Exposure to Potentially Harmful Drug-Disease Interactions in Older Community-Dwelling Veterans Based on the Healthcare Effectiveness Data and Information Set Quality Measure: Who Is at Risk?

Up to 28% of elderly residents in Europe are at risk of malnutrition. As uniform diagnostic criteria for malnutrition have not been formulated, in autumn 2018, the Global Leadership Initiative on Malnutrition (GLIM) presented a consensus on its diagnosis. According to the consensus, the diagnosis of malnutrition requires a positive screening test result for the risk of malnutrition, and the presence of at least one etiologic and one phenotypic criterion. This study aimed to assess the diagnostic performance and accuracy of the Mini Nutritional Assessment—Short Form (MNA-SF) against GLIM criteria. The analysis involved 273 community-dwelling volunteers aged ≥ 60 years. All participants were screened for malnutrition with the MNA-SF questionnaire. Next, the GLIM phenotypic and etiologic criteria were assessed in all subjects. Based on the presence of at least one phenotypic and one etiologic criterion, malnutrition was diagnosed in more than one-third of participants (n = 103, 37.7%). According to the MNA-SF, only 7.3% of subjects had malnutrition, and 28.2% were at risk of malnutrition. The agreement between the MNA-SF score and the GLIM criteria were observed in only 22.3% of the population. The sensitivity and specificity of MNA-SF against the GLIM criteria were fair (59.2% and 78.8%, respectively). The area under the curve (AUC) was 0.77, indicating the fair ability of MNA-SF to diagnose malnutrition. Based on the present study results, the best solution may be an optional replacement of the screening tool in the first step of the GLIM algorithm with clinical suspicion of malnutrition.

Download Full-text

Physical performance and movement-evoked pain profiles in community-dwelling individuals at risk for knee osteoarthritis

Experimental Gerontology ◽

10.1016/j.exger.2017.08.026 ◽

2017 ◽

Vol 98 ◽

pp. 186-191 ◽

Cited By ~ 17

Author(s):

Yenisel Cruz-Almeida ◽

Josue Cardoso ◽

Joseph L. Riley ◽

Burel Goodin ◽

Christopher D. King ◽

...

Keyword(s):

At Risk ◽

Knee Osteoarthritis ◽

Physical Performance ◽

Community Dwelling

Download Full-text

Use of the SF-36 to Identify Community Dwelling Rural Elderly at Risk for Hospitalization

Public Health Nursing ◽

10.1046/j.1525-1446.1999.00223.x ◽

1999 ◽

Vol 16 (3) ◽

pp. 223-227 ◽

Cited By ~ 11

Author(s):

Richardean Benjamin-Coleman ◽

Betty Alexy

Keyword(s):

At Risk ◽

Rural Elderly ◽

Community Dwelling ◽

Sf 36

Download Full-text

Working to Increase Stability through Exercise (WISE): screening, recruitment, and baseline characteristics

Trials ◽

10.1186/s13063-021-05761-0 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Christopher N. Sciamanna ◽

Noel H. Ballentine ◽

Melissa Bopp ◽

Vernon M. Chinchilli ◽

Joseph T. Ciccolo ◽

...

Keyword(s):

Physical Activity ◽

At Risk ◽

Physical Activity Intervention ◽

Past History ◽

Fragility Fractures ◽

Community Dwelling ◽

Common Reason ◽

Recruitment Methods ◽

Phone Calls ◽

The Impact

Abstract Background The aim of this paper is to describe the utility of various recruitment modalities utilized in the Working to Increase Stability through Exercise (WISE) study. WISE is a pragmatic randomized trial that is testing the impact of a 3-year, multicomponent (strength, balance, aerobic) physical activity program led by trained volunteers or delivered via DVD on the rate of serious fall-related injuries among adults 65 and older with a past history of fragility fractures (e.g., vertebral, fall-related). The modified goal was to recruit 1130 participants over 2 years in three regions of Pennsylvania. Methods The at-risk population was identified primarily using letters mailed to patients of three health systems and those over 65 in each region, as well as using provider alerts in the health record, proactive recruitment phone calls, radio advertisements, and presentations at community meetings. Results Over 24 months of recruitment, 209,301 recruitment letters were mailed, resulting in 6818 telephone interviews. The two most productive recruitment methods were letters (72% of randomized participants) and the research registries at the University of Pittsburgh (11%). An average of 211 letters were required to be mailed for each participant enrolled. Of those interviewed, 2854 were ineligible, 2,825 declined to enroll and 1139 were enrolled and randomized. Most participants were female (84.4%), under age 75 (64.2%), and 50% took an osteoporosis medication. Not having a prior fragility fracture was the most common reason for not being eligible (87.5%). The most common reason provided for declining enrollment was not feeling healthy enough to participate (12.6%). Conclusions The WISE study achieved its overall recruitment goal. Bulk mailing was the most productive method for recruiting community-dwelling older adults at risk of serious fall-related injury into this long-term physical activity intervention trial, and electronic registries are important sources and should be considered.

Download Full-text

Abstract 83: Effect of Dietary Cholesterol and Egg Consumption On Mortality And Cardiovascular Risk in the REGARDS Study

Stroke ◽

10.1161/str.46.suppl_1.83 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

J David Spence ◽

Suzanne Judd ◽

Virginia Howard ◽

Monika Safford ◽

George Howard

Keyword(s):

At Risk ◽

Racial Differences ◽

Cardiovascular Events ◽

Dietary Cholesterol ◽

Total Mortality ◽

Egg Yolk ◽

Community Dwelling ◽

Egg Consumption ◽

Patients At Risk ◽

Regards Study

Background and purpose: It has long been recommended that patients at risk of cardiovascular events limit their intake of dietary cholesterol to <200 mg/day. One large egg yolk contains more than 200mg of cholesterol, and also contains 250mg of phosphatidylcholine, which is converted by intestinal bacterial to trimethylamine. In the face of increasingly widespread belief that consumption of dietary cholesterol and eggs is harmless, we analyzed the effects of these dietary constituents on mortality and cardiovascular outcomes in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study population. Methods: A longitudinal cohort study of 30,239 community-dwelling black and white individuals aged 45+ years, recruited between January 2003 and October 2007 from the 48 contiguous states. The study oversampled black participants (44%), and residents of the southeastern “stroke belt” (56%). We analyzed total mortality and atherosclerotic events (ischemic stroke, myocardial infarction and revascularization) after 4.9 (SD 1.7) years of followup. Hazard ratios were computed for egg consumption and cholesterol consumption by quartiles, adjusted for race, age, sex, income, education, region, dyslipidemia, exercise, hypertension, diabetes, smoking, atrial fibrillation and caloric intake. Results: As shown in the table, there was a dose-related increase in all-cause mortality and atherosclerotic events with both cholesterol intake and egg consumption. Conclusions: Recommendations to limit the intake of cholesterol remain good advice for patients at risk of cardiovascular events. As one large egg yolk contains more than the daily recommended intake of cholesterol, egg yolk consumption should also be limited.

Download Full-text

Assessment of Sarcopenia Among Community-Dwelling At-Risk Frail Adults Aged 65 Years and Older Who Received Multidomain Lifestyle Interventions

JAMA Network Open ◽

10.1001/jamanetworkopen.2019.13346 ◽

2019 ◽

Vol 2 (10) ◽

pp. e1913346 ◽

Cited By ~ 4

Author(s):

Yanxia Lu ◽

Mathew Niti ◽

Keng Bee Yap ◽

Crystal Tze Ying Tan ◽

Ma Shwe Zin Nyunt ◽

...

Keyword(s):

At Risk ◽

Community Dwelling ◽

Lifestyle Interventions

Download Full-text

Effects of oral nutritional supplement with HMB on nutritional status and functional outcomes in community-dwelling older adults at risk of malnutrition: A randomized, placebo-controlled trial

Clinical Nutrition ESPEN ◽

10.1016/j.clnesp.2020.09.828 ◽

2020 ◽

Vol 40 ◽

pp. 679-680

Author(s):

S.L. Tey ◽

D.T.T. Huynh ◽

J. Oliver ◽

G. Baggs ◽

Y. Choe ◽

...

Keyword(s):

Older Adults ◽

At Risk ◽

Nutritional Status ◽

Functional Outcomes ◽

Controlled Trial ◽

Nutritional Supplement ◽

Community Dwelling ◽

Oral Nutritional Supplement ◽

Community Dwelling Older Adults

Download Full-text

The effects of a strong desire to void on gait for incontinent and continent older community‐dwelling women at risk of falls

Neurourology and Urodynamics ◽

10.1002/nau.24234 ◽

2019 ◽

Vol 39 (2) ◽

pp. 642-649 ◽

Cited By ~ 1

Author(s):

Marie‐Hélène Paquin ◽

Cyril Duclos ◽

Nolween Lapierre ◽

Lucie Dubreucq ◽

Melanie Morin ◽

...

Keyword(s):

At Risk ◽

Community Dwelling ◽

Risk Of Falls

Download Full-text

Impact of Malnutrition on Low Muscle Mass in Community-Dwelling Older People in Singapore: Findings from the SHIELD study

Current Developments in Nutrition ◽

10.1093/cdn/nzaa040_080 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 80-80

Author(s):

Siew Ling Tey ◽

Samuel Teong Huang Chew ◽

Yatin Berde ◽

Geraldine Baggs ◽

Choon How How ◽

...

Keyword(s):

At Risk ◽

Nutritional Status ◽

Bone Mass ◽

Older People ◽

Muscle Mass ◽

Community Dwelling ◽

Risk Category ◽

Calf Circumference ◽

Factors Associated ◽

Community Dwelling Older People

Abstract Objectives Malnutrition contributes to loss of muscle mass. There is limited information on the prevalence of low muscle mass in community-dwelling older people who are (not) at risk of malnutrition. Factors associated with muscle mass are also not well characterized. This cross-sectional study aimed to determine the prevalence of low appendicular skeletal muscle mass index (ASMI; ASM/height2) in older people with normal nutritional status (Malnutrition Universal Screening Tool, MUST risk category = low) and those at risk of malnutrition (MUST risk category = medium or high), and to determine factors associated with ASMI. Methods Strengthening Health In ELDerly through nutrition (SHIELD) is a study involving 1211 (400 with normal nutritional status and 811 at risk of malnutrition) community-dwelling older people aged ≥65 years in Singapore. Low ASMI was determined by bioelectrical impedance analysis (Asian Working Group for Sarcopenia, 2014). Results One in five (20.6%) nourished participants had low ASMI vs. four in five (81.3%) participants at risk of malnutrition had low ASMI (P < 0.0001). Older people with low ASMI were more likely to be admitted to the hospital, had longer length of stay, 25-hydroxyvitamin D deficiency, and lower education level, compared to those with normal ASMI (all P ≤ 0.0472). In the multiple linear regression model, age (coefficient, b = −0.013 kg/m2; P < 0.001), gender (female: b = −0.963 kg/m2; P < 0.001), calf circumference (b = 0.042 kg/m2; P < 0.001), bone mass (b = 0.593 kg/m2; P < 0.001), BMI (b = 0.129 kg/m2; P < 0.001), and Physical Activity Scale for the Elderly (PASE) score (b = 0.001 kg/m2; P = 0.048) were associated with ASMI. Conclusions Community-dwelling older people at risk of malnutrition had four-fold greater risk of having low ASMI as compared to nourished counterparts. Increasing age was associated with lower ASMI, whereas calf circumference, bone mass, BMI, PASE score, and being male were positively associated with ASMI. These findings highlight the importance of screening for low muscle mass and maintaining muscle health as part of the overall malnutrition management in this population group. Funding Sources The Economic Development Board of Singapore, Abbott Nutrition, and Changi General Hospital funded this study.

Download Full-text