Psychosocial Correlates of Nutritional Risk in Older Adults

2005 ◽  
Vol 66 (2) ◽  
pp. 95-97 ◽  
Author(s):  
C.S. Jacob Johnson

The psychosocial correlates of nutritional risk among older adults were examined in a study involving 54 people over age 65 (range, 65 to 98; average, 81), who were selected through a convenience sampling strategy. Measures included a background questionnaire, Mini Nutritional Assessment, Life Satisfaction Index Form Z, Geriatric Depression Scale, and Lubben's Social Network Scale. Seventeen percent of participants were found to be at risk of malnutrition. Compared with those who had adequate nutrition, at-risk participants had lower levels of social support (approaching statistical significance, p=0.08) and life satisfaction (not significant), and significantly higher levels of depression (p=0.04). Hierarchical multiple regression analysis showed that depression and social support were significant correlates of nutritional risk (p=0.01). Nutrition professionals should have a multidisciplinary perspective when they assess older adults’ nutritional status.

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2429
Author(s):  
María Consuelo Velázquez-Alva ◽  
María Esther Irigoyen-Camacho ◽  
María Fernanda Cabrer-Rosales ◽  
Irina Lazarevich ◽  
Isabel Arrieta-Cruz ◽  
...  

This study evaluated the association between nutritional status, depressive symptoms, and the number of prescription drugs taken by older adults living in nursing homes in Mexico City. In a cross-sectional study, 262 participants were subjected to anthropometric and nutritional (Mini Nutritional Assessment (MNA)) evaluations; additionally, their depression (Geriatric Depression Scale (GDS)) and functional status were assessed. Multiple logistic regression was used for identifying factors associated with the risk of malnutrition/malnourishment. The mean age of participants was 83.1 ± 8.6 years. A total of 59.9% and 21.1% were at risk of malnutrition and malnourished, respectively. With respect to depression, 27.9% of the participants had mild depression, while 11.4% showed severe depression. An inverse correlation between MNA evaluations and depression scores was found (Spearman’s ρ = −0.4624, p < 0.001); residents with a better nutritional status had lower depression scores. Individuals with depressive symptoms were approximately five times more likely to be at risk of malnutrition or malnourished (OR = 5.82, 95% CI = 2.27–14.89) than individuals without depression. Residents taking three or more prescription drugs daily (OR = 1.83, 95% CI = 1.27–2.63, p < 0.001) were more likely to be at risk of malnutrition or malnourished. In summary, poor nutritional status was associated with depression, while the intake of numerous prescription drugs was associated with being at risk of malnutrition or malnourished.


Author(s):  
G. Marques Rodrigues ◽  
J.F. Santos da Silva ◽  
D. Bittencourt Ferreira ◽  
L.M. Santiago ◽  
L. Lima Luz ◽  
...  

Objective: To analyze to role of the Short-Form Mini Nutritional Assessment in the nutritional assessment of elderly individuals with cancer. Study Design: Cross-sectional epidemiological study. Location: Outpatient services at eight cancer hospitals in the cities of Campo Grande and Rio de Janeiro, in Brazil. Participants: 333 individuals, aged 60 or older, with prostate cancer, interviewed in the period before the definition of cancer treatment. Methods: The nutritional profile was assessed with the Short Form Mini Nutritional Assessment (MNA-SF) and with the Body Mass Index (BMI), according to Lipschitz’s classification. Socio-demographic and clinical variables were also considered. We analyzed the distribution of elderly individuals by MNA-SF items according to MNA-SF and BMI categories and the Fisher’s exact test was applied for testing the statistical significance of the observed differences (p≤0.05). Results: Based on the MNA-SF, 235 (73.0%) individuals had an adequate nutritional status; 74 (23.0%) were at risk for malnutrition and 13 (4.0%) were considered malnourished. Based on the BMI, 49 elders (15.2%) were classified as low weight; 150 (46.4%) as normal weight and 124 (38.4%) as overweight. For each item in the MNS-SF, the frequency of answers corresponding to deficiencies was high among elderly individuals at risk for malnutrition, with statistical significance. With respect to the BMI, only “Food intake declined over the past 3 months” and “BMI” had statistically significant differences. Conclusion: MNA-SF showed a good relationship between its component items and proved to be an adequate tool to describe nutritional risk in elderly cancer patients. Early detection of this risk paves the way for an early nutritional approach and for preventing undesirable outcomes with respect to the health of those individuals. As other advantages, MNA-SF is easy to interpret, demands a short time for application and is well accepted by the elders.


2017 ◽  
Vol 117 (4) ◽  
pp. 532-540 ◽  
Author(s):  
Lisa Söderström ◽  
Andreas Rosenblad ◽  
Eva Thors Adolfsson ◽  
Leif Bergkvist

AbstractMalnutrition predicts preterm death, but whether this is valid irrespective of the cause of death is unknown. The aim of the present study was to determine whether malnutrition is associated with cause-specific mortality in older adults. This cohort study was conducted in Sweden and included 1767 individuals aged ≥65 years admitted to hospital in 2008–2009. On the basis of the Mini Nutritional Assessment instrument, nutritional risk was assessed as well nourished (score 24–30), at risk of malnutrition (score 17–23·5) or malnourished (score <17). Cause of death was classified according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, into twenty different causes of death. Data were analysed using Cox proportional hazards regression models. At baseline, 55·1 % were at risk of malnutrition, and 9·4 % of the participants were malnourished. During a median follow-up of 5·1 years, 839 participants (47·5 %) died. The multiple Cox regression model identified significant associations (hazard ratio (HR)) between malnutrition and risk of malnutrition, respectively, and death due to neoplasms (HR 2·43 and 1·32); mental or behavioural disorders (HR 5·73 and 5·44); diseases of the nervous (HR 4·39 and 2·08), circulatory (HR 1·95 and 1·57) or respiratory system (HR 2·19 and 1·49); and symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (HR 2·23 and 1·43). Malnutrition and risk of malnutrition are associated with increased mortality regardless of the cause of death, which emphasises the need for nutritional screening to identify older adults who may require nutritional support in order to avoid preterm death.


2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Angel G Hilerio Lopez

Malnutrition in the older adult is an ongoing situation in Mexico and is most apparent in individuals that reside in hospitals, nursing homes, and retirement homes. For that reason, it is necessary to evaluate the nutritional status of these adults by means of the Mini Nutritional Assessment (MNA) and levels of three serum indicators that are commonly ordered when making malnutrition diagnosis. An analytical cross-sectional study was carried out on 100 older adults residing in eldercare facilities. Nutritional status was evaluated by means of the MNA and three serum indicators (albumin, ferritin, and hemoglobin). Descriptive statistics were used to analyze sociodemographic characteristics, and a Student’s t test, based on gender and reference values, was used to compare mean values of the three serum indicators.  A Chi-square test was used to compare proportions in individuals, based on gender, who had normal nutritional status or were malnourished, and who were at-risk of malnutrition.  A One-way ANOVA with Scheffé post hoc test was used to identify the association between serum indicators and nutritional status of older adults. Of the 100 older adults studied, 53% were men and 47% were women. The mean age was 85±0.7 years. According to the MNA, 20% had normal nutritional status, 55% were at-risk of malnutrition, and 25% were malnourished. The mean indicator values were: albumin 4.7±0.04 g/dL, ferritin 74.2±8.7 ng/mL, and hemoglobin 13.0±0.1 g/dL. No significant association was found between serum indicators and each MNA classification; however, when the same indicators were compared between the sexes, hemoglobin showed a significant difference (P=0.037). Women had lower values but those values did not extend beyond the established physiological range for this population. There was a 55% prevalence of risk of malnutrition in the nutritional status of older adults living in Mexican eldercare facilities in a Mexican province and it was even more frequent in women. 


Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2407
Author(s):  
Konstantinos Gkiouras ◽  
Stavros Cheristanidis ◽  
Theopoula D. Papailia ◽  
Maria G. Grammatikopoulou ◽  
Nikolaos Karamitsios ◽  
...  

Although food insecurity has been associated with a disadvantageous socioeconomic status, especially in older adults, its association with comorbidities is less clear. The scope of the present cross-sectional study was to assess the prevalence of food insecurity among older adults and evaluate the association between food insecurity, malnutrition, chronic disease, multimorbidity and healthcare utilization. A total of 121 older adults (mean (standard deviation) age: 72.6 (8.1)) were recruited from a Primary Care Health Center from 10 August 2019 to 10 September 2019. Food insecurity and malnutrition status were assessed by the Household Food Insecurity Access Scale and Mini Nutritional Assessment tool, respectively. Recorded variables included financial, family data and comorbidities. The prevalence of food insecurity in the sample reached 50.4%, with men and older adults malnourished or at risk for malnutrition, exhibiting high risk for food insecurity. Multimorbidity, frequency of health care utilization and medication adherence were not associated with food insecurity, possibly due to the free health services and remunerated medications offered by the Greek government. However, male gender and malnutrition risk were significant predictors of food insecurity in the multiple logistic analyses. This study highlights the need for mainstreaming food insecurity assessment among older adults with comorbidities, especially those at risk for malnutrition.


2021 ◽  
Vol 34 ◽  
Author(s):  
Mariana de Paula SANTANA ◽  
Nadine Motta FIGUEIREDO ◽  
Sergio CHOCIAY JUNIOR ◽  
Tainá Aparecida SILVA ◽  
Rosimeire Aparecida Manoel SEIXAS ◽  
...  

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.


2013 ◽  
Vol 17 (12) ◽  
pp. 2834-2843 ◽  
Author(s):  
Yu Xuan Koo ◽  
Min Li Kang ◽  
Angie Auyong ◽  
Glen Zq Liau ◽  
Jeremy Hoe ◽  
...  

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.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 295-295
Author(s):  
Sunghwan Cho ◽  
Kyuhyung Chung

Abstract Depression increases suicidal risk lowers quality of life in older adults. However, it is unknown how loneliness and depression are associated with young-old and old-older adults. This study examined association of loneliness and depression from the National Social Life, Health, and Aging Project (NSHAP) (2015-2016), estimating moderating effects of social support. The sample of this study was community dwelling Medicare beneficiaries aged 65+ (n=1,532): young-older adults (n=903) and old-older adults (n=629). Loneliness was measured by the Revised University of California, Los Angeles Loneliness Scale short form (3 items; young, M=.86, SD=.73; old, M=.87, SD=.67; range 0-3). Social support consists of two variables each measured by 4 items, spouse/partner support (young, M=2.29, SD=.50; old, M=2.26, SD=.51; range 0-3) and family support (young-old, M=2.19, SD=.52; old-old, M=2.23, SD=.52; range 0-3). Depression was measured by Center for Epidemiological Studies Depression scale (11 items, young, M=1.41, SD=.42; old, M=1.45, SD=.42; range 1-4). Multiple linear regression was used in this study, including relevant covariates. Findings indicated loneliness in both groups (young, p&lt;.001; old, p&lt;.001), spouse support in both groups (young, p&lt;.001; old, p&lt;.001) had statistical significance in depression. Family support in young-older adults (p&lt;.05) had a statistical significance for depression. Interaction of loneliness and spouse support moderated the relationship between loneliness and depression in old-older adults (p&lt;.05). Findings suggest old-older adults’ loneliness and depression could be soothed by spousal support. Spousal support could be important in that the informal caregiver is likely to focus on older adults with fragility at the end of their lives.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S392-S392
Author(s):  
Rose Ann DiMaria-Ghalili ◽  
Sarah Charbonneau ◽  
Keyanna Bynum ◽  
Michael Neidrauer ◽  
Michael S Weingarten ◽  
...  

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.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Teresa Madeira ◽  
Catarina Peixoto-Plácido ◽  
Nuno Sousa-Santos ◽  
Nuno Mendonça ◽  
Osvaldo Santos ◽  
...  

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.


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