scholarly journals Nutritional and Functional Indicators and Their Association With Mortality Among Older Adults With Alzheimer’s Disease

2020 ◽  
Vol 35 ◽  
pp. 153331752090716
Author(s):  
O. Vicente de Sousa ◽  
J. Mendes ◽  
T. F. Amaral
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Functional Status ◽  
Gait Speed ◽  
Nutritional Assessment ◽  
Handgrip Strength ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Calf Circumference

This study investigated how different nutritional and functional status indicators are associated with mortality in patients with Alzheimer’s disease (AD). A prospective cohort study was conducted among 79 community-dwelling older adults with AD. Follow-up was 60 months. Undernutrition status was evaluated by Mini Nutritional Assessment (MNA), body mass index, mid-arm muscle circumference (MAMC), calf circumference, and phase angle. Functional status was assessed by handgrip strength, and usual gait speed. Twenty-two participants died (27.8%). Results show that undernutrition (hazard ratio [HR] 5.69, 95% confidence interval [CI] 2.21-14.61), weight loss (HR 3.82, 95% CI 1.37-10.63), underweight (HR 3.24, 95% CI 1.18-8.82), low MAMC (HR 4.54, 95% CI 1.65-12.48), calf circumference ≤ 31 (HR 4.27, 95% CI 1.63-11.16), low HGS (HR 3.11, 95% CI 1.18-8.17), and low gait speed (HR 4.73, 95% CI 1.68-13.27) were all associated with mortality. In conclusion, a poor nutritional and functional status was associated with a higher risk of mortality, regardless of sex, age, marital status, education, and cognitive function.

scholarly journals Nutritional problems in older adults with Alzheimer’s disease: Risk of malnutrition and sarcopenia

2017 ◽  
Vol 30 (3) ◽  
pp. 273-285
Author(s):  
Danielle Rodrigues LECHETA ◽  
Maria Eliana Madalozzo SCHIEFERDECKER ◽  
Ana Paula de MELLO ◽  
Ivete BERKENBROCK ◽  
João CARDOSO NETO ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Nutritional Status ◽  
Rating Scale ◽  
Nutritional Assessment ◽  
Disease Risk ◽  
Elderly Care ◽  
Mini Nutritional Assessment ◽  
Capital City

ABSTRACT Objective Understand the nutritional problems and detect the presence of sarcopenia in older adults with Alzheimer’s disease. Methods Descriptive cross-sectional study carried out among elderly patients with Alzheimer’s disease receiving care at the Unidade de Saúde de Atenção ao Idoso (Elderly Care Unit) in a capital city in Southern Brazil between November 2010 and July 2011. The Clinical Dementia Rating scale was used for the evaluation of staging severity of dementia. Participants’ nutritional status was classified using The Mini Nutritional Assessment. The following tests were used to diagnose sarcopenia: bioelectrical impedance, hand grip strength, and the Timed Up and Go test. Anthropometric measurements and laboratory tests (hemoglobin, lymphocytes, serum albumin, and total cholesterol) were performed. Results Ninety-six older adults (mean age of 78 years) were evaluated. It was observed prevalence of mild Alzheimer’s disease in 54.2% of the participants; 55.2% were at risk of malnutrition; unintentional weight loss was observed in 64.6%, 55.3% had lower number of lymphocytes, and 43.7% had severe sarcopenia. Conclusion The prevalence of risk of malnutrition and sarcopenia is high among older adults with Alzheimer’s disease. Future studies should focus on the evaluation of nutritional interventions aimed at maintaining the nutritional status and muscle mass in these individuals.

scholarly journals Predictors of nutritional status among community-dwelling older adults in Wuhan, China

2009 ◽  
Vol 12 (8) ◽  
pp. 1189-1196 ◽  
Author(s):  
Yanhong Han ◽  
Sijian Li ◽  
Yanling Zheng
Keyword(s):  
Older Adults ◽  
Nutritional Status ◽  
Marital Status ◽  
Functional Status ◽  
Nutritional Assessment ◽  
Linear Regression Analysis ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Related Factors ◽  
Convenience Sample

AbstractObjectivesTo examine the nutritional and functional status of community older adults in China, to identify the related factors and best predictors of elder nutrition.Design, setting and subjectsA cross-sectional, descriptive correlation design was utilized. A convenience sample of 162 community older adults (aged ≥65 years) were administered three questionnaires, which were used to obtain demographic characteristics, nutritional status (Mini Nutritional Assessment, MNA) and functional status (Instrumental Activities of Daily Living, IADL).ResultsThe mean MNA score was 23·8 (sd 3·92), 36·4 % of elders were at risk of malnutrition and 8·0 % were malnourished; 61·7 % were functionally independent. Spearman’s correlation analysis indicated that age, marital status, education level, personal income, number of chronic medical conditions suffered and functional status had significant correlations with nutritional status. Stepwise multiple linear regression analysis identified that the best predictors were the number of chronic conditions suffered, age, functional status and marital status.ConclusionsThe study has suggested that nutritional health remains a problem among older adults in the Chinese community. A large proportion was on the borderline of malnutrition, and deficiency as well as excesses coexisted. Malnutrition is an increasing hazard especially for those suffering from more diseases, at a highly advanced age, functionally dependent and widowed.

Recruitment and Screening Methods in Alzheimer’s Disease Research: The FIT-AD Trial

2021 ◽  
Author(s):  
Susan Greimel ◽  
Jean F Wyman ◽  
Lin Zhang ◽  
Fang Yu
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Exercise Intervention ◽  
Community Outreach ◽  
Community Dwelling ◽  
Single Site ◽  
Recruitment Strategy ◽  
Screening Methods ◽  
Screening Process

Abstract Background Recruiting older adults with Alzheimer’s disease (AD) dementia into clinical trials is challenging requiring multiple approaches. We describe recruitment and screening processes and results from the FIT-AD Trial, a single site, pilot randomized controlled trial testing the effects of a 6-month aerobic exercise intervention on cognition and hippocampal volume in community-dwelling older adults with mild-to moderate AD dementia. Methods Ten recruitment strategies and a four-step screening process were used to ensure a homogenous sample and exercise safety. The initial target sample was 90 participants over 48 months which was increased to 96 to allow those in the screening process to enroll if qualified. A tertiary analysis of recruitment and screening rates, recruitment yields and costs, and demographic characteristics of participants was conducted. Results During the 48-month recruiting period, 396 potential participants responded to recruitment efforts, 301 individuals were reached and 103 were tentatively qualified. Of these, 67 (69.8%) participants completed the optional magnetic resonance (MRI) imaging and seven were excluded due to abnormal MRI findings. As a result, we enrolled 96 participants with a 2.92 screen ratio, 2.14 recruitment rate, and 31.9% recruitment yield. Referrals (28.1%) and Alzheimer’s Association events/services (21.9%) yielded over 49% of the enrolled participants. Total recruitment cost was $ 38,246 or $ 398 per randomized participant. Conclusions A multi-prong approach involving extensive community outreach was essential in recruiting older adults with AD dementia into a single-site trial. For every randomized participant, three individuals needed to be screened. Referrals were the most cost-effective recruitment strategy.

scholarly journals Communicating 5-Year Risk of Alzheimer’s Disease Dementia: Development and Evaluation of Materials that Incorporate Multiple Genetic and Biomarker Research Results

2020 ◽  
pp. 1-14
Author(s):  
Jessica Mozersky ◽  
Sarah Hartz ◽  
Erin Linnenbringer ◽  
Lillie Levin ◽  
Marissa Streitz ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Absolute Risk ◽  
Brain Mri ◽  
Community Dwelling ◽  
Educational Materials ◽  
Research Results ◽  
Material Development ◽  
Biomarker Research

Background: Cognitively normal (CN) older adults participating in Alzheimer’s disease (AD) research increasingly ask for their research results—including genetic and neuroimaging findings—to understand their risk of developing AD dementia. AD research results are typically not returned for multiple reasons, including possible psychosocial harms of knowing one is at risk of a highly feared and untreatable disease. Objective: We developed materials that convey information about 5-year absolute risk of developing AD dementia based on research results. Methods: 20 CN older adults who received a research brain MRI result were interviewed regarding their wishes for research results to inform material development (Pilot 1). Following material development, 17 CN older adults evaluated the materials for clarity and acceptability (Pilot 2). All participants were community-dwelling older adults participating in longitudinal studies of aging at a single site. Results: Participants want information on their risk of developing AD dementia to better understand their own health, satisfy curiosity, inform family, and future planning. Some articulated concerns, but the majority wanted to know their risk despite the limitations of information. Participants found the educational materials and results report clear and acceptable, and the majority would want to know their research results after reviewing them. Conclusion: These materials will be used in a clinical study examining the psychosocial and cognitive effects of offering research results to a cohort of CN older adults. Future AD research may incorporate the return of complex risk information to CN older adults, and materials are needed to communicate this information.

GAIT SPEED AND HANDGRIP STRENGTH AS PREDICTORS OF INCIDENT DISABILITY IN MEXICAN OLDER ADULTS

2014 ◽  
pp. 1-4
Author(s):  
T. LOPEZ-TEROS ◽  
L.M. GUTIERREZ-ROBLEDO ◽  
M.U. PEREZ-ZEPEDA
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Daily Living ◽  
Handgrip Strength ◽  
Statistical Significance ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Performance Tests ◽  
One Year

Physical performance tests are associated with different adverse outcomes in older people. Theobjective of this study was to test the association between handgrip strength and gait speed with incidentdisability in community-dwelling, well-functioning, Mexican older adults (age ≥70 years). Incident disability wasdefined as the onset of any difficulty in basic or instrumental activities of daily living. Of a total of 133participants, 52.6% (n=70) experienced incident disability during one year of follow-up. Significant associationsof handgrip strength (odds ratio [OR] 0.96, 95% confidence interval [95%CI] 0.93-0.99) and gait speed (OR0.27, 95%CI 0.07-0.99) with incident disability were reported. The inclusion of covariates in the models reducedthe statistical significance of the associations without substantially modifying the magnitude of them. Handgripstrength and gait speed are independently associated with incident disability in Mexican older adults.

PREDICTING THE EFFICACY OF PROTEIN-ENERGY SUPPLEMENTATION IN FRAIL OLDER ADULTS LIVING IN COMMUNITY

2014 ◽  
pp. 1-6
Author(s):  
C.O. KIM
Keyword(s):  
Older Adults ◽  
Nutritional Assessment ◽  
Linear Regression Analysis ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Home Healthcare ◽  
Post Intervention ◽  
Frail Older Adults ◽  
Protein Energy ◽  
Energy Supplementation

Background:Protein-energy malnutrition is a major cause of functional decline in the elderly and isclearly an important component of frailty. However, limited evidence is available about how to select frailindividuals most benefiting from protein-energy supplementation. Objectives:1) To investigate factors associatedwith stronger benefits from protein-energy supplementation, and 2) to test the hypothesis that the severity offrailty is associated with the efficacy of protein-energy supplementation. Design:Secondary analysis of data froma pre-post-intervention study and a clinical trial. Setting:National Home Healthcare Services in Gangbuk-gu,Seoul, South Korea. Participants:123 community-dwelling frail older adults [usual gait speed (UGS) <0.6m/secand Mini Nutritional Assessment (MNA) <24]. Intervention:Each participant was received with two 200 mL perday of commercial liquid formula (providing additional 400 kcal of energy and 25 g of protein per day) for 12weeks. Measurements:Relative change in the Physical Functioning (PF) and Short Physical Performance Battery(SPPB) score between the baseline and 12-week follow-up assessments were measured. Results:Multilevelmixed-effect linear regression analysis showed that a lower level of baseline UGS was associated with a greaterimprovement in PF and SPPB score after adjustment for age, gender, education, living status, beneficiary ofpublic assistance, number of chronic diseases, compliance, and type of dataset (p<0.001). A lower level ofbaseline MNA score was associated with greater change in PF and SPPB score after adjustment for multiplecovariates (p<0.045). Participants with severe frailty (UGS <0.3 m/sec + MNA <17) showed 52.4% and 44.6%more relevant improvements in PF and SPPB score, respectively, than those with mild frailty (UGS 0.3-0.6 m/sec+ MNA 17-24) (p<0.001). Conclusion:Slower UGS and lower MNA score are independently associated with thegreater efficacy of protein-energy supplementation on functional status.

scholarly journals Sarcopenia, physical frailty, undernutrition and obesity cooccurrence among Portuguese community-dwelling older adults: results from Nutrition UP 65 cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e033661 ◽  
Author(s):  
Ana Rita Sousa-Santos ◽  
Cláudia Afonso ◽  
Nuno Borges ◽  
Alejandro Santos ◽  
Patrícia Padrão ◽  
...  
Keyword(s):  
Older Adults ◽  
Nutritional Assessment ◽  
Multinomial Logistic Regression ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Secondary Outcome ◽  
Physical Frailty ◽  
Cross Sectional ◽  
European Working

ObjectivesTo investigate the coexistence of sarcopenia, frailty, undernutrition and obesity and to identify the factors associated with the cooccurrence of these conditions in an older population.DesignCross-sectional.SettingPortugal.Participants1454 older adults with 65 years or older, from Nutrition UP 65 study.Primary and secondary outcome measuresSarcopenia was identified using the European Working Group on Sarcopenia in Older People 2 guidelines and physical frailty using Fried phenotype. Mini-Nutritional Assessment-Short Form was used to ascertain undernutrition, and obesity was evaluated by body mass index.Results57.3% presented at least one condition, 38.0% were identified with one and 19.3% were identified with two or more conditions. When all preconditions were considered, 95.7% of the older adults presented at least one of these preconditions or conditions. Multinomial logistic regression multivariate analysis revealed that being male (OR 0.61; 95% CI 0.43 to 0.88), being married or in a common-law marriage (OR 0.58; 95% CI 0.40 to 0.84) and having a higher educational level (OR 0.23; 95% CI 0.07 to 0.73) were inversely associated with having two or more conditions, while age >75 years (OR 1.60; 95% CI 1.14 to 2.24), a poor self-perception of health status (OR 5.61; 95% CI 3.50 to 9.01), ≥5 medications (OR 3.11; 95% CI 1.77 to 5.46) and cognitive impairment (OR 1.84; 95% CI 1.37 to 2.48) were directly associated.ConclusionsAlmost three out of five older adults presented at least one of the conditions related to nutritional status, and about one in five had two or more of these occurrences. However, the low coexistence observed between all of these reinforces the need to assess them all individually during the geriatric assessment.

scholarly journals Aerobic Fitness and Cognition Changes After Exercise Training in Alzheimer's Disease

2017 ◽  
Vol 6 (2) ◽  
pp. 22-28
Author(s):  
Dereck L. Salisbury ◽  
Fang Yu
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Linear Regression ◽  
Exercise Training ◽  
Aerobic Fitness ◽  
Repeated Measures ◽  
The United States ◽  
Community Dwelling ◽  
The Relationship

Background: Alzheimer's disease (AD) currently affects 5.4 million Americans and is the sixth leading cause of death in the United States. The mechanism of exercise-induced brain adaptations are not fully understood, but enhanced aerobic fitness has been postulated as an essential physiological mechanism and is beginning to be studied. The purpose of this analysis was to examine the relationship between changes in aerobic fitness and cognition following 6 months of aerobic exercise training in older adults with AD. Methods: Twenty-seven community-dwelling older adults with mild to moderate AD completed a 6-month, 3 times per week, moderate-vigorous intensity cycling exercise program in 2 identical studies using a single-group repeated-measures designs. AD symptoms were measured with the AD Assessment Scale–cognitive subscale (ADAS-cog), while aerobic fitness was assessed by the intermittent shuttle walk test (ISWT) at baseline and 6 months. Pearson's correlation coefficient tests and linear regression were used to assess the relationship between changes in aerobic fitness and cognition. Results: Adjusted for age, the 6-month change in ISWT distance had an inverse relationship with the 6-month change in ADAS-Cog (r = −0.49; P = .01), indicating that enhanced aerobic fitness was associated with improved cognitive changes. Linear regression was statistically significant when adjusted by age (F([2,14] =5.33, P =.01, R2 = .31). Conclusion: Enhanced aerobic fitness may attenuate cognitive decline in persons with mild to moderate AD.

scholarly journals Factors associated with nutritional risk and appetite loss in long-aged older people

2021 ◽  
Vol 34 ◽  
Author(s):  
Mariana de Paula SANTANA ◽  
Nadine Motta FIGUEIREDO ◽  
Sergio CHOCIAY JUNIOR ◽  
Tainá Aparecida SILVA ◽  
Rosimeire Aparecida Manoel SEIXAS ◽  
...  
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Depressive Symptoms ◽  
Older People ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Perceived Health ◽  
Nutritional Risk ◽  
Calf Circumference ◽  
Appetite Loss

ABSTRACT Objective To analyze the factors that are associated with the nutritional risk and appetite loss of long-aged older people with two assessment instruments. Methods A cross-sectional and quantitative study was developed in Três Lagoas, a city in the Brazilian state of Mato Grosso do Sul. The household data collection was conducted with 87 long-aged older adults (≥90 years) living in the community. The risk of malnutrition, malnutrition, and the risk of weight loss were the dependent variables, assessed by the Simplified Nutritional Appetite Questionnaire and by the Mini-Nutritional Assessment - Short Form. The association with independent sociodemographic, general health, psychological, cognitive, and physical variables was analyzed using logistic regressions. Results Most of the older adults were female (55.2%), with an average age of 93.3 years, and 1.4 years of schooling. According to the Simplified Nutritional Appetite Questionnaire, 34.5% of the older individuals were at risk of losing weight. As for the results of the Mini-Nutritional Assessment, 19.5% were classified as malnourished, and 39.1% at risk of malnutrition. A greater nutritional risk in both instruments was associated with the individual's poorer self-perceived health, lower calf circumference, and presence of depressive symptoms. The greater the number of medications used, the lower the chance of weight loss. The agreement between the two instruments was low. Conclusion There was an association connecting malnutrition and appetite/weight loss with lower calf circumference, worse self-perceived health status, and presence of depressive symptoms. These results can assist in interventions planning to reduce the nutritional risk and improve the life quality of older adults.

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