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 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.

THE FEASIBILITY OF STANDARDISED GERIATRIC ASSESSMENT TOOLS AND PHYSICAL EXERCISES IN FRAIL OLDER ADULTS

2017 ◽  
pp. 1-4
Author(s):  
A.D. Jadczak ◽  
N. Mahajan ◽  
R. Visvanathan
Keyword(s):  
Older Adults ◽  
Geriatric Assessment ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Assessment Tools ◽  
Geriatric Population ◽  
Frail Older Adults ◽  
Physical Exercises ◽  
Sf 36 ◽  
Cognitive Screen

Geriatric assessment tools are applicable to the general geriatric population; however, their feasibility in frail older adults is yet to be determined. The study aimed to determine the feasibility of standardised geriatric assessment tools and physical exercises in hospitalised frail older adults. Various assessment tools including the FRAIL Screen, the Charlson Comorbidity Index, the SF-36, the Trail Making Test (TMT), the Rapid Cognitive Screen, the Self Mini Nutritional Assessment (MNA-SF) and the Lawton iADL as well as standard physical exercises were assessed using observational protocols. The FRAIL Screen, MNA-SF, Rapid Cognitive Screen, Lawton iADL and the physical exercises were deemed to be feasible with only minor comprehension, execution and safety issues. The TMT was not considered to be feasible and the SF-36 should be replaced by its shorter form, the SF-12. In order to ensure the validity of these findings a study with a larger sample size should be undertaken.

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 Malnutrition in older adults on financial assistance in an urban Asian country: a mixed methods study

2013 ◽  
Vol 17 (12) ◽  
pp. 2834-2843 ◽  
Author(s):  
Yu Xuan Koo ◽  
Min Li Kang ◽  
Angie Auyong ◽  
Glen Zq Liau ◽  
Jeremy Hoe ◽  
...  
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Nutritional Status ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Food Services ◽  
Adequate Nutrition ◽  
Depression Risk ◽  
Co Morbidity

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.

scholarly journals NUTRITION ASSESSMENT PROTOCOLS IN COMMUNITY-DWELLING OLDER ADULTS WITH CHRONIC WOUNDS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S392-S392
Author(s):  
Rose Ann DiMaria-Ghalili ◽  
Sarah Charbonneau ◽  
Keyanna Bynum ◽  
Michael Neidrauer ◽  
Michael S Weingarten ◽  
...  
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Chronic Wounds ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Lessons Learned ◽  
Community Dwelling ◽  
Nutrition Assessment ◽  
Double Blind ◽  
Age Related

Abstract Older adults are at risk for altered nutritional status and functional impairment due to physiological (e.g., age-related changes, acute and chronic co-morbid conditions) and psychosocial factors (e.g., depression, loneliness, cognitive impairment). Those with alterations in nutritional and/or functional status are at risk for poor health outcomes-including delayed healing of chronic wounds. We will discuss our lessons learned when devising nutrition assessment protocols from our ongoing double-blind randomized control clinical trial testing the effectiveness of ultrasound treatment on healing chronic leg wounds. The discussion will focus on the following measures: the Mini-Nutritional Assessment, hand-grip strength assessment, and inflammatory biomarkers.

scholarly journals Malnutrition and obesity in community-dwelling older adults: concomitant conditions? (PEN-3S study)

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Teresa Madeira ◽  
Catarina Peixoto-Plácido ◽  
Nuno Sousa-Santos ◽  
Nuno Mendonça ◽  
Osvaldo Santos ◽  
...  
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Nutritional Status ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Screening Tools ◽  
World Health ◽  
Anthropometric Measures ◽  
Community Dwelling Older Adults

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.

scholarly journals Financial Strain Is Associated with Malnutrition Risk in Community-Dwelling Older Women

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Laura J. Samuel ◽  
Sarah L. Szanton ◽  
Carlos O. Weiss ◽  
Roland J. Thorpe ◽  
Richard D. Semba ◽  
...  
Keyword(s):  
Older Adults ◽  
Older Women ◽  
Nutritional Assessment ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Financial Strain ◽  
Monthly Basis ◽  
Aging Study ◽  
The Relationship

This study examined the relationship between financial strain, or difficulty acquiring necessities, and malnutrition risk in a community dwelling sample of frail and nonfrail women aged 70–79 in the Women’s Health and Aging Study (n=679). Malnutrition risk was measured with a modified version of the Mini-Nutritional Assessment Short Form (MNA-SF) and defined as a score <11, financial strain was measured by (1) sufficiency of money on a monthly basis and (2) adequacy of income for food, and income was measured by ordinal categories. Mean (SD) modified MNA-SF score was 12.2 (1.80), and 14.7% of women had malnutrition risk. Women who usually did not have enough money to make ends meet had more than four-fold increased odds of malnutrition risk (OR=4.54; 95% CI: 2.26, 9.14) compared to their counterparts who had some money left over each month. This was only slightly attenuated after control for income and education, (OR=4.08; 95% CI: 1.95, 8.52) remaining robust. These results show an association between financial strain and malnutrition risk, independent of income, in older women. Self-reported financial strain may be preferable to income as a screener for malnutrition risk in older adults in clinical and research settings.

scholarly journals Associations Between Dentition Status and Nutritional Status in Community-Dwelling Older Adults

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 19-19
Author(s):  
Samantha Honeywell ◽  
Hamed Samavat ◽  
EIleen Hoskin ◽  
Riva E. Touger-Decker ◽  
Rena Zelig
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Nutritional Status ◽  
Tooth Loss ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
The United States ◽  
Community Dwelling ◽  
Future Research ◽  
Functional Dentition

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

scholarly journals Social Frailty Is Associated With the Risk of Malnutrition Among Community-Dwelling Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 398-398
Author(s):  
Seoyoon Jane Lee ◽  
Miji Kim ◽  
Hayoung Shim ◽  
Heeeun Jung ◽  
Yuri Seo ◽  
...  
Keyword(s):  
Older Adults ◽  
Nutritional Assessment ◽  
Adult Population ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Daily Lives ◽  
Frailty Status ◽  
Social Capitals ◽  
Older Adult Population ◽  
Community Dwelling Older Adults

Abstract Social frailty does not merely affect the level of socialization, but also the means of obtaining resources for the daily lives of older adults. It is highly associated with the quality of life during advanced age. In this study, we analyzed the association between the Mini-Nutritional Assessment (MNA®) score (range 0-30) and 18 singular items and social frailty status of community-dwelling older adults. A total of 2,552 community-dwelling older adults aged 70-84 years (mean age 76.9±4.0, 51.8% female) from the Korean Frailty and Aging Cohort Study (KFACS) were assessed. The social frailty status was assessed in four categories- absence of economic resources, social resources, social activities, and social interactions. A higher MNA® score indicates better nutritional status. The prevalence of social frailty in older adults was 27.9% (mean age 78.1±4.0, 67.7% female). Approximately 40% of the participants were at risk of malnutrition or malnourished (p&lt;0.001), while socially robust group accounted for 23% (p&lt;0.001). They were at a higher risk of a lower MNA® score (odds ratio [OR] 0.90, 95% confidence interval [CI], 0.84-0.96). Socially-frail older adults have a higher possibility of not eating three full meals a day (OR 2.33, 95% CI 1.19-4.55) which increases the risk of malnutrition. In conclusion, social frailty, as a means of linking resources -including economic and social capitals- to the older adult population directly impacts the risk of malnutrition and requires an appropriate intervention.

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