What Are the Risk Factors for Malnutrition in Older-Aged Institutionalized Adults?

Malnutrition is common in older adults and is associated with functional impairment, reduced quality of life, and increased morbidity and mortality. The aim of this study was to explore the association between health (including depression), physical functioning, disability and cognitive decline, and risk of malnutrition. Participants were recruited from nursing homes in Italy and completed a detailed multidimensional geriatric evaluation. All the data analyses were completed using Stata Version 15.1. The study included 246 participants with an age range of 50 to 102 (80.4 ± 10.5). The sample was characterised by a high degree of cognitive and functional impairment, disability, and poor health and nutritional status (according to Mini Nutritional Assessment (MNA), 38.2% were at risk for malnutrition and 19.5% were malnourished). Using a stepwise linear regression model, age (B = −0.043, SE = 0.016, p = 0.010), depression (B = −0.133, SE = 0.052, p = 0.011), disability (B = 0.517, SE = 0.068, p < 0.001), and physical performance (B = −0.191, SE = 0.095, p = 0.045) remained significantly associated with the malnutrition risk in the final model (adjusted R-squared = 0.298). The logistic regression model incorporating age, depression, disability, and physical performance was found to have high discriminative accuracy (AUC = 0.747; 95%CI: 0.686 to 0.808) for predicting the risk of malnutrition. The results of the study confirm the need to assess nutritional status and to investigate the presence of risk factors associated with malnutrition in order to achieve effective prevention and plan a better intervention strategy.

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Nutritional Status and Cardiometabolic Risk Factors in Institutionalized Adults with Cerebral Palsy

Medicina ◽

10.3390/medicina55050157 ◽

2019 ◽

Vol 55 (5) ◽

pp. 157 ◽

Cited By ~ 1

Author(s):

Aurora Norte ◽

Coral Alonso ◽

José Miguel Martínez-Sanz ◽

Ana Gutierrez-Hervas ◽

Isabel Sospedra

Keyword(s):

Risk Factors ◽

At Risk ◽

Cerebral Palsy ◽

Nutritional Status ◽

Cardiometabolic Risk ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Density Lipoprotein ◽

Cardiometabolic Risk Factors ◽

Lipoprotein Cholesterol

Background and Objectives: Cerebral palsy (CP) is a set of permanent disorders that limit physical activity and increase the risk of developing other diseases, such as metabolic syndrome (MS). Adequate nutrition can contribute to the prevention of associated symptoms. The main objective of this study is to evaluate the nutritional status and the prevalence of cardiometabolic risk factors in adults with CP and Gross Motor Function Classification System (GMFCS) levels between IV and V. Materials and Methods: A sample of 41 adults with CP and GMFCS levels from IV to V were studied. The variables used in the study were age, sex, weight, height, mean age, and GMFCS level range. To evaluate nutritional status, body mass index and the Mini Nutritional Assessment (MNA), a nutritional screening tool, were used. To assess cardiometabolic risk, data on obesity, central obesity, blood pressure, fasting plasma glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides were collected. Results: More than 80% of the population studied was malnourished or at risk of malnutrition, according to the MNA tool classification ranges, and around 35% of the studied population was within the underweight range. Regarding cardiometabolic risk factors, only one adult with CP was diagnosed with MS. Conclusions: The studied population of adults with CP and GMFCS levels between IV and V is not a population at risk of MS; however, the high prevalence of malnutrition, as well as some of the most prevalent cardiovascular risk factors, should be taken into consideration.

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Abstract WP385: Gender Differences in Nutritional Status After a Stroke

Stroke ◽

10.1161/str.48.suppl_1.wp385 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Estela Sanjuan Menendez ◽

Fidel Lopez Espuela ◽

Juan Carlos Portilla ◽

Katherine E Santana ◽

Marta Holguin Mohedas ◽

...

Keyword(s):

Risk Factors ◽

Gender Differences ◽

Nutritional Status ◽

Acute Stroke ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Female Gender ◽

Stroke Severity ◽

Anthropometric Parameters ◽

The Impact

Introduction: Malnutrition has been associated with a worse outcome in stroke. Its frequency is not well established and sometimes the impact is not considered. Objective: To explore gender differences on nutritional status (NS) after acute stroke and its impact on stroke outcome at 90 days. Methods: We evaluated consecutive acute stroke patients admitted to the Stroke Unit. We analyzed baseline demographics, vascular risk factors, analytic and anthropometric parameters, and stroke characteristics. We determined NS at baseline and 90 days by Mini Nutritional Assessment (MNA) scale to detect patients at malnutrition risk (MR). We divided groups by gender. Chi square test was applied for qualitative variables and T student for quantitative. A probability value of <0.05 was considered significant for all tests. Results: We included 95 patients, 45 women (47,4%). Differences were found comparing women vs men and age (77,9 ± 1,02 vs 75,1 ± 0,9), alcohol consumption (6,7% vs 60%), smoking (4,4% vs 26%) and body mass index (30,1 ± 5,1 vs 27,3 ± 4,5); p<0.05. There were no significant differences related to gender and stroke type (ischemic 88,9% vs 84%, p=0.49) nor stroke severity at baseline (NIHSS 5±4 vs 4±4 p=0.18), neither in risk factors (hypertension, diabetes, atrial fibrillation, dislipidemia), comorbidities nor socioeconomic differences. There were no gender differences in the occurrence of in-hospital complications (27,3% vs 16,3%; p=0,2), dysphagia (6,7% vs 6,0%; p=0.89) nor in NIHSS scoring at discharge (3±3 vs 2±3; p=0.08). On admission, MR was present in 28,5% of the patients. There were no differences between gender and DR (31,1% vs 26%; p=0.58). At 90 days, MR increased to 46,4%. We found significant gender differences (57,8% vs 32%; p=0.024). In the adjusted analysis, female gender was associated with a worst NS at 90days [OR 3,56 (1,1-11,5)]. Modified Rankin scale (mRs) score at 90 days was <=2 in 77,8% of women and 82% of men, p=0.607. MNA score at 90 days was independently associated with a better outcome (mRs<=2) at 90 days adjusted by gender OR 0,13 (0,14-0,46). Conclusion: In our series, female gender was independently related to worse nutritional status at 90 days after the stroke.

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

Nutrients ◽

10.3390/nu11071551 ◽

2019 ◽

Vol 11 (7) ◽

pp. 1551 ◽

Cited By ~ 2

Author(s):

Romy Conzade ◽

Steven Phu ◽

Sara Vogrin ◽

Ebrahim Bani Hassan ◽

Walter Sepúlveda-Loyola ◽

...

Keyword(s):

Older Adults ◽

Nutritional Status ◽

Physical Performance ◽

Nutritional Assessment ◽

Bone Turnover Marker ◽

Mini Nutritional Assessment ◽

Community Dwelling ◽

Care Plan ◽

Musculoskeletal Health ◽

Care Plans

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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Epidemiological Determinants of Malnutrition Status among Geriatric Population Residing at High Altitude Region of Rural Uttarakhand, India

Proceedings of The Nutrition Society ◽

10.1017/s0029665120002086 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Ritika Khandelwal ◽

Umesh Kapil ◽

Aakriti Gupta

Keyword(s):

Risk Factors ◽

Nutritional Status ◽

High Altitude ◽

Nutritional Assessment ◽

Scientific Evidence ◽

Mini Nutritional Assessment ◽

Geriatric Population ◽

Cross Sectional ◽

High Prevalence ◽

Loss Of Appetite

AbstractBackgroundHigh prevalence of Malnutrition exists amongst the geriatric population in India. Evidence on malnutrition is available from the plain regions of the country. However there is lack of scientific evidence on malnutrition status of geriatric population residing at high altitude regions of Uttarakhand, India.Materials and methodsA community based cross-sectional study was conducted during 2015–2016 in District Nainital. Thirty clusters were identified using population proportionate to size sampling method; 30 geriatric subjects were selected from each cluster. Study population included 980 geriatric aged 60 years and above. Nutritional status of the geriatric population was assessed using Mini Nutritional Assessment (MNA) tool. Standard procedures were used to determine the height, weight, MCC and MUAC. The BMI was calculated from the measurements of weight (kg) and height (cm) (kg/m2). Data was entered in MS Excel 2007 and analyzed using SPSS version 20.0.ResultsThe MNA revealed that only 22.4% geriatric subjects had satisfactory nutritional status, 14.3% were malnourished and 63.3% were “at risk” of malnutrition. High prevalence of malnutrition was found among subjects belonging to age group of 60–70 years (58.9%), illiterate (74.5%) with family monthly income (1866–5546;43.3%), financially dependent (75.2%), with loss of appetite (71.6%), with chewing problem (63.1%) and who consumed < 2 full meals daily. (73.1%; all p < 0.0001;) in comparison to the subjects who had satisfactory nutritional status.ConclusionsThe present findings revealed that the high prevalence of malnutrition amongst the geriatric population in India. The risk factors identified were financial dependency, dietary intake, loss of appetite and chewing problem. Interventions to decrease these risk factors possibly may lead to reduction in malnutrition among geriatric population.

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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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Validation of the Mini Nutritional Assessment short-form (MNA®-SF): A practical tool for identification of nutritional status

The journal of nutrition health & aging ◽

10.1007/s12603-009-0214-7 ◽

2009 ◽

Vol 13 (9) ◽

pp. 782-788 ◽

Cited By ~ 716

Author(s):

M. J. Kaiser ◽

◽

J. M. Bauer ◽

C. Ramsch ◽

W. Uter ◽

...

Keyword(s):

Nutritional Status ◽

Nutritional Assessment ◽

Short Form ◽

Mini Nutritional Assessment ◽

Practical Tool

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Association of GDF15 With Inflammation and Physical Function During Aging and Recovery After Acute Hospitalization: A Longitudinal Study of Older Patients and Age-Matched Controls

The Journals of Gerontology Series A ◽

10.1093/gerona/glab011 ◽

2021 ◽

Cited By ~ 1

Author(s):

Juliette Tavenier ◽

Line Jee Hartmann Rasmussen ◽

Aino Leegaard Andersen ◽

Morten Baltzer Houlind ◽

Anne Langkilde ◽

...

Keyword(s):

Nutritional Status ◽

Physical Function ◽

Plasma Levels ◽

Older Patients ◽

Nutritional Assessment ◽

Short Form ◽

Mini Nutritional Assessment ◽

Acute Illness ◽

Urokinase Plasminogen Activator Receptor

Abstract Growth differentiation factor 15 (GDF15) is a stress-induced cytokine. Its plasma levels increase during aging and acute illness. In older Patients and age-matched Controls, we evaluated whether GDF15 levels (i) were associated with recovery after acute illness, and (ii) reflected different trajectories of aging and longitudinal changes in health measures. Fifty-two older Patients (≥65 years) were included upon admission to the emergency department (ED). At 30 days after discharge (time of matching), Patients were matched 1:1 on age and sex with Controls who had not been hospitalized within 2 years of inclusion. Both groups were followed up after 1 year. We assessed plasma levels of GDF15 and inflammatory biomarkers, frailty, nutritional status (mini nutritional assessment short-form), physical and cognitive function, and metabolic biomarkers. In Patients, elevated GDF15 levels at ED admission were associated with poorer resolution of inflammation (soluble urokinase plasminogen activator receptor [suPAR]), slowing of gait speed, and declining nutritional status between admission and 30-day follow-up. At time of matching, Patients were frailer and overall less healthy than age-matched Controls. GDF15 levels were significantly associated with participant group, on average Patients had almost 60% higher GDF15 than age-matched Controls, and this difference was partly mediated by reduced physical function. Increases in GDF15 levels between time of matching and 1-year follow-up were associated with increases in levels of interleukin-6 in Patients, and tumor necrosis factor-α and suPAR in age-matched Controls. In older adults, elevated GDF15 levels were associated with signs of accelerated aging and with poorer recovery after acute illness.

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Effect of the Mini Nutritional Assessment-Short Form (MNA-SF) in Elderly Burn Patients

Journal of Burn Care & Research ◽

10.1093/jbcr/irab164 ◽

2021 ◽

Author(s):

Jia-Yu Wei ◽

Shu-Ting Shi ◽

Dan Sun ◽

Guo-Zhong Lyu

Keyword(s):

Wound Healing ◽

Nutritional Status ◽

Nutritional Assessment ◽

Short Form ◽

Mini Nutritional Assessment ◽

The Elderly ◽

Reference Points ◽

Nutrition Intervention ◽

Burn Patients ◽

Cross Sectional

Abstract Objective Nutritional assessment can early identify patients who are malnourished and at risk of malnutrition. To examine the effect of nutritional status on wound healing in elderly burn patients, we used the MNA-SF to measure the nutritional status of elderly patients. This study aimed to examine the role of MNA-SF in elderly burn patients through the correlation analysis of wound-healing indicators and MNA-SF score. Design Prospective observational and cross-sectional study. Methods This study used the MNA-SF to investigate the elderly burn patients at the department of burn. According to the score, the patients fell into three groups: good nutritional status (more than 12 points), malnutrition risk (8~11 points), and malnutrition (0~7 points). At the same time, we measured and compared the wound-healing indicators among the three groups of patients, and detected the correlation. Results The statistical analysis found gender had a slight influence on the score of nutritional status. While age was negatively correlated with the MNA-SF score and nutrition-related indicators. There was a low positive linear correlation between the wound healing percent area change or wound healing rate of patients and the score of the MNA-SF. Conclusion This study finds malnutrition is common among hospitalized elderly burn patients. The application of the MNA-SF in elderly burn patients is efficient and accurate to identify malnutrition early and prevent further obstruction of the normal wound healing, which can provide reference points for early nutrition intervention programs.

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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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