Quality of life, functional impairment and social factors as determinants of nutritional status in older adults: The VERISAÚDE study (original) (raw)
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Clinical Nutrition, 2012
Background & aims: There is no valid, fast and easy-to-apply set of criteria to determine (risk of) undernutrition in community-dwelling older persons. The aim of this study was to develop and validate such criteria. Methods: Selection of potential anthropometric and undernutrition-related items was based on consensus literature. The criteria were developed using 15-year mortality in community-dwelling older persons ! 65 years (Longitudinal Aging Study Amsterdam, n ¼ 1687) and validated in an independent sample (InCHIANTI, n ¼ 1142). Results: Groups distinguished were: (1) undernutrition (mid-upper arm circumference <25 cm or involuntary weight loss !4 kg/6 months); (2) risk of undernutrition (poor appetite and difficulties climbing staircase); and (3) no undernutrition (others). Respective hazard ratio's for 15-year mortality were: (1) 2.22 (95% CI 1.83e2.69); and (2) 1.57 (1.22e2.01) ((3) ¼ reference). The area under the curve (AUC) was 0.55. Comparable results were found stratified by sex, excluding cancer/obstructive lung disease/(past) smoking, using 6-year mortality, and applying results to the InCHIANTI study (hazard ratio's 2.12 and 2.46, AUC 0.59). Conclusions: The developed set of criteria (SNAQ 65þ ) for determining (risk of) undernutrition in community-dwelling older persons shows good face validity and moderate predictive validity based on the consistent association with mortality in a second independent study sample.
Nutrition Research, 2008
Undernutrition is a common problem associated with clinical complications such as impaired immune response, reduced muscle strength, impaired wound healing, and susceptibility to infections; therefore, it is an important treatment target to reduce morbidity and mortality associated with chronic diseases and aging. The aim of the present study was to apply a reliable and valid instrument for the determination of undernutrition risk in an in-hospital patient population and to describe possible associations between risk of undernutrition and some aspects of health-related quality of life in patients with chronic diseases. Fifty-six adult patients with different chronic diseases were interviewed with NUFFE questionnaire and the EQ-5D. Anthropometric measurements were performed. Reliability and validity of the NUFFE instrument was tested, and its correlation with EQ-5D was calculated. Euro-Qol scores correlated significantly with the total NUFFE scores and with the items constructing the most important factor of the instrument, explaining 53.74% of its variance. Nutritional form for the elderly was shown to be a reliable instrument in the study group because its internal consistency measured by Cronbach α was 0.62, and the item-total score correlations were significant for the half of the items. Criterion-related validity, concurrent validity, and construct validity of NUFFE were established. We have shown that impaired level of healthrelated quality of life is an important determinant of risk for undernutrition. Nutritional form for the elderly is an appropriate instrument to estimate undernutrition risk in a general, in-hospital patient population with various chronic diseases and to identify "at risk" patients who may benefit from professional dietary interventions to reduce undernutrition-related complications.
Revisiting the concept of malnutrition in older people
Journal of Clinical Nursing, 2007
Aim. The aim of this study is to revisit the concept of malnutrition in older people, trace the new development and test the use of refined framework with empirical data.Background. Malnutrition in older people is a common and significant problem worldwide. Continuing Chen's earlier work in 2001, a refinement was conducted and a prospective study was designed to test the use of this refined framework.Design. A cohort study of 114 hospitalized older patients in Northern Taiwan.Methods. The sample consists of 114 older patients aged 65 years and older, who were admitted for the cardiac and orthopaedic services at a tertiary 2300-bed hospital. From March to August 2004, assessed by one trained nurse, participants completed a structured face-to-face interview evaluating their age, visual/hearing impairments, oral health, cognitive status, comorbidities, medication use, social economic status, functional status, social support, depressive symptoms and nutritional status within 48 hours of admission. Participants who stayed >5 days were reassessed before discharge (n = 70). The data from admission were the main focus of this report.Results. Regression analysis revealed that that more medication taken, female gender, lower functional status (beta = 0·34, P < 0·001) and higher depressive symptoms were independent predictors of poor nutritional status, with the full model accounting for 48·2% of the variance. The result is in-line with the original theoretical underpinnings and it suggests that this refined framework detailing sub-concepts and measurable indices appears to fit the empirical data and suitable for clinical use.Conclusion. The findings lend support to the use of this framework in managing malnutrition in older people.Relevance to clinical practice. Nurses have an essential role in providing care for older people a framework like this would provide a road map guiding the intervention efforts.
Malnutrition in elderly: Social and economic determinants
The journal of nutrition, health & aging, 2012
Malnutrition occurs frequently in the frailest groups of the population, especially in people who are on a low income and elderly subjects, overall if they are institutionalized. The aim of this study was to assess the prevalence of malnutrition in a sample of elderly people living in different settings and to identify the determinants of malnutrition. Methods: A total of 718 subjects, 472 females (F) and 246 males (M), were recruited from nursing homes or were free living in three different regions in Italy. Nutritional status, depression, social, functional and cognitive status, were evaluated. Results: According to the Mini Nutritional Assessment (MNA), a high prevalence of malnutrition was found out in both genders: 26% of F and 16.3% of M were classified as being malnourished (MNA<17); 40.9% of F and 35% of M were at risk of malnutrition (MNA 17-23,5). The prevalence of malnutrition was significantly higher in NH subjects in both sexes. Moreover, a relationship was shown between malnutrition and inability to shop, prepare and cook meals because of a low income, distance from markets or supermarkets as well as impossibility to drive the car or to use public transportation. This study confirms the necessity to routinely perform nutritional status evaluation in elderly subjects, to carry out training courses for health workers (doctors, nurses, psychologists, dietitians), to implement nutritional education of the geriatric population, to develop tools and guidelines for health workers and caregivers, to identify and reduce clinical, functional, social or economic risk factors for malnutrition.
Public Health Nutrition, 2016
ObjectiveMalnutrition is a common and relevant syndrome in elderly people due to its influence on quality of life. The main aim of the present study was to identify health determinants of malnutrition or risk of malnutrition.DesignCross-sectional study collecting information on sociodemographic and health factors (co-morbidity, cognitive or affective problems, prescription medication use, frailty status, self-rated health) as determinants of nutritional status, assessed by the short form of the Mini Nutritional Assessment.SettingForty-three senior centres from Galicia (north-western Spain) participated to recruit participants.SubjectsA representative community-dwelling sample of 749 elderly people aged ≥65 years.ResultsOf the total participants, 14·3 % were malnourished/at risk of malnutrition. Presence of overweight or obesity, depressive symptoms, polypharmacy (use of five or more prescription medications), presence of pre-frailty or frailty status and poor self-rated health showe...
Determination of nutritional status and is effective factors among the elderly
2016
Nutritional status is effective in individuals' health and ability. In fact, inappropriate food intake during old ages results in nutritional shortcomings, incidence of many special disorders, and consumption of many health services. This Cross sectional study was conducted to assessment nutritional status and assess impact of some medical and life style factor on nutritional status in Iranian Community-Dwelling Older Adults. Study was conducted on 240 individuals over 60 years of age Nutritional status was assessed using the short form of Mini Nutrition Assessment (MNA) questionnaire. Data were analyzed using chi-square test, ANOVA, and regression model. According to the results, 140(58.3) of the samples were female, with the mean age of 66.98 +/- 6.23 years. Besides, 39(16.2) of the participants had malnutrition, 162 (67.5) were exposed to malnutrition, and 39(16.2) had normal nutritional status. The results showed a significant relationship between nutritional status and some...
Clinical Epidemiology and Global Health
The negative outcomes like an increased risk of falling, anemia, immune dysregulation, impaired cognitive status, reduced muscle function, increased morbidity and mortality associated with malnutrition are believed to affect the economy of the country in the future years. In this backdrop, this study aims to evaluate the nutritional status and different risk factors associated with malnutrition among elderly patients at a tertiary care public teaching hospital. Methods: This questionnaire-based study utilized the "Mini Nutritional Assessment-Short Form" tool to evaluate the nutritional status of elderly inpatients (aged 60 years or more). The data obtained from 235 participants reporting in the medicine department is presented. Based upon MNA-SF tool parameters, a well-determined score was obtained and on the basis of scores, the patients were categorized into "normal" (12-14), "at risk of malnutrition" (8-11 points) and "malnourished" (0-7 points). Multinomial logistic regression was performed to study the influence of different determinants on the nutritional status among elderly inpatients. Results: The studied sample had a high frequency of 50.2% for the patients who are "at risk of malnutrition" and 46.4% of patients were "malnourished". Based on the evaluated scores of MNA-SF tool, this study also confirms that the mobility functions, the decline in food intake and weight loss are major risk factors for malnutrition. Conclusions: A very high prevalence of malnutrition was observed, in consonance with the previous reports. The findings also indicate that malnutrition is a multifactorial condition mostly associated with mobility dysfunction followed by somatic factors and socio-demographic factors. Further studies are required to map the risk factors in order to avoid the associated negative outcomes.
Nutrition (Burbank, Los Angeles County, Calif.), 2018
The aim of this study was to assess nutritional status and associated factors in elderly individuals. This cross-sectional study was conducted in residential homes with a probabilistic cluster sample. Two-hundred eighty-seven individuals 65-74 y of age were interviewed and examined in the city of Cruz Alta, state of Rio Grande do Sul, Brazil. A structured questionnaire was used to assess the socioeconomic, behavioral, and general health conditions; the number of present teeth were counted. Nutrition was assessed with a validated instrument-the Mini Nutritional Assessment-which classifies the patient as normal (eutrophic), at nutritional risk, or malnourished. For data analysis, the participants were categorized in eutrophic or at nutritional risk (at risk of malnutrition + malnourished). The associations were assessed by either the χ or Mann-Whitney tests. Uni- and multivariate Poisson regression analyses verified the associations. The significance level was set at 5%. The prevalenc...
Malnutrition, Quality of Life and Their Relationship among Older Adults: A Scoping Review
JANUARY 2023
Malnutrition and poor quality of life (QoL) in older adults are becoming a public health concern. Therefore, this review article summarised significant studies which investigated the assessment of malnutrition and QoL and its relation. A literature research on academic journals published from 2011 to 2021 was conducted by using electronic databases, which were Google Scholar, PubMed, Science Direct and SCOPUS. A total of 21 studies with 26,569 participants were identified and included in this review. The prevalence of malnutrition ranged from 1.6% to 26.5%, and poor QoL was significant amongst malnourished older adults. In conclusion, malnutrition is associated with poor QoL amongst older adults. Future studies regarding factors that influence malnutrition and its relation towards the QoL amongst older adults are needed as it will help in assisting the healthcare professions to combat these health problems.