One-bite-sized 3D printed finger foods, oriented to malnutrition, sarcopenia and frailty prevention in the older people

BACKGROUND

In this study, innovative chocolate, citrus and mixture flavoured tofu-based nutritionally customised, dysphagia-oriented, comfortably consumed, appetising, one-bite-sized finger foods, oriented to malnutrition, sarcopenia and frailty prevention in older people were created by using 3D printing technology. Developed products were characterised by evaluating chemical composition and physical properties and performing sensory evaluation among geriatric clinic residents (≥60 years).

RESULTS

The dietary composition of the developed foods was: 19-21 g (100 g)-1 protein, 6-8 g (100 g)-1 fibre, 8-9 g (100 g)-1 fat, 11 mg (100 g)-1 iron, 14 mg (100 g)-1 zinc, 70 μg (100 g)-1 selenium. Foods were also enriched with branched-chain amino acids, such as leucine, isoleucine and valine. All formulated foods were classified as level 6 by International Dysphagia Diet Standardisation Initiative classification. Chocolate-flavoured food was much harder (4914 g) with lower adhesiveness value (-33.6 g s), compared to the citrus- or mixture-flavoured foods. Older people evaluated all finger foods as very easy handled by hand, soft, easy to swallow, having a moderate flavour intensity and a weak afterfeel. Despite the fact that the chocolate food was evaluated as having the highest hardness and gumminess values by the instrumental method, this difference was not noticeable to the evaluators. However 7% of the participants said that 3D printed foods were sticky to dentures.

CONCLUSION

The results suggest that it is possible to create nutrient-dense comfortably consumed 3D printed foods, oriented to malnutrition, sarcopenia and frailty prevention in older people. © 2024 Society of Chemical Industry.

Impaired Subjective Visual Vertical and Increased Visual Dependence in Older Adults With Falls

Aging affects the vestibular system and may disturb the perception of verticality and lead to increased visual dependence (VD). Studies have identified that abnormal upright perception influences the risk of falling. The aim of our study was to evaluate subjective visual vertical (SVV) and VD using a mobile virtual reality-based system for SVV assessment (VIRVEST) in older adults with falls and evaluate its relationship with clinical balance assessment tools, dizziness, mental state, and depression level. This study included 37 adults >65 years who experienced falls and 40 non-faller age-matched controls. Three tests were performed using the VIRVEST system: a static SVV, dynamic SVV with clockwise and counter-clockwise background stimulus motion. VD was calculated as the mean of absolute values of the rod tilt from each trial of dynamic SVV minus the mean static SVV rod tilt. Older adults who experienced falls manifested significantly larger biases in static SVV (p = 0.012), dynamic SVV (p < 0.001), and VD (p = 0.014) than controls. The increase in static SVV (odds ratio = 1.365, p = 0.023), dynamic SVV (odds ratio = 1.623, p < 0.001) and VD (odds ratio = 1.460, p = 0.010) tilt by one degree significantly related to falls risk in the faller group. Fallers who had a high risk of falling according to the Tinetti test exhibited significantly higher tilts of dynamic SVV than those who had a low or medium risk (p = 0.037). In the faller group, the increase of the dynamic SVV tilt by one degree was significantly related to falls risk according to the Tinetti test (odds ratio = 1.356, p = 0.049). SVV errors, particularly with the dynamic SVV test (i.e., greater VD) were associated with an increased risk of falling in the faller group. The VIRVEST system may be applicable in clinical settings for SVV testing and predicting falls in older adults.

Formulating protein-based beverages for the dysphagia diets of the elderly: viscosity, protein quality, in vitro digestion, and consumers acceptability

BACKGROUND

Dysphagia is defined as a disorder of the swallowing mechanism. The most common management of dysphagia is diet modification by thickening food and beverages. This study aimed to obtain protein-based beverages for the dysphagia diets of the elderly, corresponding to the 'honey' (III) level of dysphagia fluids according to the National Dysphagia Diet classifications, and containing 100 g kg^-1 of good-quality proteins with a high rate of hydrolysis during digestion.

RESULTS

Four protein formulations made from pea proteins, milk proteins, a mixture of milk and pea proteins, and milk proteins with added konjac glucomannan, were evaluated on the basis of rheological characterization and proteolysis kinetics during in vitro digestion. The mixture of milk proteins and pea proteins, and the mixture of milk proteins with added konjac glucomannan, showed typical yielding pseudoplastic fluid behavior with similar apparent viscosity but different structural characteristics. These differences were the reason for the differences in proteolysis kinetics during digestion. The mixture of milk and pea proteins showed viscous liquid behavior and was more rapidly hydrolyzed under gastrointestinal conditions than mixtures containing milk proteins and konjac glucomannan acting as a weak gel system.

CONCLUSION

We presume that geriatric consumers with swallowing difficulties may benefit from 'honey'-level viscosity, protein-based beverages containing pea and milk proteins through faster proteolysis and better bioaccessibility of amino acids during digestion. © 2020 Society of Chemical Industry.

Older Adults-Potential Users of Technologies

Background and objective: The successful adoption of technology is becoming increasingly important to functional independence and successful ageing in place. A better understanding of technology usage amongst older people may help to direct future interventions aimed at improving their healthcare. We aimed to obtain the first data regarding technology use, including gerontechnologies, represented by fall detectors, from older adults in Lithuania. Material and methods: The research was carried out in the framework of the project Smart Gerontechnology for Healthy Ageing, which involved assessing the use of technologies and the readiness to use gerontechnologies, as represented by fall detectors. A total of 375 individuals that were more than 60 years of age were enrolled in the study. The self-reporting questionnaires were completed by geriatric in-patients, hospitalized in the geriatric department, and also by community-dwelling older adults. Results: Geriatric in-patients' use of computers and the internet was associated with age (every year of age decreased the probability of computer and internet use by 0.9-times) and a positive attitude towards new technologies-this predictor increased the use of a computer by six-times in comparison with people who did not have such an attitude. Sex and education had no influence on computer use for geriatric in-patients. For community-dwelling older adults, the use of computers and internet was associated with age, education (a university education increased the use of computers and the internet by four times), and a positive attitude towards technologies. Conclusions: Lithuanian older women in the study used computers, the internet, and cell phones equally with men. Increasing age was a strong negative predictor of technology use. A positive attitude to new technologies was a strong positive predictor of technology use. Most geriatric patients and community-dwelling older adults were ready to use technologies that permit ageing in place.

Nutritional status of rural community-dwelling older people and changes after following nutritional recommendations

BACKGROUND

It is crucial that community nurses in remote areas are competent to recognize the risk of malnutrition in older people and be able to help them to improve their nutritional status.

AIM

To examine the factors associated with malnutrition and the impact of nutritional recommendations in rural community-dwelling older people.

DESIGN

This was a cross-sectional descriptive study.

METHOD

The study was conducted in 2014 in a rural primary health care setting in Lithuania with 169 older people. Nutritional status was assessed using the Mini Nutritional Assessment tool. Older people who were at risk of malnutrition or were already malnourished (n = 82) received written nutritional recommendations and were reassessed after 6 months.

RESULTS

Nutritional status was normal for 51.5% of participants, 43.2% had risk of malnutrition, and 5.3% had malnutrition. Risk of malnutrition or malnutrition was associated with chronic and intermittent pain, chewing difficulties, swallowing disorders, dental problems, and medication use. The nutritional status of participants at risk of malnutrition or malnourished had improved 6 months later.

CONCLUSIONS

Risk of malnutrition or malnutrition was prevalent among rural community-dwelling older. The study highlighted that positive health outcomes are achievable in undernourished or at risk of malnutrition older people when nutritional recommendations are applied with minimal resources.

Perioperative factors affecting length of hospital stay among elderly patients

BACKGROUND AND OBJECTIVE

Timely assessment and prevention of risk factors for the main perioperative complications in elderly patients provide an opportunity to avoid them, decrease mortality, and diminish costs associated with longer hospital stay. The aim of this study was to estimate perioperative factors that could potentially predict the length of stay and to estimate their predictive value using a comprehensive geriatric assessment among elderly patients.

MATERIAL AND METHODS

The study population comprised 99 surgical patients aged 65 and more. The patients were followed up until discharge. Study data analysis included questionnaires, anthropometric measurements before surgery, assessment and interviews after surgery, and case histories. Univariate and multivariate logistic regression analysis was performed.

RESULTS

Malnutrition was detected in 53.5% of the patients. Postoperative cognitive disorder was documented in 18.2% of elderly patients. The mean length of hospital stay was 10.1 days (SD, 9.14). Multivariate logistic regression analysis revealed that the best predictors for longer hospital stay in elderly patients were malnutrition (OR, 4.2; 95% CI, 1.5-11.8; P=0.007) together with postoperative cognitive impairment (OR, 9.2; 95% CI, 1.0-83.3; P=0.048). The total predictive value of the model was 70.5%.

CONCLUSIONS

. Malnutrition and a postoperative cognitive disorder were independent risk factors for longer hospital stay, while depression, cognitive impairment, functional dependence, and poor physical status were not independently associated with longer hospital stay. A comprehensive geriatric assessment can help assess the risk factors for longer treatment and predict the length of hospital stay, thus enabling the planning of optimal healthcare management of elderly patients.