scholarly journals Identifying and Managing Malnutrition, Frailty and Sarcopenia in the Community: A Narrative Review

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2316
Author(s):  
Shelley Roberts ◽  
Peter Collins ◽  
Megan Rattray
Keyword(s):  
Healthcare Professionals ◽  
Monitoring And Evaluation ◽  
Community Dwelling ◽  
Community Context ◽  
Care Process ◽  
Community Settings ◽  
Community Based ◽  
Comprehensive Overview ◽  
Nutrition Care ◽  
Community Dwelling Older Adults

Malnutrition, frailty and sarcopenia are becoming increasingly prevalent among community-dwelling older adults; yet are often unidentified and untreated in community settings. There is an urgent need for community-based healthcare professionals (HCPs) from all disciplines, including medicine, nursing and allied health, to be aware of, and to be able to recognise and appropriately manage these conditions. This paper provides a comprehensive overview of malnutrition, frailty and sarcopenia in the community, including their definitions, prevalence, impacts and causes/risk factors; and guidance on how these conditions may be identified and managed by HCPs in the community. A detailed description of the care process, including screening and referral, assessment and diagnosis, intervention, and monitoring and evaluation, relevant to the community context, is also provided. Further research exploring the barriers/enablers to delivering high-quality nutrition care to older community-dwelling adults who are malnourished, frail or sarcopenic is recommended, to inform the development of specific guidance for HCPs in identifying and managing these conditions in the community.

Activity-Monitor Accuracy in Measuring Step Number and Cadence in Community-Dwelling Older Adults

2008 ◽  
Vol 16 (2) ◽  
pp. 201-214 ◽  
Author(s):  
P. Margaret Grant ◽  
Philippa M. Dall ◽  
Sarah L. Mitchell ◽  
Malcolm H. Granat
Keyword(s):  
Older Adults ◽  
Activity Monitor ◽  
Community Dwelling ◽  
Percentage Error ◽  
Criterion Measure ◽  
Community Based ◽  
Walking Speeds ◽  
Exercise Classes ◽  
Community Dwelling Older Adults ◽  
Step Number

The primary purpose of this study was to investigate the accuracy of theactivPAL physical activity monitor in measuring step number and cadence in older adults. Two pedometers (New-Lifestyles Digi-Walker SW-200 and New-Lifestyles NL-2000) used in clinical practice to count steps were simultaneously evaluated. Observation was the criterion measure. Twenty-one participants (65-87 yr old) recruited from community-based exercise classes walked on a treadmill at 5 speeds (0.67, 0.90, 1.12, 1.33, and 1.56 m/s) and outdoors at 3 self-selected speeds (slow, normal, and fast). The absolute percentage error of theactivPAL was <1% for all treadmill and outdoor conditions for measuring steps and cadence. With the exception of the slowest treadmill speed, the NL-2000 error was <2%. The SW-200 was the least accurate device, particularly at slower walking speeds. TheactivPAL monitor accurately recorded step number and cadence. Combined with its ability to identify primary postures, theactivPALmight be a useful and versatile device for measuring activity in older adults.

An overview of enteral feeding in the community

2021 ◽  
Vol 26 (1) ◽  
pp. 26-29
Author(s):  
Sarah Jane Palmer
Keyword(s):  
Enteral Feeding ◽  
Healthcare Professionals ◽  
Social Needs ◽  
Care Plan ◽  
Medical Attention ◽  
Community Settings ◽  
Community Based ◽  
Basic Principles ◽  
Endoscopic Gastrostomy ◽  
Peg Tube

Enteral feeding in community settings is becoming increasingly common, and this article aims to help nurses and other healthcare professionals to refresh their knowledge of the important concepts in the community-based care of patients receiving enteral nutrition via a percutaneous endoscopic gastrostomy (PEG) tube. The article provides an overview on the management and care of the patient, the basic principles surrounding the equipment used, identifying the wider team and essential communication to bear in mind, as well as the importance of tailoring a care plan to the individual's needs, taking into consideration cognition, mental health, social needs and other factors. The article also covers red flags that may be seen in the community after tube insertion that require immediate medical attention.

scholarly journals Hip Protectors for Community-Dwelling Older Adults

2021 ◽  
Vol 1 (9) ◽  
Author(s):  
Keeley Farrell ◽  
Melissa Walter
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Hip Fracture ◽  
Hip Fractures ◽  
Pelvic Fractures ◽  
Community Dwelling ◽  
Community Settings ◽  
Hip Protectors ◽  
Frail Older Adults ◽  
Community Dwelling Older Adults

In community-dwelling older adults who wore hip protectors there was no difference in the risk of hip fractures or pelvic fractures, compared to those who did not wear hip protectors. Three guidelines were identified that include recommendations around the use of hip protectors in older adults. One guideline suggests that hip protectors should be considered in adults at risk for falls and hip fracture. One guideline conditionally recommends hip protectors for frail older adults in the appropriate environment. One guideline suggests that hip protectors should not be considered in older adults in community settings.

scholarly journals Behavioral Health, Social Engagement, and Long-Term Care Services Use Among Community Older Adults: USA vs. Taiwan

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 348-349
Author(s):  
Su-I Hou ◽  
Chien-Ching Li ◽  
Darren Liu
Keyword(s):  
Older Adults ◽  
Behavioral Health ◽  
Social Engagement ◽  
Long Term Care ◽  
Community Dwelling ◽  
Community Based ◽  
Term Care ◽  
Aging In Community ◽  
Community Dwelling Older Adults

Abstract As healthcare advances, older adults are living longer. While 90% of older adults prefer aging in their own homes and communities, it is important to examine key factors influencing healthy aging-in-community and community-based long-term care (LTC) services available in different countries. This symposium examines behavioral health, social engagement, and LTC services utilization among community-dwelling older adults in the USA and Taiwan. Lessons learned from older adults across countries will provide insights for tailored community-based LTC services and program development. Dr. Hou from The University of Central Florida (UCF) will highlight similarities and differences in behavioral health profiles and the topics that most interest community-dwelling older Americans participating in three aging-in-community programs in Central Florida. Dr. Wang from Case Western Reserve University will examine the impact of neighborhood social cohesion on mobility among community-dwelling older Americans aged 65 and older from the national Health and Retirement Study. Dr. Liu from National Cheng-Kung University in Taiwan will share results of healthy lifestyle on quality of life among community-dwelling older adults in southern Taiwan. Dr. Young from State University of New York at Albany will compare long-term care use among community-dwelling older adults with and without dementia in Central Taiwan. Finally, Drs. Cao and Hou from UCF will analyze home and community-based services in the USA versus Taiwan. This symposium will further discuss similarities and differences of key factors related to healthy aging-in-community, along with practical recommendations and lessons learned across countries and cultural environments to improve community-based long-term care services and programs.

Community-dwelling older adults' perceptions of dignity: core meanings, challenges, supports and opportunities

2013 ◽  
Vol 34 (8) ◽  
pp. 1292-1313 ◽  
Author(s):  
KATHY BLACK ◽  
DEBRA DOBBS
Keyword(s):  
Older Adults ◽  
Older People ◽  
The United States ◽  
Community Dwelling ◽  
Health Issues ◽  
Policy And Practice ◽  
Community Based ◽  
Self Identity ◽  
Community Dwelling Older Adults

ABSTRACTDignity is a universally important issue for all people, and particularly vital for older adults who face multiple losses associated with ageing. In the United States of America and beyond, the maintenance of dignity is a key aim of policy and service provision for older people. Yet surprisingly little research has been conducted into the meaning of dignity to community-based older adults in the context of everyday life. As life expectancy continues to increase worldwide, unprecedented numbers of people are living longer than ever before. The majority of older adults will face declining health and other factors that may impact dignity in the course of ageing in their communities. This paper reports on a study that explored older people's understandings and experiences of dignity through focus groups and a survey. Three key components of dignity are identified: autonomy, relational and self-identity. In addition, the paper discusses a range of factors that can facilitate or inhibit a sense of dignity for older people, including long-term health issues, sensory deficits and resilience to life events. Finally, the implications of these findings for policy and practice are considered in the context of American social structures and values.

scholarly journals Effects of Community-Based Physical-Cognitive Training, Health Education, and Reablement among Rural Community-Dwelling Older Adults with Mobility Deficits

2021 ◽  
Vol 18 (17) ◽  
pp. 9374
Author(s):  
Chen-Yi Song ◽  
Pay-Shin Lin ◽  
Pei-Lun Hung ◽  
Keyword(s):  
Older Adults ◽  
Health Education ◽  
Cognitive Training ◽  
Rural Community ◽  
Functional Independence ◽  
Performance Measure ◽  
Community Dwelling ◽  
Control Group ◽  
Community Based ◽  
Community Dwelling Older Adults

Reablement services are approaches for maintaining and improving the functional independence of older adults. Previous reablement studies were conducted in a home environment. Due to the limited evidence on the effects of multicomponent interventions and reablement in a community-based context, this study aimed to develop and evaluate the effect of community-based physical–cognitive training, health education, and reablement (PCHER) among rural community-dwelling older adults with mobility deficits. The trial was conducted in rural areas of New Taipei City, Taiwan. Older adults with mild to moderate mobility deficits were recruited from six adult daycare centers, and a cluster assignment was applied in a counterbalanced order. The experimental group (n = 16) received a PCHER intervention, comprising 1.5 h of group courses and 1 h of individualized reablement training, while the control group (n = 12) underwent PCHE intervention, comprising 1.5 h of group courses and 1 h of placebo treatment. A 2.5-h training session was completed weekly for 10 weeks. The outcome measures contained the de Morton Mobility Index (DEMMI), the Saint Louis University Mental Status (SLUMS) Examination, the Barthel Index (BI), the Short Physical Performance Battery (SPPB), and the Canadian Occupational Performance Measure (COPM). The PCHER significantly improved the DEMMI, SLUMS, BI, SPPB, and COPM (all p < 0.05), with medium-to-large effect sizes. PCHER also showed an advantage over PCHE in terms of the SPPB (p = 0.02). This study verified that combining individualized reablement with group-based multicomponent training was superior to group courses alone in enhancing the functional abilities of community-dwelling older adults with mobility deficits.

Life satisfaction and frailty in community-based older adults: cross-sectional and prospective analyses

2013 ◽  
Vol 25 (10) ◽  
pp. 1709-1716 ◽  
Author(s):  
Philip D. St John ◽  
Suzanne L. Tyas ◽  
Patrick R. Montgomery
Keyword(s):  
Older Adults ◽  
Life Satisfaction ◽  
Population Based ◽  
Community Dwelling ◽  
Community Based ◽  
Cross Sectional ◽  
Gender Education ◽  
Community Dwelling Older Adults ◽  
Prospective Analyses

ABSTRACTBackground:Frailty may be associated with reduced life satisfaction (LS). The objectives of this paper are to determine if (1) frailty is associated with LS in community-dwelling older adults in cross-sectional analyses; (2) frailty predicts LS five years later; and (3) specific domains of LS are preferentially associated with frailty.Methods:This paper presents analysis of an existing population-based cohort study of 1,751 persons aged 65+ who were assessed in 1991, with follow-up five years later. LS was measured using the terrible–delightful scale, which measures overall LS and LS in specific domains. Frailty was measured using the Brief Frailty Instrument. Analyses were adjusted for age, gender, education, and marital status.Results:Frailty was associated with overall LS at time 1 and predicted overall LS at time 2. This was seen in unadjusted analyses and after adjusting for confounding factors. Frailty was associated with all domains of LS at time 1, and predicted LS at time 2 in all domains except housing and self-esteem. However, the effect was stronger for LS with health than with other domains for both times 1 and 2.Conclusions:Frailty is associated with LS, and the effect is strongest for LS with health.

scholarly journals Global Cognitive Impairment Prevalence and Incidence in Community Dwelling Older Adults—A Systematic Review

Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 84
Author(s):  
Ricardo Pais ◽  
Luís Ruano ◽  
Ofélia P. Carvalho ◽  
Henrique Barros
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Community Dwelling ◽  
Cognitive Tests ◽  
Community Based ◽  
Definition Of ◽  
Community Dwelling Older Adults

(1) Background: We proposed to review worldwide estimates of cognitive impairment prevalence and incidence in adults older than 50 years of age living in the community. (2) Methods: Systematic searches were performed in January 2019 using MEDLINE/PubMed. Articles were selected if they referred to cognitive impairment, prevalence, incidence, elders, and population or community-based studies. Analysis, aggregated by different methodologic features, was performed. (3) Results: Prevalence (80 studies) ranged between 5.1% and 41% with a median of 19.0% (25th percentile = 12.0%; 75th percentile = 24.90%). Incidence (11 studies) ranged from 22 to 76.8 per 1000 person-years with a median of 53.97 per 1000 person-years (25th percentile = 39.0; 75th percentile = 68.19). No statistically significant effects were found except for inclusion age. (4) Conclusion: We propose that the homogenization and clarification of the definition of what constitutes cognitive impairment are essential to refine the epidemiological understanding of this entity. The results of this review reinforce the importance of adherence to standardized cut-off scores for cognitive tests to promote study comparability.

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