Nutritional intake and malnutrition in institutionalised and non-institutionalised older adults

2021 ◽  
pp. 1-33
Author(s):  
T. Madeira ◽  
M. Severo ◽  
D. Correia ◽  
C. Lopes ◽  
J. Gorjão Clara

Abstract Malnutrition (synonym: undernutrition) is prevalent among older adults, which may be partly related to changes in dietary intake, but evidence on the link between malnutrition and diet is scarce. The aims of this study were to estimate the association between energy/nutrients intake and malnutrition, and to characterise nutritional inadequacy in institutionalised and non-institutionalised older adults. A national survey was conducted including a Portuguese representative sample of nursing home (NH) residents (n=563) and community-dwellers (n=837) aged ≥ 65. Data included sociodemographic characteristics, self-reported health, loneliness feelings, nutritional status (Mini Nutritional Assessment®), and dietary intake (two non-consecutive 24-hour recalls). A higher energy intake was associated with lower odds of malnutrition risk (being ‘at risk of malnutrition’ or ‘malnourished’) in both settings, but only significant among NH residents after adjusting for confounders (NH: odds ratio [OR]=0.66, 95% confidence interval [CI] 0.50, 0.86; community: OR=0.64, 95% CI 0.37, 1.10). The intake of carbohydrates, fat, fibre, vitamin C, sodium, and potassium was inversely associated with malnutrition risk in NH residents; as well as protein, fat, vitamin B6, folates, sodium, potassium, calcium, and magnesium intake in community-dwellers. After additional adjustment for total energy only sodium and magnesium intake of community-dwellers remained significantly associated. The prevalence of inadequate nutrient intake was generally higher for the malnutrition risk group, which was particularly evident among community-dwellers. The effect of dietary intake on nutritional status seems more dependent on total energy and carbohydrates intake in institutionalised elders, whereas among community-dwellers protein and some micronutrients appear to have a greater impact.

Geriatrics ◽  
2018 ◽  
Vol 3 (3) ◽  
pp. 60 ◽  
Author(s):  
Tony Arjuna ◽  
Michelle Miller ◽  
Tomoko Ueno ◽  
Renuka Visvanathan ◽  
Kylie Lange ◽  
...  

The effects of “standard (STD)” vs. “protein- and energy-enriched (HEHP)” food-service meals on the nutrient intake, nutritional status, functional capacity, and wellbeing of older adults was investigated using a 12 week, double-blinded, parallel group design. All participants received dietetics counseling and either an STD (2.3 MJ and 30 g protein per meal) or a HEHP (4.6 MJ and 60 g protein) hot lunchtime meal for at least 3 days/week; those who did not want food-service meals were included in the control group (CON). Twenty-nine participants completed the study (STD = 7; HEHP = 12; CON = 10). From baseline to week 12, the HEHP subjects increased their mean daily energy intake from 6151 ± 376 kJ to 8228 ± 642 kJ (p = 0.002 for effect of time) and protein intake from 67 ± 4 g to 86 ± 8 g (p = 0.014 for effect of time). The MNA (Mini Nutritional Assessment) score was increased significantly in HEHP by 4.0 ± 1.1 points (p = 0.001), but not in the STD and CON groups (2.8 ± 2.1 points and 1.8 ± 1.1 points, p > 0.05). No difference was found for other clinical outcomes between the groups. The findings indicate that provision of HEHP-fortified food-service meals can increase energy and protein intake and improve the nutritional status of nutritionally at-risk older people.


2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Angel G Hilerio Lopez

Malnutrition in the older adult is an ongoing situation in Mexico and is most apparent in individuals that reside in hospitals, nursing homes, and retirement homes. For that reason, it is necessary to evaluate the nutritional status of these adults by means of the Mini Nutritional Assessment (MNA) and levels of three serum indicators that are commonly ordered when making malnutrition diagnosis. An analytical cross-sectional study was carried out on 100 older adults residing in eldercare facilities. Nutritional status was evaluated by means of the MNA and three serum indicators (albumin, ferritin, and hemoglobin). Descriptive statistics were used to analyze sociodemographic characteristics, and a Student’s t test, based on gender and reference values, was used to compare mean values of the three serum indicators.  A Chi-square test was used to compare proportions in individuals, based on gender, who had normal nutritional status or were malnourished, and who were at-risk of malnutrition.  A One-way ANOVA with Scheffé post hoc test was used to identify the association between serum indicators and nutritional status of older adults. Of the 100 older adults studied, 53% were men and 47% were women. The mean age was 85±0.7 years. According to the MNA, 20% had normal nutritional status, 55% were at-risk of malnutrition, and 25% were malnourished. The mean indicator values were: albumin 4.7±0.04 g/dL, ferritin 74.2±8.7 ng/mL, and hemoglobin 13.0±0.1 g/dL. No significant association was found between serum indicators and each MNA classification; however, when the same indicators were compared between the sexes, hemoglobin showed a significant difference (P=0.037). Women had lower values but those values did not extend beyond the established physiological range for this population. There was a 55% prevalence of risk of malnutrition in the nutritional status of older adults living in Mexican eldercare facilities in a Mexican province and it was even more frequent in women. 


Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2429
Author(s):  
María Consuelo Velázquez-Alva ◽  
María Esther Irigoyen-Camacho ◽  
María Fernanda Cabrer-Rosales ◽  
Irina Lazarevich ◽  
Isabel Arrieta-Cruz ◽  
...  

This study evaluated the association between nutritional status, depressive symptoms, and the number of prescription drugs taken by older adults living in nursing homes in Mexico City. In a cross-sectional study, 262 participants were subjected to anthropometric and nutritional (Mini Nutritional Assessment (MNA)) evaluations; additionally, their depression (Geriatric Depression Scale (GDS)) and functional status were assessed. Multiple logistic regression was used for identifying factors associated with the risk of malnutrition/malnourishment. The mean age of participants was 83.1 ± 8.6 years. A total of 59.9% and 21.1% were at risk of malnutrition and malnourished, respectively. With respect to depression, 27.9% of the participants had mild depression, while 11.4% showed severe depression. An inverse correlation between MNA evaluations and depression scores was found (Spearman’s ρ = −0.4624, p < 0.001); residents with a better nutritional status had lower depression scores. Individuals with depressive symptoms were approximately five times more likely to be at risk of malnutrition or malnourished (OR = 5.82, 95% CI = 2.27–14.89) than individuals without depression. Residents taking three or more prescription drugs daily (OR = 1.83, 95% CI = 1.27–2.63, p < 0.001) were more likely to be at risk of malnutrition or malnourished. In summary, poor nutritional status was associated with depression, while the intake of numerous prescription drugs was associated with being at risk of malnutrition or malnourished.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 69-69
Author(s):  
Berna Rahi ◽  
Tracy Daou ◽  
Nour Gereige ◽  
Yara Issa ◽  
Yara Moawad ◽  
...  

Abstract Objectives We aimed to assess the polypharmacy effect on appetite and malnutrition risk among Lebanese nursing home residents. We hypothesized that polypharmacy will be associated to lower appetite and increased of malnutrition. Methods A cross-sectional pilot study was carried out in two nursing homes in the North-Lebanon region. Fifty-three older adults (OA) aged 60 and above were recruited and were interviewed face-to-face. A general questionnaire was administered to gather information about their socio-demographics, dietary habits and physical activity routine. Appetite was evaluated by the Simplified Nutritional Appetite Questionnaire (SNAQ) validated for use with nursing homes residents. The participants' nutritional status was assessed using the Short Form of the Mini-Nutritional Assessment (MNA-SF). Polypharmacy was determined if OA were taking 5 or more medications. Information about attitudes towards the use, the number and the cost of medications was also collected. Differences in SNAQ and MNA scores based on polypharmacy were tested using Independent t-tests. Logistic regression was performed to assess the association between polypharmacy and nutritional status after adjusting for several factors. Results Our sample constituted of 49.1% females with an average age of 67.6 ± 3.8 and BMI of 22.3 ± 1.7 kg/m2. The majority were widowed (79.2%) and had a low level of education (85% elementary education). Regarding the MNA scores, 33% had a normal nutritional status while 59% were at risk of malnutrition and 8% were malnourished, with an average MNA score of 10.1 ± 2.2. The average SNAQ score was 11.0 ± 3.3, with 85% scoring ≤14, indicating an significant risk of at least 5% weight loss withing 6 months. Regarding medication use, 50.9% of OA take at least 5 drugs/d with an average of 4.3 ± 2 drugs. Independent t-tests showed that MNA scores were significantly lower in those taking 5 drugs/d vs those taking less (9.4 ± 2.5 vs 10.8 ± 1.6, P = .024) while no significant difference was observed for SNAQ scores (10.3 ± 2.9 vs 11.6 ± 3.6, P = .13). Logistic regressions did not show any significant association between polypharmacy and MNA or SNAQ categories. Conclusions Lower MNA scores were observed in OA taking ≥5 drugs/d indicating a higher risk of malnutrition with polypharmacy. This is significant since malnutrition can further worsen the aging process. Funding Sources N/A.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S247-S247
Author(s):  
Takashi Amano ◽  
Carlos Andres Gallegos

Abstract Providing effective public services to improve the nutritional status among older adults is pivotal in countries experiencing population aging. Public investment and social policy in Ecuador have focused mainly on standard food-based interventions and cash transference programs. These efforts, however, may be not effective enough to reach those populations that need the most. This study aims to identify those populations that should be targeted by specific interventions. Data were drawn from Ecuador’s Survey of Health, Welfare and Aging (SABE) – 2009, a probability sample of households with at least one person who were 60 years or older in Ecuador. The final sample consisted of 5,235 people who were 60 years or older. Ethnic identity was categorized into four categories: Indigenous People, Mestizo (Mixed of Spanish and Indigenous People), Afro-Ecuadorian/Mulato, and Other. Nutritional status was measured using Mini Nutritional Assessment (MNA). Ordered logistic regression analysis was utilized to assess the association between ethnic identity and nutritional status. Results revealed that the Indigenous ethnicity was significantly associated with worse nutritional status compared to Mestizo and Other even after controlling for a range of covariates including socio-economic status, health related factors, and social support. These findings suggest the existence of underlaying factors hindering the nutritional status of among indigenous older adults in Ecuador. Considering the information revealed by SABE, interventions and other strategies should be targeted and designed specifically accounting for the needs, preferences, and culture of the most vulnerable population.


2013 ◽  
Vol 17 (12) ◽  
pp. 2834-2843 ◽  
Author(s):  
Yu Xuan Koo ◽  
Min Li Kang ◽  
Angie Auyong ◽  
Glen Zq Liau ◽  
Jeremy Hoe ◽  
...  

AbstractObjectiveThe objectives of the present study were to assess the nutritional status, identify factors for malnutrition risk and evaluate barriers to adequate nutrition among recipients of the Public Assistance (PA) scheme for socio-economically disadvantaged Singaporeans.DesignUsing a cross-sectional study design, we assessed PA recipients’ malnutrition risk using the DETERMINE Nutritional Health checklist and the full Mini-Nutritional Assessment (MNA), as well as their nutritional knowledge, co-morbidity burden, depression risk, instrumental and basic activities of daily living (IADL and BADL), and awareness and utilization of available food services. In-depth interviews were also conducted on malnourished individuals (MNA score < 17) to understand barriers to adequate nutrition.SettingHomes of community-living older adults and nursing homes of institutionalized older adults.SubjectsAll PA recipients aged ≥55 years in Central Singapore District.ResultsFour hundred and sixty-five of 511 (91·0 %) eligible PA recipients participated in the study. The prevalence of malnutrition in the study population was 2·8 %. However, 50·3 % were at risk of malnutrition. Among community-dwelling respondents, the risk of malnutrition was independently associated with age >75 years, currently unmarried, BADL impairment, depression risk and BMI < 19·0 kg/m2. Qualitative analysis revealed that financial, social and physical barriers and lack of knowledge were the main contributors to poor nutritional status. Only half were aware of subsidized food services and education increased interest in utilizing food services. Among nursing home respondents, those who were BADL impaired were more likely to be at risk of malnutrition.ConclusionsAmong PA recipients, the prevalence of malnutrition is low but the risk of malnutrition is high. Education on adequate nutrition and food services are recommended.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Teresa Madeira ◽  
Catarina Peixoto-Plácido ◽  
Nuno Sousa-Santos ◽  
Nuno Mendonça ◽  
Osvaldo Santos ◽  
...  

AbstractBoth malnutrition (which here refers to undernutrition) and obesity are prevalent in older adults, but they are frequently seen as mutually exclusive. In fact, a low body mass index (BMI) is one of the aetiological diagnostic criteria for malnutrition. On the contrary, the concomitant presence of malnutrition and obesity has been less studied. The aim of this study was to characterise the nutritional status of community-dwelling older adults (≥ 65 years old) living in Portugal. The study included a nationally representative sample of randomly selected community-dwelling older adults. Trained nutritionists collected data through face-to-face structured interviews regarding sociodemographic characteristics, nutritional status and anthropometric measures (namely, weight and height), among other variables of the PEN-3S study. Nutritional status was assessed by the 18-item Mini Nutritional Assessment (full MNA®), in which a lower score indicates worse nutritional status. The World Health Organisation's (WHO) BMI cut-offs for adults were followed (obesity: BMI ≥ 30Kg/m2). MNA and BMI categories estimates (95% CI) were obtained using Complex Samples analysis (SPSS® 24.0). Non-difference between sexes was analysed with Chi-square tests. Complete information was available for 1110 community-dwelling participants (mean age: 75.9 ± 8.1 years; 48.9% women; 71.4% attended school for < 5 years). According to the MNA, 0.5% (95%CI: 0.2–1.7) were classified as malnourished and 16.0% (12.9–19.7) were at risk of malnutrition. Following WHO's BMI criteria, 0.6% (0.2–1.5) had a BMI ≤ 18.5Kg/m2, 41.9% (37.9–46.0) had a BMI between 25–30Kg/m2, and 36.7% (32.8–40.9) presented a BMI ≥ 30Kg/m2. The prevalence of risk of malnutrition was significantly higher for women (20.1%, 95%CI: 15.4–25.9) than men (10.4%, 7.6–14.1; p < 0.001). The prevalence of obesity was also significantly higher for women (42.2%, 35.9–48.7 versus 29.3%, 24.8–34.2; p = 0.007). Moreover, 13.9% (9.2–20.4) were simultaneously at risk of malnutrition and had a BMI ≥ 30Kg/m2, while no one in this BMI category was classified as malnourished. Although appropriate BMI cut-offs for older adults are still uncertain, these results highlight that a high BMI does not exclude the risk of malnutrition, particularly in women. Therefore, health professionals should routinely screen for malnutrition using multi-component, validated screening tools, irrespective of the BMI. In fact, malnutrition is preventable if detected on time and effective interventions exist. The concomitant presence of malnutrition and obesity may pose additional challenges to the treatment.


2020 ◽  
pp. 1-11
Author(s):  
Elsie Nana Aba Abbiw Hayfron ◽  
Reginald Adjetey Annan ◽  
Anthony Kwaku Edusei ◽  
Charles Apprey ◽  
Odeafo Asamoah-Boakye

BACKGROUND: Older adults, both institutionalized and free-living are vulnerable to nutritional deficiencies and poor nutritional status, which affect morbidity and quality of life amongst them. Yet, little attention on nutritional needs is given to this vulnerable group in many developing countries, and very little data exist on the nutritional status of older Ghanaians. OBJECTIVE: This study assessed dietary intakes, anthropometric status, and anaemia prevalence among older adults in Effutu Municipality, Ghana. METHODS: Using a cross-sectional design, anthropometry, repeated 24-hour dietary recall, haemoglobin levels were determined among 150 older adults (60–87 years). The Mini Nutritional Assessment (MNA) questionnaire was used to determine malnutrition prevalence among older adults. RESULTS: None of the older adults met estimated average requirement (EAR) and adequate intake (AI) for vitamin E and calcium respectively, and 72.0%, 71.3%, 99.3%, 98.7%,76.0% had insufficient intake for energy, protein, zinc, folate and vitamin C respectively. Also, 39.3% were anaemic using haemoglobin cut-offs, 12.0% were malnourished based on the MNA tool and 28.0% were underweight based on BMI index. Married older adults (OR = 0.1, p = 0.005, 95% CI = 0.1–0.5) had lower odds for anaemia than those who were divorced. Underweight participants had 11.7 increased odds of being anaemic (OR = 11.7, p = 0.048, 95% CI = 1.0–135.0) than overweight participants. Those who had adequate vitamin C (OR = 0.3, p = 0.018, 95% CI = 0.1–0.8) and folate (OR = 0.2, p = 0.396, 95% CI = 0.1–6.7) intakes had lower odds of being anaemic than those with inadequate vitamin C and folate intakes, while those who had adequate iron (OR = 1.4, p = 0.412, 95% CI = 0.6–3.2) and vitamin B12 (OR = 1.6, p = 0.473, 95% CI = 0.5–5.3) intakes were more likely to be anaemic CONCLUSIONS: Inadequate nutrient intakes, anaemia, underweight and malnutrition prevalence were found among these older adults. Anaemia was associated with being underweight, but not nutrients intake. The nutritional needs of older people should be addressed to reduce risks for disease.


2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 19-19
Author(s):  
Samantha Honeywell ◽  
Hamed Samavat ◽  
EIleen Hoskin ◽  
Riva E. Touger-Decker ◽  
Rena Zelig

Abstract Objectives Older adults in the United States are at greater risk for tooth loss and malnutrition than those younger than 65 years. Prior research regarding associations between dentition status and nutritional status in older adults is heterogeneous. The primary aim of this study was to explore associations between dentition status and nutritional status in older adults. Methods This was a retrospective, cross-sectional study of data from older adults (65–89 years) who received care at the Rutgers School of Dental Medicine clinics between June 1, 2015 and June 1, 2020. Nutritional status was determined using Self Mini Nutritional Assessment (Self-MNA). Records were included if they had complete odontogram and Self-MNA data. Spearman rank correlation was performed to analyze the relationships between Self-MNA scores and number of teeth. Chi-square, Fisher's Exact, and Kruskal-Wallis tests were used to examine the associations between nutritional status category, number of remaining teeth categories, and presence of functional dentition defined as ≥21 teeth. Results Of the 305 records available, 53.8% were female. The median Self-MNA score was 13, indicative of normal nutritional status; 93.1% of the sample had some tooth loss (mean ± SD = 16.7 ± 8.8 teeth). Those who were at risk for or who had malnutrition had fewer teeth (P = 0.02) than those with normal nutritional status. Those with 20–28 teeth or functional dentition were significantly more likely to be of normal nutritional status (P = 0.02 and P = 0.03, respectively) than to be at risk of or have malnutrition, compared to those with fewer teeth. Those with fewer than 20 teeth had significantly lower Self-MNA scores than those with 20 or more teeth (P = 0.02). Conclusions Older adults who were at risk of or who had malnutrition had fewer teeth than those with normal nutritional status. Those with functional dentition were more likely to have a normal nutritional status than those without functional dentition. Future research in larger more diverse samples is needed to better understand the associations between dentition status and nutritional status. Funding Sources None


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fatemeh Hoseinzadeh-Chahkandak ◽  
Mehran Rahimlou ◽  
Fatemeh Salmani ◽  
Elham Ansarifar ◽  
Mitra Moodi ◽  
...  

Abstract Background Few data are available on the nutritional status of Iranian geriatric population. The present study aimed to determine the nutritional status of older adults’ population in Birjand, East of Iran. Methods The community-based cohort study was performed on older adults population (60 years and older) living in urban and rural areas of Birjand. The mini nutritional assessment (MNA) questionnaire was used to assess nutritional status. Anthropometric and biochemical evaluation were also performed for all of the participants. Results A total of 1417 geriatric person were enrolled in this study, which, most of them were female (51.9 %). According to MNA tool, most of the participants (73.3 %) had normal nutrition (MNA score ≥ 24). Malnourished (MNA score < 17) and at high risk of malnutrition (MNA score: 17- 23.5) were constituted 0.9 % and 25.8 % of the participants, respectively. Marital status, occupation, period of education and family member were associated with nutritional status. Multiple logistic regression showed that with increase of body mass index (BMI) (OR = 0.96), education years (OR = 0.95), hemoglobin (OR = 0.86) and lymphocyte (OR = 0.98), the odds of malnutrition decreased, but with increase of age the odds (1.03) of malnutrition is also elevated. Conclusions MNA could successfully forecast the risk of malnutrition and malnourished people. Sociodemographic factors are associated with the nutritional status.


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