scholarly journals The relationship of nutritional risk with diet quality and health outcomes in community-dwelling older adults

2021 ◽  
Author(s):  
Ilse Bloom ◽  
Anna Pilgrim ◽  
Karen A. Jameson ◽  
Elaine M. Dennison ◽  
Avan A. Sayer ◽  
...  
Keyword(s):  
Older Adults ◽  
Grip Strength ◽  
Risk Score ◽  
Diet Quality ◽  
Community Dwelling ◽  
Nutritional Risk ◽  
Risk Scores ◽  
Cross Sectional ◽  
Nutrition Risk

Abstract Objectives To identify early nutritional risk in older populations, simple screening approaches are needed. This study aimed to compare nutrition risk scores, calculated from a short checklist, with diet quality and health outcomes, both at baseline and prospectively over a 2.5-year follow-up period; the association between baseline scores and risk of mortality over the follow-up period was assessed. Methods The study included 86 community-dwelling older adults in Southampton, UK, recruited from outpatient clinics. At both assessments, hand grip strength was measured using a Jamar dynamometer. Diet was assessed using a short validated food frequency questionnaire; derived ‘prudent’ diet scores described diet quality. Body mass index (BMI) was calculated and weight loss was self-reported. Nutrition risk scores were calculated from a checklist adapted from the DETERMINE (range 0–17). Results The mean age of participants at baseline (n = 86) was 78 (SD 8) years; half (53%) scored ‘moderate’ or ‘high’ nutritional risk, using the checklist adapted from DETERMINE. In cross-sectional analyses, after adjusting for age, sex and education, higher nutrition risk scores were associated with lower grip strength [difference in grip strength: − 0.09, 95% CI (− 0.17, − 0.02) SD per unit increase in nutrition risk score, p = 0.017] and poorer diet quality [prudent diet score: − 0.12, 95% CI (− 0.21, − 0.02) SD, p = 0.013]. The association with diet quality was robust to further adjustment for number of comorbidities, whereas the association with grip strength was attenuated. Nutrition risk scores were not related to reported weight loss or BMI at baseline. In longitudinal analyses there was an association between baseline nutrition risk score and lower grip strength at follow-up [fully-adjusted model: − 0.12, 95% CI (− 0.23, − 0.02) SD, p = 0.024]. Baseline nutrition risk score was also associated with greater risk of mortality [unadjusted hazard ratio per unit increase in score: 1.29 (1.01, 1.63), p = 0.039]; however, this association was attenuated after adjustment for sex and age. Conclusions Cross-sectional associations between higher nutrition risk scores, assessed from a short checklist, and poorer diet quality suggest that this approach may hold promise as a simple way of screening older populations. Further larger prospective studies are needed to explore the predictive ability of this screening approach and its potential to detect nutritional risk in older adults.

scholarly journals Characteristics of Nutritionally Vulnerable Community-Dwelling Older Adults Consuming Oral Nutritional Supplements (OR16-08-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Suela Sulo ◽  
Linda Schiffer ◽  
Patricia Sheean ◽  
Isabel Farrar ◽  
Jamie Partridge ◽  
...  
Keyword(s):  
Older Adults ◽  
Nutritional Supplements ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Nutritional Risk ◽  
Cross Sectional ◽  
Nutrition Risk ◽  
Targeted Interventions ◽  
Oral Nutritional Supplements ◽  
Community Dwelling Older Adults

Abstract Objectives There are limited data on nutrition risk profiles of community-dwelling older adults and their consumption patterns of oral nutritional supplements (ONS). This study assessed the characteristics of nutritionally vulnerable ONS users versus non-ONS users. Methods A cross-sectional study of White, Black and Hispanic community-dwelling adults, ≥55 years of age, residing in Chicago metropolitan area (MSA), USA was conducted over a 4-month period. Demographic characteristics, Katz's activities of daily living (ADL), healthcare resource utilization, and ONS consumption in the last six months were collected via a telephone survey. Nutrition risk was assessed via the abridged Patient Generated Subjective Global Assessment (abPG-SGA) and the DETERMINE checklist. Characteristics of ONS and non-ONS users were compared using t-tests and chi-square tests. A multivariable logistic regression assessed which characteristics were independently associated with ONS use. Results Of 1001 participants surveyed, 996 provided data on ONS use; 26% (n = 261) were classified as ‘high’ nutrition risk, and 11% (n = 114) reported consuming ONS. ONS users reported consuming on average 4.7 bottles/week, with recommendation primarily received from their physician (37%). ONS users were more likely to be at high nutritional risk than non-users per both abPG-SGA (43% vs 24%, P < .001) and DETERMINE (68% vs 48%, P < .001) results. They were less likely to be independent on all ADLs (86% vs 92%, P = .03), reported higher healthcare utilization, and were more likely to take ≥3 drugs/day (77% vs 53%, P < .001). Higher nutritional risk (per abPG-SGA), lower body mass index, hospitalization in past 6 months, and taking ≥3 drugs/day were significantly (P < .05) associated with ONS use. Conclusions Although one in four older community-dwellers living in the Chicago MSA were at high nutrition risk, only 11% of them reported consuming ONS. Older adults are more likely to consume ONS and experience poor health outcomes and polypharmacy. These results suggest that identification of nutrition risk among community-dwelling older adults remains unaddressed and may not result in nutrition interventions. Improved identification of nutrition risk and implementation of targeted interventions with ONS is warranted for older community-dwelling adults. Funding Sources Abbott, Columbus, OH, USA.

scholarly journals A Modified CAIDE Risk Score as a Screening Tool for Cognitive Impairment in Older Adults

2021 ◽  
pp. 1-14
Author(s):  
Magdalena I. Tolea ◽  
Jaeyeong Heo ◽  
Stephanie Chrisphonte ◽  
James E. Galvin
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Risk Score ◽  
Clinical Sample ◽  
Community Sample ◽  
Community Dwelling ◽  
Cognitive Testing ◽  
Risk Scores ◽  
Predictive Values

Background: Although an efficacious dementia-risk score system, Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) was derived using midlife risk factors in a population with low educational attainment that does not reflect today’s US population, and requires laboratory biomarkers, which are not always available. Objective: Develop and validate a modified CAIDE (mCAIDE) system and test its ability to predict presence, severity, and etiology of cognitive impairment in older adults. Methods: Population consisted of 449 participants in dementia research (N = 230; community sample; 67.9±10.0 years old, 29.6%male, 13.7±4.1 years education) or receiving dementia clinical services (N = 219; clinical sample; 74.3±9.8 years old, 50.2%male, 15.5±2.6 years education). The mCAIDE, which includes self-reported and performance-based rather than blood-derived measures, was developed in the community sample and tested in the independent clinical sample. Validity against Framingham, Hachinski, and CAIDE risk scores was assessed. Results: Higher mCAIDE quartiles were associated with lower performance on global and domain-specific cognitive tests. Each one-point increase in mCAIDE increased the odds of mild cognitive impairment (MCI) by up to 65%, those of AD by 69%, and those for non-AD dementia by >  85%, with highest scores in cases with vascular etiologies. Being in the highest mCAIDE risk group improved ability to discriminate dementia from MCI and controls and MCI from controls, with a cut-off of ≥7 points offering the highest sensitivity, specificity, and positive and negative predictive values. Conclusion: mCAIDE is a robust indicator of cognitive impairment in community-dwelling seniors, which can discriminate well between dementia severity including MCI versus controls. The mCAIDE may be a valuable tool for case ascertainment in research studies, helping flag primary care patients for cognitive testing, and identify those in need of lifestyle interventions for symptomatic control.

Associations between elevated growth differentiation factor-15 and sarcopenia among community-dwelling older adults

2021 ◽  
Author(s):  
Miji Kim ◽  
Jeremy D Walston ◽  
Chang Won Won
Keyword(s):  
Older Adults ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Baseline Serum ◽  
Growth Differentiation Factor 15 ◽  
Differentiation Factor ◽  
Study Participants ◽  
Community Dwelling Older Adults ◽  
Prospective Analyses

Abstract Background Growth differentiation factor 15 (GDF-15) is associated with disease progression, mitochondrial dysfunction, and mortality. Elevated GDF-15 level was recently reported to be associated with poorer physical performance in healthy adults. However, the association between serum GDF-15 level and sarcopenia in community-dwelling older adults has not been well characterized. Methods We conducted cross-sectional (n = 929) and two-year prospective analyses (n = 788) among participants aged 70–84 years enrolled in the Korean Frailty and Aging Cohort Study. Participants with an estimated glomerular filtration rate of &lt;60 mL/min/1.73 m 2 were excluded. Appendicular lean mass was measured using dual-energy X-ray absorptiometry. Sarcopenia status was determined according to the Asian Working Group for Sarcopenia-2019 algorithm. Results At baseline, 16.6% of the participants had sarcopenia. Median GDF-15 concentration was higher in the sarcopenic group than in the non-sarcopenic group (1221 pg/mL vs. 1019 pg/mL, p&lt;0.001). In the multivariate analysis adjusted for cardiometabolic risk and biological factors, the highest GDF-15 tertile (≥1245 pg/mL) had an increased likelihood of sarcopenia (odds ratio, 1.96; 95% confidence interval, 1.16–3.33) than the lowest tertile (&lt;885 pg/mL). During the two-year follow-up period, 67 (10.1%) individuals without sarcopenia at baseline developed sarcopenia. There were no significant associations between baseline serum GDF-15 levels and incident sarcopenia or its components (all p&gt;0.05). Conclusions Elevated GDF-15 was associated with prevalent sarcopenia but not able to predict incident sarcopenia in the 2-year follow-up. Further studies are needed to explore the pathophysiological roles of GDF-15 in the development of sarcopenia.

Exploring trajectories in dietary adequacy of the B vitamins folate, riboflavin, vitamins B6 and B12, with advancing older age: a systematic review

2020 ◽  
pp. 1-11 ◽  
Author(s):  
N. Gillies ◽  
D. Cameron-Smith ◽  
S. Pundir ◽  
C. R. Wall ◽  
A. M. Milan
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Community Dwelling ◽  
B Vitamins ◽  
Cross Sectional ◽  
Longitudinal Changes ◽  
Dietary Adequacy ◽  
Metabolism Regulation ◽  
Age Related

Abstract Maintaining nutritional adequacy contributes to successful ageing. B vitamins involved in one-carbon metabolism regulation (folate, riboflavin, vitamins B6 and B12) are critical nutrients contributing to homocysteine and epigenetic regulation. Although cross-sectional B vitamin intake in ageing populations is characterised, longitudinal changes are infrequently reported. This systematic review explores age-related changes in dietary adequacy of folate, riboflavin, vitamins B6 and B12 in community-dwelling older adults (≥65 years at follow-up). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, databases (MEDLINE, Embase, BIOSIS, CINAHL) were systematically screened, yielding 1579 records; eight studies were included (n 3119 participants, 2–25 years of follow-up). Quality assessment (modified Newcastle–Ottawa quality scale) rated all of moderate–high quality. The estimated average requirement cut-point method estimated the baseline and follow-up population prevalence of dietary inadequacy. Riboflavin (seven studies, n 1953) inadequacy progressively increased with age; the prevalence of inadequacy increased from baseline by up to 22·6 and 9·3 % in males and females, respectively. Dietary folate adequacy (three studies, n 2321) improved in two studies (by up to 22·4 %), but the third showed increasing (8·1 %) inadequacy. Evidence was similarly limited (two studies, respectively) and inconsistent for vitamins B6 (n 559; −9·9 to 47·9 %) and B12 (n 1410; −4·6 to 7·2 %). This review emphasises the scarcity of evidence regarding micronutrient intake changes with age, highlighting the demand for improved reporting of longitudinal changes in nutrient intake that can better direct micronutrient recommendations for older adults. This review was registered with PROSPERO (CRD42018104364).

scholarly journals Prevalence and Determinants of Undernutrition in A Sample of Dutch Community-Dwelling Older Adults: Results from Two Online Screening Tools

2019 ◽  
Vol 16 (9) ◽  
pp. 1562 ◽  
Author(s):  
Jos W. Borkent ◽  
Elke Naumann ◽  
Emmelyne Vasse ◽  
Ellen van der Heijden ◽  
Marian A. E. de van der Schueren
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Healthy Aging ◽  
General Information ◽  
Community Dwelling ◽  
Screening Tools ◽  
Nutritional Risk ◽  
Cross Sectional ◽  
Increased Risk ◽  
Screen Ii

To stimulate undernutrition screening among Dutch community-dwelling adults, a website was developed with general information on healthy eating for healthy aging and self-tests. Based on cross-sectional data obtained from the self-tests, we studied nutritional risk factors (early determinants) as well as risk of undernutrition (late symptoms). SCREEN II (n = 2470) was used to asses nutritional risk factors. This tool consists of 16 items regarding nutritional intake, perception of body weight, appetite, oral health and meal preparation. An adjusted SNAQ65+ (n = 687) was used to assess risk of undernutrition. This four-item tool contains questions on weight loss, appetite, walking stairs and body mass index. Differences between age-groups (65–74, 75–84, ≥85) were tested by logistic regression. Overall prevalence of nutritional risk factors was 84.1%, and increased risk of undernutrition was 56.8%. Participants aged ≥85 scored worst on almost all items of the SCREEN II and the SNAQ65+. In conclusion: A large proportion of older adults reported early determinants for increased nutrition risk, while a smaller, yet remarkable proportion scored positive on undernutrition risk. Internet screening may be a useful, contemporary, and easy, accessible way to reach older adults who are at nutritional risk and may thus contribute to early identification and prevention of undernutrition.

Longitudinal changes in aerobic power in older men and women

2004 ◽  
Vol 97 (2) ◽  
pp. 781-789 ◽  
Author(s):  
Liza Stathokostas ◽  
Shanthi Jacob-Johnson ◽  
Robert J. Petrella ◽  
Donald H. Paterson
Keyword(s):  
Older Adults ◽  
Aerobic Power ◽  
Ventilatory Threshold ◽  
Community Dwelling ◽  
Maximal Heart Rate ◽  
Cross Sectional ◽  
Men And Women ◽  
Rate Of Decline ◽  
Young Old

The purpose of this study was to describe the longitudinal (10 yr) decline in aerobic power [maximal O2 uptake (V̇o2 max)] and anaerobic threshold [ventilatory threshold (TV̇e)] of older adults living independently in the community. Ten years after initial testing, 62 subjects (34 men, mean age 73.5 ± 6.4 yr; 28 women, 72.1 ± 5.3 yr) achieved V̇o2 max criteria during treadmill walking tests to the limit of tolerance, with TV̇e determined in a subset of 45. V̇o2 max in men showed a rate of decline of −0.43 ml·kg−1·min−1·yr−1, and the decline in V̇o2 max was consequent to a lowered maximal heart rate with no change in the maximum O2 pulse. The women showed a slower rate of decline of V̇o2 max of −0.19·ml·kg−1·min−1·yr−1 ( P < 0.05), again with a lowered HRmax and unchanged O2 pulse. In this sample, lean body mass was not changed over the 10-yr period. Changes in V̇o2 max were not significantly related to physical activity scores. TV̇e showed a nonsignificant decline in both men and women. Groupings of young-old (65–72 yr at follow-up) vs. old-old (73–90 yr at follow-up) were examined. In men, there were no differences in the rate of V̇o2 max decline. The young-old women showed a significant decline in V̇o2 max, whereas old-old women, initially at a V̇o2 max of 19.4 ± 3.1 ml·kg−1·min−1, showed no loss in V̇o2 max. The longitudinal data, vs. cross-sectional analysis, showed a greater decline for men but similar estimates of the rates of change in women. Thus the 10-yr longitudinal study of the cohort of community-dwelling older adults who remained healthy, ambulatory, and independent showed a 14% decline in V̇o2 max in men, and a smaller decline of 7% in women, with the oldest women showing little change over the 10-yr period.

Development and Validation of a Risk Score to Predict the First Hip Fracture in the Oldest Old: A Retrospective Cohort Study

2019 ◽  
Vol 75 (5) ◽  
pp. 980-986 ◽  
Author(s):  
Ming-Tuen Lam ◽  
Chor-Wing Sing ◽  
Gloria H Y Li ◽  
Annie W C Kung ◽  
Kathryn C B Tan ◽  
...  
Keyword(s):  
Hong Kong ◽  
Hip Fracture ◽  
Fracture Risk ◽  
Risk Score ◽  
Validation Cohort ◽  
Oldest Old ◽  
Community Dwelling ◽  
Risk Scores ◽  
Derivation Cohort

Abstract Background To evaluate whether the common risk factors and risk scores (FRAX, QFracture, and Garvan) can predict hip fracture in the oldest old (defined as people aged 80 and older) and to develop an oldest-old-specific 10-year hip fracture prediction risk algorithm. Methods Subjects aged 80 years and older without history of hip fracture were studied. For the derivation cohort (N = 251, mean age = 83), participants were enrolled with a median follow-up time of 8.9 years. For the validation cohort (N = 599, mean age = 85), outpatients were enrolled with a median follow-up of 2.6 years. A five-factor risk score (the Hong Kong Osteoporosis Study [HKOS] score) for incident hip fracture was derived and validated, and its predictive accuracy was evaluated and compared with other risk scores. Results In the derivation cohort, the C-statistics were .65, .61, .65, .76, and .78 for FRAX with bone mineral density (BMD), FRAX without BMD, QFracture, Garvan, and the HKOS score, respectively. The category-less net reclassification index and integrated discrimination improvement of the HKOS score showed a better reclassification of hip fracture than FRAX and QFracture (all p &lt; .001) but not Garvan, while Garvan, but not HKOS score, showed a significant over-estimation in fracture risk (Hosmer–Lemeshow test p &lt; .001). In the validation cohort, the HKOS score had a C-statistic of .81 and a considerable agreement between expected and observed fracture risk in calibration. Conclusion The HKOS score can predict 10-year incident hip fracture among the oldest old in Hong Kong. The score may be useful in identifying the oldest old patients at risk of hip fracture in both community-dwelling and hospital settings.

scholarly journals Apathy and cognitive and functional decline in community-dwelling older adults: results from the Baltimore ECA longitudinal study

2010 ◽  
Vol 22 (5) ◽  
pp. 819-829 ◽  
Author(s):  
Diana E. Clarke ◽  
Jean Y. Ko ◽  
Constantine Lyketsos ◽  
George W. Rebok ◽  
William W. Eaton
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
General Health Questionnaire ◽  
Functional Decline ◽  
Population Based ◽  
Community Dwelling ◽  
Public Health Importance ◽  
Cross Sectional ◽  
Prevalence Estimates

ABSTRACTBackground: Apathy, a complex neuropsychiatric syndrome, commonly affects patients with Alzheimer's disease. Prevalence estimates for apathy range widely and are based on cross-sectional data and/or clinic samples. This study examines the relationships between apathy and cognitive and functional declines in non-depressed community-based older adults.Methods: Data on 1,136 community-dwelling adults aged 50 years and older from the Baltimore Epidemiologic Catchment Area (ECA) study, with 1 and 13 years of follow-up, were used. Apathy was assessed with a subscale of items from the General Health Questionnaire. Logistic regression, t-tests, χ2 and Generalized Estimating Equations were used to accomplish the study's objectives.Results: The prevalence of apathy at Wave 1 was 23.7%. Compared to those without, individuals with apathy were on average older, more likely to be female, and have lower Mini-mental State Examination (MMSE) scores and impairments in basic and instrumental functioning at baseline. Apathy was significantly associated with cognitive decline (OR = 1.65, 95% CI = 1.06, 2.60) and declines in instrumental (OR = 4.42; 95% CI = 2.65, 7.38) and basic (OR = 2.74; 95%CI = 1.35, 5.57) function at 1-year follow-up, even after adjustment for baseline age, level of education, race, and depression at follow-up. At 13 years of follow-up, apathetic individuals were not at greater risk for cognitive decline but were twice as likely to have functional decline. Incidence of apathy at 1-year follow up and 13-year follow-up was 22.6% and 29.4%, respectively.Conclusions: These results underline the public health importance of apathy and the need for further population-based studies in this area.

scholarly journals Meaningful Activities and Psychosomatic Functions in Japanese Older Adults after Driving Cessation

2021 ◽  
Vol 18 (24) ◽  
pp. 13270
Author(s):  
Atsushi Nakamura ◽  
Michio Maruta ◽  
Hyuma Makizako ◽  
Masaaki Miyata ◽  
Hironori Miyata ◽  
...  
Keyword(s):  
Older Adults ◽  
Grip Strength ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Driving Frequency ◽  
Driving Cessation ◽  
Cross Sectional ◽  
Meaningful Activity ◽  
Weak Muscle ◽  
Japanese Older Adults

The purpose of this cross-sectional study was to analyse the differences in meaningful activities and psychosomatic function depending on the driving status of community-dwelling older adults. Data from 594 older adults were obtained, including activities meaningful to individuals and psychosomatic functions, such as grip strength, depression, cognitive function, and ability of activity. Participants were divided into active driving (n = 549) and after driving cessation (n = 45) groups. In addition, the active driving group was operationally divided into three groups: high-frequency group (n = 387), medium group (n = 119), and infrequent group (n = 42). In the after driving cessation group, grip strength, and Japan Science and Technology Agency Index of Competence scores were significantly lower. Furthermore, the proportion of apathy and physical and social frailty was significantly higher in the after driving cessation group. Regarding meaningful activity, domestic life scores in the after driving cessation group were significantly higher than those of the active driving group. Decreased driving frequency in the active driving group was associated with weak muscle strength, lack of interest, and low activity. This study demonstrated that meaningful activity differed based on the driving status. Hence, we should support the activities of older adults who are considering driving cessation.

scholarly journals Body mass index but not genetic risk is longitudinally associated with altered structural brain parameters

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anne Tüngler ◽  
Sandra Van der Auwera ◽  
Katharina Wittfeld ◽  
Stefan Frenzel ◽  
Jan Terock ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Genetic Predisposition ◽  
Brain Structure ◽  
Genetic Risk ◽  
Community Dwelling ◽  
Risk Scores ◽  
Genetic Score ◽  
Cross Sectional

AbstractEvidence from previous studies suggests that elevated body mass index (BMI) and genetic risk for obesity is associated with reduced brain volume, particularly in areas of reward-related cognition, e.g. the medial prefrontal cortex (AC-MPFC), the orbitofrontal cortex (OFC), the striatum and the thalamus. However, only few studies examined the interplay between these factors in a joint approach. Moreover, previous findings are based on cross-sectional data. We investigated the longitudinal relationship between increased BMI, brain structural magnetic resonance imaging (MRI) parameters and genetic risk scores in a cohort of n = 502 community-dwelling participants from the Study of Health in Pomerania (SHIP) with a mean follow-up-time of 4.9 years. We found that (1) increased BMI values at baseline were associated with decreased brain parameters at follow-up. These effects were particularly pronounced for the OFC and AC-MPFC. (2) The genetic predisposition for BMI had no effect on brain parameters at baseline or follow-up. (3) The interaction between the genetic score for BMI and brain parameters had no effect on BMI at baseline. Finding a significant impact of overweight, but not genetic predisposition for obesity on altered brain structure suggests that metabolic mechanisms may underlie the relationship between obesity and altered brain structure.

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