Intake In Older Adults Research Articles

Changes in Alcohol Intake by Educational Level among Older Men and Women in Spain during the 21st Century

Abstract Background and objectives Despite alcohol use being very common in older adults, studies are scarce and suggest alcohol use may be increasing. Furthermore, despite the known relationship between education and alcohol consumption, there is limited evidence of educational differences in older adults. Our objective was to describe trends in alcohol consumption in individuals aged ≥65 by sex and educational level in Spain. Research design and methods 43,157 participants aged ≥65 years were drawn from Spain’s national health surveys between 2001-2020, representing the non-institutionalized population. The outcomes were various measures of self-reported past-year alcohol intake. Age-standardized rates and negative binomial regression models were used to examine trends and differences in alcohol intake by educational level, sex, and period (2001-2009 vs. 2011-2020). Results The average daily alcohol intake and prevalence of heavy average drinking (>20/10 g/day) decreased over time, especially among men, while moderate average drinking remained unchanged or even increased. Alcohol intake increased with increasing educational levels. All drinking measures showed educational inequalities, and these were greater in women than men. The mean amount of drinking showed the greatest inequality, with and adjusted prevalence ratio of 2.6 in women and 1.1 in men between university relative to primary education level. Discussion and implications Alcohol intake in older adults decreased over time in Spain for heavy average drinking and average drinking amount, although not for moderate average drinking. Consumption remains highest among the highest educational levels, which may negatively affect health. Programs addressing alcohol consumption among older adults are needed to minimize alcohol-related harm.

Exploring the links among brain iron accumulation, cognitive performance, and dietary intake in older adults: A longitudinal MRI study

This study evaluated longitudinal brain iron accumulation in older adults, its association with cognition, and the role of specific nutrients in mitigating iron accumulation. MRI-based, quantitative susceptibility mapping estimates of brain iron concentration were acquired from seventy-two healthy older adults (47 women, ages 60–86) at a baseline timepoint (TP1) and a follow-up timepoint (TP2) 2.5–3.0 years later. Dietary intake was evaluated at baseline using a validated questionnaire. Cognitive performance was assessed at TP2 using the uniform data set (Version 3) neuropsychological tests of episodic memory (MEM) and executive function (EF). Voxel-wise, linear mixed-effects models, adjusted for longitudinal gray matter volume alterations, age, and several non-dietary lifestyle factors revealed brain iron accumulation in multiple subcortical and cortical brain regions, which was negatively associated with both MEM and EF performance at T2. However, consumption of specific dietary nutrients at TP1 was associated with reduced brain iron accumulation. Our study provides a map of brain regions showing iron accumulation in older adults over a short 2.5-year follow-up and indicates that certain dietary nutrients may slow brain iron accumulation.

Efficacy of pain treatment therapies for chronic pain among clients in assisted living facilities: A systematic review

Background: More than 60% of residents in assisted living homes experience pain, a complex and subjective emotion. Here, we examine the effectiveness of pain management treatments for residents in assisted living facilities who suffer from chronic pain. Method: In this review, the PRISMA Statement was adhered to. Included were intervention studies, whether or not they were randomized. Retrospective studies, studies without a control group, and studies without an intervention were among the studies that were excluded. Subjects having chronic pain who were 60 years of age or older, of any gender, and permanently residing in an institutional environment, such as a assisted living facilities or residential care facility, were included in studies that matched the qualifying requirements. Result: Eight papers total—three non-randomized and five randomized controlled trials—were included in our systematic review. Acupuncture, massage, music therapy, and analgesics are among the interventions employed. Analgesics was the most effective intervention. Exercise had similar effects to social interventions on neuropsychiatric symptoms, pain, and medication intake in older adults with chronic pain; Epsom salt hot fermentation is more effective than regular salt; and acupressure is anticipated to be a beneficial and effective nursing intervention for the elderly with chronic pain. Conclusion: The most beneficial treatment outcome was obtained from the analgesic medication therapy. Alternative therapies without the use of drugs provide modest to significant therapeutic results.

Cost-effectiveness of protein-rich meals and snacks for increasing protein intake in older adults

ObjectivesTo investigate the cost-effectiveness of protein-rich meals and snacks for increasing protein intake in home-dwelling older adults. DesignCost effectiveness analysis from a randomized controlled trial, the Power Meals study. SettingParticipants were randomized into one of three groups for eight weeks: a protein-rich meal, snack and bread (Protein), a regular meal (Normal) and a control group without meal service (Control). ParticipantsHome-dwelling home care clients, caregivers and care recipients aged ≥ 65 years (n = 65). MeasurementsProtein intake was assessed by a three-day food diary at the end of the study. Cost for the daily diet was estimated by using Finnish grocery store databases and the prices of the food service. The cost-effectiveness was assessed by an incremental cost-effectiveness ratio (ICER). ResultsCosts for the daily diet in the Protein (8.35 €/d) and the Normal (7.94 €/d) groups were significantly higher than in the control group (5.65 €/d) (p < 0.001). Incremental cost-effectiveness analysis showed that increasing protein intake was cost-effective in the Protein group as incremental cost-effectiveness ratio was 8.11 in the Protein, 8.72 in the Normal and 6.45 in the Control group. ConclusionsIncluding protein rich meals and snacks in a diet increases protein intake in home-dwelling older adults cost-effectively.

Protein Intake and Mortality in Older Adults With Chronic Kidney Disease

Avoiding high protein intake in older adults with chronic kidney disease (CKD) may reduce the risk of kidney function decline, but whether it can be suboptimal for survival is not well known. To estimate the associations of total, animal, and plant protein intake with all-cause mortality in older adults with mild or moderate CKD and compare the results to those of older persons without CKD. Data from 3 cohorts (Study on Cardiovascular Health, Nutrition and Frailty in Older Adults in Spain 1 and 2 and the Swedish National Study on Aging and Care in Kungsholmen [in Sweden]) composed of community-dwelling adults 60 years or older were used. Participants were recruited between March 2001 and June 2017 and followed up for mortality from December 2021 to January 2024. Those with no information on diet or mortality, with CKD stages 4 or 5, or undergoing kidney replacement therapy and kidney transplant recipients were excluded. Data were originally analyzed from June 2023 to February 2024 and reanalyzed in May 2024. Cumulative protein intake, estimated via validated dietary histories and food frequency questionnaires. The study outcome was 10-year all-cause mortality, ascertained with national death registers. Chronic kidney disease was ascertained according to estimated glomerular filtration rates, urine albumin excretion, and diagnoses from medical records. The study sample consisted of 8543 participants and 14 399 observations. Of the 4789 observations with CKD stages 1 to 3, 2726 (56.9%) corresponded to female sex, and mean (SD) age was 78.0 (7.2) years. During the follow-up period, 1468 deaths were recorded. Higher total protein intake was associated with lower mortality among participants with CKD; adjusted hazard ratio (HR) for 1.00 vs 0.80 g/kg/d was 0.88 (95% CI, 0.79-0.98); for 1.20 vs 0.80 g/kg/d, 0.79 (95% CI, 0.66-0.95); and for 1.40 vs 0.80 g/kg/d, 0.73 (95% CI, 0.57-0.92). Associations with mortality were comparable for plant and animal protein (HRs, 0.80 [95% CI, 0.65-0.98] and 0.88 [95% CI, 0.81-0.95] per 0.20-g/kg/d increment, respectively) and for total protein intake in participants younger than 75 years vs 75 years or older (HRs, 0.94 [95% CI, 0.85-1.04] and 0.91 [95% CI, 0.85-0.98] per 0.20-g/kg/d increment in total protein intake, respectively). However, the hazards were lower among participants without CKD than in those with CKD (HRs, 0.85 [95% CI, 0.79-0.92] and 0.92 [95% CI, 0.86-0.98] per 0.20-g/kg/d increment, respectively; P = .02 for interaction). In this multicohort study of older adults, higher intake of total, animal, and plant protein was associated with lower mortality in participants with CKD. Associations were stronger in those without CKD, suggesting that the benefits of proteins may outweigh the downsides in older adults with mild or moderate CKD.

The Association of Oral Processing Factors and Nutrient Intake in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis.

Oral health and food oral-processing issues emerge with functional decline in the older adult population, potentially increasing the risk of malnutrition. Impairment of oral health is associated with poorer nutrition status; however, the relationship between oral factors and the intake of each nutrient remains poorly understood. The associations between different oral factors and nutrient intakes among community-dwelling older adults were investigated. A literature search from 5 databases (Web of Science, Scopus, Cochrane Library, Ovid [MEDLINE and Embase], and CINAHL) was completed on February 1, 2022. The search was limited to peer-reviewed articles published between the years 2012 and 2022. Six cross-sectional studies were included in the meta-analysis. Two authors independently completed the data extraction and summarized the study characteristics, factors adjusted for in the statistical analysis, the outcome, and summary statistics of the results. Meta-analyses showed evidence of a significant association between compromised oral factors (namely, denture status, chewing ability, and the number of teeth) with lower energy (weighted mean difference [WMD], -107 kcal d-1 (95% CI, -132 to -81), protein (WMD, -5.2 g d-1; 95% CI, -6.6 to -3.8), fat (WMD, -4.6 g d-1; 95% CI, -6.7 to -2.6), carbohydrate (WMD, -8.8 g d-1; 95% CI, -13.9 to -3.7), and vitamin C intakes (WMD, -12.9 mg d-1; 95% CI, -16.6 to -9.2) in older adults. Oral health can be an indicator of compromised daily energy, protein, fat, carbohydrate, and vitamin C intakes in older adults. However, the small sample size of the studies included in this review and the heterogeneity among macronutrient studies should be considered. Because of the lack of studies covering all aspects of food oral processing (eg, salivary flow rate, tongue pressure), the associations between oral processing and nutrient intake were not thoroughly explored. PROSPERO registration no. CRD42022308823.

#1205 Protein intake and mortality in older adults with chronic kidney disease: a multicohort study

Abstract Background and Aims Limiting protein intake in older adults with chronic kidney disease (CKD) may reduce the risk of its progression, but whether it can adversely impact nutritional status and overall health is not well known. We aimed to study the associations of total, animal, and plant protein intake with all-cause mortality in older adults with CKD and replicated the analyses in those without CKD for comparison. Method We used data from three cohorts (Seniors-ENRICA 1 and Seniors-ENRICA 2 in Spain and SNAC-K in Sweden) of community-dwelling adults ≥60 years (2 555 with CKD and 6014 without). According to estimated glomerular filtration rates, urine albumin excretion, and diagnoses from electronic health records, 98% of participants with CKD were in stages 2 and 3. Cumulative protein intake was estimated via validated dietary histories and food frequency questionnaires. Vital status was ascertained with national death registers. Associations were estimated with Cox proportional hazards regression models, adjusted for sociodemographic, lifestyle, morbidity, and dietary variables. Results After a median follow-up of 10 years, 1 901 deaths were recorded. Higher total protein intake was associated with lower mortality among participants with CKD [hazard ratio (95% confidence interval) for 1.15 and 1.35 g/kg/day versus 1.0 g/kg/day = 0.93 (0.88, 0.98) and 0.85 (0.76, 0.95), respectively]. Low total protein intake was more detrimental to the youngest old (&amp;lt;75 years) and high total protein was less beneficial. Plant protein showed a stronger protective association with mortality than animal protein [0.73 (0.59, 0.90) and 0.91 (0.85, 0.98) per 0.2 g/kg/day increment, respectively]. Among participants without CKD, most hazard ratios were lower, especially in the oldest old, but no significant interactions between protein intake, CKD, and mortality arose. Conclusion Higher protein intake might have a positive impact on mortality in older adults with mild or moderate CKD, particularly plant protein. Recommendations for these patients may not differ substantially from those without CKD.

Appetite, food intake, and gut hormone responses to glycomacropeptide protein ingestion in older adults: A feasibility, acceptability, and pilot study

Glycomacropeptide (GMP) has a unique amino acid profile which may make less satiating than other dietary proteins. This study assessed the feasibility and likely acceptability of a leucine-enriched GMP drink and determined appetite response in older adults (OA). Thirteen OA (11f; 70 ± 4 years) were recruited for sensory assessments of a leucine-enriched GMP drink when mixed with water and with fruit smoothie, compared with whey protein isolate (WHEY). Participants also partook in a single focus group exploring acceptability to protein and supplementation. Separately, a counterbalanced, double-blind study with twelve OA (8f; 69 ± 3 years) was conducted to determine appetite and gut hormone responses. Fasting subjective appetite was recorded using visual analogue scales and a fasted venous blood sample was collected (to measures acyl-ghrelin, PYY, GLP-1, and CCK) before participants consumed either: GMP protein (27g + 3g leucine, 350 mL water), WHEY (30g, 350 mL water), or water. Participants rested for 240 min, with appetite measures and blood sampling throughout. An ad libitum pasta-based meal was then consumed. Sensory testing revealed low pleasantness rating for GMP in water vs. WHEY (16 ± 14 vs 31 ± 24, p = 0.016). GMP addition to smoothie reduced pleasantness (26 ± 21 vs. 61 ± 29, p = 0.009) and worsened the aroma (46 ± 15 vs. 69 ± 28, p = 0.014). The focus group revealed uncertainty of protein needs and a scepticism of supplements, with preference for food. Gut hormone response did not differ between GMP and WHEY (nAUC for all gut hormones p > 0.05). There was no difference between conditions for lunch ad libitum intake (549 ± 171 kcal, 512 ± 238 kcal, 460 ± 199 kcal for GMP, WHEY, and water, p = 0.175), or for subjective appetite response. Leucine-enriched GMP was not less satiating than WHEY, and low palatability and scepticism of supplements question the likely acceptability of GMP supplementation. Providing trusted nutritional advice and food enrichment/fortification may be preferred strategies for increasing protein intake in OA.

Prevalence estimation of sarcopenia using bioelectrical impedance analysis in elderly people in Lahore

Sarcopenia is the loss of muscle mass and strength, or both, and physiological functions through aging. Early detection of muscle weakness results in better care and interventions regarding dietary habits and protein intake in older adults. The objective of this study was to investigate the prevalence of sarcopenia in a Pakistani population and to correlate dietary habits and lifestyle with the prevalence of sarcopenia. A sample size of 150 individuals, both male and female, of age sixty and above was used. Cardiovascular disease and renal failure patients were excluded. The research field was the community of Lahore. Muscle power was calculated using a handgrip strength dynamometer, and gait speed was calculated using a pedometer. After screening, muscle mass was calculated using bioelectrical impedance analysis, from which sarcopenia was diagnosed. In the age group of 60–65 years, 123 individuals (82%) had low muscle strength and 93 (83%) had low muscle mass. In the age group of 66–70 years, 15 individuals (83.3%) had low muscle strength. In the age group of 71–75 years, 9 individuals (90%) had low muscle strength. The percentage of low muscle strength in the age group of 76+ years was 100%. The percentage of severe sarcopenia was 6%, and moderate sarcopenia was approximately 10% for individuals 60 years of age and older. The prevalence rates of sarcopenia were 21.53% in males and 11.76% in females. Sarcopenia is an emerging health issue in older adults, and early detection and lifestyle modification will lead to a better health outcome and correlate dietary habits and lifestyle with the prevalence of sarcopenia.

Impact of increased protein intake in older adults: a 12-week double-blind randomised controlled trial.

Emerging evidence suggests health-promoting properties of increased protein intake. There is increased interest in plant protein but a dearth of information in relation to its impact on muscle function. The objective of the present work was to examine the impact of intake of different types of proteins on muscle functional parameters including handgrip strength, biomarkers of metabolic health, sleep quality and quality of life in a group of older adults. Healthy men and women aged 50years and older entered a double-blinded, randomised, controlled nutritional intervention study with three parallel arms: high plant protein, high dairy protein and low protein. Participants consumed once daily a ready-to-mix shake (containing 20g of protein in high protein groups) for 12weeks. Changes in handgrip and leg strength, body composition, metabolic health, quality of life and sleep quality were analysed by linear mixed models in an intention-to-treat approach. Eligible participants (n= 171) were randomly assigned to the groups (plant: n= 60, dairy: n= 56, low protein: n= 55) and 141 completed the study. Handgrip strength increased after the intervention (Ptime= 0.038), with no significant difference between the groups. There was no significant difference between groups for any other health outcomes. In a population of older adults, increasing protein intake by 20g daily for 12weeks (whether plant-based or dairy-based) did not result in significant differences in muscle function, body composition, metabolic health, sleep quality or quality of life, compared with the low protein group.

Mortality from decreased food intake in older adults in nursing homes: A retrospective cohort study using electronic care record data

AimTo our knowledge, no studies have examined the risk of mortality in nursing homes using the routinely collected electronic care record information. We aimed to assess the risk of mortality using food intake data documented in electronic care records from Japanese nursing homes. MethodsThis academic–industry collaborative research included 814 older adults from five nursing homes in Japan. The study period was from January 1, 2016 to June 23, 2020. We used the rate of food intake data recorded by care workers in the electronic care records of the residents. We defined decreased food intake as the percentage decrease between admission and 90 days after admission into the nursing home, with cutoffs of 10%, 20%, and 30%. ResultsThe number of older adults whose food intake decreased between admission and 90 days after admission was 114 (14.0%) at a 10% rate, 58 (7.1%) at a 20% rate, and 35 (4.3%) at a 30% rate. All three rates were significantly associated with mortality (10%: hazard ratio [HR] 2.02, 95% confidence interval [CI] 1.30–3.15; 20%: HR 3.03, 95% CI 1.68–5.47; and 30%: HR 4.50, 95% CI 2.15–9.44). ConclusionsWe found that the risk of mortality could conveniently be assessed from the food intake data collected routinely and comprehensively and documented in electronic care records in nursing homes. Our findings can be utilized in nursing homes, where medical staff are limited, to assess high-risk residents and to encourage a discussion regarding the management of end-of-life care.

Factors related to subjective evaluation of difficulty in chewing among community-dwelling older adults.

Awareness of difficulty chewing may limit the diversity of food intake in older adults. However, few studies have clarified which factors are related to subjective difficulty in chewing. The aim was to identify factors related to subjective difficulty in chewing in 70- and 80-year-old Japanese older adults. A total of 1680 participants (792 men, 888 women) were surveyed. Difficulty in chewing was assessed with questionnaires regarding food intake, such as rice, apples, beef, and hard rice crackers. The participants were classified into two groups, the "with difficulty" group (participants who answered "cannot eat," "can eat with difficulty," and "can eat if small") and the "without difficulty" group (participants who answered "can eat without problems"), according to their answers to questionnaires for each food. A logistic regression analysis with subjective difficulty in chewing as the dependent variable was performed for each food. Subjective difficulty in chewing was associated with age, occlusal force, and depression for rice; age, number of remaining teeth, occlusal force, and depression for apples; number of remaining teeth, occlusal force, and depression for beef; and number of remaining teeth and occlusal force for hard rice crackers. Age, number of remaining teeth, and occlusal force, as well as depression, might be related to subjective evaluation of difficulty chewing in community-dwelling Japanese older adults. Geriatr Gerontol Int 2024; 24: 327-333.

Comparative Analysis of Dietary and Supplemental Intake of Calcium and Vitamin D among Canadian Older Adults with Heart Disease and/or Osteoporosis in 2004 and 2015.

Despite the role of calcium and vitamin D in osteoporosis and heart disease, little research has examined changes in the intake of calcium and vitamin D among individuals with these conditions over time. Using data from the 2004 and 2015 Canadian Community Health Surveys, we investigated changes in dietary and supplemental intake of calcium and vitamin D among Canadian older adults aged ≥ 50 years, both with and without heart disease and/or osteoporosis, between 2004 and 2015. Notable declines in dietary calcium intake occurred, particularly among non-supplement users. Surprisingly, individuals with osteoporosis and heart disease, who are at higher nutritional risk, were less likely to use calcium supplements in 2015 compared to 2004. Among calcium supplement users, those with osteoporosis or both conditions experienced significant reductions in their usual calcium intake in 2015, with an increased proportion failing to meet recommended intake levels. Conversely, vitamin D supplement users experienced a substantial rise in vitamin D intake in 2015. In 2015, only a small proportion of supplement users did not meet the recommended vitamin D intake levels. These findings underscore the importance of public health initiatives to facilitate safe increases in calcium and vitamin D intake for older adults, particularly those with heart disease and osteoporosis.

Energy and nutrient intake in older adults with healthy aging during the Corona Virus Disease 19 pandemic– a cohort study

Background and objectiveLockdown measures implemented amid the COVID-19 pandemic promoted changes in lifestyle, particularly engagement in physical activity/exercise and dietary intake. However, few studies are available investigating the healthy older population, particularly in developing countries. Therefore, the objective of this study was to assess the impact of the COVID-19 pandemic on energy and nutrient intake among older adults with successful aging and to evaluate changes in muscle mass, strength and physical performance. MethodsA cohort study of 38 healthy older adults from a Brazilian geriatrics referral center were assessed at two time points: baseline – up to 1 year prior to the pandemic; and follow-up – an average of 17 months after the pandemic outbreak. Energy and nutrient intake was determined using food recalls and diary records, while muscle mass was calculated based on anthropometric parameters. Maximum hand-grip strength and Short Physical Performance Battery (SPPB) score were also evaluated. ResultsMedian age of participants was 87 years. During the pandemic, intake of protein increased from 52.6g to 63.9g (p=0.013) and micronutrients also increased: vitamin C from 35.4 mg to 76.1mg (p=0.027), vitamin B12 from 2.2mg to 3.1 mg (p=0.045), calcium from 435.1mg to 631.5mg (p<0.001), magnesium from 186.5mg to 198.9 mg (p=0.043), zinc from 5.8 mg to 7.6 mg (p=0.009), iron from 6.9mg to 7.2 mg (p=0.035) and potassium from 1941.6mg to 2115.5 mg (p=0.048). No changes in energy intake or other nutrients were evident. No difference in mass, strength or physical performance was observed during the study period. Overall, 84% of participants remained physically active, although engagement in physical exercise decreased by 50% (p<0.002). ConclusionThe increase in intake of proteins and micronutrients suggests improved diet quality during the pandemic. Engagement in physical exercise decreased significantly, but level of physical activity was maintained. No change in anthropometric parameters, strength or physical performance was evident in the population investigated.

203 Secondary hyperparathyroidism is associated with poor physical performance in older adults: results from the TUDA study

Abstract Background Vitamin D deficiency frequently leads to secondary hyperparathyroidism and is associated with frailty and sarcopenia. However, the role of hyperparathyroidism in the pathophysiology of frailty and impaired physical function is unclear. In this study, we evaluated the relationship between secondary hyperparathyroidism and poor physical performance as assessed by the Timed-Up-and-Go (TUG) test. Methods Participants were from a cross-sectional study of Irish adults aged &amp;gt;60 years. Those with eGFR &amp;lt;30 mL/min and serum calcium ≥2.5 mmol/L were excluded to avoid hyperparathyroidism due to renal impairment and primary hyperparathyroidism. We also excluded participants on drugs that may affect parathyroid hormone (PTH): (teriparatide, denosumab, activated forms of vitamin D), factors affecting physical function (glucocorticoid use: current or past &amp;gt;3 months and history of stroke) and those with an MMSE &amp;lt;24. Hyperparathyroidism was defined as a PTH ≥65 nmol/L and abnormal physical performance by TUG ≥12 seconds. The relationship between hyperparathyroidism and abnormal TUG was explored in logistic regression. Results There were 3,405 participants. 72.4% were female and mean age was 77.5 +/−7.6 years, with 36.7% having a TUG ≥12 seconds. Secondary hyperparathyroidism was significantly associated with TUG ≥12 (OR: 1.34; CI: 1.04–1.74, p = 0.026) after adjustment for age, sex, body mass index, serum 25-hydroxyvitamin D, eGFR, dairy intake, alcohol use, smoking, diabetes mellitus, cardiovascular disease (ischaemic heart disease, heart failure) and peripheral artery disease. Conclusion Secondary hyperparathyroidism was associated with a 34% increased risk of poor physical performance. Other research has demonstrated an association between elevated PTH and sarcopenia supporting a role for its direct effect on muscle function. This study highlights the importance of ensuring both adequate vitamin D status and calcium intake in older adults to reduce the risk of secondary hyperparathyroidism and its potential negative impact on the musculoskeletal system.

Exploring Whether Weight-Related Cues Affect Food Intake in Older Adults with Dementia.

Past research has shown that exposure to the image of a slim person reduces food consumption among young adults. However, it remains unknown whether this paradigm could be adapted and applied to increase food intake among older adults with dementia by exposing them to the image of a higher-weight person to mitigate weight loss and malnutrition. The present study explored whether weight-related visual cues affect the amount of food consumed by older adults with dementia. In the experiment, twenty-one elderly people with dementia living in a nursing home were visually exposed to one of four conditions (a cartoon image of a normal-weight chef, a higher-weight chef, a flower or no image) during real-life daily lunch situations over the course of four weeks, during which each condition was presented for one week. Results demonstrate that participants finished their meals more frequently when they were exposed to the image of the higher-weight chef than when they were not exposed to any images. These results suggest that exposure to a cartoon chef character representing a stereotyped social group related to body weight activates the stereotype and increases stereotype-consistent behavior in older adults with dementia. The present findings will contribute to understanding the effect of visual information on eating behavior and to designing eating environments which facilitate sufficient nutrition intake among older adults with dementia.

Barriers and Facilitators to Fluid Intake in Older Adults: Study Protocol

Barriers and Facilitators to Fluid Intake in Older Adults: Study Protocol

Association between dietary vitamin E intake and cognitive decline among old American: National Health and Nutrition Examination Survey.

Numerous studies have reported that vitamin E plays a key role in nervous system development and neurotransmitter production. This study aimed to investigate changes in vitamin E intake in older adults with low cognitive performance using NHANES. In this cross-sectional study, we examined a sample of 2255 American adults aged 60 and over between 2011 and 2014. We collected dietary data by averaging two recalls for dietary use to determine vitamin E intake. We assessed cognitive function using five tests and analyzed the association between these variables using a multivariate logistic regression model. A total of 2255 participants aged ≥ 60years from the National Health and Nutrition Examination Survey (NHANES) for the 2011-2014 cycle were included in the analysis. Vitamin E intake was negatively associated with cognitive function. In the Z test, with each 1mg/day increase in dietary intake of vitamin E, there was a 6% decrease in the correlation with cognitive impairment (OR = 0.94, 95% CI 0.91-0.97) in the fully fitted model (OR = 0.94, 95% CI 0.91-0.97). These findings remained consistent when analyzing the exposure as a categorical variable. In comparison to Q1, Q4 showed a 53% reduction in the incidence of cognitive impairment in the Z test (OR = 0.47, 95% CI 0.33-0.67).No significant statistical interaction between the variables was found. An increased dietary intake of vitamin E has been associated with decreased cognitive impairment in individuals over 60years old. The dose-response curve showed an L-shaped association between dietary vitamin E intake and cognitive decline in US adults, with an inflection point of approximately 9.296mg/day.

Dehydration among the Elderly: A Comparison between Nine Different Clinical and Metabolic Criteria

Background: Dehydration, as a common problem in older adults, plays a significant role in morbidity and mortality. The elderly are more susceptible to dehydration and fluid deficiency due to age-related factors. There is not much literature concerning fluid intake in older adults. This study aims to investigate fluid intake and dehydration prevalence in older people and compare the accuracy of potential markers in the detection of dehydration.&#x0D; Methods: This cross-sectional study was done on 127 old people (48 males and 79 females) selected from a nursing home in Shiraz, Iran. Socioeconomic status was assessed via interview. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), urine specific gravity (USG), urine color (UC) and bioelectrical impedance analysis (BIA), extracellular water (ECW), intracellular water (ICW), and total body water (TBW) were measured. The fluid intakes were recorded using a beverage and fluid intake questionnaire. Total fluid intakes were compared using two fluid intake guidelines (European guidelines and US guidelines) as well. Furthermore, anthropometric indices were measured.&#x0D; Results: The mean age of participants was 73.01± 5.70 year. Fluid intake was 2.32 ± 0.48 liter/day. Based on urine specific gravity (USG) (˃1.020) and SBP (SBP ˂ 100 mmHg), 9.4% and 14.2% of the participants were dehydrated respectively. Among all hydration criteria, ECW had the highest potential for detection which identified 72.4% of participants as dehydrated. Among fluid intake guidelines, US guidelines were the best in dehydration diagnosis (112 individuals out of 127).&#x0D; Conclusions: Although urinary markers and physical indexes (SBP and HR) could not be used to determine hydration status, BIA measurements, especially ECW, have the potential to detect dehydration. In addition, daily fluid intakes are still practical for assessment of hydration status.

Relationship between Adherence to the 2019 Canada’s Food Guide Recommendations on Healthy Food Choices and Nutrient Intakes in Older Adults

BackgroundFollowing Canada’s food guide (CFG) recommendations should ensure adequate nutrient intakes. Older adults have increased needs for certain nutrients and nutrient density; the extent to which adherence to CFG recommendations can help reduce inadequate nutrient intakes is unknown. ObjectivesWe aimed to assess the relationship between adherence to CFG recommendations on healthy food choices and intake of key nutrients in adults 65 y and older from the Canadian Community Health Survey 2015 - Nutrition. MethodsSecondary analysis of data from 4093 older adults of the Canadian Community Health Survey 2015 - Nutrition (mean age, 73.6 y, 54% females). Dietary intakes were measured using an interviewer-administered 24-h dietary recall, including 1 repeat in a subsample (42%). The National Cancer Institute multivariate method was used to estimate usual (i.e., long-term) dietary intakes. Adherence to CFG recommendations was measured using the Healthy Eating Food Index (HEFI)-2019 score. Simple linear and logistic regression models estimated the effect of increased HEFI-2019 score on usual nutrient intakes and the prevalence of inadequate nutrient intakes (i.e., below the estimated average requirements), respectively. ResultsCompared with the prevalence of inadequate intakes at median HEFI-2019 score (46.4/80 points), a higher HEFI-2019 (+11 points) was associated with reductions in the prevalence of inadequate intakes of magnesium, vitamin B6 and protein [–19.8% (95% confidence interval (CI): –30.8, –8.9), –12.7% (95% CI: –22.5, –3.0), and –4.7% (95% CI: –9.4, –0.1), respectively]. In contrast, data for higher HEFI-2019 scores were compatible with increased prevalence of inadequate intakes of folate, vitamin D, and calcium [4.0% (95% CI: –8.4, 16.3), 2.6% (95% CI: 1.1, 4.0), and 2.3% (95% CI: –3.0, 7.5), respectively]. ConclusionsBased on dietary intakes of Canadian older adults in 2015, increasing the degree of adherence to CFG recommendations on healthy food choices may reduce nutrient intake inadequacy for most key nutrients except folate, vitamin D, and calcium.