Predictive factors for nutritional risk and malnutrition in institutionalized Portuguese older adults

Abstract Background Independence is related to the aging process. Loss of independence is defined as the inability to make decisions and participate in activities of daily living (ADLs). Independence is related to physical, psychological, biological, and socioeconomic factors. An enhanced understanding of older people’s independence trajectories and associated risk factors would enable the develop early intervention strategies. Methods Independence trajectory analysis was performed on patients identified in the Unité de Prévention de Suivi et d’Analyse du Vieillissement (UPSAV) database. UPSAV cohort is a prospective observational study. Participants were 221 community-dwelling persons aged ≥75 years followed for 24 months between July 2011–November 2013 and benefits from a prevention strategy. Data were collected prospectively using a questionnaire. Independence was assessed using the “Functional Autonomy Measurement System (Système de Mesure de l’Autonomie Fonctionnelle (SMAF))”. Group-based trajectory modeling (GBTM) was performed to identify independence trajectories, and the results were compared with those of k-means and hierarchical ascending classifications. A multinomial logistic regression was performed to identify predictive factors of the independence trajectory. Results Three distinct trajectories of independence were identified including a “Stable functional autonomy (SFA) trajectory” (53% of patients), a “Stable then decline functional autonomy decline (SDFA) trajectory” (33% of patients) and a “Constantly functional autonomy decline (CFAD) trajectory” (14% of patients). Not being a member of an association, and previous fall were significantly associated of a SDFA trajectory (P < 0.01). Absence of financial and human assistance, no hobbies, and cognitive disorder were significantly associated with a CFAD trajectory (P < 0.01). Previous occupation and multiple pathologies were predictive factors of both declining trajectories SDFA and CFAD. Conclusions Community-living older persons exhibit distinct independence trajectories and the predictive factors. The evidence from this study suggests that the prevention and screening for the loss of independence of the older adults should be anticipated to maintaining autonomy.

Download Full-text

Polish Translation and Validation of the Mini Sarcopenia Risk Assessment (MSRA) Questionnaire to Assess Nutritional and Non-Nutritional Risk Factors of Sarcopenia in Older Adults

Nutrients ◽

10.3390/nu13041061 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1061

Author(s):

Roma Krzymińska-Siemaszko ◽

Ewa Deskur-Śmielecka ◽

Arkadiusz Styszyński ◽

Katarzyna Wieczorowska-Tobis

Keyword(s):

Risk Factors ◽

Older Adults ◽

Risk Assessment ◽

Predictive Value ◽

High Sensitivity ◽

Community Dwelling ◽

Nutritional Risk ◽

Polish Language ◽

Community Dwelling Older Adults ◽

Translation And Validation

A simple, short, cheap, and reasonably sensitive and specific screening tool assessing both nutritional and non-nutritional risk factors for sarcopenia is needed. Potentially, such a tool may be the Mini Sarcopenia Risk Assessment (MSRA) Questionnaire, which is available in a seven-item (MSRA-7) and five-item (MSRA-5) version. The study’s aim was Polish translation and validation of both MSRA versions in 160 volunteers aged ≥60 years. MSRA was validated against the six sets of international diagnostic criteria for sarcopenia used as the reference standards. PL-MSRA-7 and PL-MSRA-5 both had high sensitivity (≥84.9%), regardless of the reference standard. The PL-MSRA-5 had better specificity (44.7–47.2%) than the PL-MSRA-7 (33.1–34.7%). Both questionnaires had similarly low positive predictive value (PL-MSRA-5: 17.9–29.5%; PL-MSRA-7: 14.4–25.2%). The negative predictive value was generally high for both questionnaires (PL-MSRA-7: 89.8–95.9%; PL-MSRA-5: 92.3–98.5%). PL-MSRA-5 had higher accuracy than the PL-MSRA-7 (50.0–55% vs. 39.4–45%, respectively). Based on the results, the Mini Sarcopenia Risk Assessment questionnaire was successfully adopted to the Polish language and validated in community-dwelling older adults from Poland. When compared with PL-MSRA-7, PL-MSRA-5 is a better tool for sarcopenia risk assessment.

Download Full-text

Healthcare-Seeking Behavior among Chinese Older Adults: Patterns and Predictive Factors

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062969 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2969

Author(s):

Yanbing Zeng ◽

Yuanyuan Wan ◽

Zhipeng Yuan ◽

Ya Fang

Keyword(s):

Older Adults ◽

Predictive Factors ◽

Medical Insurance ◽

Utilization Rate ◽

Heckman Selection Model ◽

Healthcare Seeking ◽

Inpatient Services ◽

Medical Institutions ◽

Seeking Behavior ◽

Healthcare Seeking Behavior

This study aimed to investigate the patterns and predictive factors of healthcare-seeking behavior among older Chinese adults. A sample of 10,914 participants aged ≥60 years from the 2011, 2013 and 2015 China Health and Retirement Longitudinal Study (CHARLS) was included. The bivariate analyses and Heckman selection model was used to identify predictors of healthcare-seeking behavior. Results shows that the utilization rate of outpatient services increased from 21.61% in 2011 to 32.41% in 2015, and that of inpatient services increased from 12.44% to 17.68%. In 2015, 71.93% and 92.18% chose public medical institutions for outpatient and inpatient services, 57.63% and 17.00% chose primary medical institutions. The individuals who were female, were younger, lived in urban, central or western regions, had medical insurance, had poor self-rated health and exhibited activity of daily living (ADL) impairment were more inclined to outpatient and inpatient services. Transportation, medical expenses, the out-of-pocket ratio and the urgency of the disease were associated with provider selection. The universal medical insurance schemes improved health service utilization for the elderly population but had little impact on the choice of medical institutions. The older adults preferred public institutions to private institutions, preferred primary institutions for outpatient care, and higher-level hospitals for hospitalization.

Download Full-text

Factors Influencing Dietary Intake Frequencies and Nutritional Risk among Community-Residing Older Adults

Journal of Nutrition in Gerontology and Geriatrics ◽

10.1080/21551197.2018.1524809 ◽

2018 ◽

Vol 37 (3-4) ◽

pp. 255-268

Author(s):

Lindsay MacNab ◽

Sarah L. Francis ◽

Ingrid Lofgren ◽

Catherine Violette ◽

Mack C. Shelley ◽

...

Keyword(s):

Older Adults ◽

Dietary Intake ◽

Nutritional Risk ◽

Factors Influencing

Download Full-text

Correction to: Incidence and predictive factors of postoperative hypocalcaemia according to type of thyroid surgery in older adults

Endocrine ◽

10.1007/s12020-021-02943-3 ◽

2021 ◽

Author(s):

María Paz Barbier ◽

Evelin Mingote ◽

Noelia Sforza ◽

Yanina Morosán Allo ◽

Maximiliano Lotartaro ◽

...

Keyword(s):

Older Adults ◽

Predictive Factors ◽

Thyroid Surgery ◽

Postoperative Hypocalcaemia

Download Full-text

Barriers and facilitators to nutritional risk screening of older adults in primary care

Proceedings of The Nutrition Society ◽

10.1017/s0029665120004255 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Christine Mills

Keyword(s):

Older Adults ◽

Primary Care ◽

Grey Literature ◽

Community Dwelling ◽

Barriers And Facilitators ◽

Nutritional Risk ◽

Term Care ◽

Risk Screening ◽

Google Search ◽

Nutritional Risk Screening

AbstractIntroduction:Over one-third of these community-dwelling older adults in Canada are at increased nutritional risk. Worldwide, two-thirds of older adults are at increased nutritional risk, although this figure includes those who are hospitalized or in long term care. Nutritional risk can lead to malnutrition; this occurs when an individual's food intake has an imbalance of energy, protein, or other nutrients. Nutritional risk and malnutrition are associated with poor quality of life, increased hospitalization, and premature mortality. Since malnutrition starts in the community, primary care is the ideal location for nutritional risk screening. If nutritional risk is identified early, before it progresses to malnutrition, it can be more easily treated. It is therefore important to understand barriers and facilitators to nutritional risk screening in primary care.Materials and Methods:The peer-reviewed and grey literature were searched. The databases CINAHL, Embase, Medline, and Google Scholar were used to identify articles related to barriers and facilitators to nutritional risk screening of older adults in primary care. A Google search identified publications from the grey literature related to nutritional risk screening of older adults. Key informants consisting of health care professionals working in primary care were asked to identify additional barriers. The Theoretical Domains Framework (TDF) was used to classify the barriers and facilitators.Results:Nine barriers and nine facilitators relating to nutritional risk screening of older adults in primary care were identified. These barriers and facilitators were located within the following domains of the TDF: knowledge; skills; social/professional role and identity; beliefs about capabilities; beliefs about consequences; motivation and goals; memory, attention and decision processes; environmental context and resources; social influences; emotions; behavioural regulation; and nature of the behaviours.Discussion:The TDF can be used to examine the barriers and facilitators to nutritional risk screening of older adults in primary care. Identification and classification of these barriers and facilitators can aid in the development and implementation of interventions designed to improve rates of nutritional risk screening in primary care. Identifying older adults at nutritional risk can help to prevent malnutrition, by intervening early when poor dietary intake may still be relatively easy and inexpensive to address. Screening is the first step in this identification.

Download Full-text

Racial Disparities in Nutritional Risk among Community-Dwelling Older Adults in Adult Day Health Care

Journal of Nutrition in Gerontology and Geriatrics ◽

10.1080/21551197.2019.1647327 ◽

2019 ◽

Vol 38 (4) ◽

pp. 345-360 ◽

Cited By ~ 1

Author(s):

Tina R. Sadarangani ◽

Lydia Missaelides ◽

Gary Yu ◽

Chau Trinh-Shevrin ◽

Abraham Brody

Keyword(s):

Older Adults ◽

Health Care ◽

Racial Disparities ◽

Community Dwelling ◽

Nutritional Risk ◽

Adult Day Health Care ◽

Community Dwelling Older Adults

Download Full-text

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16091562 ◽

2019 ◽

Vol 16 (9) ◽

pp. 1562 ◽

Cited By ~ 5

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.

Download Full-text