scholarly journals The feasibility of conducting acute sarcopenia research in hospitalised older patients: a prospective cohort study

2021 ◽  
Author(s):  
Carly Welch ◽  
Carolyn Greig ◽  
Zeinab Majid ◽  
Tahir Masud ◽  
Hannah Moorey ◽  
...  
Keyword(s):  
Physical Performance ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Performance Testing ◽  
Drop Out ◽  
Queen Elizabeth Hospital ◽  
Completion Rates ◽  
Elective Colorectal Surgery ◽  
Acute Setting ◽  
Drop Out Rates

Abstract Purpose To assess feasibility of conducting acute sarcopenia research in complex populations of hospitalised older adults. Methods Patients ≥ 70 years old were recruited to three cohorts: elective colorectal surgery, emergency (abdominal) surgery, medical patients with infections. Participants were recruited to the elective cohort in preoperative assessment clinic, and acutely admitted participants from surgical and medical wards at the Queen Elizabeth Hospital Birmingham. Serial measures of muscle quantity (ultrasound quadriceps, bioelectrical impedance analysis), muscle function (hand grip strength, physical performance), and questionnaires (mini-nutritional assessment, physical function) were performed at baseline, within 7 (± 2) days of admission/surgery, and 13 (± 1) weeks post-admission/surgery. Feasibility outcomes were assessed across timepoints including recruitment and drop-out rates, and procedure completion rates. Results Eighty-one participants were recruited (mean age 79, 38.3% females). Recruitment rates were higher in elective (75%, 24/32) compared to emergency surgery (37.2%, 16/43), and medical participants (45.1%, 41/91; p = 0.003). Drop-out rates varied from 8.3 to 19.5% at 7 days, and 12.5–43.9% at 13 weeks. Age and gender did not differ between patients assessed for eligibility, approached, or recruited. Completion rates were highest for ultrasound quadriceps (98.8%, 80/81 across all groups at baseline). Gait speed completion rates were lower in medical (70.7%, 29/41) compared to elective participants (100%, 24/24) at baseline. Conclusion Higher participation refusal and drop-out rates should be expected for research involving recruitment of participants from the acute setting. Assessment of muscle quantity/quality through ultrasound is recommended in early-stage trials in the acute setting, where completion rates of physical performance testing are expected to be lower.

scholarly journals Improving Completion Rates in Adult Education Through Social Responsibility

2016 ◽  
Vol 28 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Bjarne Wahlgren ◽  
Kristina Mariager-Anderson
Keyword(s):  
Adult Education ◽  
Social Responsibility ◽  
Educational System ◽  
Training Programs ◽  
Drop Out ◽  
Completion Rates ◽  
Educational Culture ◽  
Drop Out Rates ◽  
Teachers Attitudes ◽  
Positive Effect

Dropout is a serious problem within education. This article reports on an intervention project, titled “New Roles for the Teacher—Increased Completion Rates Through Social Responsibility,” which sought to reduce nonattendance and drop-out rates in the Danish adult educational system by improving teachers’ competences. This goal was pursued by engaging teachers in training programs aimed at improving their relational competences. The data showed that these focused training programs have an effect on the educational culture at the colleges and on the teachers’ attitudes toward the importance of reducing drop-out rates. As a consequence, the teachers acted more consistently and purposefully to prevent dropout, and a positive effect of the intervention on drop-out rates was documented.

scholarly journals What Are the Risk Factors for Malnutrition in Older-Aged Institutionalized Adults?

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2857
Author(s):  
Lorenzo M. Donini ◽  
Blossom C. M. Stephan ◽  
Aldo Rosano ◽  
Alessio Molfino ◽  
Eleonora Poggiogalle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nutritional Status ◽  
Regression Model ◽  
Physical Performance ◽  
Functional Impairment ◽  
Nutritional Assessment ◽  
Intervention Strategy ◽  
Mini Nutritional Assessment ◽  
Effective Prevention ◽  
Age Range

Malnutrition is common in older adults and is associated with functional impairment, reduced quality of life, and increased morbidity and mortality. The aim of this study was to explore the association between health (including depression), physical functioning, disability and cognitive decline, and risk of malnutrition. Participants were recruited from nursing homes in Italy and completed a detailed multidimensional geriatric evaluation. All the data analyses were completed using Stata Version 15.1. The study included 246 participants with an age range of 50 to 102 (80.4 ± 10.5). The sample was characterised by a high degree of cognitive and functional impairment, disability, and poor health and nutritional status (according to Mini Nutritional Assessment (MNA), 38.2% were at risk for malnutrition and 19.5% were malnourished). Using a stepwise linear regression model, age (B = −0.043, SE = 0.016, p = 0.010), depression (B = −0.133, SE = 0.052, p = 0.011), disability (B = 0.517, SE = 0.068, p < 0.001), and physical performance (B = −0.191, SE = 0.095, p = 0.045) remained significantly associated with the malnutrition risk in the final model (adjusted R-squared = 0.298). The logistic regression model incorporating age, depression, disability, and physical performance was found to have high discriminative accuracy (AUC = 0.747; 95%CI: 0.686 to 0.808) for predicting the risk of malnutrition. The results of the study confirm the need to assess nutritional status and to investigate the presence of risk factors associated with malnutrition in order to achieve effective prevention and plan a better intervention strategy.

scholarly journals Changes in Nutritional Status and Musculoskeletal Health in a Geriatric Post-Fall Care Plan Setting

Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1551 ◽  
Author(s):  
Romy Conzade ◽  
Steven Phu ◽  
Sara Vogrin ◽  
Ebrahim Bani Hassan ◽  
Walter Sepúlveda-Loyola ◽  
...  
Keyword(s):  
Older Adults ◽  
Nutritional Status ◽  
Physical Performance ◽  
Nutritional Assessment ◽  
Bone Turnover Marker ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Care Plan ◽  
Musculoskeletal Health ◽  
Care Plans

Understanding how changes in nutritional status influence musculoskeletal recovery after falling remains unclear. We explored associations between changes in nutritional status and musculoskeletal health in 106 community-dwelling older adults aged ≥65 years, who attended the Falls and Fractures Clinic at Sunshine Hospital in St Albans, Australia after falling. At baseline and after 6 months, individuals were assessed for Mini Nutritional Assessment (MNA®), grip strength, gait speed, Timed Up and Go (TUG) test, Short Physical Performance Battery (SPPB), and bone turnover marker levels. Associations were examined using multiple linear regression, adjusted for baseline covariates and post-fall care plans. Over 6 months, the prevalence of malnutrition or risk thereof decreased from 29% to 15% using MNA <24/30. Specifically, 20 individuals (19%) improved, 7 (7%) deteriorated, and 73 (69%) maintained nutritional status, including 65 (61%) who remained well-nourished and 8 (8%) who remained malnourished/at risk. A 1-point increase in MNA score over 6 months was associated with an increase of 0.20 points (95% confidence interval 0.10, 0.31, p < 0.001) in SPPB score. Improvement in nutritional status was associated with improvement in physical performance, providing a basis for interventional studies to ascertain causality and evaluate nutritional models of care for post-fall functional recovery in older adults.

scholarly journals The Nutritional Status of Long-Term Institutionalized Older Adults Is Associated with Functional Status, Physical Performance and Activity, and Frailty

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3716
Author(s):  
Itxaso Mugica-Errazquin ◽  
Idoia Zarrazquin ◽  
Jesús Seco-Calvo ◽  
Javier Gil-Goikouria ◽  
Ana Rodriguez-Larrad ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Nutritional Status ◽  
Functional Status ◽  
Physical Performance ◽  
Barthel Index ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Multiple Linear Regression Model

Among older adults living in long-term nursing homes (LTNHs), maintaining an adequate functional status and independence is a challenge. Whilst a poor nutritional status is a potential risk factor for a decreased function in this population, its role is not fully understood. Here, using a transversal multicenter study of 105 older adults living in 13 LTNHs, we analyzed the associations between nutritional status, as measured by the Mini Nutritional Assessment (MNA), and the parameters of functional status, physical performance, physical activity, and frailty as well as comorbidity and body composition. The MNA scores were positively correlated with the Barthel Index, handgrip strength, Short Physical Performance Battery (SPPB) scores, absolute muscle power, and Assessment of Physical Activity in Frail Older People (APAFOP) scores and were negatively correlated with dynamic balance and frailty. In a multiple linear regression model controlling for gender and age, the APAFOP score (β = 0.386), BMI (β = 0.301), and Barthel Index (β = 0.220) explained 31% of the variance in the MNA score. Given the observed close relationship between the MNA score and functional status, physical performance and activity, and frailty, interventions should jointly target improvements in both the nutritional status and functional status of LTNH residents. Strategies designed and implemented by interdisciplinary professional teams may be the most successful in improving these parameters to lead to better health and quality of life.

Mangelernährung bei geriatrischen Traumapatienten

2014 ◽  
Vol 23 (01) ◽  
pp. 5-10
Author(s):  
E.C. Bliemel ◽  
R. Aigner ◽  
C. Rolfes ◽  
S. Ruchholtz ◽  
B. Buecking ◽  
...  
Keyword(s):  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Nutritional Risk ◽  
Risk Screening ◽  
Prädiktive Validität ◽  
Nutritional Risk Screening

ZusammenfassungDie Inzidenz von Mangelernährung geriatrischer Patienten wird im Allgemeinen mit über 50 % angegeben. Mangelernährung bei geriatrischen Traumapatienten rangiert im Kollektiv der proximalen Femurfrakturen zwischen 30 und 50 %. Insgesamt erscheinen sowohl die angegebenen Häufigkeiten als auch die angewandten Messinstrumente inhomogen. Malnutrition führt zu einer Verschlechterung der Wundheilung, einer längeren postoperativen Immobilität, einem verlängerten Krankenhausaufenthalt sowie zu einer Steigerung der Mortalität. Unter Hinzuziehung bestehender Leitlinien erreichen das Mini Nutritional Assessment (MNA) sowie das Nutritional Risk Screening (NRS) eine ausreichende prädiktive Validität in diesem geriatrischen Patientengut, um ein Screening auf Mangelernährung durchzuführen. Bezüglich möglicher therapeutischer Interventionen ist die Studienlage limitiert: Vorhandene Studien zeigen oft eine geringe Patientenzahl und demente Patienten, die besonders häufig mangelernährt sind, wurden häufig ausgeschlossen. Eine Leitlinie explizit für dieses spezielle Patientengut existiert aktuell nicht. Ein suffizientes Screening des Ernährungszustandes sowie Daten zur Durchführbarkeit und Effizienz einer kurzfristigen perioperativen Nahrungsergänzung könnten einen wichtigen Beitrag zur Stabilisierung dieser oft multimorbiden und fragilen Patienten leisten.

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