scholarly journals Malnutrition and Food Insecurity Might Pose a Double Burden for Older Adults

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.

2015 ◽  
Vol 28 (3) ◽  
pp. 231-240 ◽  
Author(s):  
Ana Luísa Moreira dos Santos ◽  
Teresa Maria de Serpa Pinto Freitas do Amaral ◽  
Nuno Pedro Garcia Fernandes Bento Borges

OBJECTIVE: To evaluate the prevalence of undernutrition in older adults aged >75 years living in communities and to identify the main factors independently associated with undernutrition. METHODS: A cross-sectional study was conducted using a random sample of family physicians' medical records of 86 older adults aged >75 years living in the community studied. Their nutritional status was evaluated using the Mini Nutritional Assessment. RESULTS: A total of 10.5% of the elderly were undernourished and 41.9% were at undernutrition risk. According to the logistic regression multivariable model, the following characteristics: being widowed (OR=6.7; 95%CI=1.8-24.6); being institutionalized (OR=12.6; 95%CI=1.7-90.5); or having a negative self-perception of health (OR=15.0; 95%CI=3.3-69.1) were independently associated with a significant increase of undernutrition risk. CONCLUSION: The current study shows that undernutrition is highly prevalent in Portuguese older adults aged >75 years living in communities. The major factors independently associated with their undernutrition are being widowed and institutionalized and having negative self-perception of health. The results obtained show that undernutrition and its associated factors are very serious problems for older adults and a challenge in their health care.


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. 


2017 ◽  
Vol 20 (4) ◽  
pp. 598-610 ◽  
Author(s):  
Renata Damião ◽  
Álvaro da Silva Santos ◽  
Alicia Matijasevich ◽  
Paulo Rossi Menezes

ABSTRACT: Objective: The aim of this study was to evaluate the prevalence of malnutrition risk and its association with socioeconomic, behavioral, and health characteristics in the community-dwelling elderly. Methods: A cross-sectional study with individuals aged ≥ 60 years. Nutritional status was evaluated using the Mini Nutritional Assessment. Socioeconomic, behavioral, and health information was also collected from all participants. The association between each variable and the risk of malnutrition was calculated and adjusted using Poisson hierarchical regression. Results: The initial sample consisted of 3,101 elderly people, of whom 28.3% (95%CI 25.3 - 31.4%) were at risk of malnutrition. The multivariate analysis showed that the risk of malnutrition was significantly higher in women without formal education, who did not live with a partner, and identified as black-skinned. The risk of malnutrition was twice as high in individuals with no family income as compared to those who earned at least three minimum wages. Smokers were also more likely to be at risk of malnutrition than individuals who had never smoked. Participants suffering from kidney, respiratory or heart disease were at higher risk of malnutrition than those with no history of such illnesses. Conclusion: These findings could be used to help in the development of health policies and in the establishment of adequate programs aimed at reducing the risk of malnutrition in this population.


Author(s):  
D. J. Patil ◽  
M. M. Shindhe

Background: Worldwide the elderly population gradually increasing and that will definitely pose several challenges. Malnutrition is one of the major but neglected problem in elderly. They are at risk of malnutrition due to physical, psychological, social, dietary and environmental risk factors. Malnutrition in elderly is associated with adverse health effects. Hence to study the nutritional status of elderly.Methods: The study was carried out between January 2016- June 2017. 545 elderly were included in the study. Out of the 6 subcentres, 1 subcentre (Uchagaon) was selected by simple random sampling technique and house to house survey was carried out to select eligible elderly participants in the villages of selected subcentre. Data was collected from eligible elderly by using mini nutritional assessment (MNA) tool.Results: Majority of the participants (65.1%) were between the age group of 60-69 years. 55% were females. 23.5% were malnourished, 49% were at risk of malnutrition and 27.5% had normal nutritional status.Conclusions: The present study concluded that majority of the elderly were at risk of malnutrition. There is a need of actions to improve the nutritional status of the elderly.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Aya Ashraf Sayed ◽  
Nayera Samy Mostafa ◽  
Salma Mohamed Samir El Said

Abstract Objectives To screen elderly participants for early Dementia in primary care in Egypt using a newly developed Early Dementia Questionnaire (EDQ) and comparing it with standard assessment tool, Mini Mental State Examination (MMSE). Design A cross-sectional study. Setting and Participants The study included 220 elder adults (both men and women) recruited from a primary healthcare center, the outpatient geriatric clinic at Ain Shams University hospitals and elderly clubs (Community dwelling) in Cairo Governorate, Egypt. Methods A cross-sectional study was conducted on a group of elderly patients using systematic random sampling. Elderly depression was excluded using the Geriatric Depression Scale (GDS). Diagnosed cases of dementia and other mental or psychiatric disorders and illiterate participants were excluded from the study. A face-to-face interview was done using EDQ with the participants to elicit symptoms of early dementia. The participants were then assessed with MMSE using variable cut-off points according to age and educational level. Results Prevalence of dementia among the study participants was 81.4% by EDQ and 19.5% by MMSE. The EDQ demonstrated a sensitivity of 97.7% with specificity of 22.6%. Positive predictive value of EDQ was 23.5% with the negative predictive value of 97.6%. A significant association was found between possible dementia, hypertension, Mini Nutritional Assessment and urinary incontinence. Conclusion The EDQ is more sensitive than MMSE for screening of early dementia.


Author(s):  
Shrivathsa D.N. ◽  
Chandana G. Manglik ◽  
Ranish Deelan Saldanha ◽  
Prajna P. Sharma

Background: The percentage of elderly is growing rapidly worldwide. They are at a risk of malnutrition due to physiological, psychological, social, dietary and environmental factors.The present study was conducted to find the malnourished elderly in the community. The aims and objectives of the study were to evaluate the nutritional status of elderly using Mini Nutritional Assessment (MNA) scales; to evaluate the dietary consumption in terms of total calories and protein intake; to assess the factors associated with the malnutrition; to educate regarding nutritional importance in elderly.Methods: A community based cross-sectional study was conducted among the geriatric population (n=117) in rural Mangaluru using convenient sampling technique. After obtaining oral consent, mini nutritional assessment scale was used and socio-demography was collected. Total screening score of 14 and assessment score of 16 were summed up to get the total assessment score of 30 to determine the person’s nutritional status.Results: Majority (60.6%) of the study population was females and 39.4% were males. 53% population were Muslims and 51% belonged to nuclear family. According to MNA scale, 54 (46.7%) were at risk of malnutrition, 17 (14.5%) were suffering from malnutrition and rest 46 (39.3%) had normal nutritional status. There was a significant correlation of MNA score with BMI.Conclusions: The results suggest that MNA is a useful tool in the identification of elderly at risk of malnutrition. Due to the high prevalence of elderly who were malnourished or at the risk of malnutrition, a more detailed evaluation, regular follow up and dietary intervention is required.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fatemeh Hoseinzadeh-Chahkandak ◽  
Mehran Rahimlou ◽  
Fatemeh Salmani ◽  
Elham Ansarifar ◽  
Mitra Moodi ◽  
...  

Abstract Background Few data are available on the nutritional status of Iranian geriatric population. The present study aimed to determine the nutritional status of older adults’ population in Birjand, East of Iran. Methods The community-based cohort study was performed on older adults population (60 years and older) living in urban and rural areas of Birjand. The mini nutritional assessment (MNA) questionnaire was used to assess nutritional status. Anthropometric and biochemical evaluation were also performed for all of the participants. Results A total of 1417 geriatric person were enrolled in this study, which, most of them were female (51.9 %). According to MNA tool, most of the participants (73.3 %) had normal nutrition (MNA score ≥ 24). Malnourished (MNA score < 17) and at high risk of malnutrition (MNA score: 17- 23.5) were constituted 0.9 % and 25.8 % of the participants, respectively. Marital status, occupation, period of education and family member were associated with nutritional status. Multiple logistic regression showed that with increase of body mass index (BMI) (OR = 0.96), education years (OR = 0.95), hemoglobin (OR = 0.86) and lymphocyte (OR = 0.98), the odds of malnutrition decreased, but with increase of age the odds (1.03) of malnutrition is also elevated. Conclusions MNA could successfully forecast the risk of malnutrition and malnourished people. Sociodemographic factors are associated with the nutritional status.


PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3345 ◽  
Author(s):  
Raimunda Montejano Lozoya ◽  
Nieves Martínez-Alzamora ◽  
Gonzalo Clemente Marín ◽  
Silamani J.A. Guirao-Goris ◽  
Rosa María Ferrer-Diego

Background Various scales have been used to perform a quick and first level nutritional assessment, and the MNA is one of the most used and recommended by experts in the elderly in all areas. This scale has a short form, the MNA-SF, revised and validated in 2009, which has two versions: the BMI-MNA-SF contains the first six items of the full scale including Body Mass Index while the CC-MNA-SF includes Calf Circumference instead of BMI. Objective To evaluate the predictive ability for nutritional status of the two versions of the MNA-SF against the MNA in free-living elderly in the province of Valencia. Methods Cross-sectional study of 660 free-living elderly in the province of Valencia selected in 12 community centres using stratified sampling by blocks. Inclusion criteria: being aged 65 or over, living at home, having functional autonomy, residing in the province of study for more than one year, regularly attending community centres and voluntarily wanting to take part. Results Of the 660 subjects studied, 319 were men (48.3%) and 341 (51.7%) women with a mean age of 74.3 years (SD = 6.6). In terms of nutritional assessment, using the BMI-MNA-SF and the CC-MNA-SF we found that 26.5% and 26.2% were at risk of malnutrition and 0.9% and 1.5% were malnourished respectively. With the full MNA, 23.3% were at risk of malnutrition. Spearman’s rank correlation coefficients indicate a high association between the full MNA score and the MNA-SFs scores (BMI-MNA-SF: ρ = 0.78p < 0.001; CC-MNA-SF: ρ = 0.78p < 0.001). In addition we obtained a very high correlation between the two MNA-SFs (ρ = 0.96p < 0.001). We evaluated the agreement between the full MNA and the MNA-SFs classification in three nutritional categories (normal nutritional status, risk of malnutrition, malnutrition) with Cohen’s kappa coefficients (BMI-MNA-SF: κ = 0.54p < 0.001; CC-MNA-SF: κ = 0.52p < 0.001). These values indicate moderate agreement with the full MNA. There is very good agreement between the BMI-MNA-SF and CC-MNA-SF (κ = 0.88p < 0.001). In order to determine the ability of both MNA-SFs to identify subjects not requiring any nutritional intervention, we considered the dichotomised categorisation of the full MNA and the MNA-SFs as “normal nutritional status” vs. “malnutrition and risk of malnutrition” Areas under the ROC curves using MNA as the gold standard indicate moderately high prognostic accuracy (BMI-MNA-SF: AUC = 0.88p < 0.001; CC-MNA-SF: AUC = 0.87 p < 0.001). Both versions of the MNA-SF showed similar sensitivity, specificity and diagnostic effectiveness (BMI-MNA-SF: 73.4%, 86.6%, 83.5%; CC-MNA-SF 73.4%, 86.2%, 83.2%). Conclusions In its two versions the MNA-SF presents useful predictive ability against the MNA. The advantage of the CC-MNA-SF is that using it requires fewer resources and less time in primary care, although always the characteristics of the population must take into account to make the right decision based on the MNA-SF scales.


Author(s):  
Jacob Abraham ◽  
Navaneetha N. ◽  
Felix Johns ◽  
Rajalakshmy Aiyappan ◽  
Mili M. ◽  
...  

Background: India is said to be shifting from an undernourished to over nourished population with advances in health, economy and medical care. But there is paucity of information regarding nutritional status of older adults in the country, who are socially and economically insecure. Hence the present study attempts to assess the nutritional status of people above 60 years of age, and to find the factors associated with it.Methods: A cross sectional study was conducted among 129 people aged above 60 years, residing in Pathanamthitta district, Kerala. Mini Nutritional Assessment tool (MNA) was used to classify the respondents as having ‘normal nutrition’ (score 23.5 and above), ‘at risk of malnutrition’ (17-23.5), ‘malnourished’ (<17). A 24-hour dietary recall was done to calculate per day calorie intake and compare with Recommended Daily Allowance (RDA). The results were interpreted as adequate or deficient. Descriptive statistics, chi-square and spearman’s correlation were done to find relationship between various sociodemographic variables, MNA status, BMI and calorie intake.Results: Females constituted 75.2%; 81.4% were unemployed; 62% belonged to rural area. Nutritional assessment showed 41.9% to be having normal nutrition, 46.5% at risk of malnutrition, and 11.6% malnourished. Caloric intake was less than the RDA in 89.1%. There was no association between calorie intake per day and MNA status. Education (p=0.025), place of residence (p=0.021), marital status (p=0.003), and family income (p=0.031) were factors significantly influencing nutritional status in elderly. There was significant correlation between MNA status and BMI (p<0.001, r=0.329).Conclusions: Malnutrition was seen in 11.6% of older adults in this study and another major proportion was at risk of malnutrition. Better nutritional status was significantly associated with good education, urban residence, married state, and higher family income. Dietary intake was inadequate among older adults. 24-hour dietary recall reflected nutritional status of only the malnourished.  


Author(s):  
R. Zelig ◽  
L. Byham-Gray ◽  
S.R. Singer ◽  
E.R. Hoskin ◽  
A. Fleisch Marcus ◽  
...  

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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