutrition poses a significant risk to the older population globally, highlighting the critical role of nutrition in healthy aging. In this study, the aim is to estimate the prevalence of malnutrition among older adults aged 45-59 years and the elderly population aged 60 years and above based on their socioeconomic and demographic characteristics. Furthermore, the study examines the risk factors within a multivariate framework. A sample of 59,073 individuals aged 45 years and above from the Longitudinal Aging Study in India (LASI), Wave 1 survey constitutes the study population. This study adopts a cross-sectional design. Bivariate cross-tabulation analysis and multivariate logistic regression analysis are employed to understand the prevalence and determinants of nutritional status. About 25% of males and 37% of females below the age of 60 years are overweight (including obese), while among those aged 60 years and above, 28% of males and 25% of females are underweight. The elderly male population carries a comparatively higher burden of underweight (28%) prevalence than the females (25%) in the same age group. Overall, the urban population is less likely to be underweight [AOR: 0.41, C.I 0.38-0.43] and more likely to be overweight [AOR: 2.41, C.I 2.32-2.52]. Older adults from low economic and social strata are more likely to be underweight. In terms of bio-physical factors, individuals aged 60 years and above with infections to endemic diseases [AOR: 1.24; p-value < 0.01] and those with edentulism [AOR: 1.29; p-value < 0.01] are more likely to be underweight. As evident from the study, nutritional status among older adults is a complicated manifestation of multiple risk factors and requires potential nutritional intervention. Initiating a routine screening program at the grassroots level can effectively identify older adults and the elderly in India, facilitating the provision of nutritional care.
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Affiliation(s)
- Junaid Khan
- Department of Population and Development, International Institute for Population Sciences, Deonar, Mumbai, 400088, India
| | - Aparajita Chattopadhyay
- Department of Population and Development, International Institute for Population Sciences, Deonar, Mumbai, 400088, India
| | - Subhojit Shaw
- Department of Population and Development, International Institute for Population Sciences, Deonar, Mumbai, 400088, India.
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Harper P. A Review of the Dietary Intake, Bioavailability and Health Benefits of Ellagic Acid (EA) with a Primary Focus on Its Anti-Cancer Properties. Cureus 2023; 15:e43156. [PMID: 37692691 PMCID: PMC10484468 DOI: 10.7759/cureus.43156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 09/12/2023] Open
Abstract
Ellagitannins (ET) and ellagic acid (EA) are polyphenols, present in common foods, which may exhibit significant health benefits against inflammation, infection and cancer. EA is metabolised by the gut flora to produce urolithins, which are absorbed into the systemic circulation. Urolithins are widely documented to reduce oxidative stress associated with many diseases including cancer, heart disease and liver damage. In particular, Urolithin C and D have been shown to have high anti-oxidant properties through the inhibition of reactive oxygen species (ROS). The anti-inflammatory properties of EA have been demonstrated through the down-regulation of pro-inflammatory enzymes such as COX-2 and iNOS as well as decreasing the expression of adhesion molecules. EA also regulates the gut microflora and possesses antimicrobial activity against various strains of harmful bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) and Helicobacter pylori. Numerous studies have documented the anticarcinogenic benefits of EA and have been performed on, but not limited to, prostate, colon and breast cancer cell lines and in vivo models. Conventional treatments for cancer, such as chemotherapy, can often be associated with significant side effects such as fatigue, hair loss and alopecia. Naturally-occurring food substances such as ETs potentially offer a risk-free preventative measure against cancer and could perhaps be used in synergy with current treatments. More level 1 studies are required to inform the evidence-base on this topic.
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Affiliation(s)
- Philip Harper
- Life Sciences, University of Southampton, Southampton, GBR
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Klingbeil KD, Mederos M, Park JY, Seo YJ, Markovic D, Chui V, Girgis M, Kadera BE. Laparoscopic compared to open approach for distal gastrectomy may reduce pneumonia risk for patients with gastric cancer. Surg Open Sci 2023; 14:68-74. [PMID: 37533882 PMCID: PMC10392601 DOI: 10.1016/j.sopen.2023.07.006] [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: 05/10/2023] [Revised: 06/21/2023] [Accepted: 07/16/2023] [Indexed: 08/04/2023] Open
Abstract
Background Whether laparoscopic approach to gastrectomy for gastric cancer (GC) reduces the risk of pneumonia remains unknown. In this study, we compared pneumonia outcomes for patients with GC who underwent either laparoscopic gastrectomy (LG) or open gastrectomy (OG). Methods The ACS NSQIP database was queried to identify patients with GC who underwent LG or OG between Jan 2012 - Dec 2018. Outcomes were compared using regression models. A post-hoc analysis was performed for elderly patients. Results The study cohort included 2661 patients, 23.4 % undergoing LG. Laparoscopic approach lowered pneumonia risk (OR 0.47, p = .028) and reduced hospital length of stay, (5.3 vs 7.1 days, p < .001). Elderly patients undergoing LG demonstrated similar benefits. Risk factors for pneumonia included advanced age, dyspnea and weight-loss, whereas laparoscopic approach reduced this risk. Conclusions LG in patients with GC has both statistically and clinically significant advantages over OG with respect to pneumonia. Further studies are needed to validate the relationship between postoperative pneumonia and surgical approach for gastrectomy.
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Affiliation(s)
- Kyle D. Klingbeil
- Department of Surgery, Division of Surgical Oncology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Michael Mederos
- Department of Surgery, Division of Surgical Oncology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Joon Y. Park
- Department of Surgery, Division of Surgical Oncology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Young-Ji Seo
- Department of Surgery, Division of Surgical Oncology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Daniela Markovic
- Department of Medicine, Statistics Core, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Victor Chui
- Department of Medicine, Division of Hematology and Oncology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Mark Girgis
- Department of Surgery, Division of Surgical Oncology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Brian E. Kadera
- Department of Surgery, Division of Surgical Oncology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
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Tasnim T, Sadiq MZA, Karim KMR. Depression level, nutritional status, and dietary nutrient intake of the older adult at the community level in a selected area of Bangladesh. Heliyon 2023; 9:e18199. [PMID: 37501974 PMCID: PMC10368819 DOI: 10.1016/j.heliyon.2023.e18199] [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: 08/26/2022] [Revised: 07/05/2023] [Accepted: 07/11/2023] [Indexed: 07/29/2023] Open
Abstract
Malnutrition is associated with higher rates of morbidity and death in the older population. Depression or mental health is a major component of older adult malnutrition. The aim of the study was to measure the level of malnutrition and depression in older adults, as well as their correlated factors, such as dietary energy and nutrient consumption. A cross-sectional study was conducted among 108 older individuals living in two areas of Faridpur, Bangladesh. The Mini Nutritional Assessment-Short Form (MNA-SF), Geriatric Depression (GD) Scale, and 24-h dietary recall were used to measure the nutritional status, depression level, and dietary nutrients, respectively. A total of 20.4% and 55.6% were malnourished or at risk of malnutrition, respectively. Around 81.5% of the study subjects exhibited a different degree of depression and 9.3% were identified as having severe depression. There was a significant inverse association between the MNA-SF score and the GD score (r = -0.684, p=<0.001). The average energy and protein consumption was 1387 kcal and 45.52 g, respectively; and energy and protein intake were significantly lower in the depressed group (1353 Kcal, 43.8 g) than in the non-depressed group (1530 Kcal, 52.4 g). An extremely low energy consumption (<20 kcal/kg body weight/day) was noted in 27.1% of the older adults. None of the participants in this study were able to meet the requirements for dietary fiber, calcium, vitamin B6, folate, vitamin D, and vitamin E. Specific nutrition-related intervention programs as well as social and familial support are recommended to improve the nutritional status of older adults.
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Affiliation(s)
- Tasmia Tasnim
- Department of Nutrition and Food Engineering, Daffodil International University, Daffodil Smart City, Birulia, 1216, Savar, Dhaka, Bangladesh
| | - Md Zafar As Sadiq
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, 1000, Bangladesh
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Barrón-Pavón V, González-Stager MA, Rodríguez-Fernández A. [Relationship between body composition and the risk of non-communicable chronic diseases in active older women from Chillán (Chile).]. Rev Esp Salud Publica 2023; 97:e202306045. [PMID: 37387225 PMCID: PMC10541250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 05/08/2023] [Indexed: 07/01/2023] Open
Abstract
OBJECTIVE In Chile, the elderly represent 18% of the population. In women, the aging process impacts body composition, in addition to the coexistence of other pathologies such as chronic noncommunicable diseases (NCDs). The aim of the study was to relate body composition to the presence of chronic noncommunicable diseases in active older women in the city of Chillán. METHODS The sample consisted of 284 women belonging to senior centers in Chillán. Body composition was determined by bioimpedanciometry. Sociodemographic information, prevalent pathologies, geriatric syndromes and physical activity were determined by means of a validated questionnaire. Data were analyzed with descriptive and inferential statistics in STATA 15.0 software with an α<0.05. RESULTS Of the sample, 63% were under seventy-five years of age, 77.5% had less than twelve years of schooling, the predominant socioeconomic level was low, and the poor perception of health was mainly referred to as well as the use of regular medication. Arterial hypertension (AHT) and hypercholesterolemia were prevalent with 70.4% and 48.2% respectively. Body mass index (BMI) was 29.7±4.8 and 71.8% had excess malnutrition. The group older than seventy-five years presented more body fat (BMF) and extracellular water (ECW). AHT was related to higher BMI, TGM, MBC (Mean Arm Circumference), PC (Calf Circumference) and ECW (p<0.05), while Diabetes mellitus was related to BMI and MBC. CONCLUSIONS Hypertension is the most frequent pathology and is related to higher BMI, MGT, CMB, CP and ECW, followed by DM2 which is related to BMI and CMB.
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Affiliation(s)
- Verónica Barrón-Pavón
- Departamento de Nutrición y Salud Pública, Facultad de Ciencias de Salud y de los Alimentos, Universidad del Bío-Bío.Universidad del Bío-BíoChillánChile
| | - María Angélica González-Stager
- Departamento de Nutrición y Salud Pública, Facultad de Ciencias de Salud y de los Alimentos, Universidad del Bío-Bío.Universidad del Bío-BíoChillánChile
| | - Alejandra Rodríguez-Fernández
- Departamento de Nutrición y Salud Pública, Facultad de Ciencias de Salud y de los Alimentos, Universidad del Bío-Bío.Universidad del Bío-BíoChillánChile
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Feng HY, Zhang PP, Wang XW. Presbyphagia: Dysphagia in the elderly. World J Clin Cases 2023; 11:2363-2373. [PMID: 37123321 PMCID: PMC10131003 DOI: 10.12998/wjcc.v11.i11.2363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/08/2023] [Accepted: 03/22/2023] [Indexed: 04/06/2023] Open
Abstract
Dysphagia has been classified as a “geriatric syndrome” and can lead to serious complications that result in a tremendous burden on population health and healthcare resources worldwide. A characteristic age-related change in swallowing is defined as “presbyphagia.” Medical imaging has shown some changes that seriously affect the safety and efficacy of swallowing. However, there is a general lack of awareness of the effects of aging on swallowing function and a belief that these changes are part of normal aging. Our review provides an overview of presbyphagia, which has been a neglected health problem for a long time. Attention and awareness of dysphagia in the elderly population should be strengthened, and targeted intervention measures should be actively implemented.
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Affiliation(s)
- Hai-Yang Feng
- School of Rehabilitation Medicine, Weifang Medical University, Weifang 261021, Shandong Province, China
| | - Ping-Ping Zhang
- School of Rehabilitation Medicine, Weifang Medical University, Weifang 261021, Shandong Province, China
| | - Xiao-Wen Wang
- School of Rehabilitation Medicine, Weifang Medical University, Weifang 261021, Shandong Province, China
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12
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Yang E, Lee KH. Association between Visual Impairment and Nutritional Risk among Older Adults with Diabetes: A Population-Based Cross-Sectional Study. J Korean Acad Nurs 2023; 53:167-176. [PMID: 37164345 DOI: 10.4040/jkan.22141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/24/2023] [Accepted: 02/26/2023] [Indexed: 05/12/2023]
Abstract
PURPOSE Despite the high prevalence of visual impairment caused by diabetic retinopathy and nutritional problems among older adults with diabetes, evidence regarding factors related to nutritional risk in this population is limited. Therefore, this study aimed to identify the correlates of nutritional risk among older adults with diabetes, focusing on visual impairment. METHODS This study was a secondary data analysis of the 2020 National Survey of Older Koreans aged 65 years and above. The sample comprised 2,376 older adults with diabetes, and complex sample ANOVA and Rao-Scott chi-square tests were used to compare the groups according to visual impairment. Complex-sample logistic regression analyses were conducted to verify the association between visual impairment and nutritional risk. RESULTS Older adults with diabetes, who also have severe visual impairment, are more likely to have nutritional risk status than those without impairment after controlling for covariates (odds ratio [OR] = 2.44, 95% confidence interval [CI] 1.16~5.13). Among the covariates, depression (OR = 3.58, 95% CI 2.60~4.94), dependent activities of daily living status (OR = 2.79, 95% CI 1.60~4.86), and experience of hospitalization during the past year (OR = 2.51, 95% CI 1.57~4.03) were strongly associated with nutritional risk. CONCLUSION Severe visual impairment increases the nutritional risk among older adults with diabetes. Therefore, it is essential to prevent visual impairment due to exacerbation of diabetes through appropriate management. Additionally, tailored nutritional interventions for visually impaired older adults with diabetes that consider visual characteristics are required.
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Affiliation(s)
- Eunjin Yang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Korea
| | - Kyung Hee Lee
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Korea.
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13
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Rodríguez-Mañas L, Murray R, Glencorse C, Sulo S. Good nutrition across the lifespan is foundational for healthy aging and sustainable development. Front Nutr 2023; 9:1113060. [PMID: 36761990 PMCID: PMC9902887 DOI: 10.3389/fnut.2022.1113060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 12/23/2022] [Indexed: 01/26/2023] Open
Abstract
Ensuring healthy lives and promoting wellbeing across the age spectrum are essential to sustainable development. Nutrition is at the heart of the World Health Organization (WHO) Sustainable Development Goals, particularly for Sustainable Development Goal 2/Subgoal 2, which is to End all forms of malnutrition by 2030. This subgoal addresses people of all ages, including targeted groups like young children and older adults. In recent decades, there have been marked advances in the tools and methods used to screen for risk of malnutrition and to conduct nutritional assessments. There have also been innovations in nutritional interventions and outcome measures related to malnutrition. What has been less common is research on how nutritional interventions can impact healthy aging. Our Perspective article thus takes a life-course approach to consider what is needed to address risk of malnutrition and why, and to examine how good nutrition across the lifespan can contribute to healthy aging. We discuss broad-ranging yet interdependent ways to improve nutritional status worldwide-development of nutritional programs and policies, incorporation of the best nutrition-care tools and methods into practice, provision of professional training for quality nutritional care, and monitoring health and economic benefits of such changes. Taken together, our Perspective aims to (i) identify current challenges to meeting these ideals of nutritional care, and to (ii) discover enabling strategies for the improvement of nutrition care across the lifespan. In harmony with the WHO goal of sustainable development, we underscore roles of nutrition to foster healthy human development and healthy aging worldwide.
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Affiliation(s)
- Leocadio Rodríguez-Mañas
- Service of Geriatrics, Getafe University Hospital and CIBER on Frailty and Healthy Aging (CIBERFES), Getafe, Spain,*Correspondence: Leocadio Rodríguez-Mañas,
| | - Robert Murray
- Department of Pediatrics, Emeritus, The Ohio State University College of Medicine, Columbus, OH, United States
| | | | - Suela Sulo
- Abbott Laboratories, Abbott Park, IL, United States
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14
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Ruan GT, Song MM, Zhang KP, Xie HL, Zhang Q, Zhang X, Tang M, Zhang XW, Ge YZ, Yang M, Zhu LC, Shi HP. A novel nutrition-related nomogram for the survival prediction of colorectal cancer-results from a multicenter study. Nutr Metab (Lond) 2023; 20:2. [PMID: 36600242 DOI: 10.1186/s12986-022-00719-8] [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: 03/27/2022] [Accepted: 12/18/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Precisely predicting the short- and long-term survival of patients with cancer is important. The tumor-node-metastasis (TNM) stage can accurately predict the long-term, but not short-term, survival of cancer. Nutritional status can affect the individual status and short-term outcomes of patients with cancer. Our hypothesis was that incorporating TNM stage and nutrition-related factors into one nomogram improves the survival prediction for patients with colorectal cancer (CRC). METHOD This multicenter prospective primary cohort included 1373 patients with CRC, and the internal validation cohort enrolled 409 patients with CRC. Least absolute shrinkage and selection operator regression analyses were used to select prognostic indicators and develop a nomogram. The concordance (C)-index, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) were used to assess the prognostic discriminative ability of the nomogram, TNM stage, Patient-Generated Subjective Global Assessment (PGSGA), and TNM stage + PGSGA models. The overall survival (OS) curve of risk group stratification was calculated based on the nomogram risk score. RESULTS TNM stage, radical resection, reduced food intake, activities and function declined, and albumin were selected to develop the nomogram. The C-index and calibration plots of the nomogram showed good discrimination and consistency for CRC. Additionally, the ROC curves and DCA of the nomogram showed better survival prediction abilities in CRC than the other models. The stratification curves of the different risk groups of the different TNM categories were significantly different. CONCLUSION The novel nomogram showed good short- and long-term outcomes of OS in patients with CRC. This model provides a personalized and convenient prognostic prediction tool for clinical applications.
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Affiliation(s)
- Guo-Tian Ruan
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, 10 Tie Yi Road, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Meng-Meng Song
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, 10 Tie Yi Road, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Kang-Ping Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, 10 Tie Yi Road, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Hai-Lun Xie
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, 10 Tie Yi Road, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Qi Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, 10 Tie Yi Road, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Xi Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, 10 Tie Yi Road, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Meng Tang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, 10 Tie Yi Road, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Xiao-Wei Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, 10 Tie Yi Road, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Yi-Zhong Ge
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, 10 Tie Yi Road, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Ming Yang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, 10 Tie Yi Road, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Li-Chen Zhu
- Department of Immunology, School of Preclinical Medicine, Guangxi Medical University, Nanning, China
| | - Han-Ping Shi
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, 10 Tie Yi Road, Beijing, 100038, China. .,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China.
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Nguo K, Truby H, Porter J. Total Energy Expenditure in Healthy Ambulatory Older Adults Aged ≥80 Years: A Doubly Labelled Water Study. ANNALS OF NUTRITION & METABOLISM 2023; 79:263-273. [PMID: 36592624 DOI: 10.1159/000528872] [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: 06/29/2022] [Accepted: 12/21/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION The life expectancy of older adults continues to increase; however, knowledge regarding their total energy requirements is lacking. This study aimed to compare the total energy expenditure (TEE) of older adults ≥80 years measured using doubly labelled water (DLW), with estimated TEE. The hypothesis was that the Mifflin, Ikeda, and Livingston equations will more closely estimate energy requirements than the commonly used Schofield equation. METHODS Resting metabolic rate (RMR) and TEE were measured using the reference methods of indirect calorimetry and DLW, respectively. Bland-Altman plots compared measured RMR and TEE with predicted RMR using equations (Mifflin, Ikeda, Livingston, Schofield) and predicted TEE (predicted RMR × physical activity level). RESULTS Twenty-one older adults (age range 80.7-90.1 years, BMI 26.1 ± 5.5 kg/m2) were included. The Schofield equation demonstrated the greatest bias from measured RMR, overestimating approximately up to double the mean difference (865 ± 662 kJ/day) compared with the three other equations. The Schofield equation exhibited the greatest bias (overestimation of 641 ± 1,066 kJ/day) compared with measured TEE. The other three equations underestimated TEE, with the least bias from Ikeda (37 ± 1,103 kJ/day), followed by Livingston (251 ± 1,108 kJ/day), and Mifflin (354 ± 1,140 kJ/day). Data are mean ± SD. CONCLUSIONS In older adults ≥80 years, the Ikeda, Mifflin, and Livingston equations provide closer estimates of TEE than the widely used Schofield equation. The development of nutrition guidelines therefore should consider the utilization of equations which more accurately reflect age-specific requirements.
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Affiliation(s)
- Kay Nguo
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia
| | - Helen Truby
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Science, The University of Queensland, St Lucia, Brisbane, Queensland, Australia
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Victoria, Australia
| | - Judi Porter
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
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Adamson A, Davies K, Wham C, Kepa M, Foster E, Jones A, Mathers J, Granic A, Teh R, Moyes S, Hayman K, Siervo M, Maxted E, Redwood K, Collerton J, Jagger C, Kirkwood T, Dyall L, Kerse N. Assessment of Dietary Intake in Three Cohorts of Advanced Age in Two Countries: Methodology Challenges. J Nutr Health Aging 2023; 27:59-66. [PMID: 36651487 DOI: 10.1007/s12603-023-1878-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Dietary intake information is key to understanding nutrition-related outcomes. Intake changes with age and some older people are at increased risk of malnutrition. Application, difficulties, and advantages of the 24-hour multiple pass recall (24hr-MPR) dietary assessment method in three cohorts of advanced age in the United Kingdom (UK) and New Zealand (NZ) is described. PARTICIPANTS The Newcastle 85+ study (UK) recruited a single year birth cohort of people aged 85 years during 2006-7. LiLACS NZ recruited a 10-year birth cohort of Māori (indigenous New Zealanders) aged 80-90 years and a single year birth cohort of non-Māori aged 85 years in 2010. MEASUREMENTS Two 24hr-MPR were conducted on non-consecutive days by trained assessors. Pictorial resources and language were adapted for the New Zealand and Māori contexts. Detailed methods are described. RESULTS In the Newcastle 85+ study, 805 (93%) participants consented to the 24-MPR, 95% of whom completed two 24hr-MPR; in LiLACS NZ, 218 (82%) consented and 203 (76%) Māori and 353 (90%) non-Māori completed two 24hr-MPR. Mean time to complete each 24hr-MPR was 22 minutes in the Newcastle 85+ study, and 45 minutes for Māori and 39 minutes for non-Māori in LiLACS NZ. Dietary assessment of participants residing in residential care and those requiring proxy respondents were successfully included in both studies. Most participants (83-94%) felt that data captured by the 24hr-MPR reflected their usual dietary intake. CONCLUSIONS Dietary assessment using 24hr-MPR was successful in capturing detailed dietary data including information on portion size and time of eating for over 1300 octogenarians in the UK and New Zealand (Māori and non- Māori). The 24hr-MPR is an acceptable method of dietary assessment in this age group.
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Affiliation(s)
- A Adamson
- Professor Ngaire Kerse, Department of General Practice and Primary Health Care, University of Auckland, New Zealand,
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Iuliano S, Poon S, Robbins J, Wang X, Bui M, Seeman E. Provision of High Protein Foods Slows the Age-Related Decline in Nutritional Status in Aged Care Residents: A Cluster-Randomised Controlled Trial. J Nutr Health Aging 2023; 27:166-171. [PMID: 36806871 DOI: 10.1007/s12603-022-1868-7] [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] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Malnutrition, particularly protein insufficiency, is common in institutionalised older adults and increases morbidity, mortality, and costs. We aimed to determine whether 12 months supplementation using high-protein foods (milk, cheese, yoghurt) prevents malnutrition in older adults. DESIGN Cluster randomised control study. SETTING Sixty Australian aged care facilities. PARTICIPANTS Older adults living in aged care homes (n=654, mean age 86.7±7.2 years, 72% females). Intervention Facilities randomly allocated to a high-protein (n=30 intervention) or regular (n=30 controls) menu. MEASUREMENTS Nutritional status assessed using the Mini Nutrition Assessment (MNA) tool and fasting morning blood samples (n=302) assayed for haemoglobin (Hb) and albumin. Food intake was monitored 3-monthly using visual plate waste assessment. Measurements at baseline and month 12 were analysed using random effects model accounting for clustering (facility), repeated measure and confounders. RESULTS Addition of 11g of protein as 1.5 servings of high-protein foods daily preserved nutritional status that deteriorated in controls [MNA screen (-0.68, 95%CI: -1.03, -0.32, p<0.001) and total (-0.90, 95%CI: -1.45, -0.35, p=0.001) scores], resulting in group differences in MNA screen (0.62, 95%CI: 0.17, 1.06, p=0.007) and total (0.81, 95%CI: 0.11, 1.51, p=0.023) scores and group difference in Hb (3.60g/L, 95%CI: 0.18, 7.03, p=0.039), the net result of preservation with intervention (0.19g/L, 95%CI: -2.04, 2.42, p=0.896) and a decline in controls (-3.41g/L, 95%CI: -6.01, -0.82, p=0.010). No group differences were observed for serum albumin. CONCLUSION Consumption of high-protein foods is a pragmatic approach to maintaining nutritional status in older adults in aged-care.
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Affiliation(s)
- S Iuliano
- Sandra Iuliano, Department of Endocrinology, University of Melbourne / Austin Health, Heidelberg Repatriation Hospital, Waterdale Road, West Heidelberg, Victoria, Australia, 3081, , Phone: +61 438 215 615
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18
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Alkhalaf M, Zhang Z, Chang HCR, Wei W, Yin M, Deng C, Yu P. Malnutrition and its contributing factors for older people living in residential aged care facilities: Insights from natural language processing of aged care records. Technol Health Care 2023; 31:2267-2278. [PMID: 37302059 DOI: 10.3233/thc-230229] [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] [Indexed: 06/12/2023]
Abstract
BACKGROUND Malnutrition is a serious health risk facing older people living in residential aged care facilities. Aged care staff record observations and concerns about older people in electronic health records (EHR), including free-text progress notes. These insights are yet to be unleashed. OBJECTIVE This study explored the risk factors for malnutrition in structured and unstructured electronic health data. METHODS Data of weight loss and malnutrition were extracted from the de-identified EHR records of a large aged care organization in Australia. A literature review was conducted to identify causative factors for malnutrition. Natural language processing (NLP) techniques were applied to progress notes to extract these causative factors. The NLP performance was evaluated by the parameters of sensitivity, specificity and F1-Score. RESULTS The NLP methods were highly accurate in extracting the key data, values for 46 causative variables, from the free-text client progress notes. Thirty three percent (1,469 out of 4,405) of the clients were malnourished. The structured, tabulated data only recorded 48% of these malnourished clients, far less than that (82%) identified from the progress notes, suggesting the importance of using NLP technology to uncover the information from nursing notes to fully understand the health status of the vulnerable older people in residential aged care. CONCLUSION This study identified 33% of older people suffered from malnutrition, lower than those reported in the similar setting in previous studies. Our study demonstrates that NLP technology is important for uncovering the key information about health risks for older people in residential aged care. Future research can apply NLP to predict other health risks for older people in this setting.
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Affiliation(s)
- Mohammad Alkhalaf
- Centre for Digital Transformation, School of Computing and Information Technology, University of Wollongong, Wollongong, Australia
- School of Computer Science, Qassim University, Buraydah, Saudi Arabia
| | - Zhenyu Zhang
- Centre for Digital Transformation, School of Computing and Information Technology, University of Wollongong, Wollongong, Australia
| | - Hui-Chen Rita Chang
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Wenxi Wei
- School of Nursing, University of Wollongong, Wollongong, Australia
| | | | - Chao Deng
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia
| | - Ping Yu
- Centre for Digital Transformation, School of Computing and Information Technology, University of Wollongong, Wollongong, Australia
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Pink AE, Lee LL, Low DY, Yang Y, Fong LZ, Kang AYH, Liu P, Kim H, Wang Y, Padmanabhan P, Cobiac L, Gulyás B, Pettersson S, Cheon BK. Implicit satiety goals and food-related expectations predict portion size in older adults: Findings from the BAMMBE cohort. Appetite 2023; 180:106361. [PMID: 36332849 PMCID: PMC9742320 DOI: 10.1016/j.appet.2022.106361] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 11/07/2022]
Abstract
Portion size selection is an indicator of appetite and within younger adults, is predicted by factors such as expected satiety, liking and motivations to achieve an ideal sensation of fullness (i.e., implicit satiety goals). Currently, there is limited research available on the determinants of portion size selection within older adults. Therefore, the current study aimed to examine the relationship between individual differences in implicit satiety goals, food-related expectations, and portion size selection in older adults. Free-living older adult Singaporeans (N = 115; Nmales = 62; age: M = 66.21 years, SD = 4.78, range = 60-83 years) participated as part of the Brain, Ageing, Microbiome, Muscle, Bone, and Exercise Study (BAMMBE). Participants completed questionnaires on their subjective requirements for experiencing different states of satiety and food-related expectations (i.e., liking, how filling) as well as a computerised portion size selection task. Using a multiple regression, we found that goals to feel comfortably full (B = 3.08, SE = 1.04, t = 2.96, p = .004) and to stop hunger (B = -2.25, SE = 0.82, t = -2.75, p = .007) significantly predicted larger portion size selection (R2 = 0.24, F(4,87) = 6.74, p < .001). Larger portion sizes (R2 = 0.53, F(5,90) = 20.58, p < .001) were also predicted by greater expected satiety (B = 0.47, SE = 0.09, t = 5.15, p < .001) and lower perceptions of how filling foods are (B = -2.92, SE = 0.77, t = -3.79, p < .001) but not liking (B = -0.09, SE = 0.91, t = -0.10, p = .925) or frequency (B = -18.42, SE = 16.91, t = -1.09, p = .279) of consumption of target foods. Comparing our findings to results of studies conducted with younger adults suggests the influence of factors such as satiety related goals on portion size selection may change with ageing while the influence of other factors (e.g., expected satiety/fullness delivered by foods) may remain consistent. These findings may inform future strategies to increase/decrease portion size accordingly to ensure older adults maintain an appropriate healthy weight.
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Affiliation(s)
- Aimee E Pink
- School of Social Sciences, Nanyang Technological University, 639818, Singapore; Institute of High Performance Computing, Agency for Science, Technology and Research (A*STAR), 138632, Singapore; Singapore Institute for Clinical Sciences (A*STAR), Agency for Science, Technology and Research (A*STAR), Singapore, 117599.
| | - Li Ling Lee
- School of Social Sciences, Nanyang Technological University, 639818, Singapore.
| | - Dorrain Yanwen Low
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore.
| | - Yifan Yang
- Physical Education and Sports Science, National Institute of Education (NIE), Nanyang Technological University, 637616, Singapore; Office of Education Research, National Institute of Education (NIE), Nanyang Technological University, 637616, Singapore.
| | - LaiGuan Zoey Fong
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore.
| | - Alicia Yi Hui Kang
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore.
| | - Peijia Liu
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore.
| | - Hyejin Kim
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore.
| | - Yulan Wang
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore; Singapore Phenome Centre (SPC), Nanyang Technological University, 636921, Singapore.
| | | | - Lynne Cobiac
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Health and Biosecurity, Adelaide, South Australia, 5001, Australia.
| | - Balázs Gulyás
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore; Cognitive Neuroimaging Centre (CONIC), Nanyang Technological University, 636921, Singapore; Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Sven Pettersson
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore; Department of Neurobiology, Care and Society, Karolinska Institutet, 171 77, Stockholm, Sweden; National Neuroscience Institute, Tan Tock Seng Hospital, 308433, Singapore; Sunway University, Faculty of Medical Sciences, Kuala Lumpur, 47500, Malaysia.
| | - Bobby K Cheon
- Eunice Kennedy Shriver National Institute for Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA, 20847.
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[Malnutrition management of hospitalized patients with diabetes/hyperglycemia and hip fracture]. NUTR HOSP 2022; 39:9-14. [PMID: 36546338 DOI: 10.20960/nh.04506] [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: 12/24/2022] Open
Abstract
Introduction The yearly incidence of hip fracture is very high, which generates significant healthcare and socioeconomic burden. These fractures can occur at any age, but the vast majority occur in people over 65 years of age and predominantly in women, due to the increased risk of menopause-associated osteoporosis. Type 2 diabetes mellitus (DM2), apart from altering glucose, lipid and protein metabolisms, also causes a deregulation of calcium, phosphorus and magnesium and dysfunction in bone metabolism. The prevalence of malnutrition in patients with hip fracture is also high, due to their advanced age, and the acute injury itself provokes catabolic and inflammatory responses that result in disease-related malnutrition and sarcopenia, which aggravates the patient's clinical condition. This article describes the results of the expert consensus and the responses of the panelists on the nutritional management in routine clinical practice of patients with diabetes/hyperglycemia hospitalized (non-critically ill) with hip fracture.
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[Malnutrition management of hospitalized patients with diabetes/hyperglycemia and concurrent pathologies]. NUTR HOSP 2022; 39:1-8. [PMID: 36546334 DOI: 10.20960/nh.04505] [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: 12/24/2022] Open
Abstract
Introduction Type 2 diabetes mellitus is a highly prevalent disease worldwide, generating an increasing clinical and economic burden due to its micro- and macrovascular complications. Frequently, people with diabetes are hospitalized for various pathologies. These patients generally have higher risk of complications, prolonged hospitalizations and mortality. An additional factor that worsens the prognosis in these patients is the concurrence of malnutrition, especially in elderly people. All this makes the management of these patients challenging and requires a specific nutritional approach, whose purpose is to cover the nutritional requirements while always maintaining glycemic control. The purpose of this work is to provide, based on the evidence available in the literature and clinical experience, consensus recommendations by eighteen experts in Endocrinology and Nutrition on the nutritional approach of hospitalized patients with diabetes/ hyperglycemia and compare the optimal management, based on these recommendations with bedside usual care according to a panel of Spanish doctors surveyed about their daily clinical practice. This first article of this extraordinary issue of the journal Nutrición Hospitalaria describes the methodology of the study and the results obtained regarding common issues for all pathologies.
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AlMohaisen N, Gittins M, Todd C, Burden S. What is the overlap between malnutrition, frailty and sarcopenia in the older population? Study protocol for cross-sectional study using UK Biobank. PLoS One 2022; 17:e0278371. [PMID: 36472992 PMCID: PMC9725160 DOI: 10.1371/journal.pone.0278371] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/15/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In an increasingly older adult population, understanding the inter-relationship between three age related conditions malnutrition, frailty and sarcopenia is important in order to improve their recognition, treatment and prevention. This study aims to determine the overlap between malnutrition, frailty and sarcopenia by measuring estimates of prevalence for each individual condition. In addition, we will compare two models of frailty which are the accumulation of deficits and phenotype models. METHODS/DESIGN This is a cross-sectional study that will use the UK Biobank database, which will include a subset of 381,000 participants: males and females aged 50 years and above who completed the baseline assessments. For the baseline assessments, details of the participants' characteristics will be included. All three conditions will be identified and mapped to variables collected at the baseline assessment. Variables for malnutrition will be mapped according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Frailty will be defined according to two models: the 36 deficits and the phenotype model. Finally, sarcopenia will be assessed according to the European Working Group on Sarcopenia in Older People (EWGSOP) standard. DISCUSSION This proposed study will help to understand the presence of malnutrition, frailty and sarcopenia in the older population and describe any overlap between the conditions. There is little published research on the overlap between these three conditions. Despite the similarity and shared criteria used for the identification of malnutrition, frailty and sarcopenia there is still a lack of cohesive thinking around the overlap of applied definitions and identification criteria. TRIAL REGISTRATION ClinicalTrials.gov NCT04655456 approved on the 10th of December 2020.
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Affiliation(s)
- Nada AlMohaisen
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Department of Clinical Nutrition, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Matthew Gittins
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Chris Todd
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
- Manchester University Foundation NHS Trust, Manchester, United Kingdom
| | - Sorrel Burden
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
- Salford Royal Foundation NHS Trust, Salford, United Kingdom
- * E-mail:
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Wu XS, Miles A, Braakhuis A. Effects of hydrolysed meat on dietary intake and nutritional status in aged care residents requiring pureed diets: a crossover randomised controlled trial. BMC Geriatr 2022; 22:905. [PMID: 36434542 PMCID: PMC9700874 DOI: 10.1186/s12877-022-03622-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 11/14/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND As a result of the high prevalence of dysphagia in aged care facilities, demand for pureed diets is increasing. One of the biggest challenges for pureed diets is the reduced nutritional density due to the cooking process, such as when blending or softening with liquid. This study aimed to investigate the impact of innovative energy and protein-enriched meat puree on the nutrition intake and nutritional status of aged care residents requiring pureed diets. METHODS This is a single-blinded randomised controlled trial conducted in two aged care facilities using a crossover design. Twenty-two residents aged 83.2 ± 7.3 years participated in a 12-week study. Participants were blocked randomised into two groups and received a 6-week of either control (unaltered freshly made pureed diets by facilities) or intervention diet, followed by a 2-week washout and then 6-week of alternative treatment. During the intervention, freshly made meat pureed portions were swapped to hydrolysed meat, which contained 144 -392 kcal and 5.6-6.8 g more energy and protein per 100 g. Nutrition intake was collected using a validated visual estimation method over 24 h on two non-consecutive days during the control and intervention phases. A two-tailed t-test was used to compare the significance. RESULTS The intervention diet significantly increased energy (147 ± 285 kcal, p = .02), protein (4 ± 7 g, p = .04), and fat (3 ± 8 g, p = .07) intake in comparison to the control diet. Nutritional status was improved by the end of the intervention as evidenced by a higher nutritional assessment score using Mini-Nutritional Assessment - Short Form (9.1 ± 1.8) and a weight gain of 1.3 ± 1.7 g, p = .04. No significant differences were found in body composition using bioelectrical impedance analysis, calf circumference and mid-upper arm circumference. Though handgrip strength did not differ at the end of control and intervention, significance was found between the changes in control and intervention period. Plasma branched-chain amino acid increased significantly with hydrolysed meat consumption. CONCLUSIONS As a dietary enrichment, hydrolysed meat is a promising intervention for pureed diet consumers in aged care facilities, improving residents' dietary intake and reducing malnutrition risk. Future larger multicentre studies with longer intervention periods are required to confirm the effectiveness and residents' acceptance. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ACTRN12622000888763).
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Affiliation(s)
- Xiaojing Sharon Wu
- grid.9654.e0000 0004 0372 3343Department of Nutrition, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Rd, Grafton, Auckland, 1142 New Zealand
| | - Anna Miles
- grid.9654.e0000 0004 0372 3343Department of Speech Science, School of Psychology, University of Auckland, Auckland, New Zealand
| | - Andrea Braakhuis
- grid.9654.e0000 0004 0372 3343Department of Nutrition, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Rd, Grafton, Auckland, 1142 New Zealand
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Gao M, Wu B, Jin W, Wei J, Wang J, Li J. Impact of aging on food consumption in rural China: Implications for dietary upgrading and health improvement. Front Nutr 2022; 9:933343. [PMID: 36505237 PMCID: PMC9731807 DOI: 10.3389/fnut.2022.933343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 10/31/2022] [Indexed: 11/26/2022] Open
Abstract
Background The issue of population aging in rural China is getting profound; nevertheless, its impact on food consumption has not been well evaluated. This study aims to examine the relationship between rural aging and family food consumption in rural China. Materials and methods Using the statistical yearbook data and the nationally representative household-level data from the China Rural Fixed Observation Points, this study compares the evolution of food consumption between rural and urban residents from 1985 to 2020 and analyzes the structure of food consumption expenditure of rural residents. Next, this study further investigates the impact of aging on food consumption in rural households with ordinary least squares. Results (1) The principal foods consumed by rural residents in 2020 are meat and meat products (36.8%), grain (24.5%), and vegetables (10.9%). (2) An increase in older adults has decreased the absolute consumption of all foods, while it increased relative consumption of meat and meat products, aquatic products, edible oil and fats, poultry, eggs, and sugar. (3) Due to differences in the structure of young adults' food consumption, older adults would increase their consumption of fruits and vegetables if they lived with younger adults. Conclusion The findings of this study suggest that rural older adults may increase their consumption of fruits and vegetables by advocating intergenerational cohabitation while maintaining their intake of protein to achieve a balanced dietary structure and improve their health condition.
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Affiliation(s)
- Ming Gao
- Research Center for Rural Economy, Ministry of Agriculture and Rural Affairs, Beijing, China,Institute of Rural Development, Chinese Academy of Social Sciences, Beijing, China
| | - Bi Wu
- Research Center for Rural Economy, Ministry of Agriculture and Rural Affairs, Beijing, China
| | - Wencheng Jin
- Research Center for Rural Economy, Ministry of Agriculture and Rural Affairs, Beijing, China
| | - Jiashuo Wei
- National Agricultural and Rural Development Research Institute, China Agricultural University, Beijing, China
| | - Jiwen Wang
- Research Center for Rural Economy, Ministry of Agriculture and Rural Affairs, Beijing, China,*Correspondence: Jiwen Wang,
| | - Jinkai Li
- Department of Economics, Faculty of Economics and Business Administration, Ghent University, Ghent, Belgium,Jinkai Li,
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Seid AM, Babbel NF. Prevalence of malnutrition among old age people in Africa. FRONTIERS IN AGING 2022; 3:1002367. [PMID: 36439677 PMCID: PMC9686835 DOI: 10.3389/fragi.2022.1002367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/10/2022] [Indexed: 04/14/2024]
Abstract
Background: Improved health care and rising life expectancy are creating a growing pool of old age people all over the world, including Africa. Malnutrition in the old age people is associated with both short- and long-term negative health outcomes. However, the reported burdens of malnutrition are fragmented and inconsistent, where more compiled evidence is warranted to aid decision-makers. Hence, this paper is aimed to estimate the pooled prevalence of malnutrition among old age people in Africa. Methods: A systematic search for research reporting the prevalence of malnutrition among old age people (aged above 60 years) was conducted from HINARI/PubMed and Google Scholar databases using combination keywords. Published articles in English language starting from January 2000 to October 2021 were screened. We presented the results based on the standard for reporting systematic review and meta-analysis of observational studies. A random-effect meta-analysis was done to estimate the prevalence of malnutrition along with the 95% confidence intervals. The publication bias was assessed using the funnel plot. Results: A total of 1,442 studies were retrieved based on the search strategy, where only 36 studies (n = 15,266 participants) reported from 11 African countries were included for meta-analysis. The reported prevalence of malnutrition ranges from 2.2 to 77.3% across Africa. Overall, the pooled prevalence of malnutrition was 18% (95% CI: 15-22; I2 = 98.1; p < 0.001). The prevalence is higher in the Central Africa (3.8%; 95% CI: 3.2-4.4), in the community (3.1%; 95% CI: 2.7-3.7), and among advanced age (3.5%; 95% CI: 2.3-5.4). Conclusion: The prevalence of malnutrition in African old age people is high and differs by setting, assessment tool, and country of residence. Hence, due attention to geriatric nutrition is mandatory, and the need for a valid, reliable, and simple screening tool should be thought of.
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Affiliation(s)
- Ahmed Muhye Seid
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Netsanet Fentahun Babbel
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Dietary Acid Load Was Positively Associated with the Risk of Hip Fracture in Elderly Adults. Nutrients 2022; 14:nu14183748. [PMID: 36145124 PMCID: PMC9503794 DOI: 10.3390/nu14183748] [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: 08/24/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 11/19/2022] Open
Abstract
Previous studies have shown that dietary acid load (DAL) harms bone health, but the evidence is inconsistent and insufficient. This study examined the relationships between DAL and the risk of hip fracture. This case−control study contained 1070 pairs of 1:1 age-, city-, and gender-matched incident cases and controls (mean age, 71 years) recruited in Guangdong, China. Dietary information was collected using a validated 79-item food frequency questionnaire through face-to-face interviews. DAL was estimated based on established algorithms for the potential renal acid load (PRAL) and net endogenous acid production (NEAP). Higher PRAL and NEAP were dose-dependently associated with a higher risk of hip fracture in both the conditional logistic regression model and restricted cubic spline analysis after adjusting for potential covariates. The multivariate-adjusted odds ratios and 95% CI of hip fracture for tertiles 2 and 3 (vs. 1) of DAL were 1.63 (1.18, 2.25) and 1.92 (1.36, 2.71) for PRAL and 1.81 (1.30, 2.53) and 2.55 (1.76, 3.71) for NEAP in all participants (all p-trends < 0.001), respectively. Subgroup analyses showed more pronounced associations in participants with a lower body mass index. Our findings suggested positive associations between the estimated DAL and the risk of hip fractures in the elderly Chinese population.
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Tseng MY, Liang J, Wu CC, Cheng HS, Yang CT, Chen CY, Shyu YIL. Better nutrition trajectory improves recovery following a hip fracture surgery for older persons with diabetes mellitus. Aging Clin Exp Res 2022; 34:2815-2824. [PMID: 36040680 DOI: 10.1007/s40520-022-02221-w] [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: 05/06/2022] [Accepted: 08/06/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Influences of nutritional status on hip fractured persons with diabetes mellitus (DM) following surgery have not been reported. AIMS To explore the trajectory groups of nutritional status and their influences on post-operative recovery for older persons with hip fracture and DM. METHODS A total of 169 patients with DM and hip fracture from a clinical trial were included in this analysis. Mini Nutritional Assessment was used to assess the nutritional status of the participants. Outcome variables included self-care ability, muscle strength, depressive symptoms, health related quality of life, and cognitive function, which were collected before discharge and 1-, 3-, 6-, 12-, 18-, and 24-months following hospital discharge. RESULTS Among hip fractured older persons with DM, within two years following surgery there were three nutritional trajectory groups: malnourished (28.3%), at-risk of malnutrition (41.9%) and well-nourished (29.8%). A decline in nutritional status, especially for the malnourished group, was seen in the second year. A better nutritional trajectory was associated with better recovery outcomes, including self-care ability, health related quality of life, cognitive function and less depressive symptoms. DISCUSSION Close to 30% of hip fractured persons with DM were considered to have a malnourished trajectory over 2 years following surgery. A poor nutritional trajectory was associated with poor mental health and physical recovery. CONCLUSIONS Continuous nutrition assessment during the first 2 years following hip fracture surgery for older persons with DM is important. Development and implementation of interventions targeting the malnourished trajectory group are suggested.
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Affiliation(s)
- Ming-Yueh Tseng
- Post-Baccalaureate Program in Nursing, College of Nursing, Asia University, Taichung, Taiwan
| | - Jersey Liang
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Chi-Chuan Wu
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Huey-Shinn Cheng
- Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ching-Tzu Yang
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Yen Chen
- Department of Psychiatry, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yea-Ing L Shyu
- School of Nursing and Healthy Aging Research Center, Chang Gung University, 259 Wenhua 1st Road, Guishan District, 33302, Taoyuan, Taiwan. .,Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan. .,Dementia Center, Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
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Tay W, Quek R, Kaur B, Lim J, Henry CJ. Use of Facial Morphology to Determine Nutritional Status in Older Adults: Opportunities and Challenges. JMIR Public Health Surveill 2022; 8:e33478. [PMID: 35849429 PMCID: PMC9345026 DOI: 10.2196/33478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/03/2022] [Indexed: 11/13/2022] Open
Abstract
Undiagnosed malnutrition is a significant problem in high-income countries, which can reduce the quality of life of many individuals, particularly of older adults. Moreover, it can also inflate the costs of existing health care systems because of the many metabolic complications that it can cause. The current methods for assessing malnutrition can be cumbersome. A trained practitioner must be present to conduct an assessment, or patients must travel to facilities with specialized equipment to obtain their measurements. Therefore, digital health care is a possible way of closing this gap as it is rapidly gaining traction as a scalable means of improving efficiency in the health care system. It allows for the remote monitoring of nutritional status without requiring the physical presence of practitioners or the use of advanced medical equipment. As such, there is an increasing interest in expanding the range of digital applications to facilitate remote monitoring and management of health issues. In this study, we discuss the feasibility of a novel digital remote method for diagnosing malnutrition using facial morphometrics. Many malnutrition screening assessments include subjective assessments of the head and the face. Facial appearance is often used by clinicians as the first point of qualitative indication of health status. Hence, there may be merit in quantifying these subtle but observable changes using facial morphometrics. Modern advancements in artificial intelligence, data science, sensors, and computing technologies allow facial features to be accurately digitized, which could potentially allow these previously intuitive assessments to be quantified. This study aims to stimulate further discussion and discourse on how this emerging technology can be used to provide real-time access to nutritional status. The use of facial morphometrics extends the use of currently available technology and may provide a scalable, easily deployable solution for nutritional status to be monitored in real time. This will enable clinicians and dietitians to keep track of patients remotely and provide the necessary intervention measures as required, as well as providing health care institutions and policy makers with essential information that can be used to inform and enable targeted public health approaches within affected populations.
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Affiliation(s)
- Wesley Tay
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research, Singapore, Singapore
| | - Rina Quek
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research, Singapore, Singapore
| | - Bhupinder Kaur
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research, Singapore, Singapore
| | - Joseph Lim
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research, Singapore, Singapore
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Kheifets M, Goshen A, Goldbourt U, Witberg G, Eisen A, Kornowski R, Gerber Y. Association of socioeconomic status measures with physical activity and subsequent frailty in older adults. BMC Geriatr 2022; 22:439. [PMID: 35590281 PMCID: PMC9118657 DOI: 10.1186/s12877-022-03108-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/28/2022] [Indexed: 12/03/2022] Open
Abstract
Background Despite increased recognition, frailty remains a significant public health challenge. Objective we aimed to assess the role of education and income, as well as neighborhood socioeconomic status, on physical activity and subsequent frailty in older adults. Methods Using a population-based cohort of older adults, this study examined the relationship between socioeconomic status (SES) factors, physical activity and frailty. The study included 1,799 participants (mean [SD], 74.6 (6.2), 53.3% female) from the "National Health and Nutrition Survey of Older Adults Aged 65 and Over in Israel", conducted in 2005–2006. A follow-up interview was performed 12–14 years later in a subgroup of 601 subjects (mean [SD], age 84[4]; 56% women). Self-reported leisure-time physical activity (LTPA) was measured at both baseline and follow-up. SES measures were assessed at baseline. Frailty was measured at follow-up, using the Fried's Phenotype Model. Results All SES measures were strongly and positively associated with LTPA (all p < 0.001). Eighty-two participants (14%) were classified as frail at follow-up. After age and sex adjustment and accounting for attrition bias using inverse probability weighting, baseline LTPA (OR = 2.77, 95% CI: 1.57–4.90, for inactivity; OR = 1.41, 95% CI: 0.75–2.68, for insufficient activity, compared with sufficient activity, Ptrend < 0.001) was inversely associated with incident frailty. The association persisted after further adjustment for SES and comorbidity. Conclusion Among older individuals, multiple SES measures were positively associated with LTPA, which was a strong predictor of lower subsequent frailty risk.
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Affiliation(s)
- Mark Kheifets
- Department of Cardiology, Rabin Medical Center, Petach Tikva; affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Abigail Goshen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Uri Goldbourt
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Guy Witberg
- Department of Cardiology, Rabin Medical Center, Petach Tikva; affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alon Eisen
- Department of Cardiology, Rabin Medical Center, Petach Tikva; affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ran Kornowski
- Department of Cardiology, Rabin Medical Center, Petach Tikva; affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yariv Gerber
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Satayeva Z, Tayeva A, Rskeldiyev B, Zhaksylykova G, Akhmetova N. Nutrition of older adults in the Republic of Kazakhstan. POTRAVINARSTVO 2022. [DOI: 10.5219/1747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This article discusses a study on the nutrition specifics of older adults living in social service institutions in three major cities of the Republic of Kazakhstan: Nur-Sultan, Almaty, and Shymkent. The direction of the research meets the priorities of the World Health Organization to achieve goals on aging and health. The diets of older adults in the Republic of Kazakhstan were studied, food preferences were identified, and needs for basic nutrients were established. This article presents the results of sociological surveys of older adults who answered questions about nutrition, preferred foods, raw materials, and meat products. Based on the survey results, technologies of herodietic meat products aimed at enriching the diet with proteins were developed, along with practical recommendations for a balanced diet. This area of research is relevant due to the lack of products with a herodietic profile on the Kazakhstan market.
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Gajda R, Raczkowska E, Wyka J, Suliga E, Sobaś K. Differentiation of the Nutritional Risk of Polish Elderly People According to Selected Demographic Characteristics and Declared Socioeconomic Status. Nutrients 2022; 14:nu14081582. [PMID: 35458144 PMCID: PMC9027789 DOI: 10.3390/nu14081582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/04/2022] [Accepted: 04/09/2022] [Indexed: 01/10/2023] Open
Abstract
Nutritional risk screening in older people can help to not only identify health risks but also to treat them effectively. The aim of this work was to assess the relationship between the demographic characteristics (age, gender and place of residence) and socioeconomic status of older people in the community and nutritional risk. The Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN-14) questionnaire was used to evaluate the nutritional risk. The study was conducted in 417 people (312 women and 105 men) between 60 and 95 years old (70.8 ± 6.73 years). Multivariate correspondence analysis (MCA) was used to determine the relationships between the categories of variables describing the level of nutritional risk, demographic characteristics and the value of the socioeconomic status (SES) index. To assess the relationship between identified nutritional risks, demographics and SES index variables, we used logistic regression analysis. Based on these studies, nutritional risk factors for older people in Poland were identified. It has been shown that larger cities and low socioeconomic status are closely linked to higher nutritional risk. At the same time, age and gender were not significant factors influencing nutritional risk. Identifying the factors that increase the nutritional risk of older people can help to improve their quality of life.
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Affiliation(s)
- Robert Gajda
- Department of Human Nutrition, Faculty of Biotechnology and Food Science, Wrocław University of Environmental and Life Sciences, 51-630 Wrocław, Poland; (R.G.); (J.W.)
| | - Ewa Raczkowska
- Department of Human Nutrition, Faculty of Biotechnology and Food Science, Wrocław University of Environmental and Life Sciences, 51-630 Wrocław, Poland; (R.G.); (J.W.)
- Correspondence: ; Tel.: +48-71-320-7756
| | - Joanna Wyka
- Department of Human Nutrition, Faculty of Biotechnology and Food Science, Wrocław University of Environmental and Life Sciences, 51-630 Wrocław, Poland; (R.G.); (J.W.)
| | - Edyta Suliga
- Institute of Health Sciences, Medical College, Jan Kochanowski University, 25-516 Kielce, Poland; (E.S.); (K.S.)
| | - Kamila Sobaś
- Institute of Health Sciences, Medical College, Jan Kochanowski University, 25-516 Kielce, Poland; (E.S.); (K.S.)
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Schippinger W. Comprehensive geriatric assessment. Wien Med Wochenschr 2022; 172:122-125. [PMID: 35041103 DOI: 10.1007/s10354-021-00905-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 11/30/2021] [Indexed: 11/28/2022]
Abstract
Geriatric assessment is a multidimensional and interdisciplinarily deployed diagnostic process to evaluate functional capacities and impairments in geriatric patients. The results of geriatric assessment are the basis for planning of therapeutic interventions in the multidisciplinary geriatrics team. Geriatric assessment adds essential information to the state-of-the-art diagnostic tests, such as physical examination, laboratory tests, or imaging techniques, to acquire a holistic picture about health and functional problems and needs of geriatric patients. Studies have demonstrated that geriatric assessment and the following geriatric treatment improves prognosis and increases the chance of older patients remaining in their own home after discharge from hospital after admission for an acute disease.
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Affiliation(s)
- Walter Schippinger
- Medical Director and Head of the Department of Internal Medicine, Albert Schweitzer Hospital, Geriatric Health Centres of the City of Graz, Albert-Schweitzer-Gasse 36, 8020, Graz, Austria.
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Takehisa Y, Yamato K, Arao T, Takehisa T. [Analysis of changes in location before hospital admission, discharge destination and prognostic factors for the survival in hospitals with chronic-phase inpatients]. Nihon Ronen Igakkai Zasshi 2022; 59:347-359. [PMID: 36070909 DOI: 10.3143/geriatrics.59.347] [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] [Indexed: 06/15/2023]
Abstract
AIM To clarify changes in location before hospital admission and discharge destination over the 10-year period of 2010 to 2020 and to identify prognostic factors associated with the survival in hospitals with chronic-phase inpatients. METHODS The subjects were patients newly admitted to 12 hospitals in 2010 and 2020. The age, sex, location before hospital admission, outcomes at 90 days after admission, discharge destination, and results of 6 biochemical tests at admission were evaluated. A survival analysis was performed for the age, sex, and biochemical tests at admission. RESULTS We analyzed 8007 newly hospitalized patients. Compared with 2010, there were more hospital admissions from acute-care hospitals and fewer admissions from long-term-care facilities in 2020. In addition, relative to 2010, regarding the outcomes at 90 days after admission, there were more discharges to home and residential facilities in 2020, fewer discharges to long-term-care facilities, and lower mortality rates. In the survival analysis, a multivariate analysis revealed that an elderly age, male sex, low albumin, high total cholesterol, high urea nitrogen, and low serum sodium were poor prognostic factors. These five variables were consistently poor prognostic factors in both 2010 and 2020, and Kaplan-Meier curves showed that the scores were dose-dependent prognostic factors for a poor survival. CONCLUSIONS The present analysis of pre-admission location and discharge destination in hospitals with chronic-phase patients revealed an elderly age, male sex, high urea nitrogen, low serum sodium, and low albumin at the time of admission to be strong predictors of poor outcomes in these patients.
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Affiliation(s)
- Yozo Takehisa
- Medical Foundation Heisei Hakuaikai Hakuai Memorial Hospital
| | - Kaoru Yamato
- Medical Foundation Heisei Hakuaikai Hakuai Memorial Hospital
| | - Tokuzo Arao
- General Incorporated Foundation Kishiwada Nouyuukyoukai Kishiwada Heisei Hospital
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Kim J, Wu Y, Luan H, Yang DS, Cho D, Kwak SS, Liu S, Ryu H, Ghaffari R, Rogers JA. A Skin-Interfaced, Miniaturized Microfluidic Analysis and Delivery System for Colorimetric Measurements of Nutrients in Sweat and Supply of Vitamins Through the Skin. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2103331. [PMID: 34747140 PMCID: PMC8805554 DOI: 10.1002/advs.202103331] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/27/2021] [Indexed: 06/01/2023]
Abstract
Nutrients play critical roles in maintaining core physiological functions and in preventing diseases. Technologies for delivering these nutrients and for monitoring their concentrations can help to ensure proper nutritional balance. Eccrine sweat is a potentially attractive class of biofluid for monitoring purposes due to the ability to capture sweat easily and noninvasively from nearly any region of the body using skin-integrated microfluidic technologies. Here, a miniaturized system of this type is presented that allows simple, rapid colorimetric assessments of the concentrations of multiple essential nutrients in sweat, simultaneously and without any supporting electronics - vitamin C, calcium, zinc, and iron. A transdermal patch integrated directly with the microfluidics supports passive, sustained delivery of these species to the body throughout a period of wear. Comparisons of measurement results to those from traditional lab analysis methods demonstrate the accuracy and reliability of this platform. On-body tests with human subjects reveal correlations between the time dynamics of concentrations of these nutrients in sweat and those of the corresponding concentrations in blood. Studies conducted before and after consuming certain foods and beverages highlight practical capabilities in monitoring nutritional balance, with strong potential to serve as a basis for guiding personalized dietary choices.
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Affiliation(s)
- Joohee Kim
- Center for Bio‐Integrated ElectronicsNorthwestern UniversityEvanstonIL60208USA
- Querrey Simpson Institute for BioelectronicsNorthwestern UniversityEvanstonIL60208USA
| | - Yixin Wu
- Center for Bio‐Integrated ElectronicsNorthwestern UniversityEvanstonIL60208USA
- Querrey Simpson Institute for BioelectronicsNorthwestern UniversityEvanstonIL60208USA
- Department of Materials Science and EngineeringNorthwestern UniversityEvanstonIL60208USA
| | - Haiwen Luan
- Center for Bio‐Integrated ElectronicsNorthwestern UniversityEvanstonIL60208USA
- Querrey Simpson Institute for BioelectronicsNorthwestern UniversityEvanstonIL60208USA
| | - Da Som Yang
- Center for Bio‐Integrated ElectronicsNorthwestern UniversityEvanstonIL60208USA
- Querrey Simpson Institute for BioelectronicsNorthwestern UniversityEvanstonIL60208USA
| | - Donghwi Cho
- Center for Bio‐Integrated ElectronicsNorthwestern UniversityEvanstonIL60208USA
- Querrey Simpson Institute for BioelectronicsNorthwestern UniversityEvanstonIL60208USA
| | - Sung Soo Kwak
- Center for Bio‐Integrated ElectronicsNorthwestern UniversityEvanstonIL60208USA
- Querrey Simpson Institute for BioelectronicsNorthwestern UniversityEvanstonIL60208USA
- Center for Bionics of Biomedical Research InstituteKorea Institute of Science and TechnologySeoul02792Korea
| | - Shanliangzi Liu
- Center for Bio‐Integrated ElectronicsNorthwestern UniversityEvanstonIL60208USA
- Querrey Simpson Institute for BioelectronicsNorthwestern UniversityEvanstonIL60208USA
| | - Hanjun Ryu
- Center for Bio‐Integrated ElectronicsNorthwestern UniversityEvanstonIL60208USA
- Querrey Simpson Institute for BioelectronicsNorthwestern UniversityEvanstonIL60208USA
| | - Roozbeh Ghaffari
- Center for Bio‐Integrated ElectronicsNorthwestern UniversityEvanstonIL60208USA
- Querrey Simpson Institute for BioelectronicsNorthwestern UniversityEvanstonIL60208USA
- Department of Biomedical EngineeringNorthwestern UniversityEvanstonIL60208USA
| | - John A. Rogers
- Center for Bio‐Integrated ElectronicsNorthwestern UniversityEvanstonIL60208USA
- Querrey Simpson Institute for BioelectronicsNorthwestern UniversityEvanstonIL60208USA
- Department of Materials Science and EngineeringNorthwestern UniversityEvanstonIL60208USA
- Department of Biomedical EngineeringNorthwestern UniversityEvanstonIL60208USA
- Department of Mechanical EngineeringNorthwestern UniversityEvanstonIL60208USA
- Department of Neurological SurgeryFeinberg School of MedicineNorthwestern UniversityChicagoIL60611USA
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Cristina NM, Lucia D. Nutrition and Healthy Aging: Prevention and Treatment of Gastrointestinal Diseases. Nutrients 2021; 13:4337. [PMID: 34959889 PMCID: PMC8706789 DOI: 10.3390/nu13124337] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 12/16/2022] Open
Abstract
Nutritional well-being is a fundamental aspect for the health, autonomy and, therefore, the quality of life of all people, but especially of the elderly. It is estimated that at least half of non-institutionalized elderly people need nutritional intervention to improve their health and that 85% have one or more chronic diseases that could improve with correct nutrition. Although prevalence estimates are highly variable, depending on the population considered and the tool used for its assessment, malnutrition in the elderly has been reported up to 50%. Older patients are particularly at risk of malnutrition, due to multiple etiopathogenetic factors which can lead to a reduction or utilization in the intake of nutrients, a progressive loss of functional autonomy with dependence on food, and psychological problems related to economic or social isolation, e.g., linked to poverty or loneliness. Changes in the aging gut involve the mechanical disintegration of food, gastrointestinal motor function, food transit, intestinal wall function, and chemical digestion of food. These alterations progressively lead to the reduced ability to supply the body with adequate levels of nutrients, with the consequent development of malnutrition. Furthermore, studies have shown that the quality of life is impaired both in gastrointestinal diseases, but especially in malnutrition. A better understanding of the pathophysiology of malnutrition in elderly people is necessary to promote the knowledge of age-related changes in appetite, food intake, homeostasis, and body composition in order to better develop effective prevention and intervention strategies to achieve healthy aging.
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Affiliation(s)
- Neri Maria Cristina
- Division of Gastroenterology, Geriatric Institute Pio Albergo Trivulzio, 20146 Milan, Italy
| | - d’Alba Lucia
- Department of Gastroenterology and Endoscopy, San Camillo Forlanini Hospital, 00149 Rome, Italy;
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Wang YC, Lee WY, Chou MY, Liang CK, Chen HF, Yeh SCJ, Yaung CL, Tsai KT, Huang JJ, Wang C, Lin YT, Lou SJ, Shi HY. Cost and Effectiveness of Long-Term Care Following Integrated Discharge Planning: A Prospective Cohort Study. Healthcare (Basel) 2021; 9:healthcare9111413. [PMID: 34828460 PMCID: PMC8621918 DOI: 10.3390/healthcare9111413] [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: 09/01/2021] [Revised: 10/12/2021] [Accepted: 10/18/2021] [Indexed: 11/16/2022] Open
Abstract
Little is known about the effects of seamless hospital discharge planning on long-term care (LTC) costs and effectiveness. This study evaluates the cost and effectiveness of the recently implemented policy from hospital to LTC between patients discharged under seamless transition and standard transition. A total of 49 elderly patients in the standard transition cohort and 119 in the seamless transition cohort were recruited from November 2016 to February 2018. Data collected from medical records included the Multimorbidity Frailty Index, Activities of Daily Living Scale, and Malnutrition Universal Screening Tool during hospitalization. Multiple linear regression and Cox regression models were used to explore risk factors for medical resource utilization and medical outcomes. After adjustment for effective predictors, the seamless cohort had lower direct medical costs, a shorter length of stay, a higher survival rate, and a lower unplanned readmission rate compared to the standard cohort. However, only mean total direct medical costs during hospitalization and 6 months after discharge were significantly (p < 0.001) lower in the seamless cohort (USD 6192) compared to the standard cohort (USD 8361). Additionally, the annual per-patient economic burden in the seamless cohort approximated USD 2.9–3.3 billion. Analysis of the economic burden of disability in the elderly population in Taiwan indicates that seamless transition planning can save approximately USD 3 billion in annual healthcare costs. Implementing this policy would achieve continuous improvement in LTC quality and reduce the financial burden of healthcare on the Taiwanese government.
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Affiliation(s)
- Yu-Chun Wang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung 81341, Taiwan; (Y.-C.W.); (M.-Y.C.); (C.-K.L.); (Y.-T.L.)
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (W.-Y.L.); (H.-F.C.); (S.-C.J.Y.)
| | - Wen-Ying Lee
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (W.-Y.L.); (H.-F.C.); (S.-C.J.Y.)
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung 81341, Taiwan
| | - Ming-Yueh Chou
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung 81341, Taiwan; (Y.-C.W.); (M.-Y.C.); (C.-K.L.); (Y.-T.L.)
- Department of Geriatric Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei 11221, Taiwan
- Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
| | - Chih-Kuang Liang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung 81341, Taiwan; (Y.-C.W.); (M.-Y.C.); (C.-K.L.); (Y.-T.L.)
- Department of Geriatric Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei 11221, Taiwan
- Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
| | - Hsueh-Fen Chen
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (W.-Y.L.); (H.-F.C.); (S.-C.J.Y.)
| | - Shu-Chuan Jennifer Yeh
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (W.-Y.L.); (H.-F.C.); (S.-C.J.Y.)
- Department of Business Management, National Sun Yat-sen University, Kaohsiung 80424, Taiwan
| | - Chih-Liang Yaung
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan;
| | - Kang-Ting Tsai
- Department of Geriatrics and Center for Integrative Medicine, Chi Mei Medical Center, Tainan 71004, Taiwan;
| | - Joh-Jong Huang
- Department of Health, Kaohsiung City Government, Kaohsiung 80251, Taiwan;
| | - Chi Wang
- Department of Nursing, Kaohsiung Veterans General Hospital, Kaohsiung 81341, Taiwan;
| | - Yu-Te Lin
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung 81341, Taiwan; (Y.-C.W.); (M.-Y.C.); (C.-K.L.); (Y.-T.L.)
| | - Shi-Jer Lou
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (W.-Y.L.); (H.-F.C.); (S.-C.J.Y.)
- Graduate Institute of Technological and Vocational Education, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- Correspondence: (S.-J.L.); (H.-Y.S.); Tel.: +886-7-3211101 (ext. 2648) (H.-Y.S.)
| | - Hon-Yi Shi
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (W.-Y.L.); (H.-F.C.); (S.-C.J.Y.)
- Department of Business Management, National Sun Yat-sen University, Kaohsiung 80424, Taiwan
- Graduate Institute of Technological and Vocational Education, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40604, Taiwan
- Correspondence: (S.-J.L.); (H.-Y.S.); Tel.: +886-7-3211101 (ext. 2648) (H.-Y.S.)
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Song P, Man Q, Li Y, Jia S, Yu D, Zhang J, Ding G. Association between Dietary Patterns and Low HDL-C among Community-Dwelling Elders in North China. Nutrients 2021; 13:nu13103308. [PMID: 34684309 PMCID: PMC8537052 DOI: 10.3390/nu13103308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/17/2021] [Accepted: 09/18/2021] [Indexed: 11/16/2022] Open
Abstract
We aimed to investigate the association between dietary patterns and low HDL-C among the elderly population living in North China. The data were from a national cross-sectional survey conducted in 2015. General information in terms of living habits, health status, and food intake using 24 h dietary recall for three consecutive days was procured, and the weight of edible oil and condiments recorded. Anthropometric index, blood pressure, and fasting serum lipids were measured using standard methods. Dietary patterns were derived from food categories by exploratory factor analysis, and multivariate logistic regression was used to estimate the odds ratios of low HDL-C across quartiles of dietary patterns. Among 3387 elderly participants, 21.9% had low HDL-C levels. After adjusting for potential confounding factors, participants with highest score versus lowest score in the balanced dietary pattern had a decreased risk of low HDL-C (OR = 0.38, 95% CI: 0.16-0.88, p for trend = 0.013) in the group with a BMI of 27.1 kg/m2 and above. Compared to the lowest quartile, there was a statistically significant negative association between the highest scores of the Western dietary pattern and low HDL-C (OR = 0.37, 95% CI: 0.17-0.82, p for trend = 0.018) in the group with a BMI of 21.6-24.8 kg/m2. However, greater adherence to a thrifty dietary pattern (highest quartiles vs. lowest quartiles) was associated with increased risk of low HDL-C (OR = 3.31, 95% CI: 1.05-10.40, p for trend = 0.044), especially in the subgroup with a BMI of 21.6 kg/m2 and below. The study revealed that it is urgent to develop district-specific dietary improvement plans for dyslipidemia based on the nutritional status of the elderly population in North China.
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Affiliation(s)
| | | | | | | | | | - Jian Zhang
- Correspondence: (J.Z.); (G.D.); Tel.: +86-10-66237147 (J.Z.); +86-10-66237001 (G.D.)
| | - Gangqiang Ding
- Correspondence: (J.Z.); (G.D.); Tel.: +86-10-66237147 (J.Z.); +86-10-66237001 (G.D.)
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Amiri P, Javid AZ, Moradi L, Haghighat N, Moradi R, Behbahani HB, Zarrin M, Bazyar H. Associations between new and old anthropometric indices with type 2 diabetes mellitus and risk of metabolic complications: a cross-sectional analytical study. J Vasc Bras 2021; 20:e20200236. [PMID: 34630540 PMCID: PMC8483943 DOI: 10.1590/1677-5449.200236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 08/02/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Obesity can increase the risk of diabetes mellitus and complications associated with it. OBJECTIVES The aim of this study was to estimate the associations between new and old anthropometric indices and the risk of type 2 diabetes mellitus (T2DM) and its metabolic complications. METHODS In this cross-sectional analytical study, 110 T2DM subjects and 110 healthy controls were selected by convenience sampling. Metabolic factors were evaluated including the atherogenic index of plasma (AIP), glycemic status, lipid profile, blood pressure, kidney indices, new anthropometric indices (abdominal volume index [AVI], body shape index [ABSI], lipid accumulation product [LAP], body adiposity index [BAI], and conicity index [CI]), and old anthropometric indices (weight, body mass index [BMI], and waist and hip circumference [WC and HC]). RESULTS Significant positive correlations were observed between AVI, LAP, and BAI and fasting blood glucose and HbA1c in the T2DM group (p < 0.001 for all associations). The odds ratio (OR) for T2DM elevated significantly with increasing BMI (OR: 1.30, 95% CI: 1.20-1.42), LAP (OR: 1.20, 95% CI: 1.13-1.27), and BAI (OR: 1.32, 95% CI: 1.21-1.43). The indices AVI (OR: 1.90, 95% CI: 1.57-2.29), LAP (OR: 1.19, 95% CI: 1.13-1.27), BAI (OR: 1.19, 95% CI: 1.12-1.26), WC (OR: 1.29, 95% CI: 1.18, 1.42), and HC (OR: 1.07, 95% CI: 1.01, 1.14) significantly increased the risk of metabolic syndrome (MetS). CONCLUSIONS Associations were identified between obesity indices and diabetes. These indices could be used in clinical practice for evaluation and control of T2DM.
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Affiliation(s)
- Parichehr Amiri
- Ahvaz Jundishapur University of Medical Sciences, Student Research Committee, Ahvaz, Iran.
| | - Ahmad Zare Javid
- Ahvaz Jundishapur University of Medical Sciences, School of Allied Medical Sciences, Department of Nutrition, Ahvaz, Iran.
| | - Leila Moradi
- Ahvaz Jundishapur University of Medical Sciences, Health Research Institute, Diabetes Research Center, Ahvaz, Iran.
| | - Neda Haghighat
- Shiraz University of Medical Sciences, Laparoscopy Research Center, Shiraz, Iran.
| | - Rahim Moradi
- Ahvaz Jundishapur University of Medical Sciences, School of Medicine, Department of Clinical Biochemistry, Ahvaz, Iran.
| | - Hossein Bavi Behbahani
- Ahvaz Jundishapur University of Medical Sciences, Student Research Committee, Ahvaz, Iran.
| | - Milad Zarrin
- Ahvaz Jundishapur University of Medical Sciences, Student Research Committee, Ahvaz, Iran.
| | - Hadi Bazyar
- Ahvaz Jundishapur University of Medical Sciences, Student Research Committee, Ahvaz, Iran.
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Chen LH, Wu LW. Association between serum lactate dehydrogenase and frailty among individuals with metabolic syndrome. PLoS One 2021; 16:e0256315. [PMID: 34478437 PMCID: PMC8415577 DOI: 10.1371/journal.pone.0256315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 08/03/2021] [Indexed: 01/10/2023] Open
Abstract
While metabolic syndrome (MetS) is associated with frailty, the correlation of serum lactate dehydrogenase (sLDH) and frailty with MetS remain uncertain. To investigate the relationship between sLDH and frail components in the US with MetS. A total of 4,066 participants aged 40-90 years were assessed from the database of the third National Health and Nutrition Examination Survey, 1988-1994. The participants were classified into MetS and non-MetS groups. Multivariate logistic regression analysis with four models were performed to assess the odds ratio (OR) of the divided tertiles of sLDH levels with frailty, and frail components including slow walking (SW), weakness, exhaustion, low physical activity (LPA), and low body weight (LBW). Higher sLDH levels were positively associated with frailty in the MetS group (p = 0.024) but not in non-MetS group (p = 0.102). After covariate adjustments, the OR of frailty in the upper two tertiles compared to the lowest tertile and revealed statistical significance (p < 0.05). Frail components of SW, weakness, exhaustion, and LPA were associated with higher sLDH (p < 0.05) except for LBW in MetS and non-MetS groups. The results demonstrated the strong association of higher sLDH levels and frailty among US individuals with MetS.
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Affiliation(s)
- Li-Hsiang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan, Republic of China
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Li-Wei Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- Health Management Center, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China
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40
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Home-Delivered Meals: Characterization of Food Intake in Elderly Beneficiaries. Nutrients 2021; 13:nu13062064. [PMID: 34208726 PMCID: PMC8234175 DOI: 10.3390/nu13062064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/08/2021] [Accepted: 06/11/2021] [Indexed: 12/12/2022] Open
Abstract
Objective. In this study, we focus on elderly people (≥70 years old) benefiting from a home delivery meal service as part of a social welfare program. We aimed to: (i) assess the gap between the recommended and actual nutritional intake in this population and (ii) study the relationship between the intake of nutrients and the variables characterizing the participants’ health and nutritional status. Design. A dietary survey (24-hour record) was conducted during a home interview, with 64 people receiving a home delivery meal service (75% women; 70–97 years old). At the same time, the participants answered questionnaires assessing their nutritional and health status. Results. Our data showed that the consumption of 70 to 80% participants was not sufficient for reaching the nutritional recommendations for energy and macronutrients. Additionally, the data showed that the lower the energy and protein intakes, the higher the risk of malnutrition. In addition, one third of the participants were both overweight or obese and at risk of undernutrition or undernourished. Our study demonstrated that the heavier the person, the more difficult it was for them to meet the nutritional recommendations based on kilograms of body weight. Finally, individuals receiving two to three delivered meals per day had higher energy and protein intakes than those receiving a single meal. Conclusion. These results suggest that it is important that home meal delivery companies improve the quality of their meals and service so that their recipients can better meet nutritional recommendations.
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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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Liu R, Shao W, Sun N, Lai JK, Zhou L, Ren M, Qiao C. Prevalence and the factors associated with malnutrition risk in elderly Chinese inpatients. Aging Med (Milton) 2021; 4:120-127. [PMID: 34250430 PMCID: PMC8251855 DOI: 10.1002/agm2.12143] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 12/07/2020] [Accepted: 12/07/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Malnutrition is an under recognized, but common issue in elderly patients. This study aimed to investigate the prevalence of poor nutritional status and identify comprehensive geriatric assessment-based clinical factors associated with increased malnutrition risk to assessing malnutrition risk in hospitalized elderly patients in China. METHODS A total of 365 elderly hospitalized patients (178 women, 76.37 ± 7.74 years) undertook a comprehensive geriatric assessment (CGA), and have their nutritional status assessed using the short-form mini-nutritional assessment. RESULTS Among 365 patients, 32 (8.77%) were malnourished and 112 (30.68%) were at risk of malnutrition. A logistic regression analysis showed that age (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.13-2.23), alcohol consumption (OR, 2.04; 95% CI, 1.19-3.48), presence or history of cancer or heart failure (OR, 3.48 and 2.86; 95% CI, 1.49-8.13 and 1.12-7.27), depression (OR, 2.86; 95% CI, 1.97-4.17), body mass index (OR, 5.62; 95% CI, 3.62-8.71), being dependent in activity of daily living (OR, 3.81; 95% CI, 2.61-5.57), a lower score in instrumental activities of daily living (OR, 3.01; 95% CI, 2.09-4.33), recent fall(s) (OR, 2.22; 95% CI, 1.37-2.91), cognitive impairment (OR, 1.81; 95% CI, 1.30-2.53), insomnia (OR, 1.49; 95% CI, 1.07-2.06), hemoglobin and albumin level (OR, 1.72 and 2.86; 95% CI, 1.17-2.50 and 1.53-5.36) were independent correlates of malnutrition in older patients. CONCLUSION Our study demonstrated that age, alcohol consumption, chronic diseases (cancer and heart failure), depression, body mass index, function status, recent fall(s), cognitive impairment, insomnia, and low hemoglobin and albumin levels were independently associated with malnutrition in these patients. Comprehensive geriatric assessment can provide detailed information of older patients and can be a useful tool for assessing malnutrition risk-associated factors.
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Affiliation(s)
- Rong Liu
- Department of Geriatrics Ward 2The First Hospital of Lanzhou UniversityLanzhouChina
| | - Wenchao Shao
- Department of Cardiology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Nianzhe Sun
- The First Clinical Medicine School of Lanzhou UniversityLanzhouChina
| | - Jonathan King‐Lam Lai
- Storr Liver Center, Westmead Institute for Medical ResearchUniversity of Sydney and Westmead HospitalSydneyNew South WalesAustralia
| | - Lingshan Zhou
- Department of Geriatrics Ward 2The First Hospital of Lanzhou UniversityLanzhouChina
| | - Man Ren
- Department of Geriatrics Ward 2The First Hospital of Lanzhou UniversityLanzhouChina
| | - Chendong Qiao
- Department of Geriatrics Ward 2The First Hospital of Lanzhou UniversityLanzhouChina
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Dyadic Interviews versus In-Depth Individual Interviews in Exploring Food Choices of Norwegian Older Adults: A Comparison of Two Qualitative Methods. Foods 2021; 10:foods10061199. [PMID: 34073332 PMCID: PMC8227280 DOI: 10.3390/foods10061199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 01/30/2023] Open
Abstract
The term “dyadic interview” refers to interviewing two participants together. Although there has been an increase in the use of dyadic interviews as a data collection method in qualitative studies, the literature on the use of this method with older adults is limited. This study was designed to explore the suitability of dyadic interviews as a method of data collection among older adults living at home. The study involved a direct comparison of the data obtained from dyadic interviews and in-depth individual interviews concerning older adults’ food choices. The study sample consisted of eight dyads for the dyadic interviews and six participants for the in-depth individual interviews. The dyads were composed of pairs who share a pre-existing relationship as well as pairs of strangers. We also discussed the role of participant selection and pairing in dyadic interviewing and how the interactions between the dyads may affect the result. Our results indicated that dyadic interviews can be used as an important data collection tool for home-living older adults, particularly when exploring a topic that often involves a dyadic decision. Our findings can be useful for researchers to make a more informed choice when choosing qualitative data collection methods, particularly when interviewing older people.
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Effects of nutrition, depression symptoms and demographic characteristics on dementia in the elderly population. MARMARA MEDICAL JOURNAL 2021. [DOI: 10.5472/marumj.939806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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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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Song P, Man Q, Li Y, Jia S, Yu D, Liu Z, Zhang J. Trends of Underweight Malnutrition Among Chinese Residents Aged 60 Years and Above - China, 1992-2015. China CDC Wkly 2021; 3:232-236. [PMID: 34594856 PMCID: PMC8393038 DOI: 10.46234/ccdcw2021.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/09/2021] [Indexed: 11/14/2022] Open
Abstract
What is already known about this topic? The prevalence of underweight malnutrition largely decreased in Chinese adults in recent thirty years while obesity became increasingly concerning. However, underweight malnutrition still affected elderly populations and increased risk of anemia, infection diseases, some non-communicable chronic diseases and disability. What is added by this report? In this study, data from 4 national surveys from 1992 to 2015 were analyzed to study underweight malnutrition. There was an 80.5% reduction for underweight malnutrition nationally, including a 67.5% reduction in rural areas and 67.4% in urban areas, and 76.2% in males and 79.4% in females. What are the implications for public health practice? Underweight malnutrition seriously affects the health and quality of life for older people and will lead to heavy burdens for families and society overall. Therefore, efforts should be maintained to screen, treat, and safeguard elderly populations with underweight malnutrition using nutritional improvement strategies, especially for the oldest elderly individuals in rural areas.
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Affiliation(s)
- Pengkun Song
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention. Beijing, China; Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing, China
| | - Qingqing Man
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention. Beijing, China; Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing, China
| | - Yuqian Li
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention. Beijing, China; Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing, China
| | - Shanshan Jia
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention. Beijing, China; Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing, China
| | - Dongmei Yu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention. Beijing, China; Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing, China
| | - Zhen Liu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention. Beijing, China; Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing, China
| | - Jian Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention. Beijing, China; Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing, China
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Seo AR, Kim MJ, Kim B, Seo YM, Lee GY, Park KS, Yoo JI. Associations between Frailty in Older Adults and Malnutrition in Rural Areas: 2019 Updated Version of the Asian Working Group for Sarcopenia. Yonsei Med J 2021; 62:249-254. [PMID: 33635015 PMCID: PMC7934103 DOI: 10.3349/ymj.2021.62.3.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 12/21/2020] [Accepted: 12/28/2020] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate the prevalence of frailty among an older adult population living in rural communities and to determine if frailty is associated with nutritional status after adjusting for sarcopenia and depression. MATERIALS AND METHODS This research used baseline data from the Namgaram-2 study. Frailty was evaluated using the Kaigo-Yobo checklist in an older Korean population. The nutritional statuses of older people were measured using the Korean version of the mini nutritional assessment (MNA). The recent criteria of the Asian Working Group for Sarcopenia were applied for diagnosis of sarcopenia, and depression was assessed using the Geriatric Depression Scale-Short Form. RESULTS The prevalence of frailty was 18.8% (male: 9.6%; female: 23.4%) and was significantly higher in individuals in their 80s [male, 35.3% (p<0.001); female, 42.3% (p<0.001)], those of poor economic status [male, 18.2% (p=0.012); female, 34.9% (p<0.001)], those with hypertension [female, 27.7% (p=0.008)], those with sarcopenia [male, 34.1% (p<0.001); female, 37.2% (p<0.001)], those with depression [male, 46.4% (p<0.001); female, 51.7% (p<0.001)], and those at high risk of malnutrition [male, 44.4% (p<0.001); female, 51.7% (p<0.001)]. After adjusting for demographic variables, including hypertension, diabetes, sarcopenia and depression, frailty was significantly associated with nutritional status [male: odds ratio (OR)=6.73, 95% confidence interval (CI), 1.84-24.65; female: OR=4.83, 95% CI, 2.88-8.11]. CONCLUSION For older adults, MNA is a suitable tool of use in assessing both nutritional status and frailty. Moreover, the nutritional status of older adults appears to be associated with frailty, even after corrections for physical and psychological function.
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Affiliation(s)
- Ae Rim Seo
- Department of Preventive Medicine and Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju, Korea
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea
| | - Mi Ji Kim
- Department of Preventive Medicine and Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju, Korea
| | - Bokyoung Kim
- Department of Preventive Medicine and Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju, Korea
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea
| | - Young Mi Seo
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea
| | - Gyeong Ye Lee
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea
| | - Ki Soo Park
- Department of Preventive Medicine and Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju, Korea
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea
- Department of Bio & Medical Big Data, Gyeongsang National University, Jinju, Korea.
| | - Jun Il Yoo
- Department of Orthopedic Surgery, Gyeongsang National University Hospital, Jinju, Korea.
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Shin WY, Kim JH. Poor diet quality is associated with self-reported knee pain in community-dwelling women aged 50 years and older. PLoS One 2021; 16:e0245630. [PMID: 33591989 PMCID: PMC7886155 DOI: 10.1371/journal.pone.0245630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 01/04/2021] [Indexed: 12/22/2022] Open
Abstract
In the current study, we aimed to examine the association between knee pain and diet quality in women aged ≥ 50 years using data from the Korea National Health and Nutrition Examination Survey. This was a population-based, cross-sectional study. Diet quality was assessed using the Diet Quality Index-International (DQI-I), and knee pain and osteoarthritis were self-reported. A multivariate logistic regression model was used to adjust for age, body mass index, household income, marital status, education, occupation, smoking status, hazardous alcohol use, regular physical activity, menopause, and chronic diseases, including hypertension, diabetes, dyslipidemia, osteoarthritis, and depression. A total of 3,881 women were included in this study, and the prevalence of knee pain was 25.4%. The intakes of total energy, protein, and fat were lower in women with knee pain than in those without (all P < 0.01), while the carbohydrate intake was higher (P = 0.01). No significant differences were noted in the scores for variety, overall balance, and moderation components, except for the item of total fat intake, between the DQI-I scores for women with and without knee pain, after adjusting for age. Women without knee pain showed higher scores in several items of the adequacy component (P < 0.05) than did women with knee pain. The total DQI-I scores were lower in women with knee pain than in women without knee pain, after adjusting for covariates, including osteoarthritis (OR = 0.985, 95% CI = 0.973–0.997, P = 0.01). Knee pain independent of osteoarthritis was associated with poor diet quality in community-dwelling women aged ≥ 50 years.
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Affiliation(s)
- Woo-young Shin
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Jung-ha Kim
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea
- * E-mail:
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Norton V, Lignou S, Methven L. Influence of Age and Individual Differences on Mouthfeel Perception of Whey Protein-Fortified Products: A Review. Foods 2021; 10:433. [PMID: 33669435 PMCID: PMC7920461 DOI: 10.3390/foods10020433] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 02/07/2021] [Accepted: 02/09/2021] [Indexed: 12/22/2022] Open
Abstract
Protein needs are considered to increase with age, with protein consumption being associated with many positive outcomes. Protein-fortified products are often used to improve nutritional status and prevent age-related muscle mass loss in older adults. Accordingly, older adults are commonly provided with products fortified with whey protein; however, such products can cause mouthdrying, limiting consumption and product enjoyment. Currently, the extent to which age and individual differences (e.g., saliva, oral health, food oral processing) influence the perception of whey protein-derived mouthdrying is relatively unclear. Previous research in this area has mainly focused on investigating mouthdrying, without taking into account individual differences that could influence this perception within the target population. Therefore, the main focus of this review is to provide an overview of the relevant individual differences likely to influence mouthfeel perception (specifically mouthdrying) from whey protein-fortified products, thereby enabling the future design of such products to incorporate better the needs of older adults and improve their nutritional status. This review concludes that age and individual differences are likely to influence mouthdrying sensations from whey protein-fortified products. Future research should focus more on the target population and individual differences to maximise the benefits from whey protein fortification.
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Affiliation(s)
| | | | - Lisa Methven
- Department of Food and Nutritional Sciences, Harry Nursten Building, University of Reading, Whiteknights, Reading RG6 6DZ, UK; (V.N.); (S.L.)
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Jung YJ, Lee SH, Chang JH, Lee HS, Kang EH, Lee SW. The Impact of Changes in the Intake of Fiber and Antioxidants on the Development of Chronic Obstructive Pulmonary Disease. Nutrients 2021; 13:nu13020580. [PMID: 33578669 PMCID: PMC7916350 DOI: 10.3390/nu13020580] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/08/2021] [Accepted: 02/08/2021] [Indexed: 12/14/2022] Open
Abstract
Diet is a health-related factor that can modify lung function. This study hypothesized that the change in age-related dietary intake affects lung function. The subjects who undertook a dietary assessment and spirometry in 2012 and 2017, were retrospectively collected in a health screening center. Dietary intakes were directly evaluated using food frequency questionnaires (FFQ) administered by trained dietitians and were compared at the baseline (2012) and 5-year follow-up (2017). A forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) value below 0.70 was defined as airflow limitation. Logistic regression models were used to estimate the odds ratio (ORs) adjusted for potential confounders. A total of 1439 subjects with normal spirometry were enrolled. New airflow limitations were detected in 48 subjects (3.3%) at the 5-year follow-up, including 41 (85.4%) men and 11 (22.9%) current smokers. After adjusting for age, sex, smoking history, and baseline FEV1/FVC, the odd ratios (OR) for new airflow limitation in fiber, vitamin C, and folic acid per 10% decrease in daily recommended requirement were 2.714 (95% confidence interval (CI), 1.538–4.807; p = 0.001), 1.083 (95% CI: 1.020–1.149; p = 0.007), and 1.495 (95% CI: 1.172–1.913; p = 0.001), respectively. A decreased intake of dietary fiber, vitamin C, and folic acid is associated with a newly developed airflow limitation.
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Affiliation(s)
- Young Ju Jung
- Department of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea;
- Health Screening and Promotion Center, Asan Medical Center, Seoul 05505, Korea; (J.H.C.); (H.S.L.); (E.H.K.)
| | - Se Hee Lee
- Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea;
| | - Ji Ho Chang
- Health Screening and Promotion Center, Asan Medical Center, Seoul 05505, Korea; (J.H.C.); (H.S.L.); (E.H.K.)
| | - Hye Seung Lee
- Health Screening and Promotion Center, Asan Medical Center, Seoul 05505, Korea; (J.H.C.); (H.S.L.); (E.H.K.)
| | - Eun Hee Kang
- Health Screening and Promotion Center, Asan Medical Center, Seoul 05505, Korea; (J.H.C.); (H.S.L.); (E.H.K.)
| | - Sei Won Lee
- Department of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea;
- Correspondence: ; Tel.: +82-2-3010-3990; Fax: +82-2-3010-6968
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