Levels Of Nutritional Risk Research Articles

The implications of poor nutritional status on outcomes of geriatric trauma patients

BackgroundMalnutrition is shown to be associated with worse outcomes among surgical patients, yet its postdischarge outcomes in trauma patients are not clear. This study aimed to evaluate both index admission and postdischarge outcomes of geriatric trauma patients who are at risk of poor nutritional status. MethodsThis is a secondary analysis of the prospective observational American Association of Surgery for Trauma Frailty Multi-institutional Trial. Geriatric (≥65 years) patients presenting to 1 of the 17 Level I/II/III trauma centers (2019–2021) were included and stratified using the simplified Geriatric Nutritional Risk Index (albumin [g/dL] + body mass index [kg/m2]/10) into severe (simplified Geriatric Nutritional Risk Index <5), moderate (5.5> simplified Geriatric Nutritional Risk Index ≥5), mild level of nutritional risk (6> simplified Geriatric Nutritional Risk Index ≥5.5), and good nutritional status (simplified Geriatric Nutritional Risk Index ≥6) and compared. ResultsOf the 1,321 patients enrolled, 22% were at risk of poor nutritional status (mild: 13%, moderate: 7%, severe: 3%). The mean age was 77 ± 8 years, and the median [interquartile range] Injury Severity Score was 9 [5–13]. Patients at risk of poor nutritional status had greater rates of sepsis, pneumonia, discharge to the skilled nursing facility and rehabilitation center, index-admission mortality, and 3-month mortality (P < .05). On multivariable analyses, being at risk of severe level of nutritional risk was independently associated with sepsis (adjusted odds ratio 6.21, 95% confidence interval 1.68–22.90, P = .006), pneumonia (adjusted odds ratio 4.40, 95% confidence interval 1.21–16.1, P = .025), index-admission mortality (adjusted odds ratio 3.16, 95% confidence interval 1.03–9.68, P = .044), and 3-month mortality (adjusted odds ratio 8.89, 95% confidence interval 2.01–39.43, P = .004) compared with good nutrition state. ConclusionNearly one quarter of geriatric trauma patients were at risk of poor nutritional status, which was identified as an independent predictor of worse index admission and 3-month postdischarge outcomes. These findings underscore the need for nutritional screening at admission.

Effect of Different Plasma/Red Blood Cell Ratios in Blood Transfusion Therapy on Hepatorenal Function and Nutritional Status of Patients with Traumatic Hemorrhage

Traumatic hemorrhage is the major cause of death in trauma patients, and blood transfusion therapy is a necessary measure to ensure their life safety and nutritional status. However, a significant controversy exists in clinical practice regarding the optimal ratio of plasma to red blood cells for transfusion therapy. In this study, we compared the differences in hepatorenal function and nutritional status of three groups of patients with traumatic hemorrhage receiving blood transfusions with different plasma/red blood cell ratios (2.5:1, 1:1, and 1:1.5). Patients with plasma/red blood cell ratios of 1:1 exhibited the best post-transfusion blood status, the best hepatorenal function and nutritional status after blood transfusion, and the lowest nutritional risk level. In conclusion, transfusion therapy for traumatic patients with a 1:1 plasma/red blood cell ratio can effectively improve the coagulation function of patients and replenish blood volume, while maintaining the stability of hepatorenal function and nutritional status.

Differentiation of the Nutritional Risk of Polish Elderly People According to Selected Demographic Characteristics and Declared Socioeconomic Status

Nutritional risk screening in older people can help to not only identify health risks but also to treat them effectively. The aim of this work was to assess the relationship between the demographic characteristics (age, gender and place of residence) and socioeconomic status of older people in the community and nutritional risk. The Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN-14) questionnaire was used to evaluate the nutritional risk. The study was conducted in 417 people (312 women and 105 men) between 60 and 95 years old (70.8 ± 6.73 years). Multivariate correspondence analysis (MCA) was used to determine the relationships between the categories of variables describing the level of nutritional risk, demographic characteristics and the value of the socioeconomic status (SES) index. To assess the relationship between identified nutritional risks, demographics and SES index variables, we used logistic regression analysis. Based on these studies, nutritional risk factors for older people in Poland were identified. It has been shown that larger cities and low socioeconomic status are closely linked to higher nutritional risk. At the same time, age and gender were not significant factors influencing nutritional risk. Identifying the factors that increase the nutritional risk of older people can help to improve their quality of life.

Food-Related Quality of Life in Children and Adolescents With Crohn's Disease.

Food-related quality of life (FRQoL) encompasses the psychosocial elements of eating and drinking. The FRQoL of children and adolescents with inflammatory bowel disease has not yet been assessed. This study aimed to evaluate the utility of the validated FR-Qol-29 instrument in children with Crohn's disease (CD). Children diagnosed with CD, a shared home environment healthy sibling, and healthy control subjects 6 to 17 years of age were recruited to this single-center, prospective, cross-sectional study. Children or their parent or guardian completed the FR-QoL-29 instrument. Internal consistency was assessed by completing Cronbach's α. Construct validity was established by correlating the CD FR-QoL-29 sum scores with the Physician Global Assessment and Pediatric Crohn Disease Activity Index scores. The discriminant validity was analyzed using a 1-way analysis of variance, and a Spearman's correlation coefficient test was completed to identify any correlations associated with FRQoL. Sixty children or their parent or guardian completed the FR-QoL-29 instrument (10 children in each subgroup). The internal consistency was excellent (Cronbach's α = 0.938). The mean FR-QoL-29 sum scores were 94.3±27.6 for CD, 107.6±20 for siblings, and 113.7±13.8 for control subjects (P = .005). Those with higher disease activity had worse FRQoL (Physician Global Assessment P = .021 and Pediatric Crohn Disease Activity Index P = .004). Inflammatory bowel disease FR-QoL-29 sum scores correlated with weight (P = .027), height (P = .035), body mass index (P = .023), and age (P = .015). FRQoL is impaired in children with CD. Healthy siblings also have poorer FRQoL than control subjects. Several clinical factors are associated with poorer FRQoL in children with CD including age and level of nutritional risk (weight, height, and body mass index). Further research is required validate these findings and to develop strategies for the prevention or treatment of impaired FRQoL in children with CD.

Differentiation of Nutritional Risk among Polish Seniors Based on Selected Lifestyle Characteristics.

Elderly people living in the community are a population group at high nutritional risk. The aim of this study was to assess the nutritional risk of Polish seniors in relation to the region of residence and selected lifestyle characteristics (alcohol consumption, smoking, sleep, physical activity). The SCREEN-14 (Seniors in the Community: Risk Evaluation for Eating and Nutrition) questionnaire was used to assess nutritional risk. The questionnaire was conducted among 320 Polish adults aged 60 and older. The snowball method was used to select the sample. The study was conducted from May to July 2021 in two regions. Cluster analysis with agglomeration technique was used to identify the association between categories of variables describing nutritional risk level, demographic characteristics, and lifestyle characteristics. Logistic regression analysis was used to assess the association between identified nutritional risk levels and selected lifestyle characteristics. Men over 75 and seniors living in smaller towns have been shown to be at higher nutritional risk. High nutritional risk was significantly more common among those who consumed alcohol, smoked tobacco, and had less than six hours or more than nine hours of sleep per day. In addition, low to moderate physical activity was associated with higher nutritional risk. The identification of factors that increase nutritional risk among seniors can support the planning of ways to prevent nutritional problems in this age group.

Association Between the Prognostic Nutritional Index and Cognitive Function Among Older Adults in the United States: A Population-Based Study.

Nutritional status has been recognized as an important factor influencing cognitive function-related diseases, but few comprehensive nutrition indicators are available to assess the risk of cognitive decline. This study aimed to investigate the relationship between the prognostic nutritional index (PNI) and cognitive function in an elderly population, and the differences in nutrient intake between different levels of nutritional risk. Based on cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014, we included 2,564 older participants. The lower quartile of each of the four cognitive tests was considered to have cognitive function impairment (CFI). Binary and multivariate logistic regression models were used to estimate the relationship between the PNI and the odds ratio of CFI. After adjustment for confounding variables, we found that the odds of CFI were significantly lower for participants with normal PNI levels than for those with low PNI levels. In a comparison of global cognitive impairment scores, participants with a normal PNI had lower ratios of poor cognitive performance than those with a low PNI. By comparing the nutrient intake at different PNI levels, we found a reduction in the intake of protein, dietary fiber, total saturated fatty acids, and multiple micronutrients in the low PNI group. Our study shows that the PNI can be a good predictor of the odds of CFI in the elderly population and that it is a convenient indicator of reduced intake of nutrients which may be important to brain health.

Performance of functionality measures and phase angle in women exposed to chemotherapy for early breast cancer.

The study aimed to analyze the influence of chemotherapy on nutritional status and the phase angle (PhA) as nutritional indicator for breast cancer women undergoing chemotherapy. A prospective study was performed. Women who were starting chemotherapy with no previous chemotherapy treatment were recruited. Quality of life (QoL) was collected using the EORTC QLQ-BR23 questionnaire. Bioelectrical impedance analysis, performance tests, and blood sample to albumin analyzes were collected at 2-time points: diagnosis (T0) and after 1 month of completion of therapy (T1). Mean, standard deviation, linear regression, and ANOVA in R were used to explore the results. 61 women were included. We did not find any changes in body composition. However, PhA, nutritional risk index (NRI), gait speed (GS), and handgrip strength (HGS) had expressive changes (p<0.001). 75.4% of women had PhA values below the cut-off point of 5.6°, and the group that had a lower average of PhA also expressed low NRI. PhA was a nutritional status marker and its values were influenced by changes in NRI (p<0.05). We have found supporting evidence for chemotherapy treatment resulting in worsening of prognostic factors such as PhA, and yet PhA was related to no nutritional risk. Besides a higher prevalence of obesity, 80% of the sample showed some nutritional risk level, implying the possibility of a sub-notification candidate who might benefit, for instance, from nutritional intervention in obesity groups. Further investigation about this theme may improve health measures for the prevention and screening of disease among breast cancer.

Nutritional risk and clinical outcomes in patients diagnosed with COVID-19 in a high-complexity hospital network

Introduction: the identification of nutritional risk at hospital admission is important to establish timely interventions in the COVID-19 patient care cycle, due to a high risk of it being associated with complications. Objective: to determine the association between the level of nutritional risk upon admission and in-hospital mortality at 28 days in patients diagnosed with COVID-19 treated between March and October 2020 in two hospital institutions in Colombia. Methods: a retrospective, observational study. Hospitalized patients with a diagnosis of COVID-19 were included and assessed by the Nutrition Service using the nutritional risk identification in emergencies scale, adapted from the NRS 2002 scale. In-hospital mortality at 28 days was analyzed as the primary endpoint, and hospital stay, admission to Intensive Care Unit (ICU), and requirement for mechanical ventilation as secondary endpoints. Results: a total of 1230 patients were included, with a mean age of 65.43 ± 15.90 years, mainly men (57.1 %, n = 702). A high nutritional risk (≥ 2 points) was identified in 74.3 % (n = 914). Patients with a high nutritional risk had a greater probability of in-hospital death at 28 days (HRadj: 1.64; 95 % CI: 1.11-2.44), and a greater risk of requiring mechanical ventilation (OR = 1.78; 95 % CI: 1.11-2.86) or ICU admission (OR = 1.478; 95 % CI: 1.05-2.09), as well as hospital stay longer than 7 days (OR = 1.91; 95 % CI: 1.47-2.48). Conclusions: patients with a diagnosis of COVID-19 at high nutritional risk had a significantly higher in-hospital mortality at 28 days and a higher probability of requiring mechanical ventilation, ICU admission, and prolonged hospital stay.

Serum Biomarkers Associated with Malnutrition and Nutritional Risk in Elderly Primary Care Patients: A Cross-sectional Study from Bosnia and Herzegovina.

BackgroundThe aim of the study was to determine the ability of ferritin, haemoglobin, albumin and total cholesterol to identify nutritional risk and malnutrition among elderly primary care patients.MethodsThe cross-sectional study included 446 elderly adults over 65 years of age from four areas of Bosnia and Herzegovina. In addition to anthropometric, functional, cognitive and biochemical indicators, nutritional status was evaluated using 24-hour recall of meals, the Mini Nutritional Assessment (MNA), and Seniors in the Community: Risk Evaluation for Eating and Nutrition, Version II (SCREEN II).ResultsMalnourished/at-risk study respondents had lower mean levels of haemoglobin (P=0.001) and total cholesterol (P<0.001), compared to those with normal nutritional status. Albumin levels significantly differed regarding nutritional status (P=0.004), but not nutritional risk level (P=0.521). Significant differences in serum ferritin levels were not found between malnourished and normally nourished study respondents (P=0.779) Determinants of albumin level were eating more than three meals a day (P<0.001), fewer than two portions of fruit and vegetables a day (P=0.024), drinking one glass of wine (P<0.001) and reporting functional independence (P=0.011). The AUC curves for serum ferritin, albumin and total cholesterol levels in men and women, as well as for haemoglobin levels in women, were poor to fair (AUC<0.800).ConclusionAlthough ferritin, haemoglobin, albumin and total cholesterol may be useful biomarkers of nutritional status, their accuracy in diagnosing malnutrition and nutritional risk among elderly primary health care patients is limited.

DIETARY INTAKE AND NUTRITIONAL RISK AMONG OLDER AMERICANS

A suboptimal diet and nutritional deficiency are among the leading causes of chronic diseases (e.g., cardiovascular diseases, metabolic syndrome, cancer, and osteoporosis), morbidity, and mortality. The objective of this study is to assess dietary intake and nutritional risk among older Americans. The dietary intake of 15 food and nutrients that are closely associated with the risk of poor health was assessed based on the dietary guidelines and nutritional goals for older Americans using a nationally representative sample of older adults (N=7,737) in the Health and Retirement Study Health Care and Nutrition Survey. The average consumption of most food and nutrients was out of the optimal range. For example, older men and women consumed 1.32-1.35 cups of dairy products and 1.23-1.29 ounces of whole grains, which is less than half of the suggested amount. The average consumption of sodium, on the other hand, was over 12 times greater than suggested dietary recommendation for older men and about 10 times greater for older women. The nutritional risk index (range: 0–15) was created by summing the number of dietary risk factors (not meeting the dietary guidelines and nutritional goals), the index scores for older men and older women were 11.05 (SD=2.31) and 10.09 (SD=2.60) respectively, suggesting the high level of nutritional risk. A healthy diet should be encouraged to prevent chronic diseases and improve the health of older adults. Nutritional education may be an effective way to promote a healthy diet.

The nutritional risk and short-, medium- and long-term mortality of hospitalized patients with atrial fibrillation.

To determine the association between the level of nutritional risk and the mortality of hospitalized patients with atrial fibrillation. In a prospective cohort study, we included patients hospitalized with atrial fibrillation in an internal medicine department in 2007. We calculated the nutritional risk with the Controlling Nutritional Status (CONUT) score and conducted a 10-year follow-up. To determine the variables associated with mortality in the short (3months), medium (1year) and long term (10years), we constructed a Cox proportional hazards regression model and calculated the Kaplan-Meier survival curves. The study included 282 patients with a mean (SD) age of 81.2 (7.9)years. The mean CONUT score was 4.7 (2.8) points. Thirty-six patients had zero nutritional risk, 110 had a low risk, 106 had a moderate risk, and 30 had a high risk. The median survival of the patients with zero, low, moderate and high risk was 33months, 21months, 10months and 60days, respectively. The CONUT score was independently associated with mortality at 3months (HR 1.144; 95% CI 1.062-1.233), 12months (HR 1.102; 95% CI 1.030-1.179) and 10years (HR 1.051; 95% CI 1.000-1.103). Nutritional risk is associated with the short-, medium- and long-term mortality of hospitalized patients with atrial fibrillation.

Screening of Nutritional Risk and Nutritional Support in General Surgery Patients: A Survey from Shanghai, China

To determine the prevalence of nutritional risk in surgical departments and to evaluate the impact of nutritional support on clinical outcomes. The nutritional risk in different surgical diseases and the different way of nutritional support on clinical outcomes in patients at nutritional risk remain unclear. Hospitalized patients from general surgical departments were screened using the Nutritional Risk Screening (NRS) 2002 questionnaire on admission. Data were collected on nutritional risk, complications, and length of stay (LOS). Overall, 5034 patients were recruited; the overall prevalence of nutritional risk on admission were 19.2%. The highest prevalence was found among patients with gastric cancer. At-risk patients had more complications and longer LOS than nonrisk patients. Of the at-risk patients, the complication rate was significantly lower and LOS was significantly shorter in the nutritional-support group than in the no-support group (20.9 versus 30.0%, P < 0.05). Subgroup analysis showed reduced complication rates and LOS only in patients with gastric cancer, colorectal cancer, and hepato-pancreato-biliary (HPB) cancer. Significantly lower complication rates relative to nonsupported patients were found among patients who received enteral nutrition or who received support for 5 to 7 days, or daily support entailing 16 to 25 kcal/kg of nonprotein energy. Different surgical diseases have different levels of nutritional risk. The provision of nutritional support was associated with a lower complication rate and a shorter LOS for gastric, colorectal, and HPB cancer patients at nutritional risk. The improper use of nutritional support may not improve outcomes for at-risk patients.

A Preliminary Study Examining Nutritional Risk Factors, Body Mass Index, and Treatment Retention in Opioid-Dependent Patients

Poor nutritional health among opioid-dependent individuals is well established, yet no nutritional screening tool exists for this specific population. The utility of "Determine Your Nutritional Health" developed by the Nutrition Screening Initiative is considered. The study examines the questionnaire's relevance in patients beginning opioid dependence treatment at a methadone-assisted treatment program (N = 140) by examining nutritional risk factor prevalence, body mass index, and association between nutritional risk level and treatment retention. The majority of patients reported at least one nutritional risk factor (89 %) and 59 % were at high nutritional risk. Body mass index was not related to nutritional risk; however, a trend was identified between increasing nutritional risk and decreased retention in treatment. These preliminary findings suggest the need for incorporation of nutritional screening at intake in opioid treatment programs, consideration of the effect of dietary risk on treatment retention, and the potential utility of this screening tool.

Evaluation of the nutritional risk among vulnerable seniors

Balanced nutrition is an essential component to successful aging and quality of life through maintenance of physical health, mental functioning, and social engagement. The importance of nutrition is more pronounced in economically vulnerable seniors. The purpose of the study was to determine the level of nutritional risk and examine factors significant to the nutritional risk status of low‐income senior meal program participants. Data came from 1,750 participants (843 men, 893 women) aged 60+, served by senior meal programs in San Diego County. A ten‐item measure of Nutritional Risk Status was used. Results showed that 22.4% were at moderate risk for malnutrition and 68.7% malnourished, while only 8.9% had a good nutritional status. Those with the highest nutritional risk included Hispanics (P=0.007), Blacks (P=0.004), and those with an income at or below 100% of the Federal Poverty Level (P&lt;0.001). Married participants had the lowest nutritional risk compared to other marital statuses (P &lt;0.001). Home delivered meal participants had higher nutritional risk than congregate meal participants (P&lt;0.001). Raising awareness of nutritional status may motivate at‐risk groups of seniors to initiate steps toward improving their health. Education and outreach strategies appropriate for these groups should be considered. Further efforts are warranted to ameliorate the nutritional status of vulnerable seniors.

Dietary screening tool identifies nutritional risk in older adults

Background:No rapid methods exist for screening overall dietary intakes in older adults. Objective:The purpose of this study was to develop and evaluate a scoring system for a diet screening tool to identify nutritional risk in community-dwelling older adults. Design:This cross-sectional study in older adults (n = 204) who reside in rural areas examined nutrition status by using an in-person interview, biochemical measures, and four 24-h recalls that included the use of dietary supplements. Results:The dietary screening tool was able to characterize 3 levels of nutritional risk: at risk, possible risk, and not at risk. Individuals classified as at nutritional risk had significantly lower indicators of diet quality (Healthy Eating Index and Mean Adequacy Ratio) and intakes of protein, most micronutrients, dietary fiber, fruit, and vegetables. The at-risk group had higher intakes of fats and oils and refined grains. The at-risk group also had the lowest serum vitamin B-12, folate,β-cryptoxanthin, lutein, and zeaxanthin concentrations. The not-at-nutritional-risk group had significantly higher lycopene andβ-carotene and lower homocysteine and methylmalonic acid concentrations. Conclusion:The dietary screening tool is a simple and practical tool that can help to detect nutritional risk in older adults.

Adequacy of Nutrient Intake Among Elderly Persons Receiving Home Care

ABSTRACT This study examines the adequacy of the dietary intake based on age, sex, and level of nutritional risk among 98 frail elderly persons receiving home care through Community Care Access Centres. The dietary intakes were measured using 24-hour recalls and were compared with the dietary reference intake. The participants' intakes of both macronutrients and micronutrients were found to be inadequate. On average, elderly persons were consuming more than the recommended amount of protein, but the average intakes of many vitamins and minerals were less than optimal based on the average intakes. Paradoxically, more than half of elderly participants were overweight or obese. The results highlight the need for appropriate nutrition, education, and support for elderly persons receiving home care.

Food Insecurity and Diabetes Risk Among the Northern Cheyenne

ABSTRACT Using data from a 2001 survey of a representative sample of Northern Cheyenne reservation residents, this paper examines use of a variety of food sources, nutritional health and risk factors, diabetes risk factors, and food insecurity. Results indicate that substantial proportions of the respondents had high levels of nutritional risk, food insecurity, and diabetes risk. Importantly, those using community emergency food sources and informal economic strategies to meet food shortages were more likely to be food insecure. Those with higher nutritional risk and lower nutritional health were also more likely to be food insecure. Finally, being younger, educated and using wages to obtain food increased the risk for diabetes.

Food Insecurity Among Cancer Patients in Kentucky: A Pilot Study

Food insecurity is defined as being uncertain of having enough food due to insufficient money or other resources. The purpose of this study was to examine the construct and correlates of food insecurity in a sample of cancer patients in Kentucky. Data were collected in the waiting rooms of the chemotherapy, hematology/oncology, and gynecology/oncology clinics of a university cancer center, and included 115 cancer patients actively receiving treatment (mean age, 55.85 years; range, 23 to 88 years) who completed a series of standardized measures to assess food insecurity status and psychological and nutritional well-being. Descriptive statistics and independent samples t tests were used to assess the prevalence of food insecurity in the sample, and to identify differences between the persons who were food insecure and food secure. The prevalence rates of food insecurity and food insecurity with hunger in the sample were 17.4% and 7.8%, respectively, which are higher than in the general population. Food-insecure patients had statistically significant higher levels of nutritional risk, depression, and financial strain, and lower quality of life compared with food secure patients. Fifty-five percent of food insecure patients reported not taking a prescribed medication because they could not afford it, versus 12.8% of food-secure patients (P = .002). Food insecurity may be an important consideration for clinical oncology practice, especially when caring for individuals of lower socioeconomic status. Further study is warranted, including prospective studies of cancer patients to identify causal relationships among food insecurity, cancer incidence, cancer treatments, and patient outcomes and well-being.

Food Insecurity Among Cancer Patients in Kentucky: A Pilot Study

Purpose Food insecurity is defined as being uncertain of having enough food due to insufficient money or other resources. The purpose of this study was to examine the construct and correlates of food insecurity in a sample of cancer patients in Kentucky. Patients and Methods Data were collected in the waiting rooms of the chemotherapy, hematology/oncology, and gynecology/oncology clinics of a university cancer center, and included 115 cancer patients actively receiving treatment (mean age, 55.85 years; range, 23 to 88 years) who completed a series of standardized measures to assess food insecurity status and psychological and nutritional well-being. Descriptive statistics and independent samples t tests were used to assess the prevalence of food insecurity in the sample, and to identify differences between the persons who were food insecure and food secure. Results The prevalence rates of food insecurity and food insecurity with hunger in the sample were 17.4% and 7.8%, respectively, which are higher than in the general population. Food-insecure patients had statistically significant higher levels of nutritional risk, depression, and financial strain, and lower quality of life compared with food secure patients. Fifty-five percent of food insecure patients reported not taking a prescribed medication because they could not afford it, versus 12.8% of food-secure patients (P = .002). Conclusion Food insecurity may be an important consideration for clinical oncology practice, especially when caring for individuals of lower socioeconomic status. Further study is warranted, including prospective studies of cancer patients to identify causal relationships among food insecurity, cancer incidence, cancer treatments, and patient outcomes and well-being.

Influence of Personality and Health Behaviors on Fatigue in Late and Very Late Life

There is limited understanding about variables associated with fatigue in late and very late life. The purpose of this study was to explore the longitudinal influences of personality and health behaviors on changes in fatigue. One hundred and seventy-eight participants of the Georgia Centenarian Study were part of this study. Multiple regression analyses were computed to assess the influence of personality, physical activity, stress management, and nutritional risk on fatigue after initial fatigue, self-reported health, and psychosocial variables were controlled for. Anxiety, physical activity, and nutritional risk had significant longitudinal effects on fatigue. Older adults who were anxious, less engaged in physical activity, and who had higher levels of nutritional risk were more likely to show increased fatigue levels. The results suggest that more clinical and research attention should be paid to changes of fatigue in older populations.