scholarly journals Urban-rural differentials in nutritional status of ageing in Bangladesh

Author(s):  
M. Taj Uddin ◽  
Momduha Akter ◽  
Mohammad Kamal Hossain ◽  
Mohammad Ali Raju ◽  
M. Shah Noor

Background: The growth rate of elderly is the fastest in most of the developing countries including Bangladesh. Nutrition plays fundamental role in maintaining good health especially in old age. This study was an attempt to assess the nutritional status of elderly and to compare it with their location.Methods: A total of 400 elderly in urban and rural area of Sunamgonj district have been interviewed through a structured questionnaire during July to September, 2019. A person aged 60 and above is included in the sample. Body mass index (BMI), mini nutritional assessment (MNA) short form, descriptive statistics, and Chi square test for association have been used for data analysis.Results: The analysis revealed that 17 percent elderly were under-weight, 66 percent were normal nutrition, 13 percent were over-weight and 4 percent were obese. The prevalence of malnutrition was found to be 40 percent. The rural elderly were at more risk of being malnourished compared to urban elderly. The mean BMI and MNA score of urban elderly were significantly different from the rural elderly.Conclusions: The findings show that more proportion of urban elderly are over-weight and obese compared to rural elderly. Therefore, measures should be taken to improve the nutrition status of elderly especially in rural area. 

2020 ◽  
Author(s):  
Hiroshi Yamamoto ◽  
Kenichi Ogawa ◽  
Toshifumi Morooka ◽  
Yasushi Hisamatsu ◽  
Tatsuya Ishitake

Abstract Background The nutritional and mental status of older patients are closely related and may serve as an indicator of hospital outcomes and early nutrition interventions.Objective We aim to appraise the impact on mortality and hospital outcomes by the revised simplified short-term memory recall test (STMT-R) and the short-form mini-nutritional assessment (MNA-SF) simultaneous at admission.Methods The subjects were 727 acute inpatients with ≥50 years of age from December 2014 to September 2015. Following the collection of clinical data (base illness, length of stay, etc.), survival was subsequently measured for 4-5 years until September 2019. An STMT-R score of ≤4 and MNA-SF score ≤7 were considered to indicate cognitive dysfunction and malnourishment respectively. Cox’s proportional hazards regression models were used to evaluate the hazard of death according to the severity of dementia and the nutrition status, with adjustment for potential covariates. Survival was estimated using the Kaplan-Meier method.Results The mean age of the study population was 78.9 years old, and 52.7% of the patients were female. 118 patients could not complete the cognitive test (Incomplete Testing Group [ITG]). 385 and 224 patients were classified into the cognitive dysfunction (CDG) and non-cognitive dysfunction groups (NCDG), respectively. 370, 299 and 58 patients were classified into the “malnourished” (MNG), “at risk of malnutrition” (ARNG) and “well-nourished” (WNG) groups, respectively. A poor cognitive function and poor nutritional status at admission were associated with worse clinical indicators. 276 patients (38.0%) died during the 4 to 5 years of follow-up. The risks of mortality in the ITG, CDG and MNG was 3.88 (hazard ratio; 95% confidence interval: 2.57-5.98), 1.84 (1.28-2.72) and 4.22 (1.76-13.9), respectively. In addition, the cumulative survival rate was 23.6% for the combination of advanced dementia and malnutrition, but 51.0% for moderate dementia and malnutrition. Even undernourishment may improve the prognosis of patients with mild to moderate cognitive impairment.Conclusion The early simultaneous measurements of the cognitive function and nutritional status is expected to be useful for predicting the the hospital prognosis, mortality and the effects of early comprehensive nutritional intervention in acute elderly patients with cognitive decline.


Author(s):  
Juliette Tavenier ◽  
Line Jee Hartmann Rasmussen ◽  
Aino Leegaard Andersen ◽  
Morten Baltzer Houlind ◽  
Anne Langkilde ◽  
...  

Abstract Growth differentiation factor 15 (GDF15) is a stress-induced cytokine. Its plasma levels increase during aging and acute illness. In older Patients and age-matched Controls, we evaluated whether GDF15 levels (i) were associated with recovery after acute illness, and (ii) reflected different trajectories of aging and longitudinal changes in health measures. Fifty-two older Patients (≥65 years) were included upon admission to the emergency department (ED). At 30 days after discharge (time of matching), Patients were matched 1:1 on age and sex with Controls who had not been hospitalized within 2 years of inclusion. Both groups were followed up after 1 year. We assessed plasma levels of GDF15 and inflammatory biomarkers, frailty, nutritional status (mini nutritional assessment short-form), physical and cognitive function, and metabolic biomarkers. In Patients, elevated GDF15 levels at ED admission were associated with poorer resolution of inflammation (soluble urokinase plasminogen activator receptor [suPAR]), slowing of gait speed, and declining nutritional status between admission and 30-day follow-up. At time of matching, Patients were frailer and overall less healthy than age-matched Controls. GDF15 levels were significantly associated with participant group, on average Patients had almost 60% higher GDF15 than age-matched Controls, and this difference was partly mediated by reduced physical function. Increases in GDF15 levels between time of matching and 1-year follow-up were associated with increases in levels of interleukin-6 in Patients, and tumor necrosis factor-α and suPAR in age-matched Controls. In older adults, elevated GDF15 levels were associated with signs of accelerated aging and with poorer recovery after acute illness.


Author(s):  
Jia-Yu Wei ◽  
Shu-Ting Shi ◽  
Dan Sun ◽  
Guo-Zhong Lyu

Abstract Objective Nutritional assessment can early identify patients who are malnourished and at risk of malnutrition. To examine the effect of nutritional status on wound healing in elderly burn patients, we used the MNA-SF to measure the nutritional status of elderly patients. This study aimed to examine the role of MNA-SF in elderly burn patients through the correlation analysis of wound-healing indicators and MNA-SF score. Design Prospective observational and cross-sectional study. Methods This study used the MNA-SF to investigate the elderly burn patients at the department of burn. According to the score, the patients fell into three groups: good nutritional status (more than 12 points), malnutrition risk (8~11 points), and malnutrition (0~7 points). At the same time, we measured and compared the wound-healing indicators among the three groups of patients, and detected the correlation. Results The statistical analysis found gender had a slight influence on the score of nutritional status. While age was negatively correlated with the MNA-SF score and nutrition-related indicators. There was a low positive linear correlation between the wound healing percent area change or wound healing rate of patients and the score of the MNA-SF. Conclusion This study finds malnutrition is common among hospitalized elderly burn patients. The application of the MNA-SF in elderly burn patients is efficient and accurate to identify malnutrition early and prevent further obstruction of the normal wound healing, which can provide reference points for early nutrition intervention programs.


Geriatrics ◽  
2018 ◽  
Vol 3 (3) ◽  
pp. 60 ◽  
Author(s):  
Tony Arjuna ◽  
Michelle Miller ◽  
Tomoko Ueno ◽  
Renuka Visvanathan ◽  
Kylie Lange ◽  
...  

The effects of “standard (STD)” vs. “protein- and energy-enriched (HEHP)” food-service meals on the nutrient intake, nutritional status, functional capacity, and wellbeing of older adults was investigated using a 12 week, double-blinded, parallel group design. All participants received dietetics counseling and either an STD (2.3 MJ and 30 g protein per meal) or a HEHP (4.6 MJ and 60 g protein) hot lunchtime meal for at least 3 days/week; those who did not want food-service meals were included in the control group (CON). Twenty-nine participants completed the study (STD = 7; HEHP = 12; CON = 10). From baseline to week 12, the HEHP subjects increased their mean daily energy intake from 6151 ± 376 kJ to 8228 ± 642 kJ (p = 0.002 for effect of time) and protein intake from 67 ± 4 g to 86 ± 8 g (p = 0.014 for effect of time). The MNA (Mini Nutritional Assessment) score was increased significantly in HEHP by 4.0 ± 1.1 points (p = 0.001), but not in the STD and CON groups (2.8 ± 2.1 points and 1.8 ± 1.1 points, p > 0.05). No difference was found for other clinical outcomes between the groups. The findings indicate that provision of HEHP-fortified food-service meals can increase energy and protein intake and improve the nutritional status of nutritionally at-risk older people.


Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1986 ◽  
Author(s):  
Sieske ◽  
Janssen ◽  
Babel ◽  
Westhoff ◽  
Wirth ◽  
...  

The effect of inflammation on appetite and food intake has been rarely studied in humans. In this study, we examined the association of C-reactive protein (CRP), as an inflammatory marker, with appetite and food intake among older hospitalized patients. A total of 200 older individuals, who were consecutively admitted to a geriatric acute care ward, participated in this prospective observational study. Appetite was evaluated using the Edmonton Symptom Assessment System (ESAS) and the Simplified Nutritional Appetite Questionnaire (SNAQ), respectively. Food intake was measured according to plate diagram method and participants were categorized as having food intake <75% and ≥75% of meals served. Nutritional status was evaluated using the Mini Nutritional Assessment Short Form (MNA-SF). In addition, serum CRP was analyzed and the levels >3.0 (mg/dL) were considered as moderate to severe inflammation. Of total population with mean age 81.4 ± 6.6 years (62.5% females), 51 (25.5%) had no inflammation and 88 (44.0%) and 61 (30.5%) had mild and moderate to severe inflammation, respectively. According to MNA-SF, 9.0% and 60.0% had normal nutritional status or a risk of malnutrition, respectively, whereas 31.0% were malnourished. Based on the SNAQ-appetite-question, 32.5% of the patients demonstrated poor and very poor appetite whereas 23.5% reported severe loss of appetite according to ESAS. Ninety-five (48.0%) of the participants had food intake <75% of the meals offered. Significant associations between SNAQ-appetite (p = 0.003) and ESAS-appetite (p = 0.013) scores and CRP levels were observed. In addition, significant differences were observed in CRP levels between intake ≥75% and <75% of meals served (p < 0.001). Furthermore, there were significant associations between appetite and nutritional status whereas malnourished older patients demonstrated a decreased appetite compared to those with normal nutritional status (p = 0.011). In a regression analysis, inflammation was the major independent risk factor for patients’ appetite (p = 0.003) and food intake (p = 0.011) whereas other variables such as infection (p = 0.960), chronic inflammatory diseases (p = 0.371), age (p = 0.679) and gender (p = 0.447) do not show any impact on appetite. Our findings confirm that poor appetite and low food intake are associated with inflammation in older hospitalized patients, suggesting that inflammation may contribute an important aspect to the development of malnutrition in these patients.


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.


Author(s):  
R. Mikiya ◽  
C. Momoki ◽  
D. Habu

Purpose: We investigated factors affecting diminished cough intensity in community-dwelling elderly using day care services. Participants and Methods: A total of 61 elderly males and females aged ≥65 years who were certified to receive long-term adult day care services were enrolled in this study. Assessments included: Cough intensity (assessed using cough peak flow measurements, as well as possible determinants of cough intensity, lifestyle, and demographic characteristics), nutritional status (using the Mini Nutritional Assessment-Short Form), dietary intake (using the Dietary Variety Score), routine activity (using the Japanese version of the International Physical Activity Questionnaire), care-related factors (including day care services utilization and an oral exercise regimen) as well as age, need for long-term care, gender, sarcopenia status, the Charlson Comorbidity Index, and body mass, limb skeletal mass, and respiratory indices. Results: A reduced cough peak flow (odds ratio 4.46, 95% confidence interval: 1.08–18.43) was associated with sarcopenia and was weakly (not significantly) associated with age, gender, and the Mini Nutritional Assessment-Short Form score. Conclusion: A reduced cough peak flow was independently associated with sarcopenia and associated with age, gender, and nutritional status.


Author(s):  
Satu K. Jyväkorpi ◽  
Annele Urtamo ◽  
Mika Kivimäki ◽  
Timo E. Strandberg

Abstract Introduction Sleep quality and quantity often decline as people age, which may negatively impact health. We examined how nutrition is associated with self-reported sleep quality and quantity in oldest-old community-dwelling men. Methods In this cross-sectional analysis of the Helsinki Businessmen Study (HBS), a random sample of 130 surviving participants underwent a clinical examination in 2017–2018. Food and nutrient intakes were retrieved from 3-day food diaries in 126 men, and sleep quality and quantity were determined with a questionnaire. Nutritional status was assessed using Mini Nutritional Assessment Short Form (MNA-SF), General Health and Vitality were measured with RAND-36/SF-36 health-related quality of life instrument, and albumin and creatinine levels were analyzed from fasting serum samples. Results Mean age of the survivors was 87 years (range 83–99). Self-reported sleep quality and quantity were highly correlated (p < 0.001, η2 = 0.693). Nutritional status (MNA-SF) (p = 0.006, η2 = 0.076), vegetable intake (p = 0.030. η2 = 0.041) and vitality (p = 0.008, η2 = 0.101) were associated with better sleep quality and fish (p = 0.028, η2 = 0.051) intake was associated with longer sleep duration. This association remained after adjusting for age, sleep quality, carbohydrate energy %, and albumin levels. Conclusion Healthy nutrition may be an important contributor to sleep hygiene in oldest-old men.


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