Cross-Country Differences and Similarities in Undernutrition Prevalence and Risk as Measured by SCREEN II in Community-Dwelling Older Adults

Undernutrition is highly prevalent among community-dwelling older adults. Early identification of nutrition risk is important to prevent or treat undernutrition. This study describes the prevalence rates of nutrition risk in community-dwelling older adults (aged ≥ 65) using the same validated tool across different countries and aims to identify differences in nutritional risk factors. Cross-sectional data was obtained from three datasets including participants from the Netherlands (NL), Canada (CA) and New Zealand (NZ). Seniors in the Community Risk Evaluation for Eating and Nutrition II (SCREEN II) was used to assess nutritional risk factors and prevalence of risk. Differences between countries were tested with logistic and linear regression. Sensitivity analyses were conducted to test the influence of sampling strategy. A total of 13,340 participants were included, and 66.3% were found to be at high nutrition risk. After stratifying the data for method of data sampling, prevalence rates showed some differences across countries (NL: 61.5%, NZ: 68.2%, CA: 70.1%). Risk factor items that contributed to nutrition risk also differed among countries: NZ and CA participants scored higher for weight change, skipping meals, problems with meal preparation, use of meal replacements, problems with biting and chewing, low fluid intake and problems with doing groceries, as compared to participants in NL. Low intake of fruits and vegetables and meat were more prevalent in NL. In conclusion: nutrition risk is a worldwide, highly prevalent problem among community-dwelling older adults, but risk factors contributing to nutrition risk differ by country.

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Polish Translation and Validation of the Mini Sarcopenia Risk Assessment (MSRA) Questionnaire to Assess Nutritional and Non-Nutritional Risk Factors of Sarcopenia in Older Adults

Nutrients ◽

10.3390/nu13041061 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1061

Author(s):

Roma Krzymińska-Siemaszko ◽

Ewa Deskur-Śmielecka ◽

Arkadiusz Styszyński ◽

Katarzyna Wieczorowska-Tobis

Keyword(s):

Risk Factors ◽

Older Adults ◽

Risk Assessment ◽

Predictive Value ◽

High Sensitivity ◽

Community Dwelling ◽

Nutritional Risk ◽

Polish Language ◽

Community Dwelling Older Adults ◽

Translation And Validation

A simple, short, cheap, and reasonably sensitive and specific screening tool assessing both nutritional and non-nutritional risk factors for sarcopenia is needed. Potentially, such a tool may be the Mini Sarcopenia Risk Assessment (MSRA) Questionnaire, which is available in a seven-item (MSRA-7) and five-item (MSRA-5) version. The study’s aim was Polish translation and validation of both MSRA versions in 160 volunteers aged ≥60 years. MSRA was validated against the six sets of international diagnostic criteria for sarcopenia used as the reference standards. PL-MSRA-7 and PL-MSRA-5 both had high sensitivity (≥84.9%), regardless of the reference standard. The PL-MSRA-5 had better specificity (44.7–47.2%) than the PL-MSRA-7 (33.1–34.7%). Both questionnaires had similarly low positive predictive value (PL-MSRA-5: 17.9–29.5%; PL-MSRA-7: 14.4–25.2%). The negative predictive value was generally high for both questionnaires (PL-MSRA-7: 89.8–95.9%; PL-MSRA-5: 92.3–98.5%). PL-MSRA-5 had higher accuracy than the PL-MSRA-7 (50.0–55% vs. 39.4–45%, respectively). Based on the results, the Mini Sarcopenia Risk Assessment questionnaire was successfully adopted to the Polish language and validated in community-dwelling older adults from Poland. When compared with PL-MSRA-7, PL-MSRA-5 is a better tool for sarcopenia risk assessment.

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Prevalence and Determinants of Undernutrition in A Sample of Dutch Community-Dwelling Older Adults: Results from Two Online Screening Tools

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16091562 ◽

2019 ◽

Vol 16 (9) ◽

pp. 1562 ◽

Cited By ~ 5

Author(s):

Jos W. Borkent ◽

Elke Naumann ◽

Emmelyne Vasse ◽

Ellen van der Heijden ◽

Marian A. E. de van der Schueren

Keyword(s):

Risk Factors ◽

Older Adults ◽

Healthy Aging ◽

General Information ◽

Community Dwelling ◽

Screening Tools ◽

Nutritional Risk ◽

Cross Sectional ◽

Increased Risk ◽

Screen Ii

To stimulate undernutrition screening among Dutch community-dwelling adults, a website was developed with general information on healthy eating for healthy aging and self-tests. Based on cross-sectional data obtained from the self-tests, we studied nutritional risk factors (early determinants) as well as risk of undernutrition (late symptoms). SCREEN II (n = 2470) was used to asses nutritional risk factors. This tool consists of 16 items regarding nutritional intake, perception of body weight, appetite, oral health and meal preparation. An adjusted SNAQ65+ (n = 687) was used to assess risk of undernutrition. This four-item tool contains questions on weight loss, appetite, walking stairs and body mass index. Differences between age-groups (65–74, 75–84, ≥85) were tested by logistic regression. Overall prevalence of nutritional risk factors was 84.1%, and increased risk of undernutrition was 56.8%. Participants aged ≥85 scored worst on almost all items of the SCREEN II and the SNAQ65+. In conclusion: A large proportion of older adults reported early determinants for increased nutrition risk, while a smaller, yet remarkable proportion scored positive on undernutrition risk. Internet screening may be a useful, contemporary, and easy, accessible way to reach older adults who are at nutritional risk and may thus contribute to early identification and prevention of undernutrition.

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Characteristics of Nutritionally Vulnerable Community-Dwelling Older Adults Consuming Oral Nutritional Supplements (OR16-08-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz051.or16-08-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Suela Sulo ◽

Linda Schiffer ◽

Patricia Sheean ◽

Isabel Farrar ◽

Jamie Partridge ◽

...

Keyword(s):

Older Adults ◽

Nutritional Supplements ◽

Cross Sectional Study ◽

Community Dwelling ◽

Nutritional Risk ◽

Cross Sectional ◽

Nutrition Risk ◽

Targeted Interventions ◽

Oral Nutritional Supplements ◽

Community Dwelling Older Adults

Abstract Objectives There are limited data on nutrition risk profiles of community-dwelling older adults and their consumption patterns of oral nutritional supplements (ONS). This study assessed the characteristics of nutritionally vulnerable ONS users versus non-ONS users. Methods A cross-sectional study of White, Black and Hispanic community-dwelling adults, ≥55 years of age, residing in Chicago metropolitan area (MSA), USA was conducted over a 4-month period. Demographic characteristics, Katz's activities of daily living (ADL), healthcare resource utilization, and ONS consumption in the last six months were collected via a telephone survey. Nutrition risk was assessed via the abridged Patient Generated Subjective Global Assessment (abPG-SGA) and the DETERMINE checklist. Characteristics of ONS and non-ONS users were compared using t-tests and chi-square tests. A multivariable logistic regression assessed which characteristics were independently associated with ONS use. Results Of 1001 participants surveyed, 996 provided data on ONS use; 26% (n = 261) were classified as ‘high’ nutrition risk, and 11% (n = 114) reported consuming ONS. ONS users reported consuming on average 4.7 bottles/week, with recommendation primarily received from their physician (37%). ONS users were more likely to be at high nutritional risk than non-users per both abPG-SGA (43% vs 24%, P < .001) and DETERMINE (68% vs 48%, P < .001) results. They were less likely to be independent on all ADLs (86% vs 92%, P = .03), reported higher healthcare utilization, and were more likely to take ≥3 drugs/day (77% vs 53%, P < .001). Higher nutritional risk (per abPG-SGA), lower body mass index, hospitalization in past 6 months, and taking ≥3 drugs/day were significantly (P < .05) associated with ONS use. Conclusions Although one in four older community-dwellers living in the Chicago MSA were at high nutrition risk, only 11% of them reported consuming ONS. Older adults are more likely to consume ONS and experience poor health outcomes and polypharmacy. These results suggest that identification of nutrition risk among community-dwelling older adults remains unaddressed and may not result in nutrition interventions. Improved identification of nutrition risk and implementation of targeted interventions with ONS is warranted for older community-dwelling adults. Funding Sources Abbott, Columbus, OH, USA.

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SUN-P043: Nutrition Risk Factors Associated with Malnutrition in Community-Dwelling Older Adults

Clinical Nutrition ◽

10.1016/s0261-5614(17)30583-6 ◽

2017 ◽

Vol 36 ◽

pp. S68-S69

Author(s):

A. van Amerongen ◽

I. Zwinkels ◽

S. van den Berghe ◽

M.H. de Groot ◽

J.A.E. Langius

Keyword(s):

Risk Factors ◽

Older Adults ◽

Community Dwelling ◽

Nutrition Risk ◽

Factors Associated ◽

Community Dwelling Older Adults

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Diagnostic Power of Circulatory Metabolic Biomarkers as Metabolic Syndrome Risk Predictors in Community-Dwelling Older Adults in Northwest of England (A Feasibility Study)

Nutrients ◽

10.3390/nu13072275 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2275

Author(s):

Razieh Hassannejad ◽

Hamsa Sharrouf ◽

Fahimeh Haghighatdoost ◽

Ben Kirk ◽

Farzad Amirabdollahian

Keyword(s):

Risk Factors ◽

Older Adults ◽

Metabolic Syndrome ◽

Roc Analysis ◽

Cross Validation ◽

Community Dwelling ◽

Tnf Α ◽

Diagnostic Power ◽

Metabolic Biomarkers ◽

Community Dwelling Older Adults

Background: Metabolic Syndrome (MetS) is a cluster of risk factors for diabetes and cardiovascular diseases with pathophysiology strongly linked to aging. A range of circulatory metabolic biomarkers such as inflammatory adipokines have been associated with MetS; however, the diagnostic power of these markers as MetS risk correlates in elderly has yet to be elucidated. This cross-sectional study investigated the diagnostic power of circulatory metabolic biomarkers as MetS risk correlates in older adults. Methods: Hundred community dwelling older adults (mean age: 68.7 years) were recruited in a study, where their blood pressure, body composition and Pulse Wave Velocity (PWV) were measured; and their fasting capillary and venous blood were collected. The components of the MetS; and the serum concentrations of Interleukin-6 (IL-6), Tumor Necrosis Factor-α (TNF-α), Plasminogen Activator Inhibitor-I (PAI-I), Leptin, Adiponectin, Resistin, Cystatin-C, C-Reactive Protein (CRP), insulin and ferritin were measured within the laboratory, and the HOMA1-IR and Atherogenic Index of Plasma (AIP) were calculated. Results: Apart from other markers which were related with some cardiometabolic (CM) risk, after Bonferroni correction insulin had significant association with all components of Mets and AIP. These associations also remained significant in multivariate regression. The multivariate odds ratio (OR with 95% confidence interval (CI)) showed a statistically significant association between IL-6 (OR: 1.32 (1.06–1.64)), TNF-α (OR: 1.37 (1.02–1.84)), Resistin (OR: 1.27 (1.04–1.54)) and CRP (OR: 1.29 (1.09–1.54)) with MetS risk; however, these associations were not found when the model was adjusted for age, dietary intake and adiposity. In unadjusted models, insulin was consistently statistically associated with at least two CM risk factors (OR: 1.33 (1.16–1.53)) and MetS risk (OR: 1.24 (1.12–1.37)) and in adjusted models it was found to be associated with at least two CM risk factors and MetS risk (OR: 1.87 (1.24–2.83) and OR: 1.25 (1.09–1.43)) respectively. Area under curve (AUC) for receiver operating characteristics (ROC) demonstrated a good discriminatory diagnostics power of insulin with AUC: 0.775 (0.683–0.866) and 0.785 by cross validation and bootstrapping samples for at least two CM risk factors and AUC: 0.773 (0.653–0.893) and 0.783 by cross validation and bootstrapping samples for MetS risk. This was superior to all other AUC reported from the ROC analysis of other biomarkers. Area under precision-recall curve for insulin was also superior to all other markers (0.839 and 0.586 for at least two CM risk factors and MetS, respectively). Conclusion: Fasting serum insulin concentration was statistically linked with MetS and its risk, and this link is stronger than all other biomarkers. Our ROC analysis confirmed the discriminatory diagnostic power of insulin as CM and MetS risk correlate in older adults.

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Harnessing Stakeholder Perspectives and Experience to Address Nutrition Risk in Community-Dwelling Older Adults

Healthcare ◽

10.3390/healthcare9040477 ◽

2021 ◽

Vol 9 (4) ◽

pp. 477

Author(s):

Catherine B. Chan ◽

Naomi Popeski ◽

Leah Gramlich ◽

Marlis Atkins ◽

Carlota Basualdo-Hammond ◽

...

Keyword(s):

Older Adults ◽

Design Thinking ◽

Healthcare Providers ◽

Community Organizations ◽

Community Dwelling ◽

Nutrition Risk ◽

Intersectoral Cooperation ◽

Stakeholder Perspectives ◽

Patient Representatives ◽

Community Dwelling Older Adults

Community-dwelling, older adults have a high prevalence of nutrition risk but strategies to mitigate this risk are not routinely implemented. Our objective was to identify opportunities for the healthcare system and community organizations to combat nutrition risk in this population in the jurisdiction of Alberta, Canada. An intersectoral stakeholder group that included patient representatives was convened to share perspectives and experiences and to identify problems in need of solutions using a design thinking approach. Results: Two main themes emerged from the workshop: (1) lack of awareness and poor communication of the importance of nutrition risk between healthcare providers and from healthcare providers to patients and (2) the necessity to work in partnerships comprised of patients, community organizations, healthcare providers and the health system. Conclusion: Improving awareness, prevention and treatment of malnutrition in community-dwelling older adults requires intersectoral cooperation between patients, healthcare providers and community-based organizations.

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Risk Factors for Mobility Limitation in Community-Dwelling Older Adults: A Social Ecological Perspective

Geriatric Nursing ◽

10.1016/j.gerinurse.2007.07.002 ◽

2008 ◽

Vol 29 (2) ◽

pp. 133-140 ◽

Cited By ~ 72

Author(s):

Hye A. Yeom ◽

Julie Fleury ◽

Colleen Keller

Keyword(s):

Risk Factors ◽

Older Adults ◽

Community Dwelling ◽

Mobility Limitation ◽

Ecological Perspective ◽

Social Ecological ◽

Community Dwelling Older Adults

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10-Year Renal Function Trajectories in Community-Dwelling Older Adults: Exploring the Risk Factors for Different Patterns

Journal of Clinical Medicine ◽

10.3390/jcm7100373 ◽

2018 ◽

Vol 7 (10) ◽

pp. 373

Author(s):

Chia-Ter Chao ◽

Yung-Ming Chen ◽

Fu-Hui Ho ◽

Kun-Pei Lin ◽

Jen-Hau Chen ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Logistic Regression ◽

Renal Function ◽

Estimated Glomerular Filtration Rate ◽

Community Dwelling ◽

Multivariate Logistic Regression ◽

Improve Risk Stratification ◽

Leukocyte Counts ◽

Community Dwelling Older Adults

Longitudinal changes of renal function help inform patients’ clinical courses and improve risk stratification. Rare studies address risk factors predicting changes in estimated glomerular filtration rate (eGFR) over time in older adults, particularly of Chinese ethnicity. We identified prospectively enrolled community-dwelling older adults (≥65 years) receiving annual health examinations between 2005 and 2015 with serum creatinine available continuously in a single institute, and used linear regression to derive individual’s annual eGFR changes, followed by multivariate logistic regression analyses to identify features associated with different eGFR change patterns. Among 500 elderly (71.3 ± 4.2 years), their mean annual eGFR changes were 0.84 ± 1.67 mL/min/1.73 m2/year, with 136 (27.2%) and 238 (47.6%) classified as having downward (annual eGFR change <0 mL/min/1.73 m2/year) and upward eGFR (≥1 mL/min/1.73 m2/year) trajectories, respectively. Multivariate logistic regression showed that higher age (odds ratio (OR) 1.08), worse renal function (OR 13.2), and more severe proteinuria (OR 9.86) or hematuria (OR 3.39) were predictive of a declining eGFR while greater waist circumference (OR 1.06) and higher leukocyte counts (OR 1.21) were predictive of an uprising 10-year eGFR. These findings elucidate important features associated with geriatric renal function variations, which are expected to improve their renal care.

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Prevalence and Multidimensional Risk Factors of Physical Frailty in Korean Community-Dwelling Older Adults: Findings from Korean Frailty and Aging Cohort Study

10.20944/preprints202009.0423.v1 ◽

2020 ◽

Author(s):

Heeeun Jung ◽

Miji Kim ◽

Yunhwan Lee ◽

Chang Won Won

Keyword(s):

Risk Factors ◽

Older Adults ◽

Cohort Study ◽

Medical Condition ◽

Glycosylated Hemoglobin ◽

Community Dwelling ◽

National Standard ◽

Timed Up And Go ◽

Frailty Phenotype ◽

Community Dwelling Older Adults

Frailty is defined as a state of increased vulnerability to stressors, and it predicts the disability and mortality in the older population. This study aimed to investigate standardized prevalence and multidimensional risk factors associated with frailty among the Korean community-dwelling older adults. We analyzed the baseline data of 2,907 adults aged 70–84 years (mean age 75.8±3.9 years, 57.8% women) in the Korean Frailty and Aging Cohort Study. The Fried frailty phenotype was used to define frailty. Analyzed data included sociodemographic, physical, physical function, biological, lifestyle, health condition, medical condition, psychological, and social domains. Data were standardized using the national standard population composition ratio based on the Korean Population and Housing Census. The standardized prevalence of frailty and pre-frailty was 7.9% (95% confidence interval [CI] 6.8–8.9%) and 57.2% (95% CI 45.1–48.8%), respectively. The following 14 risk factors had a significant association with frailty: at risk of malnutrition, sarcopenia, severe mobility limitation, poor social capital, rural dwellers, depressive, poor self-perceived health, polypharmacy, elevated high-sensitivity C-reactive protein, elevated glycosylated hemoglobin, low 25-hydroxy vitamin D level, longer timed up and go, and low short physical performance battery score (p<0.05). Physico-nutritional, psychological, sociodemographic, and medical factors are strongly associated with frailty.

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