scholarly journals Risk of malnutrition and associated factors in institutionalized elderly persons

2018 ◽  
Vol 21 (6) ◽  
pp. 711-717
Author(s):  
Cássia Cassol Damo ◽  
Marlene Doring ◽  
Ana Luisa Sant’Anna Alves ◽  
Marilene Rodrigues Portella

Abstract Objective : to evaluate the risk of malnutrition and associated factors in institutionalized elderly persons. Method : a cross-sectional study was carried out with elderly persons living in long-term care facilities in the municipal regions of Passo Fundo (Rio Grande do Sul) and Carazinho (Rio Grande do Sul) in 2017. A standardized, pre-codified questionnaire with sociodemographic variables was used, along with anthropometric data and the Mini Nutritional Assessment. Cognitive decline and non-intentional weight loss were also evaluated. The qualitative variables were presented in terms of univariate frequencies and the quantitative variables were described through measures of central tendency and dispersion. In order to verify the association between the categorical variables, the Pearson’s correlation coefficient, Chi-Squared test and the Fisher Exact test were applied, and in the crude and adjusted analysis the Poisson regression was used with robust variance. The level of significance was 5%. Results : a total of 399 elderly people were included, of whom 69.9% were female, 54.5% were aged 80 years or older and 88.4% were white. Of these elderly people, 61.7% lived in non-profit facilities. In the evaluation of nutritional status, 26.6% of the elderly were found to be malnourished, 48.1% were at risk of malnutrition and 25.3% had normal nutritional status. The highest prevalence ratio of at risk of malnutrition/malnutrition was with cognitive decline and unintentional weight loss (p<0.001). Conclusion : through the results, identifying nutritional status and the characteristics associated with the risk of malnutrition contribute to effective evaluation and nutritional monitoring, assisting in the prevention of diseases related to this condition.

2017 ◽  
Vol 20 (2) ◽  
pp. 175-185 ◽  
Author(s):  
Jucélia Fátima da Silva Güths ◽  
Maria Helena Vianna Metello Jacob ◽  
Ana Maria Pujol Vieira dos Santos ◽  
Guilherme Anziliero Arossi ◽  
Jorge Umberto Béria

Abstract Objective: to describe sociodemographic and family relationships, health status, depression and degree of functional capacity in institutionalized elderly persons in eleven long-term care facilities for the elderly in the north coastal region of Rio Grande do Sul, Brazil. Methods: a cross-sectional study was carried out of 60 institutionalized elderly persons without cognitive impairment, confirmed by a score greater than 13 in the Mini Mental State Exam. Questionnaires were used to obtain data on sociodemographic conditions, family relationships, and self-perception of health. Functional capacity was evaluated with the Barthel Index and the Geriatric Depression Scale was applied. Results: A predominance of women, widowed and single, with a of low level of education and precarious financial status, most of whom who did not have children, was observed. The elderly persons complained about difficulty walking (38.3%), generalized pain (16.7%) and vision problems (13.3%). The majority (95%) reported suffering from two to three chronic diseases and making daily use of three or more drugs. Although 55% of the participants presented depressive symptoms and morbidity, they reported functional independence and 50% rated their health as good. Conclusions: These data contributed to the knowledge of the health status and functional capacity of these institutionalized elderly persons, aiming to improve the care provided to this public.


Author(s):  
T. Vassilakou ◽  
G. Triantafillou ◽  
L. Evrenoglou

Background: Malnutrition is a serious problem, which cannot be easily detected among free-living elderly people, and may lead to various health and social problems and deteriorate their quality of life. Objectives: To determine the prevalence of malnutrition and malnutrition risk among free-living elderly in the community of an urban municipality of Attica and to identify socio-economic, health and dietary factors that may increase malnutrition risk. Design: Cross-sectional. Setting: Elderly people attending the Open Care Community Centers at N. Philadelphia (an urban municipality of Attica). Participants: 151 free-living people aged over 65 years (78 women and 73 men). Measurements: Mini Nutritional Assessment (MNA) questionnaire was completed, as well as socio-demographic, medical history, physical activity and alcohol consumption data was collected through a personal interview with the participants. Results: None of the individuals was found to be malnourished, but 25,8% of the sample was at risk of malnutrition. After performing backward regression analysis recent appetite (p<0,009) and weight loss (p<0,003), latest development of psychological stress or acute disease (p<0,0001), number of full-course meals (p<0,0001), protein intake index (p<0,002), minimum daily consumption of 2 portions of fruits or vegetables (p<0,0001), daily consumption of liquids (p<0,004), individual's self-evaluation of health (p<0,0001) and nutritional status (p<0,0001) all correlated significantly with MNA Screening Score. Conclusions: A significant number of free-living elderly persons were found at risk of malnutrition. Several dietary variables were found to correlate significantly with malnutrition risk. Early identification of nutritional risk of malnutrition in the community could ameliorate the nutritional status of seniors and consequently their health and quality of life.


2017 ◽  
Vol 20 (2) ◽  
pp. 186-196 ◽  
Author(s):  
Fabienne Louise Juvêncio Paes de Andrade ◽  
Joelmma Maria Rebouça de Lima ◽  
Kalyne do Nascimento Moreira Fidelis ◽  
Javier Jerez-Roig ◽  
Kenio Costa de Lima

Abstract Objective: To identify the prevalence of cognitive impairment and associated factors among institutionalized elderly persons. Methods: A cross-sectional study was conducted from October to December 2013 in Long-Term Care Facilities for the elderly in Natal, Rio Grande do Norte, Brazil, featuring 326 elderly persons of both genders. The assessment of cognitive decline was classified using the Pfeiffer test. Information on sociodemographic conditions and health status was also recorded. Nutritional status was assessed by applying the Mini Nutritional Assessment tool and functional capacity with the Katz Index. To identify the factors associated with the presence of moderate or severe cognitive impairment multiple logistic regression analysis of variables with a p value >0.20 was performed, using the Stepwise Forward method. Results: It was observed that 83.6% (95% CI: 78.9 to 87.3%) of the elderly persons had cognitive impairment. The final model, adjusted for type of LTCF, showed that being 83 years old or older was considered a risk factor for moderate or severe cognitive impairment. However, having systemic arterial hypertension (SAH) and having been institutionalized through their own choice were considered protective factors for moderate or severe cognitive impairment. Conclusion: the variables age, having SAH and having been institutionalized through their own choice are directly associated, as risk or protection factors, with the presence of severe or moderate cognitive impairment of the elderly population. The early diagnosis of these factors can lead to greater focus in setting goals for prevention and health care, thus improving the quality of life of these individuals.


2017 ◽  
Vol 20 (6) ◽  
pp. 856-868 ◽  
Author(s):  
Maria Cecília Azevedo de Aguiar ◽  
Natália Cristina Garcia Pinheiro ◽  
Karolina Pires Marcelino ◽  
Kenio Costa de Lima

Abstract Objective: to evaluate the prevalence of halitosis and associated factors in institutionalized elderly persons. Methods: a sectional study was performed with 268 elderly persons from 11 long-term care institutions in Natal in the northeast of Brazil. Data collection included an oral epidemiologic examination and questions about self-perception of oral health, as well as a consultation of medical records and the application of a questionnaire to the directors of the institutions. Halitosis was measured using the organoleptic test. The independent variables were oral, sociodemographic, institutional, general health and functional conditions. Bivariate analysis was performed using the Pearson chi-square test and Fisher's exact test, and the magnitude of effect was verified by the prevalence ratio for the independent variables in relation to the outcome, with a 95% confidence level. Results: the prevalence of halitosis was 26.1%, which was exhaled by the mouth in 98.57% of cases and by the nose in 10% of cases. Prevalence was 43% higher among non-white individuals (p=0.006); 65% higher among those living in non-profit institutions (p=0.039); 52% higher in elderly persons with oriented cognitive status (p=0.047); 41% higher in elderly persons with root caries (p=0.029); 62% higher in those who did not use dentures (p=0.046); 57% lower in edentulous persons (p<0.001); and 73% higher in elderly individuals with tongue biofilm (p=0.001). Conclusion: The occurrence of halitosis in institutionalized elderly persons was similar to other studies, but there was an expressive number of extrabuccal cases and an association with oral health problems, as well as sociodemographic, institutional and functional factors.


2019 ◽  
Vol 47 ◽  
Author(s):  
Stéfano Leite Dau ◽  
Tanise Policarpo Machado ◽  
Ezequiel Davi Dos Santos ◽  
Diorges Henrique Setim ◽  
Eduardo Rebelato Sakis ◽  
...  

Background: In various regions of Brazil, horses and cattle are considered the most susceptible animals to plant poisoning. The plants of the genus Senecio are the most important in Rio Grande do Sul because they have the active principle known as the pyrrolizidine alkaloid. Its diagnosis is made through epidemiology, clinical signs and histopathological analysis, either of the tissues obtained by biopsy or necropsy. The objective of this study was to report and characterize the epidemiological, clinical and anatomopathological findings of three cases of natural poisoning by Senecio brasiliensis in horses assisted at the Hospital Veterinário (HV) of the Universidade de Passo Fundo (UPF).Cases: Three traction horses, two males and one female, were admitted at the HV-UPF for clinical care. The animals were presenting anorexia, weight loss, dysmetria, proprioceptive deficit and signs suggestive of colic. The epidemiological study revealed that the sites where these animals were located were infested by Senecio brasiliensis. The support therapy used for equine colic in all three cases was unsuccessful. One of the animals died and the other two were euthanized, all three of them being reffered for necropsy. The post-mortem findings were mainly found in the liver, which showed accentuation of the lobular pattern and the appearance of nutmeg. During necropsy, fragments of organs from thoracic and abdominal cavities and central nervous system were collected and fixed in 10% buffered formalin. Subsequently, the samples were processed chemically, submitted to cuts of five micrometers of thickness and stained with hematoxylin and eosin for microscopic analysis. Microscopically, the liver of all three horses presented megalocytosis, fibrosis and bile ducts hyperplasia. In the central nervous system, spongiosis and the presence of Alzheimer type II astrocytes were observed. Thus, through the association of information, the diagnosis of poisoning by Senecio brasiliensis was achieved.Discussion: The diagnosis of natural poisoning by Senecio brasiliensis was obtained through the epidemiological survey that showed S. brasiliensis in pastures where all three horses were allocated.  Cases of intoxication by S. brasieliensis in cattle are more frequent than in equines, although both species are considered the most susceptible. In horses, the main clinical manifestations observed include neurological disorders, apathy, anorexia, dysphagia, weight loss, subcutaneous edema and icterus. The clinical signs presented by the equines suggested initial signs of colic syndrome, although anorexia, weight loss, dysmetria and proprioceptive deficit are commonly observed in pyrrolizidine alkaloid poisoning in the liver, both in cattle and horses. The pyrrolizidine alkaloids present in the genus Senecio that become toxic when biotransformed in the liver into a pyrrholic form highly reactive that inhibits cell mitosis and leads to the onset of megalocytosis, cell death and liver fibrosis. The necropsy findings and histopathology were characteristic of poisoning in equines, since the predominant macroscopic lesions in the liver were hepatomegaly and accentuation of lobular pattern, whereas microscopically, there was a predominance of hepatic fibrosis, megalocytosis, spongiosis and the incidence of Alzheimer's type II astrocytes in the brain. These lesions are observed both in natural and in experimental cases of poisoning in horses. Thus, through the ante-mortem and complete post-mortem evaluation of the three equines, it was possible to establish the occurrence of natural poisoning by Senecio brasiliensis in Northern Rio Grande do Sul, as well as to characterize the epidemiological, clinical and anatomopathological findings of poisoning in this species.


2020 ◽  
Vol 2 (3) ◽  
pp. 018-035
Author(s):  
Maturos Na Badalung Kanin ◽  
Bosittipichet Tatree ◽  
Leesri Thanakamon

2020 ◽  
pp. 1914-1926
Author(s):  
Jeremy Woodward

The prevalence and relevance of undernutrition in affluent societies is often unrecognized, but nutritional status significantly impacts outcomes in all disease states. Nutrition screening identifies patients at risk of undernutrition and should be carried out in hospitals and community: its components comprise past weight loss, current body mass index, and likely foreseeable nutritional challenges. A body mass index less than 18.5 kg/m2; weight loss of more than 10% over 6 months; or BMI of less than 20 kg/m2 with weight loss of more than 5% over 6 months, are all indicative of undernutrition. Nutrition support is indicated for malnourished patients or those at risk of undernutrition in view of inadequate oral intake or malabsorption. Timing of the intervention depends on the pre-existing nutritional status and the likelihood of restoring adequate intake.


2016 ◽  
Vol 19 (4) ◽  
pp. 613-625 ◽  
Author(s):  
Jair Almeida Carneiro ◽  
Gizele Carmen Fagundes Ramos ◽  
Ana Teresa Fernandes Barbosa ◽  
Élen Débora Souza Vieira ◽  
Jéssica Santos Rocha Silva ◽  
...  

Abstract Objective: To identify the prevalence of falls and associated factors in non-institutionalized elderly persons. Methods: A cross-sectional study featuring a population-based sample of non-institutionalized elderly persons in a city in the north of Minas Gerais was performed. Interviews were conducted in households by trained staff using validated instruments. We investigated the associations between falls and demographic, socioeconomic and health-related factors. After bivariate analysis, the variables associated with falls to a level of 20% were analyzed together using logistic regression, assuming at this stage a significance level of 5%. Results: The studied population was predominantly female, married and with a low educational level. The prevalence of falls was 28.4%. The factors that were associated with falls were: female gender (OR=1.67; 95% CI:1.13 to 2.47); negative self-evaluation of health (OR=1.49; 95% CI: 1.02 to 2.20); impaired functional mobility (Timed Up and Go test >20 seconds) (OR=1.66; 95CI: 1.02-2.74); the occurrence of hospitalization in the previous 12 months (OR=1.82; 95% CI: 1.17 to 2.84); and frailty measured by the Edmonton Frail Scale (OR=1.73; 95% CI: 1.14 to 2.64). Conclusions: The prevalence of falls was high for the population studied and was related to the individual health conditions of the elderly.


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