A Qualitative Exploration of Factors Associated with Malnutrition among Community-dwelling Malnourished Older People in Kandy District, Sri Lanka

Introduction: Nutrition plays an important role in older people. Numerous factors are associated with malnutrition among community-dwelling older people. However, little is known about how malnourished older people experience their nutritional status. This study aimed to explore how malnourished community-dwelling older people perceive the factors associated with their nutritional status. Methods: An explorative qualitative design was performed in Kandy District, Sri Lanka. A group of 150 malnourished community-dwelling older people identified from a cross sectional survey were invited for Focus Group Discussions (FGDs). A purposive sampling method was used. Fifteen FGDs were conducted among 85 participants. A thematic analysis was done to identify relevant themes related to malnutrition status. Results: The mean age of the participants was 68.74 years (SD± 6.32). Their age range was 60 to 97 years. Four main themes were identified through FGDs: (1) factors affecting dietary patterns, (2) food choices, (3) health status, and (4) psychological challenges. Conclusions: Community-dwelling malnourished older people stated factors associated with their dietary patterns, such as age-related factors, food choices, health status and mental status, lead to their malnutrition status. Public health professionals must understand and recognize these realities to improve the nutritional status of community-dwelling older people. Keywords: Community-dwelling, Malnutrition, Older people, Sri Lanka

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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.

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Predictors of Major Depressive Disorder in Older People

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182211894 ◽

2021 ◽

Vol 18 (22) ◽

pp. 11894

Author(s):

Susana Sousa ◽

Constança Paúl ◽

Laetitia Teixeira

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Older People ◽

Social Factors ◽

Common Mental Disorders ◽

Community Dwelling ◽

Major Depressive ◽

Factors Associated ◽

Status Mobility ◽

Community Dwelling Older People

Major depressive disorder (MDD) is one of the most common mental disorders in older people. There are several biological, psychological, and social factors associated with this disorder. This study aimed to describe the depressive state to identify the associated factors and potential predictors of MDD in a population of community-dwelling older people with probable MDD. The sample consisted of 378 participants with probable dementia, with 47.3% of them presenting MDD. The factors that were found to be associated with MDD were sex, living status, mobility, and nutritional status. Knowing the factors that can predict a condition such as MDD is extremely important, both for prevention and for the customization of interventions.

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Dietary Patterns and Risk of Frailty in Chinese Community-Dwelling Older People in Hong Kong: A Prospective Cohort Study

Nutrients ◽

10.3390/nu7085326 ◽

2015 ◽

Vol 7 (8) ◽

pp. 7070-7084 ◽

Cited By ~ 51

Author(s):

Ruth Chan ◽

Jason Leung ◽

Jean Woo

Keyword(s):

Cohort Study ◽

Hong Kong ◽

Older People ◽

Prospective Cohort Study ◽

Dietary Patterns ◽

Prospective Cohort ◽

Community Dwelling ◽

Chinese Community ◽

Community Dwelling Older People

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Nutritional Status and Risk Factors for Frailty in Community-Dwelling Older People: A Cross-Sectional Study

Nutrients ◽

10.3390/nu12041041 ◽

2020 ◽

Vol 12 (4) ◽

pp. 1041 ◽

Cited By ~ 2

Author(s):

Pilar Pérez-Ros ◽

Rafael Vila-Candel ◽

Lourdes López-Hernández ◽

Francisco Miguel Martínez-Arnau

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Nutritional Status ◽

Older People ◽

Cross Sectional Study ◽

Community Dwelling ◽

Sectional Study ◽

Cross Sectional ◽

Community Dwelling Older People ◽

The Relationship

Objective: This study aims to assess the relationship that frailty has with nutritional status and functional risk factors in community-dwelling older adults. Methods: Cross-sectional study in community-dwelling older people, independent for walking and without impaired cognition. Frailty was assessed by Fried criteria. Nutritional status was analyzed by the Mini Nutritional Assessment Short Form (MNA-SF), biochemical markers (albumin, total proteins, cholesterol, lymphocytes, and hemoglobin); and anthropometric parameters (body mass index [BMI], body fat percentage, handgrip, and perimeters). A comprehensive geriatric assessment analyzed other risk factors: functionality, cognition, falls, comorbidity, polypharmacy, physical activity, and quality of life (QoL). Results: We included 564 elderly people with a mean age of 76.05 (standard deviation 3.97) years; 63.1% (n = 356) were women, and 83.9% (n = 473) were prefrail, and frail. The sample presented high functionality and a nutritional status with a predominance of overweight and obesity. Factors associated with frailty (R2 = 0.43) were age over 75 years (odds ratio [OR] 3.31, 95% confidence interval [CI] 1.76, 6.21; p < 0.001), female gender (OR 2.37, 95% CI 1.24, 4.52; p = 0.009), anemia (OR 2.45, 95% CI 1.19, 5.02; p = 0.015), falls (OR 1.94, 95% CI 1.12, 3.25; p = 0.016) and the fear of falling (OR 4.01: 95% CI 1.76, 9.16; p = 0.001). Performing more than 3 weekly hours of physical activity was found to be a protective factor (OR 0.23, 95% CI 0.15, 0.35; p < 0.001). Conclusions: The relationship between frailty and malnutrition in functionally independent community-dwelling older people is unclear. More studies are needed to know what nutritional markers are related to frailty, cognition, and functionality in order to discriminate the risk factors for community-dwelling older people at risk of malnutrition and dependency.

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A theoretical and empirical review of psychological factors associated with falls-related psychological concerns in community-dwelling older people

International Psychogeriatrics ◽

10.1017/s1041610214002701 ◽

2015 ◽

Vol 27 (7) ◽

pp. 1071-1087 ◽

Cited By ~ 33

Author(s):

C. C. Hughes ◽

I. I. Kneebone ◽

F. Jones ◽

B. Brady

Keyword(s):

Older People ◽

Psychological Factors ◽

Community Dwelling ◽

Activity Level ◽

Future Research ◽

Negative Consequences ◽

Factors Associated ◽

Moderate Evidence ◽

Tentative Evidence ◽

Community Dwelling Older People

ABSTRACTBackground:Four constructs are encompassed by the term “falls-related psychological concerns” (FrPC); “fear of falling” (FOF), “falls-related self-efficacy” (FSe), “balance confidence” (BC) and “outcome expectancy” (OE). FrPC are associated with negative consequences including physical, psychological, and social. Identifying factors associated with FrPC could inform interventions to reduce these concerns.Methods:Sixty-two empirical papers relating to psychological factors associated with FrPC in community-dwelling older people (CDOP) were reviewed. Four levels of evidence were used when evaluating the literature: good, moderate, tentative, and none.Results:Evidence that anxiety predicted FOF, BC, and OE was tentative. Moderate evidence was found for anxiety predicting FSe. Good evidence was found for depression predicting FSe. Moderate evidence was found for depression predicting both FOF and BC. No evidence was found for depression predicting OE. Tentative evidence was found for FSe predicting depression. Good and moderate evidence was found for quality of life (QoL) being predicted by FOF and BC respectively. Tentative evidence was found for FSe predicting QoL. Moderate evidence was found for QoL predicting both FSe and BC. No evidence was found for QoL predicting FOF. Good and moderate evidence was found for activity avoidance/restriction (AA/AR) being predicted by FOF and FSe respectively. Tentative evidence was found for BC and OE predicting AA/AR, as well as for AA/AR predicting FOF. Moderate evidence for activity level (AL) predicting FOF was identified, however the evidence of this predicting FSe and BC was tentative. Evidence for FOF, FSe, and BC predicting AL was tentative as was evidence to suggest FOF predicted coping.Conclusions:Mixed evidence has been found for the association of psychological factors in association with FrPCs. Future research should employ theoretically grounded concepts, use multivariate analysis and longitudinal designs.

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