Relationship between five Epigenetic Clocks, Telomere Length and Functional Capacity assessed in Older Adults: Cross-sectional and Longitudinal Analyses

DNA methylation age acceleration (DNAmAA, derived from an epigenetic clock) and relative leukocyte telomere length (rLTL) are widely accepted biomarkers of aging. Nevertheless, it is still unclear which aspects of aging they represent best. Here we evaluated longitudinal associations between baseline rLTL and DNAmAA (estimated with 7-CpG clock) and functional assessments covering different domains of aging. Additionally, we made use of cross-sectional data on these assessments and examined their association with DNAmAA estimated by five different DNAm age measures. Two-wave longitudinal data was available for 1,083 participants of the Berlin Aging Study II (BASE-II) who were re-examined on average 7.4 years after baseline as part of the GendAge study. Functional outcomes were assessed with Fried’s frailty score, Tinetti mobility test, falls in the past 12 months (yes/no), Finger-floor distance, Mini Mental State Examination (MMSE), Center for Epidemiologic Studies Depression Scale (CES-D), Activities of Daily Living (ADL), Instrumented ADL (IADL) and Mini Nutritional Assessment (MNA). Overall, we found no evidence for an association between the molecular biomarkers measured at baseline, rLTL and DNAmAA (7-CpG clock), and functional assessments assessed at follow-up. Similarly, a cross-sectional analyses of follow-up data did also not show evidence for associations of the various DNAmAA measures (7-CpG clock, Horvath’s clock, Hannum’s clock PhenoAge, and GrimAge) with functional assessments. In conclusion, neither rLTL nor 7-CpG DNAmAA were able to predict impairment in the analyzed assessments over a ~7-year time-course. Similarly, DNAmAA estimated from five epigenetic clocks was not a good cross-sectional marker of health deterioration either.

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

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.

Serum Leptin Levels, Nutritional Status, and the Risk of Healthcare-Associated Infections in Hospitalized Older Adults

We aimed to determine whether serum leptin levels are predictive of the occurrence of healthcare-associated infections (HAIs) in hospitalized older patients. In a prospective cohort, 232 patients had available data for leptin and were monitored for HAIs for 3 months. Admission data included comorbidities, invasive procedures, the Mini Nutritional Assessment (MNA), BMI, leptin, albumin and C-reactive protein levels, and CD4 and CD8 T-cell counts. Multivariate logistic regression modelling was used to identify predictors of HAIs. Of the 232 patients (median age: 84.8; females: 72.4%), 89 (38.4%) experienced HAIs. The leptin level was associated with the BMI (p < 0.0001) and MNA (p < 0.0001) categories. Women who experienced HAIs had significantly lower leptin levels than those who did not (5.9 μg/L (2.6–17.7) and 11.8 (4.6–26.3), respectively; p = 0.01; odds ratio (OR) (95% confidence interval): 0.67 (0.49–0.90)); no such association was observed for men. In a multivariate analysis of the women, a lower leptin level was significantly associated with HAIs (OR = 0.70 (0.49–0.97)), independently of comorbidities, invasive medical procedures, and immune status. However, leptin was not significantly associated with HAIs after adjustments for malnutrition (p = 0.26) or albuminemia (p = 0.15)—suggesting that in older women, the association between serum leptin levels and subsequent HAIs is mediated by nutritional status.

Effect of chocolate on older patients with cancer in palliative care: a randomised controlled study

Background Older advanced stage cancer patients, with changes in nutritional status, represent an important demand for palliative care. The aim was to determine the effects of 4 weeks of chocolate consumption on the nutritional status of older cancer patients in palliative care. Methods Older cancer patients in palliative care with ambulatory (n = 46) monitoring were randomized to control (CG, n = 15), intervention with 55% cocoa chocolate (IG1, n = 16) and intervention with white chocolate (IG2, n = 15) groups and evaluated before and after 4 weeks for nutritional status (primary outcome), evaluated by the Mini Nutritional Assessment tool (MNA). Food consumption, anthropometry, body composition, laboratory parameters and quality of life (QL) with the European Organization for the Research and Treatment of Cancer instrument were also evaluated. Results IG1 progressed with increased screening (estimated difference [95% CI]: − 1.3 [− 2.2;-0.4], p < 0.01), and nutritional (estimated difference [95% CI]: − 1.3 [− 2.5;-0.1], p = 0.04) scores on the MNA, with no change in anthropometry and body composition. Regarding antioxidant capacity, reduced glutathione levels increased (estimated difference [95% CI]: − 0.8 [− 1.6;-0.02], p = 0.04) and malondealdehyde levels decreased in IG2 (estimated difference [95% CI]:+ 4.9 [+ 0.7;+ 9.1], p = 0.02). Regarding QL, functionality improved in IG1, with higher score in the functional domain (estimated difference [95% CI]:-7.0 [− 13.3;-0.7], p = 0.03). Conclusions The consumption of chocolate with a greater cocoa content may contribute to the improvement of the nutritional status and functionality among older cancer patients in palliative care. The consumption of white chocolate was associated with improved oxidative stress. Trial registration A randomized clinical trial (ClinicalTrials.gov NCT04367493).

Relación del riesgo nutricional y la presencia de depresión en adultos mayores ambulatorios de Aguascalientes, México.

Introducción: La depresión es un trastorno afectivo caracterizado por sentimientos de desesperación y tristeza. Existe una relación entre la malnutrición y la presencia de depresión en el adulto mayor institucionalizado y/o de comunidad rural. Objetivo: estudiar la relación de la depresión y el estado nutricional en el adulto mayor de comunidad de Aguascalientes, México. Métodos: Estudio descriptivo correlacional, transversal, los participantes fueron adultos mayores (>60 años) pertenecientes a una estancia de día, en Aguascalientes, México (n= 50). El estado nutricio se evaluó mediante el Mini Nutritional Assessment (MNA) y antropometría. La depresión se evaluó mediante la Escala de Depresión Geriátrica de Yesavage (GDS). Se utilizaron pruebas estadísticas como: U de Mann Whitney para diferencias entre grupos y la asociación entre riesgo nutricio y depresión por Correlación de Pearson. Resultados: La clasificación del estado nutricio de los adultos mayores evaluados fue la siguiente: Normalidad: 76%, en riesgo de malnutrición: 22%, malnutrición: 2%. La prevalencia de depresión fue de 40%. Los indicadores antropométricos se encuentran alterados en el adulto mayor con depresión (p = 0.03), se observó una correlación inversa entre el MNA y la EDG, (r = -0.528, p =0.0001), un menor peso o IMC, esto aunado a una mayor edad contribuirá a la presencia de depresión. Conclusión: El riesgo nutricional es un factor importante a considerar en la presencia de depresión en el adulto mayor. Siendo esta relación una pauta a seguir como parte del tratamiento nutricio de esta población como adyuvante en la terapia del adulto mayor con depresión.

Determinants of undernutrition among older adults in South Gondar Zone, Ethiopia: a community-based study

ObjectivesThe objectives of this study were to assess the prevalence and determinants of undernutrition among older adults aged 65 years in the south Gondar Zone, Ethiopia, in 2020.DesignA community-based cross-sectional study.SettingThe study was conducted from 1 October to 15 December 2020, in the South Gondar Zone, Ethiopia. Study participants were selected by systematic random sampling. A pretested and structured questionnaire adapted from different literature was used to collect data. Anthropometric measurements were taken following the standard procedure.ParticipantsA total of 290 older adults aged greater than or equal to 65 years of age were included in the study.Data analysisDescriptive and summary statistics were employed. Multiple logistic regression was fitted to identify determinants of undernutrition. ORs and their 95% CIs were computed to determine the level of significance.Outcome measuresUndernutrition was assessed by using Body Mass Index and Mini Nutritional Assessment (MNA) tool.ResultsThe prevalence of undernutrition was 27.6% (95% CI 22.4 to 32.8), and 2.1% (95% CI 0.7 to 3.8) of the study participants were overweight. Based on the MNA tool, 29.7% (95% CI 24.5 to 35.2) of the study participants were undernourished and 61.7% (95% CI 55.5 to 67.2) were at risk of undernourishment. Rural residence adjusted OR (aOR)=10.3 (95% CI 3.6 to 29.4), inability to read and write aOR=3.5 (95% CI 1.6 to 7.6), decrease in food intake aOR=13.5 (95% CI 6.1 to 29.5) and household monthly income of less than US$35.6 aOR=4.3 (95% CI 1.9 to 9.4) were significantly and independently associated with undernutrition.ConclusionThe level of undernutrition among older adults in the study area was high, making it an important public health burden. The determinants of undernutrition were a place of residence, educational status, food intake and monthly income.

Malnutrition and Influencing Factors in Aged Patients: A Hospital-Based Cross-Sectional Study

Malnutrition refers to a nutritional ailment that functionally and clinically distresses the body. It is very common in aged people. The nutritional status of this vulnerable group in low-income countries does not remain focused upon. Therefore, this study was designed to investigate the magnitude of malnutrition and to correlate different factors amongst aged patients administered in a reputed Medical College Hospital in Dinajpur district, Bangladesh. An observational cross-sectional study was conducted to evaluate the nutritional eminence of hospitalized aged patients through the original 18-item full Mini Nutritional Assessment (MNA) screening tool. We evaluated 238 patients in this study. Of whom, 144 (60.5%) were men and 94 (39.5%) were women, whose average age were 68.7 ± 7 years. MNA revealed a prevalence of 46.2% for risk of malnutrition, 31.9% for malnutrition, and 21.8% for within normal. Aged patients who lived alone were malnourished than the patients living with others (p < 0.001). Laboratory investigation revealed that malnourished individuals had substantively decreased levels of serum albumin (2.5 ± 0.7 g/dl), hemoglobin (10.3 ± 1.7 g/dl), lymphocytes (1.4 ± 0.9×10^9/L), and cholesterol (150 ± 35.9 mg/dl). About forty-nine and 32.9 percent of individuals with malnutrition had a severe or a moderate decrease in food intakes respectively. Different health problems collectively had influenced malnutrition. Malnourished patients had a tendency to hospitalize for a longer period of time. Thus malnutrition in hospitalized aged patients was highly prevalent and was associated with low food intake, the presence of health problems, and prolonged length of hospital stay.

Socioeconomic, Eating- and Health-Related Limitations of Food Consumption among Polish Women 60+ Years: The ‘ABC of Healthy Eating’ Project

The study aimed at identifying the socioeconomic, eating- and health-related limitations and their associations with food consumption among Polish women 60+ years old. Data on the frequency of consumption of fruit, vegetables, dairy, meat, poultry, fish, legumes, eggs, water and beverages industrially unsweetened were collected with the Mini Nutritional Assessment (MNA®) and were expressed in the number of servings consumed per day or week. Three indexes: the Socioeconomic Status Index (SESI), the Eating-related Limitations Score (E-LS) and the Health-related Limitations Score (H-LS) were developed and applied. SESI was created on the base of two variables: place of residence and the self-reported economic situation of household. E-LS included: difficulties with self-feeding, decrease in food intake due to digestive problems, chewing or swallowing difficulties, loss of appetite, decrease in the feeling the taste of food, and feeling satiety, whereas H-LS included: physical function, comorbidity, cognitive function, psychological stress and selected anthropometric measurements. A logistic regression analysis was performed to assess the socioeconomic, eating-, and health-related limitations of food consumption. Lower socioeconomic status (vs. higher) was associated with a lower chance of consuming fruit/vegetables ≥2 servings/day (OR = 0.25) or consuming dairy ≥1 serving/day (OR = 0.32). The existence of multiple E-LS limitations (vs. few) was associated with a lower chance of consuming fruit/vegetables ≥2 servings/day (OR = 0.72), consuming dairy ≥1 serving/day (OR = 0.55) or consuming water and beverages industrially unsweetened ≥6 cups/day (OR = 0.56). The existence of multiple H-LS limitations was associated with a lower chance of consuming fruit/vegetables ≥2 servings/day (OR = 0.79 per 1 H-LS point increase) or consuming dairy ≥1 serving/day (OR = 0.80 per 1 H-LS point increase). Limitations found in the studied women were related to insufficient consumption of selected groups of food, which can lead to malnutrition and dehydration. There is a need for food policy actions, including practical educational activities, to eliminate barriers in food consumption, and in turn to improve the nutritional and health status of older women.