Psychosocial correlates of nutritional status of family caregivers of persons with dementia

2013 ◽  
Vol 26 (1) ◽  
pp. 105-113 ◽  
Author(s):  
Laetitia Rullier ◽  
Alexia Lagarde ◽  
Jean Bouisson ◽  
Valérie Bergua ◽  
Marion Torres ◽  
...  

ABSTRACTBackground:This exploratory study investigated the associations of individual characteristics of both persons with dementia and family caregivers with the nutritional status of caregivers.Methods:This cross-sectional study was conducted at home by psychogerontologist within the frame of a community gerontological center in rural areas of south west France. The study participants comprised 56 community-dwelling persons with dementia (mean 80.7 years, SD 6.5) and 56 family caregivers (mean 70.9 years, SD 11.0). Persons with dementia were assessed with Mini-Mental State Examination (MMSE), Basic Activities Of Daily Living (ADL), Instrumental ADL (IADL), and NeuroPsychiatric Inventory (NPI), and family caregivers with the Burden Interview (Zarit scale), the State-Trait Anxiety Inventory (STAI Y-B), the Center for Epidemiologic Studies Depression Scale (CES-D), the emotional impact measure of NPI and the Autonomy, Gerontology and Group Resources scale (AGGIR scale). For both, nutritional status was evaluated using the Mini Nutritional Assessment (MNA®).Results:Among family caregivers, 32.1% were at risk of malnutrition and 5.4% were malnourished, and among people with dementia, 58.9% and 23.2%, respectively. NPI severity score of apathy of persons with dementia (Beta = −0.342, p = 0.001), dependency on AGGIR scale (Beta = −0.336, p = 0.002), and CES-D score of caregivers (Beta = −0.365, p = 0.001) were associated with caregivers’ MNA score (Adjusted R2 = 0.480, p < 0.001).Conclusion:These preliminary findings emphasize the need for routine assessment of depressive symptoms, functional and nutritional status in dementia family caregivers, and confirm the value of investigating caregivers’ nutritional risk through an integrative view including psychosocial approach.

2020 ◽  
Vol 32 (S1) ◽  
pp. 127-127
Author(s):  
Fatima Urzal ◽  
Ana Quintão ◽  
Catarina Santos ◽  
Nuno Moura ◽  
Ana Banazol ◽  
...  

IntroductionAs in other countries, Portuguese family caregivers have unmet needs regarding information and distress. START (STrAtegies for RelaTives) is a manual-based coping intervention for families of people with dementia, including coping strategies and stress-management components, by Livingston and colleagues (https://www.ucl.ac.uk/psychiatry/research/mental-health-older-people/projects/start). In the UK, START has been clinically effective, immediately and continuing even after 6-years, without increasing costs. Clinical training and supervision ensures treatment fidelity. In Portugal, these kind of interventions are less available and, when provided, are mostly supportive and fail to address coping strategies. Paradoxically, recruitment may also prove challenging.ObjectivesWe describe the development of the Portuguese translation of START, incorporating guidance from the UK team, and a pilot study of delivery to family caregivers of people with dementia. We will also discuss the challenges of recruiting participants and delivering the intervention.MethodWe translated the START intervention and recruited family caregivers from neurology and psychiatry outpatients, in a central hospital in Lisbon. Our baseline assessment included the Hospital Anxiety and Depression Scale and the Zarit Burden Interview. The pilot is still ongoing at time of submitting, so we focus on recruitment, baseline assessments and process issues.ResultsDuring a three-month period, we recruited six caregivers. Five were primary caregivers (spouses or adult children) who had been caring for their relatives for 2 up to 10 years. Two caregivers met the international cutoff for clinically relevant affective disorder . The most frequent motivators for taking part were learning to communicate with their relatives and increasing knowledge to build community resources. Overall, the subjective impression of the therapist in charge is that the intervention seems acceptable and promising.Discussion/ConclusionsThis pilot study will eventually lead to an improved version of the Portuguese version of the START manual. So far, the intervention seems appropriate for selected caregivers in Portugal. However, response to striking unmet needs, particularly basic home support, may need to precede interventions like START. We look forward to concluding the intervention study and analyzing the implementation challenges, as a basis to inform a wider-scale trial.


2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
B A Akodu ◽  
S O Akinwunmi ◽  
A Onajole

Abstract Introduction Depression causes and worsens malnutrition. The prevalence of malnutrition in the elderly of the developed world was about 22.6% and about 40% of hospitalized elderly are malnourished while about 4.8% have one major depressive episode in people aged 50 and above. Food rich in omega-3 has antidepressant effect and its low intake is linked with dementia. Decrease dietary folate has been linked with depression. This study was aimed at determining the relationship between depression and nutritional status among the elderly in selected primary healthcare centers (PHC) in Lagos Nigeria. Method A descriptive cross-sectional study was conducted using multi-stage technique to select 219 participants by systematic sampling method from the selected PHC centers. Data was collected using structured interviewer-administered questionnaires. Nutritional status and Depression were assessed using Mini-Nutritional Assessment and Geriatric Depression Scale respectively. Data analysis was carried out using Epi-info 7.1. Associations were tested using Chi-square for categorical variables while t-test and analysis of variance were used for continuous variables. Associations were statistically significant if two-tailed probability was less than 5% (0.05). Results It was found that 57.9% and 47.1% were malnourished and depressed respectively. There was a statistically significant association between the sex of the participants and the nutritional status (p = 0.048). Statistically significant association existed between sex (p = 0.024), marital status (p = &lt;0.001), educational qualification and depression. Statistically significant association between monthly income (p = &lt;0.001), living arrangement (p = 0.002) and depression was demonstrated. There was a statistically significant association between family support (p = &lt;0.001), nutritional status (p = &lt;0.001) and depression. There was statistically significant difference between the height (p = 0.00885), weight (p = 0.00052, waist-hip ratio (p = 0.036) and the nutritional status. Remarkably, there was statistically significant difference between the waist (p = 0.023) and hip circumference (p = 0.047) and their level of depression. Conclusion A high prevalence of poor nutritional status and depression existed among the elderly primary healthcare centers.


Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1363 ◽  
Author(s):  
Doyeon Kim ◽  
Yongsoon Park

Both inflammation and poor nutritional status are major risk factors of frailty, and the dietary inflammatory index (DII) has been suggested as being associated with the risk of frailty. The present study aimed to investigate whether DII scores were positively associated with the risk of frailty in older individuals, particularly those with poor nutritional status. In total, 321 community-dwelling older individuals aged 70–85 years were recruited and categorized as non-frail, pre-frail, and frail according to the Cardiovascular Health Study index. DII scores were calculated based on 24-h dietary recall, and nutritional status was assessed using the Mini Nutritional Assessment. Multinomial logistic regression analysis showed that DII scores were positively associated with the risk of frailty in older individuals (odds ratio, OR 1.64, 95% confidence interval, 95% CI 1.25–2.17), particularly those with poor nutritional status (OR 1.68, 95% CI 1.21–2.34). Among the frailty criteria, weight loss (OR 1.29, 95% CI 1.03–1.60), low walking speed (OR 1.33, 95% CI 1.10–1.61), and low grip strength (OR 1.34, 95% CI 1.13–1.60) were associated with DII scores. In addition, the optimal DII cut-off score for frailty was ≥0.93 (sensitivity 71%; specificity: 72%; area under the receiver operating characteristic curve, AUC = 0.792). The present study showed that a pro-inflammatory diet was associated with increased risk of frailty, particularly in older individuals with poor nutritional status. Future randomized controlled trials with a low DII diet for the prevention of frailty are needed to confirm our finding.


2018 ◽  
Vol 75 (1) ◽  
pp. 96-107 ◽  
Author(s):  
Angela M. H. J. Mengelers ◽  
Michel H. C. Bleijlevens ◽  
Hilde Verbeek ◽  
Elizabeth Capezuti ◽  
Frans E. S. Tan ◽  
...  

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 20 (S1) ◽  
Author(s):  
Agnieszka Guligowska ◽  
◽  
Andrea Corsonello ◽  
Małgorzata Pigłowska ◽  
Regina Roller-Wirnsberger ◽  
...  

Abstract Background Different mechanisms connect the nutritional status with the occurrence and the course of chronic kidney disease (CKD). The end-stage renal disease is complicated by catabolic inflammatory reactions and cachexia which leads to malnutrition (undernutrition). On the other hand, obesity is an important risk factor for the development and acceleration of CKD. Methods In the SCOPE study, community-dwelling persons aged 75 years and over, from 6 European countries and Israel were examined at the baseline phase. We assessed the relationship between anthropometric measures (Body Mass Index (BMI), circumferences of arm (AC), waist (WC), hip (HC), and calf (CC), waist-to-hip ratio - WHR, waist-to-height ratio - WHtR, risk of malnutrition (Mini Nutritional Assessment - MNA), serum albumin) and estimated glomerular filtration rate (eGFR) calculated by Berlin Initiative Study (BIS) equation. Results We studied 2151 subjects (932 men and 1219 women) with a mean age of 79.5 ± 5.9 years. A total of 1333 (62%) participants had CKD (GRF < 60 ml/min/1.73 m2). Negative correlations between eGFR and weight, AC, WC, HC, CC, BMI, WHtR were observed. Positive correlation occurred between eGFR and MNA score (Spearman’s rho = 0.11) and albumin concentration (rho = 0.09). Higher weight, AC, WC, HC, CC, BMI and WHtR increased the odds ratio of CKD; higher MNA (OR = 0.98, 95% CI 0.94–1.0) and higher serum albumin (OR = 0.73, 95% CI 0.53–1.0) were weakly associated with reduced odds. The risk of malnutrition was the highest with eGFR < 30 as compared to eGFR > 60 (OR = 2.95, 95%CI = 1.77–4.94 for MNA < 24; OR = 5.54, 95%CI = 1.66–18.5 for hypoalbuminemia < 3.5 g/dL). Conclusion The population of community dwelling people aged 75+ with CKD shows general features of overweight and obesity with a small prevalence of malnutrition. For anthropometric measures, the strongest association with eGFR and the highest odds of CKD were identified using WC, HC, CC and WHtR. Albumin level and MNA, but not MNA Short Form, indicated an increased odds of malnutrition with a decrease in eGFR.


2015 ◽  
Vol 27 (12) ◽  
pp. 2031-2044 ◽  
Author(s):  
Anna-Eva Prick ◽  
Jacomine de Lange ◽  
Jos Twisk ◽  
Anne Margriet Pot

ABSTRACTBackground:Earlier research showed that multi-component dyadic interventions – including a combination of intervention strategies and addressing both the person with dementia and caregiver – have a beneficial impact on the mental and physical health of people with dementia and their family caregivers. A randomized controlled trial (RCT) of a multi-component dyadic intervention, which is a translated and adapted version of an intervention that has been shown to be effective in the US by Teri et al. (2003), was performed. The effects on caregivers’ mood (primary outcome), burden, general health, and salivary cortisol levels (secondary outcomes) were studied.Methods:Community-dwelling people with dementia and their family caregivers (N = 111 dyads) were randomly assigned. The experimental group received eight home visits during three months, combining physical exercise and support (psycho-education, communication skills training, and planning of pleasant activities). Both the physical exercise and support component were directed at both the person with dementia and the caregiver. The comparison group received monthly information bulletins and phone calls. There were three measurements at baseline (prior to the intervention), at three months, and at six months into the intervention. Data were analyzed with Generalized Estimating Equations (GEE) based on an intention-to-treat analysis of all available data.Results:All analyses showed no benefits of the intervention over time on any of the outcomes.Conclusion:The negative results might be explained by the translation and adaptation of the intervention that has been shown to be effective in the US: the intervention was shortened and did not include cognitive reframing. However, only the health effects on people with dementia and not on caregivers were studied in the US. Several other factors might also have played a role, which are important for future studies to take into account. These are: the usual health care in the country or region of implementation; the wishes and needs of participants for specific intervention components; the room for improvement regarding these components; the inclusion of positive outcome measures, such as pleasure, and the quality of the relationship.


2017 ◽  
Vol 29 (5) ◽  
pp. 765-776 ◽  
Author(s):  
Ashley Macleod ◽  
Gemma Tatangelo ◽  
Marita McCabe ◽  
Emily You

ABSTRACTBackground:Family caregivers of people with dementia have significant unmet needs in regard to their caregiving role. Despite this, they are reluctant to utilize services to reduce their burden. The aim of this study was to examine the barriers and facilitators of service use among family caregivers of people with dementia.Method:Semi-structured interviews were conducted with 24 family caregivers of community-dwelling people with dementia. Of these, 12 were partner caregivers (4 men, 8 women) and 12 were offspring caregivers (2 men, 10 women). The interviews were transcribed and analyzed using thematic analysis.Results:Six main barriers and three facilitators were identified. These barriers and facilitators were relevant across many types of services and supports. The barriers were: the inability to find information about relevant services or support, the poor quality or mistrust of the services, the inflexibility of services, caregivers’ beliefs about their obligations to the caregiving role and resistance by the care recipient. Key facilitators were: having good communication with the care recipient, having an “expert” point of contact, and having beliefs about the caregiving role that enabled the use of services.Conclusion:Given the significant changes in the aged care service-system, it is important to discuss the barriers faced by family caregivers of people with dementia. This will inform the development of targeted strategies to address the lack of service use among these family caregivers.


2020 ◽  
Author(s):  
Mohammad Rahanur Alam ◽  
Md. Shahadat Hossain ◽  
Akibul Islam Chowdhury ◽  
Marufa Akhter ◽  
Abdullah Al Mamun ◽  
...  

Background: The average life expectancy of the Bangladeshi population has been rising over the last decade due to the economic growth along with improved medicare. Although the increased number of geriatric people and their health is a matter of great concern, this issue remains unnoticed here. Objectives: To assess the nutritional status of the functionality and to analyze the association between nutritional status and functional ability of the selected Bangladeshi geriatric population. Methods: A community-based cross-sectional study was conducted among 400 participants, covering Chittagong, Noakhali, Comilla, and Jessore district of Bangladesh from December 2019 to February 2020. A standard and pretested questionnaire containing Mini Nutritional Assessment (MNA), Tinetti Performance Oriented Mobility Assessment (POMA), Activities of daily living scale (ADL), Lawton-Brody Instrumental Activities of Daily Living Scale (IADL), was used. Results: According to our study, The prevalence of malnutrition and people at risk of malnutrition have been 25.4% and 58.8%, respectively. In the case of functionality, 63.3% of subjects have high falling risk, and 61.8% of subjects can independently do their daily activities while 38.3% are dependent. Furthermore, almost 80% of people are dependent in terms of doing living skills. High risk of falling (OR=10.823; 95% CI: 5.846-20.37; p<0.001), poor skill in doing ADL (OR=6.206; 95% CI: 4.021-9.581; p<0.001), along with dependency in performing IADL (OR=4.477; 95% CI: 2.833-7.075; p<0.001) are significantly associated with malnutrition. Conclusions: Geriatric malnutrition can accelerate disability conditions, which can lead to early functional aging and subsequent loss in the quality of life.


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