Changes in Nutritional Status and Musculoskeletal Health in a Geriatric Post-Fall Care Plan Setting

Understanding how changes in nutritional status influence musculoskeletal recovery after falling remains unclear. We explored associations between changes in nutritional status and musculoskeletal health in 106 community-dwelling older adults aged ≥65 years, who attended the Falls and Fractures Clinic at Sunshine Hospital in St Albans, Australia after falling. At baseline and after 6 months, individuals were assessed for Mini Nutritional Assessment (MNA®), grip strength, gait speed, Timed Up and Go (TUG) test, Short Physical Performance Battery (SPPB), and bone turnover marker levels. Associations were examined using multiple linear regression, adjusted for baseline covariates and post-fall care plans. Over 6 months, the prevalence of malnutrition or risk thereof decreased from 29% to 15% using MNA <24/30. Specifically, 20 individuals (19%) improved, 7 (7%) deteriorated, and 73 (69%) maintained nutritional status, including 65 (61%) who remained well-nourished and 8 (8%) who remained malnourished/at risk. A 1-point increase in MNA score over 6 months was associated with an increase of 0.20 points (95% confidence interval 0.10, 0.31, p < 0.001) in SPPB score. Improvement in nutritional status was associated with improvement in physical performance, providing a basis for interventional studies to ascertain causality and evaluate nutritional models of care for post-fall functional recovery in older adults.

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Malnutrition in older adults on financial assistance in an urban Asian country: a mixed methods study

Public Health Nutrition ◽

10.1017/s1368980013002413 ◽

2013 ◽

Vol 17 (12) ◽

pp. 2834-2843 ◽

Cited By ~ 6

Author(s):

Yu Xuan Koo ◽

Min Li Kang ◽

Angie Auyong ◽

Glen Zq Liau ◽

Jeremy Hoe ◽

...

Keyword(s):

Older Adults ◽

At Risk ◽

Nutritional Status ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Community Dwelling ◽

Food Services ◽

Adequate Nutrition ◽

Depression Risk ◽

Co Morbidity

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.

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Malnutrition and obesity in community-dwelling older adults: concomitant conditions? (PEN-3S study)

Proceedings of The Nutrition Society ◽

10.1017/s002966512000556x ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Teresa Madeira ◽

Catarina Peixoto-Plácido ◽

Nuno Sousa-Santos ◽

Nuno Mendonça ◽

Osvaldo Santos ◽

...

Keyword(s):

Older Adults ◽

At Risk ◽

Nutritional Status ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Community Dwelling ◽

Screening Tools ◽

World Health ◽

Anthropometric Measures ◽

Community Dwelling Older Adults

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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Associations Between Dentition Status and Nutritional Status in Community-Dwelling Older Adults

Current Developments in Nutrition ◽

10.1093/cdn/nzab033_019 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 19-19

Author(s):

Samantha Honeywell ◽

Hamed Samavat ◽

EIleen Hoskin ◽

Riva E. Touger-Decker ◽

Rena Zelig

Keyword(s):

Older Adults ◽

At Risk ◽

Nutritional Status ◽

Tooth Loss ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

The United States ◽

Community Dwelling ◽

Future Research ◽

Functional Dentition

Abstract Objectives Older adults in the United States are at greater risk for tooth loss and malnutrition than those younger than 65 years. Prior research regarding associations between dentition status and nutritional status in older adults is heterogeneous. The primary aim of this study was to explore associations between dentition status and nutritional status in older adults. Methods This was a retrospective, cross-sectional study of data from older adults (65–89 years) who received care at the Rutgers School of Dental Medicine clinics between June 1, 2015 and June 1, 2020. Nutritional status was determined using Self Mini Nutritional Assessment (Self-MNA). Records were included if they had complete odontogram and Self-MNA data. Spearman rank correlation was performed to analyze the relationships between Self-MNA scores and number of teeth. Chi-square, Fisher's Exact, and Kruskal-Wallis tests were used to examine the associations between nutritional status category, number of remaining teeth categories, and presence of functional dentition defined as ≥21 teeth. Results Of the 305 records available, 53.8% were female. The median Self-MNA score was 13, indicative of normal nutritional status; 93.1% of the sample had some tooth loss (mean ± SD = 16.7 ± 8.8 teeth). Those who were at risk for or who had malnutrition had fewer teeth (P = 0.02) than those with normal nutritional status. Those with 20–28 teeth or functional dentition were significantly more likely to be of normal nutritional status (P = 0.02 and P = 0.03, respectively) than to be at risk of or have malnutrition, compared to those with fewer teeth. Those with fewer than 20 teeth had significantly lower Self-MNA scores than those with 20 or more teeth (P = 0.02). Conclusions Older adults who were at risk of or who had malnutrition had fewer teeth than those with normal nutritional status. Those with functional dentition were more likely to have a normal nutritional status than those without functional dentition. Future research in larger more diverse samples is needed to better understand the associations between dentition status and nutritional status. Funding Sources None

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DENTITION AND MALNUTRITION RISK IN COMMUNITYDWELLING OLDER ADULTS

Journal of Aging Research and Lifestyle ◽

10.14283/jarcp.2018.19 ◽

2018 ◽

pp. 1-8

Author(s):

R. Zelig ◽

L. Byham-Gray ◽

S.R. Singer ◽

E.R. Hoskin ◽

A. Fleisch Marcus ◽

...

Keyword(s):

Older Adults ◽

At Risk ◽

Nutritional Status ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Community Dwelling ◽

Nutrition Status ◽

Cross Sectional ◽

Increased Risk ◽

The Impact

Background and Objective: Older adults are at risk for both impaired oral health and suboptimal nutritional status. The objective of this study was to explore the relationships between malnutrition risk and missing teeth in community-dwelling older adults. Design: This was a retrospective cross-sectional analysis of data obtained from the electronic health records of 107 patients aged 65 and older who attended an urban northeast US dental school clinic between June 1, 2015 and July 15, 2016. Odontograms and radiographs were used to identify teeth numbers and locations; malnutrition risk was calculated using the Self-Mini Nutritional Assessment (Self-MNA). Relationships between numbers of teeth and malnutrition risk were assessed using bivariate logistic regression. Results: Participants (N=107) were 72.6 years (SD=5.6) of age; 50.5% were female. Mean Self-MNA score was 12.3 (SD=2.0) reflective of normal nutrition status; 20.6% were at risk for malnutrition, 4.7% were malnourished. Greater than 87% were partially or completely edentulous. Those with 10-19 teeth had lower Self-MNA scores (mean=11.6, SD=2.5) than those with 0-9 teeth (mean=12.7, SD=1.3) or 20 or more teeth (mean=12.6, SD=1.8) and had an increased risk for malnutrition (OR=2.5, p=0.076). Conclusion: The majority of this sample of older adults were partially edentulous and of normal nutritional status. Those with 10-19 teeth were more likely to be at risk for malnutrition. Further studies are needed to examine relationships between tooth loss and malnutrition risk and the impact of impaired dentition on the eating experience in a larger sample and to inform clinical practice.

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The Nutritional Status of Long-Term Institutionalized Older Adults Is Associated with Functional Status, Physical Performance and Activity, and Frailty

Nutrients ◽

10.3390/nu13113716 ◽

2021 ◽

Vol 13 (11) ◽

pp. 3716

Author(s):

Itxaso Mugica-Errazquin ◽

Idoia Zarrazquin ◽

Jesús Seco-Calvo ◽

Javier Gil-Goikouria ◽

Ana Rodriguez-Larrad ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Nutritional Status ◽

Functional Status ◽

Physical Performance ◽

Barthel Index ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Multiple Linear Regression Model

Among older adults living in long-term nursing homes (LTNHs), maintaining an adequate functional status and independence is a challenge. Whilst a poor nutritional status is a potential risk factor for a decreased function in this population, its role is not fully understood. Here, using a transversal multicenter study of 105 older adults living in 13 LTNHs, we analyzed the associations between nutritional status, as measured by the Mini Nutritional Assessment (MNA), and the parameters of functional status, physical performance, physical activity, and frailty as well as comorbidity and body composition. The MNA scores were positively correlated with the Barthel Index, handgrip strength, Short Physical Performance Battery (SPPB) scores, absolute muscle power, and Assessment of Physical Activity in Frail Older People (APAFOP) scores and were negatively correlated with dynamic balance and frailty. In a multiple linear regression model controlling for gender and age, the APAFOP score (β = 0.386), BMI (β = 0.301), and Barthel Index (β = 0.220) explained 31% of the variance in the MNA score. Given the observed close relationship between the MNA score and functional status, physical performance and activity, and frailty, interventions should jointly target improvements in both the nutritional status and functional status of LTNH residents. Strategies designed and implemented by interdisciplinary professional teams may be the most successful in improving these parameters to lead to better health and quality of life.

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Use of Mini Nutritional Assessment (MNA®) as a Nutritional Screening Tool among Urban Older Adults in Pasay City, Philippines

Acta Medica Philippina ◽

10.47895/amp.v52i3.403 ◽

2018 ◽

Vol 52 (3) ◽

Author(s):

Ernani R. Bullecer ◽

Maribel M. Develos

Keyword(s):

Older Adults ◽

Body Mass Index ◽

At Risk ◽

Nutritional Status ◽

Body Mass ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Community Dwelling ◽

Urban Setting ◽

Full Form

Objective. This study has been conducted to determine the prevalence of malnutrition and nutritionally-at-risk community-dwelling older adults in an urban setting through the use of Mini Nutritional Assessment (MNA®). Methods. A cross-sectional survey was done among older adults in Barangay Sto. Niño, an urban poor community in Pasay City, Metro Manila to determine the prevalence of malnutrition and older adults using the short and full form of the Mini Nutritional Assessment (MNA®). Anthropometric assessment was done to determine body mass index as well as physical examination to determine presence of nutrient deficiencies. Results. Using the Asia Pacific cut-off for BMI, it can be noted that 16.5% were classified as underweight. On the other hand, results of the MNA® short form screening showed that less than half (42.6%) of the study respondents have normal nutritional status. Majority of the respondents were either malnourished (14.8%) or at risk of malnutrition (42.6%). Moreover, results of the Full MNA® form showed that almost half of the study respondents were either malnourished (8.2%) or at risk of malnutrition (39.3%). The rest of the study respondents were classified as having normal nutritional status (52.5%). Conclusion. As compared to Body Mass Index, which can only identify prevalence of malnutrition, the MNA®, both short and full form, was not only able to identify malnourished and nutritionally-at-risk older adult as well as provide variables that may screen for possible causes of malnutrition. This is necessary and relevant for timely nutrition intervention for improved nutritional outcome among older adults.

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Predictors of nutritional status among community-dwelling older adults in Wuhan, China

Public Health Nutrition ◽

10.1017/s1368980008003686 ◽

2009 ◽

Vol 12 (8) ◽

pp. 1189-1196 ◽

Cited By ~ 36

Author(s):

Yanhong Han ◽

Sijian Li ◽

Yanling Zheng

Keyword(s):

Older Adults ◽

Nutritional Status ◽

Marital Status ◽

Functional Status ◽

Nutritional Assessment ◽

Linear Regression Analysis ◽

Mini Nutritional Assessment ◽

Community Dwelling ◽

Related Factors ◽

Convenience Sample

AbstractObjectivesTo examine the nutritional and functional status of community older adults in China, to identify the related factors and best predictors of elder nutrition.Design, setting and subjectsA cross-sectional, descriptive correlation design was utilized. A convenience sample of 162 community older adults (aged ≥65 years) were administered three questionnaires, which were used to obtain demographic characteristics, nutritional status (Mini Nutritional Assessment, MNA) and functional status (Instrumental Activities of Daily Living, IADL).ResultsThe mean MNA score was 23·8 (sd 3·92), 36·4 % of elders were at risk of malnutrition and 8·0 % were malnourished; 61·7 % were functionally independent. Spearman’s correlation analysis indicated that age, marital status, education level, personal income, number of chronic medical conditions suffered and functional status had significant correlations with nutritional status. Stepwise multiple linear regression analysis identified that the best predictors were the number of chronic conditions suffered, age, functional status and marital status.ConclusionsThe study has suggested that nutritional health remains a problem among older adults in the Chinese community. A large proportion was on the borderline of malnutrition, and deficiency as well as excesses coexisted. Malnutrition is an increasing hazard especially for those suffering from more diseases, at a highly advanced age, functionally dependent and widowed.

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Associations between Dentition Status and Nutritional Status in Community-Dwelling Older Adults

JDR Clinical & Translational Research ◽

10.1177/23800844211063859 ◽

2022 ◽

pp. 238008442110638

Author(s):

S. Honeywell ◽

H. Samavat ◽

R. Touger-Decker ◽

J.S. Parrott ◽

E. Hoskin ◽

...

Keyword(s):

Older Adults ◽

At Risk ◽

Nutritional Status ◽

Health Care Professionals ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Community Dwelling ◽

Routine Practice ◽

Lower Odds ◽

Functional Dentition

Background/Objective: Older adults are at higher risk of malnutrition. The aim of this study was to explore associations between nutritional status and dentition status among older adults seeking care in a dental clinic. Methods: This was a cross-sectional study of data from older adults (65–89 y) who received care at a northeastern US urban dental school clinic between June 2015 and June 2020 (N = 305). Clinical and demographic data were obtained from the electronic health record; nutritional status was determined using the Self–Mini Nutritional Assessment (Self-MNA), and odontograms and digital radiography were used to determine dental data. Adjusted multivariable models were used to explore associations between variables. Results: The sample was 53.8% female with a median age of 72.0 y. The median Self-MNA score was 13, reflective of normal nutritional status; 29.5% were at risk of or had malnutrition. Median numbers of teeth and posterior and anterior occluding pairs of teeth (POP, AOP) were 18.0, 2.0, and 5.0, respectively. Those with normal nutritional status had significantly more teeth, POPs, and AOPs than those at risk of or with malnutrition (P = 0.015, P = 0.015, and P = 0.039, respectively). Every additional unit increase in the number of natural or restored teeth or POP was associated with significantly lower odds of being at risk of or with malnutrition (3% and 13%, respectively). Having functional dentition was associated with 46% lower odds of being at risk of or with malnutrition. Conclusion: This study demonstrated that older adults who had more teeth, better occlusion, and functional dentition were more likely to be of normal nutritional status than those who had less teeth, had poorer occlusion, and lacked functional dentition. Further research with larger, more diverse samples and varied measures of dentition are needed to better understand the associations between nutritional status and dentition status. Knowledge Transfer Statement: The findings from this study suggest that older adults with fewer teeth and therefore less efficient occlusion are at higher risk for malnutrition than those with more teeth and better occlusion. Health care professionals should include screening for dentition and malnutrition as part of their routine practice to identify patients who may have tooth loss and be at risk of malnutrition and refer them accordingly for interventions to optimize oral health and nutritional status.

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Denture Wearing and Malnutrition Risk Among Community-Dwelling Older Adults

Nutrients ◽

10.3390/nu12010151 ◽

2020 ◽

Vol 12 (1) ◽

pp. 151 ◽

Cited By ~ 2

Author(s):

Ya Su ◽

Michiko Yuki ◽

Kengo Hirayama ◽

Miho Sato ◽

Tianfang Han

Keyword(s):

Older Adults ◽

Nutritional Status ◽

Nutritional Assessment ◽

Short Form ◽

Mini Nutritional Assessment ◽

Bioelectrical Impedance ◽

Impedance Analysis ◽

The Elderly ◽

Community Dwelling ◽

Partial Denture

Most studies have associated denture wearing with a higher risk of malnutrition and lower nutritional intake in the elderly. As the effect of wearing dentures remains debatable, the aim of this study was to determine if older adults wearing dentures have a higher risk of malnutrition. We recruited 294 Japanese community-dwelling adults aged ≥65 years from two elderly welfare centers in Sapporo. The Mini Nutritional Assessment-Short Form (MNA-SF) was used to assess their nutritional status. Their demographic characteristics, eating habits, and health status were assessed using a questionnaire. Moreover, salt-impregnated taste paper and bioelectrical impedance analysis were used to obtain salt taste sensitivity and body composition (body mass index and protein mass). The mean age of older adults was 75.8 ± 5.8 years and 71.1% were women. We found that 74.1% of the older adults wore dentures. The proportion of the whole population with a risk of malnutrition was 23.5%. Multivariate analysis revealed that partial denture wearing could be protective against the risk of malnutrition. In this study, we found more partial denture wearers with normal nutritional conditions and cooking by themselves than non-denture-wearing older adults. Furthermore, complete denture wearers were eating significantly less meats or fish every day. This study suggests that using partial dentures to replace the lost teeth to meet the dietary needs of the elderly is critical to maintaining a healthy nutritional status. Moreover, it also indicates the importance of providing education to older adults who wear complete dentures.

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Food Services Using Energy- and Protein-Fortified Meals to Assist Vulnerable Community-Residing Older Adults Meet Their Dietary Requirements and Maintain Good Health and Quality of Life: Findings from a Pilot Study

Geriatrics ◽

10.3390/geriatrics3030060 ◽

2018 ◽

Vol 3 (3) ◽

pp. 60 ◽

Cited By ~ 1

Author(s):

Tony Arjuna ◽

Michelle Miller ◽

Tomoko Ueno ◽

Renuka Visvanathan ◽

Kylie Lange ◽

...

Keyword(s):

Older Adults ◽

Nutritional Status ◽

G Protein ◽

Protein Intake ◽

Nutritional Assessment ◽

Food Service ◽

Mini Nutritional Assessment ◽

Good Health ◽

Control Group ◽

Fortified Food

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.

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