Aspects of frailty syndrome, nutritional status and comorbidities in the elderly

Background: Frailty syndrome is one of the most important multifactorial medical syndromes, which is characterized by a decrease in functionality of many systems and organs. Material and methods: In order to establish the nutritional determinants that contribute to the onset of frailty syndrome, a study was performed on a group of 50 patients, aged ≥65 years with chronic pathologies and geriatric syndromes. All participants were examined according to clinical features (history, clinical examination), Mini Nutritional Assessment and of the Complex Geriatric Assessment, which included: the data of the frailty tools, age category, Vulnerable Elders Survey, Charlson Comorbidity Index, autonomy – Activity Daily Living, Instrumental Activity Daily Living, Tinetti scale, psychoaffective status – by memory test Mini-Mental State Examination and the Geriatric Scale of Depression in the context of nutrition in the elderly. A clustered analysis (k-means method) of nutritional status showed that the most relevant indicators that separated the clusters were: age category, gender, clinical scale of frailty, comorbidities and polymedication. Results: Frailty through the multidimensional aspects that it meets has an increased prevalence among the elderly with an unfavorable prognosis. Following the proposed study, it was revealed that insufficient nutrition and comorbidities can lead to the weakening of the institutionalized age. The results obtained by evaluating the bio-psycho-social aspects characterize the profile of the institutionalized elderly and can be used as a basis for the development of effective strategies aimed at reducing physical, cognitive and social frailty. Conclusions: The comparative evaluation between both groups of elderly people by gender, showed a normal nutritional status with a higher share in women in the group of 75-84 years, compared to older men, and malnutrition was practically manifested equally in both groups in the study (men/women)

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Hubungan Tingkat Kemandirian dalam Melakukan Aktivitas Kehidupan Sehari-Hari dan Status Gizi pada Usia Lanjut di Panti Sosial Tresna Werdha Sabai Nan Aluih Sicincin

Jurnal Kesehatan Andalas ◽

10.25077/jka.v5i1.469 ◽

2016 ◽

Vol 5 (1) ◽

Author(s):

Afifah Alfyanita ◽

Rose Dinda Martini ◽

Husnil Kadri

Keyword(s):

Nutritional Status ◽

Daily Living ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

The Elderly ◽

Cross Sectional Study ◽

Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Chi Square Test

AbstrakPeningkatan Usia Harapan Hidup (UHH) penduduk Indonesia mengakibatkan peningkatan populasi usia lanjut (usila). Peningkatan usila berdampak terutama pada peningkatan angka ketergantungan dalam melakukan Aktivitas Kehidupan Sehari-hari (AKS). Penurunan tingkat kemandirian dalam melakukan AKS adalah salah satu faktor yang mempengaruhi status gizi usila. Tujuan penelitian ini adalah untuk menentukan hubungan tingkat kemandirian dalam melakukan AKS dan status gizi usia lanjut. Penelitian ini merupakan penelitian analitik observasional dengan rancangan cross-sectional study dan menggunakan kuisioner ADL Barthel dan Mini Nutritional Assessment (MNA) sebagai instrumen. Sebanyak 66 sampel diambil dari seluruh penghuni Panti Sosial Tresna Werdha Sabai Nan Aluih Sicincin yang memenuhi kriteria inklusi. Data berupa hasil tingkat kemandirian dan status gizi dianalisis menggunakan uji chi-square, dengan derajat kepercayaan 95%. Dari 66 subjek penelitian terdapat 36 usila (54,5%) tidak mandiri dalam melakukan AKS dan 39 usila (59,1%) memiliki status gizi berisiko malnutrisi. Uji chi-square menunjukkan nilai p adalah 0,015 (p<0,05). Kesimpulan penelitian adalah terdapat hubungan yang bermakna antara tingkat kemandirian dalam melakukan AKS dan status gizi pada usia lanjut di Panti Sosial Tresna Werdha Sabai Nan Aluih Sicincin.Kata kunci: tingkat kemandirian, aktivitas kehidupan sehari-hari, status gizi, usia lanjut AbstractThe increasing of life expectancy at Indonesia's population may lead to an increase in the elderly population. The main impact of this condition is the increasing of elderly dependency in performing Activity of Daily Living (ADL). Decreased level of independence in performing ADL is one of the factors that affect the nutritional status of elderly. The objective of this study was to determine the relationship between the level of independence in performing ADL and nutritional status of elderly.This research was an observational analytical study which designed as cross-sectional study. The instruments of this research were Barthel ADL and Mini Nutritional Assessment (MNA). 66 samples were taken from all the inhabitants of Panti Sosial Tresna Werdha Sabai Nan Aluih Sicincin who fulfill the inclusion criteria. The results of the level of independence and nutritional status were analyzed using chi-square test, with a degree of confidence of 95%. Of the 66 subjects there were 36 elderly (54.5%) not independent in performing ADL and 39 elderly (59.1%) were at risk of malnutrition. Chi-square test showed p value 0,015 (p<0.05).The conclusion is the significant relationship between the level of independence in performing ADL and nutritional status of the elderly in Social House Tresna Werdha Sabai Nan Aluih. Keywords: level of independence, performing Activity of Daily Living , nutritional status, elderly

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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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Nutritional status assessment of elderly using MNA tool in rural Belagavi: a cross sectional study

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20184572 ◽

2018 ◽

Vol 5 (11) ◽

pp. 4799

Author(s):

D. J. Patil ◽

M. M. Shindhe

Keyword(s):

At Risk ◽

Nutritional Status ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Sampling Technique ◽

Simple Random Sampling ◽

The Elderly ◽

Cross Sectional Study ◽

Cross Sectional ◽

Adverse Health Effects

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.

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Relationship between Malnutrition and Functional Disability in Selected Community-Dwelling Geriatric Population in Bangladesh

10.1101/2020.08.02.20167049 ◽

2020 ◽

Author(s):

Mohammad Rahanur Alam ◽

Md. Shahadat Hossain ◽

Akibul Islam Chowdhury ◽

Marufa Akhter ◽

Abdullah Al Mamun ◽

...

Keyword(s):

Nutritional Status ◽

Activities Of Daily Living ◽

Daily Living ◽

Functional Disability ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Community Dwelling ◽

Average Life Expectancy ◽

Geriatric Population ◽

Cross Sectional

Background: The average life expectancy of the Bangladeshi population has been rising over the last decade due to the economic growth along with improved medicare. Although the increased number of geriatric people and their health is a matter of great concern, this issue remains unnoticed here. Objectives: To assess the nutritional status of the functionality and to analyze the association between nutritional status and functional ability of the selected Bangladeshi geriatric population. Methods: A community-based cross-sectional study was conducted among 400 participants, covering Chittagong, Noakhali, Comilla, and Jessore district of Bangladesh from December 2019 to February 2020. A standard and pretested questionnaire containing Mini Nutritional Assessment (MNA), Tinetti Performance Oriented Mobility Assessment (POMA), Activities of daily living scale (ADL), Lawton-Brody Instrumental Activities of Daily Living Scale (IADL), was used. Results: According to our study, The prevalence of malnutrition and people at risk of malnutrition have been 25.4% and 58.8%, respectively. In the case of functionality, 63.3% of subjects have high falling risk, and 61.8% of subjects can independently do their daily activities while 38.3% are dependent. Furthermore, almost 80% of people are dependent in terms of doing living skills. High risk of falling (OR=10.823; 95% CI: 5.846-20.37; p<0.001), poor skill in doing ADL (OR=6.206; 95% CI: 4.021-9.581; p<0.001), along with dependency in performing IADL (OR=4.477; 95% CI: 2.833-7.075; p<0.001) are significantly associated with malnutrition. Conclusions: Geriatric malnutrition can accelerate disability conditions, which can lead to early functional aging and subsequent loss in the quality of life.

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Nutritional status of elderly and its association with frailty among them

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20214859 ◽

2021 ◽

Author(s):

Amit Vasant Deshpande ◽

Baer Philip Ravikumar

Keyword(s):

At Risk ◽

Nutritional Status ◽

Activities Of Daily Living ◽

Outpatient Clinic ◽

Daily Living ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

P Value ◽

Cross Sectional ◽

Study Participants

Background: Malnutrition among geriatrics remain undetected. The present study was conducted to assess the prevalence of malnutrition among geriatric outpatients and various factors associated with it.Methods: This cross-sectional study was done in Mamata medical college, Khammam, Telangana, in which we included geriatric patients (more than 60 years of age) who visited the outpatient clinic between January 2021 till March 2021. All study participants were evaluated for the following two domains of frailty: physical frailty and psychological frailty.Results: During the study period, we included 185 participants in the study. Based on mini nutritional assessment (MNA), 20% participants had normal nutrition, 55% were at risk of malnutrition and 25% had malnutrition. We observed that 59% of the participants with malnutrition were aged more than 80 years, 35% were smokers, 67% were living alone and 83% had comorbidities. It was observed that 67% and 57% of the study participants with malnutrition had impaired activities of daily living and impaired instrumental activities of daily living respectively. 54% of those malnutrition were depressed, which was significantly higher as compared to those with normal nutrition and those at risk of malnutrition (p value <0.05).Conclusions: The results of the present study demonstrate the nutritional status of geriatric outpatients is associated with physical as well as psychological frailty. Therefore, it is recommended that detailed nutritional assessment of patients of geriatric age groups should be conducted when they present in the outpatient clinic for any reason or complaint.

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Nutrition as a Health Determinant in Elderly Patients

Current Medicinal Chemistry ◽

10.2174/0929867324666170523125806 ◽

2019 ◽

Vol 26 (19) ◽

pp. 3652-3661 ◽

Cited By ~ 4

Author(s):

Tecla Mastronuzzi ◽

Ignazio Grattagliano

Keyword(s):

Nutritional Status ◽

Elderly Population ◽

Nutritional Assessment ◽

Caloric Intake ◽

Mini Nutritional Assessment ◽

The Elderly ◽

Nutritional Intervention ◽

Social Risk ◽

Social Risk Factors ◽

The Impact

Background: An adequate caloric intake is a major determinant for the health status especially when degenerative conditions become a predominant risk for difficult-to-treat diseases as in aging. Methods: A structured search of literature on the major databases was performed using terms as nutrition, elderly and malnutrition. Results: According to most referenced articles, it appears to be unquestionable that both organic and social risk factors [economic hardship, loneliness, institutionalization] are important as determining causes of protein-caloric malnutrition. Some anthropometric, clinical and laboratory parameters can help to make diagnosis and quantify malnutrition. However, most of them are not cheap or are not simple to perform especially in the setting of General Practice. The application of a simple questionnaire [Mini Nutritional Assessment, MNA] allows to obtain in a fast, easy and non-invasive way a valid assessment of the nutritional status in geriatric patients. The maintenance of the nutritional status is the best measure to counteract the risk of proteincaloric malnutrition and its complications which often sneakily affects elderly population and in particular frail patients. Conclusion: This review, based on updated concepts, examines all the above mentioned points together with some aspects associated with malnutrition as an indicator of disease severity and health costs in the elderly population. Finally, the impact of nutritional intervention and nutrients supplementation on general indices of malnutrition are discussed as a promising strategy.

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Mini-Nutritional Assessment predicts functional decline of elderly Taiwanese: result of a population-representative sample

British Journal Of Nutrition ◽

10.1017/s0007114511004880 ◽

2011 ◽

Vol 107 (11) ◽

pp. 1707-1713 ◽

Cited By ~ 25

Author(s):

Li-Chin Lee ◽

Alan C. Tsai

Keyword(s):

At Risk ◽

Activities Of Daily Living ◽

Daily Living ◽

Nutritional Assessment ◽

Short Form ◽

Functional Decline ◽

Mini Nutritional Assessment ◽

Predictive Ability ◽

The Elderly ◽

Population Based

Nutrition is a key element in geriatric health and is important for functional ability. The present study examined the functional status-predictive ability of the Mini-Nutritional Assessment (MNA). We analysed the dataset of the ‘Survey of Health and Living Status of the Elderly in Taiwan’, a population-based study conducted by the Bureau of Health Promotion of Taiwan. Study subjects ( ≥ 65 years old) who completed both the 1999 and 2003 surveys were rated with the long form and short form of the MNA at baseline and with the Activities of Daily Living (ADL) and the Instrument Activities of Daily Living (IADL) scales 4 years later (end-point). The ability of the MNA to predict ADL or IADL dependency was evaluated with logistic regression models. The results showed that the elderly who were rated malnourished or at risk of malnutrition at baseline generally had significantly higher ADL or IADL scores 4 years later. Lower baseline MNA scores also predicted a greater risk of ADL or IADL dependency. These associations exist even among the elderly who were free of ADL or IADL dependency at baseline. The results clearly indicate that the MNA is able to predict ADL and IADL dependency (in addition to rating current nutritional status) of the elderly. The MNA, especially the short form, should be a valuable tool for identifying elderly at risk of functional decline and/or malnutrition in clinical practice or community programmes.

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Complementarity of the Mini-Nutritional Assessment and Activities of Daily Living for predicting follow-up mortality risk in elderly Taiwanese

British Journal Of Nutrition ◽

10.1017/s0007114512001730 ◽

2012 ◽

Vol 109 (4) ◽

pp. 658-666 ◽

Cited By ~ 6

Author(s):

Alan C. Tsai ◽

Li-Chin Lee ◽

Jiun-Yi Wang

Keyword(s):

Nutritional Status ◽

Activities Of Daily Living ◽

Mortality Risk ◽

Daily Living ◽

Nutritional Assessment ◽

Short Form ◽

Mini Nutritional Assessment ◽

Cox Regression Analysis ◽

All Cause Mortality

Physical functional ability and nutritional status are two major indicators for predicting the risk of mortality in older adults. The present study examined the complementarity of the Activities of Daily Living (ADL) and the Mini-Nutritional Assessment (MNA) for predicting follow-up 4-year all-cause mortality risk in elderly Taiwanese. We analysed data of the ‘Survey of Health and Living Status of the Elderly in Taiwan’, a population-based longitudinal cohort study which involved 2872 men and women of ≥ 65 years old at baseline (1999). We rated their functional dependency with the ADL scale and nutritional status with the MNA (both the long form, LF and the short form, SF) at baseline, and analysed the complementarity of the two scales in predicting follow-up 4-year all-cause mortality with Cox regression analysis and the net reclassification improvement (NRI) to quantify the improvement. The results showed that both ADL and MNA offered improvement in predicting follow-up mortality risk beyond that predicted by either one alone according to the Akaike information criterion and the NRI. The MNA-SF was nearly as effective as the MNA-LF in improving the predictive ability of the ADL. The present study suggests that the MNA (especially the SF because of its simplicity and time-saving feature) together with the ADL scale might be of value for predicting the mortality risk of frail elderly living in various settings.

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How an Oncologist’s Intuition Compares to a Geriatric Assessment

Oncology Research and Treatment ◽

10.1159/000513737 ◽

2021 ◽

pp. 1-8

Author(s):

Sebastian Willy Ertl ◽

Hans-Christoph Heuer ◽

Michael Konrad Stahl

Keyword(s):

Cancer Patients ◽

Geriatric Assessment ◽

Mini Mental State Examination ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Living Alone ◽

Additional Information ◽

Comorbidity Index ◽

Older Cancer Patients ◽

State Examination

Background: A geriatric assessment (GA) is recommended before treating older cancer patients. The goal of this study was to investigate if the additional information from a GA and discussion by a multidisciplinary board (MB) change the treatment recommendations. Patients and Methods: Older cancer patients (n = 421) were prospectively assessed by an oncologist for eligibility for chemotherapy. A multidimensional GA was performed and a discussion about each patient was held by a MB including a geriatrician. Differences between the judgment made by the oncologist, that of the MB, and the Balducci classification were examined. A statistical model of the MB decision-making process was established and evaluated. Results: The treating oncologist and the MB judged 12 and 15% of the patients as frail, 41 and 38% as vulnerable, and 46 and 47% as fit. Overall, 83% agreement was observed. Based on the Balducci classification, 55% of the patients were frail, 30% were vulnerable, and 15% were fit. Only 34% of congruency with the oncologist’s judgment was observed. In a 2-stage logistics model, activities of daily living and the Mini-Mental-State Examination (MMSE) proved most suitable for identifying frail patients. Tinetti’s test, age, Charlson Comorbidity Index, living alone, the MMSE, and the Mini-Nutritional Assessment fitted best to distinguish between vulnerable and fit. Conclusions: Regarding the decision of systemic treatment for older patients, the judgment by an experienced oncologist was comparable to that of an MB and both were significantly different from the Balducci classification. For some patients, the additional discussion of GA data in an MB may change treatment decisions.

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Nutritional status, dementia, and mobility among nursing home’s residents: First exhaustive cross-sectional study in Limousin territory (France)

PLoS ONE ◽

10.1371/journal.pone.0250595 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250595

Author(s):

Philippe Fayemendy ◽

Gustave Mabiama ◽

Thibault Vernier ◽

Aude Massoulard-Gainant ◽

Carole Villemonteix ◽

...

Keyword(s):

Nutritional Status ◽

Mini Mental State Examination ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Cross Sectional Study ◽

Sectional Study ◽

Mobility Patterns ◽

Cross Sectional ◽

Nutritional Data ◽

State Examination

Background Aging is accompanied by a drop in the level of health and autonomy, within Western countries more and more people being cared for in nursing homes (NH). The nutritional data in NH in France remain poor, not exhaustive and not representative. The objective of the study was to assess the nutritional status, dementia and mobility patterns among residents of NH in the Limousin territory of France. Methods The study was cross-sectional, descriptive and exhaustive, conducted with the residents of 13 voluntary NH. Undernutrition was identified using French High Authority for Health criteria, and obesity if Body Mass Index >30, in the absence undernutrition criterion. The Mini Mental State examination scores was used for dementia assessment at the threshold of 24. The Mini Nutritional AssessmentTM was used for mobilitity assessment. The statistics were significant at the 5% threshold. Results 866 residents (70.6% women) included with an average age of 85.3 ± 9.3 years. Undernutrition was 27.5%, obesity 22.9%, dementia 45.7% and very low mobility 68.9%. Women were older than men, more often undernourished, more often demented and more often had very low mobility (p<0.01). Undernutrition (p<0.0001) and low mobility (p<0.0001) were significantly higher among those with dementia versus those without dementia. Very low mobility was higher among undernourished (p<0.05). Conclusions Undernutrition and obesity are important problems in NH in France. Being a woman, having dementia and having a very low mobility may induce undernutrition.

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