Mini Nutritional Assessment Questionnaire Research Articles

Relationship between duration of heart failure and nutritional status in hospitalised patients - preliminary cross-sectional study

Abstract Introduction Heart failure (HF) is a chronic disease which is one of the most common causes of hospitalisation of elderly patients. Nutritional status has a crucial impact on the course of disease and survival. HF frequently occurs with nutritional deficits, which may lead to malnutrition and loss of skeletal mass, which makes the prognosis worse. Nutritional status depends also on the patient's economic status, ability to prepare meals, and availability of fresh vegetables and fruits. Knowledge of the connection between the duration of heart failure and nutritional status will enable selection of patients with a higher risk of malnutrition, for which nutritional support should be considered. Purpose The study aims to assess the variability of nutritional status in heart failure patients over the duration of the disease, using the Mini Nutritional Assessment (MNA) and Geriatric Nutritional Risk Index (GNRI). Methods The nutritional status of 134 patients with HF admitted to the cardiology department was assessed with the MNA questionnaire. Additionally, GNRI has counted from serum albumin concentration, weight and height of patients. Patients were divided according to the duration of HF into two groups, one with patients with equal or less than five years of history of disease and the second with patients with HF lasting more than five years. Results The mean age was 52.4±16.9 years, 20.2% of patients were women, and the mean LVEF was 30.3±13.8%. The group of patients with HF lasting equal or less than five years was younger than patients with more than five years of the disease (49.5±16.9 years vs. 57.3 ±16.2 years, p=0.002). There were no significant differences in sex, LVEF and NYHA class between the two groups. According to MNA and GNRI scores, the nutritional status had no differences between the group of patients suffering from HF for more than five years compared with those with HF lasting 5 years or less (p=0.50; p=0.63, respectively). Moreover, the time of HF lasting was not correlated with scores of MNA and GNRI (p=0.33; p=0.22). Conclusions The study found no significant association between the nutritional status of patients and duration of heart failure. Therefore, monitoring nutritional status is crucial, irrespective of the duration of HF. It is necessary to analyse this issue in a larger group of patients with heart failure to identify specifically which patients are at risk of malnutrition and how nutritional status changes with the duration of the disease.

Relationship of Biochemical Parameters and Echocardiogram Findings with Appetite in Patients having Reduced Ejection Fraction Heart Failure

Objective: To determine the relationship of biochemical parameters and echocardiogram findings with appetite and nutritional status in patients with heart failure with reduced ejection fraction. Study Design: Cross-sectional study.Place and Duration of Study: This study was conducted at the Department of Medicine, Combined Military Hospital (CMH), Peshawar, Pakistan, from February 2022 to August 2022.Methods: The study was conducted on adult patients with heart failure for at least three months. Indoor patients, those with hospitalization within the last four weeks, and unwilling patients were excluded. The Council on Nutrition Appetite Questionnaire and Mini Nutritional Assessment questionnaire were administered in direct face-to-face interviews. A transthoracic echocardiogram was done to document the left ventricular ejection fraction. Different hematological and biochemical parameters were also analyzed.Results: There were 76 patients aged 55.92± 15.22 years. Mean mini nutritional assessment and Council on Nutrition appetite questionnaire scores were 17.89± 5.23 and 20.74± 8.19, respectively. Based on mini nutritional assessment scores, 36 were malnourished, 27 were at risk of malnutrition, and 13 had normal nutritional status. Using Council on Nutrition appetite questionnaire scores, 57 were at risk of malnutrition, while 19 had no risk. Left ventricular ejection fraction and hemoglobin were lower in malnourished patients. However, there were no differences in other biochemical parameters amongst patients with good or poor nutritional status.Conclusion: Patients with heart failure had poor appetite and nutritional status proportionate to the degree of left ventricular systolic dysfunction. How to cite this: Saeed B, Arshad AR, Hussain M. Relationship of Biochemical Parameters and Echocardiogram Findings with Appetite and Nutritional Status in Patients with Heart Failure with Reduced Ejection Fraction. Life and Science. 2024; 5(2): 144-150. doi: http://doi.org/10.37185/LnS.1.1.359

IJCM_6A: Prevalence of Malnutrition and its associated factors among elderly population in rural field practice area of Madras Medical College- A Cross-Sectional Study

Background: In India the elderly population (>60years) is on a raising trend has more than tripled in last 50 years and the projections for 2031 is 178.59 million of total population. As the health of the elderly will be an important issue defining the health of the whole population, hence elderly malnutrition is on focus. Objectives: To estimate the prevalence of malnutrition and factors associated with malnutrition among elderly population in rural field practice area of Madras Medical College. Methodology: This cross-sectional study was conducted from October to November-2023 among 480 elderly participants selected by simple random sampling in Medavakkam area. This study was done by using an interviewer administered semi-structured questionnaire that includes socio-demographic details and Mini Nutritional Assessment Questionnaire. Body Mass Index used to identify Obesity based on Asia Pacific BMI guidelines. Data was entered in MS-Excel and analysed using SPSS v16. Results: Among 480 participants,79.8% were in the age group of 60-70years,18.1% and 2.1% were in the age group of 71-80years and >80years respectively. Among them 53.1%were male. The prevalence of malnutrition and at risk of malnutrition were 7.7%(95%CI:5.5-10.5) and 39%(95%CI:34.6- 43.5) respectively which was assessed using MNA-questionnaire. Prevalence of obesity was 45.8%(95%CI:41.3-50.4) based on Asia-Pacific BMI guidelines. A significant association was found between malnutrition and older age groups, female gender, no formal education, kutcha house, widowed, unemployed and dependent financial status. Conclusion: According to this study, prevalence of malnutrition and at risk of malnutrition were lesser than previous studies done in rural South India, but the prevalence of Obesity found to be high (45.8%). Both undernutrition and over-nutrition are important health issues to be considered in elderly population. These problems can be solved through community level nutrition status screening of elderly and health education to the elderly and their families regarding balanced dietary practices and lifestyle modification, thereby enhancing their nutritional status and their quality of life.

Association between Dietary Practice and Gait Speed in Community-Dwelling Older Adults with Overweight and Obesity: A Cross-Sectional Study.

Slow gait speed is associated with poorer clinical outcomes and higher rates of functional limitation and mortality in older adults, especially when combined with overweight or obesity. Aging is also associated with nutritional deficits. The aim of our study was to assess the potential association between dietary practice and gait speed performance in community-dwelling older adults with overweight and obesity. Participants underwent body composition measurement with the Tanita MC-780MA Bioimpedance Analyzer (BIA). Dietary patterns were assessed with the Mini Nutritional Assessment (MNA) questionnaire, and a dietary adequacy (DA) score system was constructed. The four-meter gait speed test was performed in order to assess gait speed. Of 222 participants, aged 67.6 ± 6.6 years, with a body mass index (BMI) of 31.9 ± 4.5 kg/m2, 34.7% had reduced gait speed and lower DA compared to those with normal gait speed (2.99 ± 1.12 vs. 3.37 ± 1.07; p < 0.05). The DA score of participants with slower gait speed was more likely to fall below the median than that of participants with normal gait speed (70.1% vs. 51.7%; p < 0.05). Participants with slower gait speed were more likely to be nutritionally at risk of low DA (22.1% vs. 10.3%; p < 0.05). Logistic regression analysis, after adjustment for confounders, showed that the risk of having a slow gait speed was 75% lower among those with a higher DA score (OR = 0.25; 95% CI = 0.11-0.53). Older adults with overweight or obesity in community dwellings might need to be supported with nutritional interventions that can improve their gait speed.

Nutrition self-efficacy intervention to improve nutritional status of Iranian older adults

ObjectivesOlder adults are a vulnerable group that is at risk of poor nutritional status, which can lead to disease and increase their healthcare costs. Our study aimed to investigate the impact of a self-efficacy intervention on the nutritional status of older adults.MethodsA controlled before and after study was conducted on 110 older adults in the Mashhad, Iran, from 2020 to 2022. Participants were randomly allocated to the intervention (n = 55) and control groups (n = 55). Participants in the intervention group received educational training that was based on the self-efficacy theory. The control group received the routine care. Data collection tools included demographic information questionnaire, Mini Nutritional Assessment Questionnaire, and standard self-efficacy questionnaire. The questionnaires were completed at baseline (before intervention), instantly after the intervention, and at 3-months follow-up by participants in both groups. Data were analyzed using SPSS version 25 and the significance level was considered less than 0.05.ResultsThe Mean of nutritional status in the intervention group, at the baseline, immediately after intervention and 3 months of follow-up were 25.1 ± 2.3, 28.3 ± 5.2 and 27.6 ± 6., respectively. This increase was significant (p < 0.001). Our findings revealed that self-efficacy among participants in the intervention group significantly changed (P < 0.001) across time from baseline through follow-up. There was no significant difference in the mean of self-efficacy and nutritional status in the control group during the study period (P > 0.05).ConclusionThis current study provided a basis to examine in the effectiveness of such intervention using a properly powered randomized controlled study. Therefore, it can be concluded that self-efficacy interventions are a promising approach to improving the nutritional behaviors of the older adults.Trial registration: IRCT20160619028529N9.

Intestinal Parasitic Infections and Associated Factors Among Primary School Students in Tehran

Background: Parasitic infections in children can negatively impact their growth, health, nutrition status, and cognitive development. Objectives: This study aimed to investigate intestinal parasitic infection and its relationship with the nutritional status of primary school students in Tehran in 2020. Methods: The current study was conducted on 250 samples collected by the available sampling method from 2 selected residential settlements in Tehran. The samples were tested using both direct and formalin ether concentration (sedimentation) methods. The nutritional status of participants was evaluated using the Mini Nutritional Assessment (MNA) questionnaire. The data were analyzed by the χ2 test. A significant level was considered 0.05. Results: Of the 250 student samples surveyed, 45 exhibited parasitic infection. In terms of nutrition, 18 cases were malnourished, 212 cases were exposed to malnutrition, and 20 cases had normal nutrition. The frequency of parasitic infection was higher in malnourished students (P &lt; 0.05). It was also higher in students whose parents' education levels (especially the mother) were lower. Conclusions: It seems that parasitic infections are associated with students’ nutritional status and their parent education.

Exploring the relationship between malnutrition and the systemic immune-inflammation index in older inpatients: a study based on comprehensive geriatric assessment

BackgroundMalnutrition is a prevalent and major challenge among senior citizens, possibly due to the continual low-grade inflammatory state of the body. A novel inflammatory parameter, the systemic immune-inflammation index (SII), is highly valuable in evaluating and predicting the prognosis of a wide range of diseases. This study aims to explore the significance of the SII in assessing malnutrition in older inpatients.MethodsThis retrospective study included 500 senior hospitalized patients who met the inclusion and exclusion criteria from the Comprehensive Geriatric Assessment database of the First Hospital of Jilin University. The Mini-Nutritional Assessment (MNA) questionnaire was used to evaluate the nutritional status of patients. The SII was calculated using complete blood counts, and we performed natural logarithm transformation of the SII [ln(SII)]. Multivariable logistic regression analysis was used to identify the association between ln(SII) and malnutrition. To ensure the stability of the findings, a sensitivity analysis was conducted.ResultsThe 500 patients had a mean age of 77.29 ± 9.85 years, and 68.6% were male. In accordance with the MNA, 30.4% of the patients were malnourished or at risk of malnutrition, and patients in this group had considerably greater levels of ln(SII) than patients with adequate nutrition (P < 0.001). The optimum ln(SII) cutoff value for patients with malnutrition or at risk of malnutrition was 6.46 (SII = 635.87) with 46.7% sensitivity and 80.2% specificity [95% CI: 0.613–0.721, AUC: 0.667, P < 0.001]. Multivariable logistic regression demonstrated that ln(SII) was an independent risk factor for the risk of malnutrition or malnutrition in older individuals (OR 3.984, 95% CI: 2.426–6.543, P < 0.001). Other metrics from the geriatric comprehensive assessment, including body mass index, calf circumference, fat ratio, activities of daily living and instrumental activities of daily living, and geriatric depression scale scores, were also independently correlated with nutritional status.ConclusionsAccording to our research, a high SII is an independent predictor of older inpatient malnutrition, and the SII aids in screening for malnutrition and may be a potential target for intervention. Comprehensive geriatric assessment parameters such as BMI, calf circumference, fat ratio, activities of daily living and depression were also linked to malnutrition.

Quality of life and socio-demographic factors associated with nutritional risk in Brazilian community-dwelling individuals aged 80 and over: cluster analysis and ensemble methods.

The aim of the present study was to use cluster analysis and ensemble methods to evaluate the association between quality of life, socio-demographic factors to predict nutritional risk in community-dwelling Brazilians aged 80 and over. This cross-sectional study included 104 individuals, both sexes, from different community locations. Firstly, the participants answered the sociodemographic questionnaire, and were sampled for anthropometric data. Subsequently, the Mini-Mental State Examination (MMSE) was applied, and Mini Nutritional Assessment Questionnaire (MAN) was used to evaluate their nutritional status. Finally, quality of life (QoL) was assessed by a brief version of World Health Organizations' Quality of Life (WHOQOL-BREF) questionnaire and its older adults' version (WHOQOL-OLD). The K-means algorithm was used to identify clusters of individuals regarding quality-of-life characteristics. In addition, Random Forest (RF) and eXtreme Gradient Boosting (XGBoost) algorithms were used to predict nutritional risk. Four major clusters were derived. Although there was a higher proportion of individuals aged 80 and over with nutritional risk in cluster 2 and a lower proportion in cluster 3, there was no statistically significant association. Cluster 1 showed the highest scores for psychological, social, and environmental domains, while cluster 4 exhibited the worst scores for the social and environmental domains of WHOQOL-BREF and for autonomy, past, present, and future activities, and intimacy of WHOQOL-OLD. Handgrip, household income, and MMSE were the most important predictors of nutritional. On the other hand, sex, self-reported health, and number of teeth showed the lowest levels of influence in the construction of models to evaluate nutritional risk. Taken together, there was no association between clusters based on quality-of-life domains and nutritional risk, however, predictive models can be used as a complementary tool to evaluate nutritional risk in individuals aged 80 and over.

The status and socio-demographic predictors of geriatric malnutrition of rural Maharashtra of central India: A cross-sectional study

Introduction: The elderly population has a lot to give to society but various issues like malnutrition hinder their activities and affect their quality of life. Objective: The current study was proposed to assess the nutritional status of the elderly in rural Maharashtra of central India. Method: This cross-sectional study recruited 460 elderly individuals and was conducted in selected four villages of same district in central India for 5 months (Aug-Dec 2021). Stratified sampling method was used. This study used the MNA (Mini Nutritional Assessment) questionnaire and haemoglobin level to assess the nutritional status of the elderly. Univariate analysis and multivariate analysis were carried out using R software. Results: Out of 460 study subjects, 42 (9.13%) were malnourished and 286 (62.17%) were at risk of malnutrition. The study assessed 300 elderly for hemoglobin status and 129 (43%) were found anemic. The elderly who belonged to the age group 71-80 years had lesser odds of having satisfactory nutritional status (OR=0.53) while age group &gt;80 was more prone to anemia (OR= 1.71). The odds of satisfactory nutritional status were higher for elderly who had education less than secondary school (OR=2.02) and for elderly those who had completed high secondary schooling (OR=4.94) and those who belonged to the nuclear family (OR=1.59). The study showed elderly who belonged to Open caste had lesser odds of having anemia (OR=0.68). Conclusion: The study found high prevalence of anaemia (43%) and at-risk malnutrition (62.17%) in the geriatric population. Policymakers should prioritise nutritional interventional policy, and stakeholders should promote the existing nutritional policies of this vulnerable group.

Bioimpedentiometry parameters used as indicators of frailty and malnutrition: association between G8 score and Phase angle (PHA) in elderly cancer patients.

Since the incidence of cancer increases with age, in older cancer patients important information may be missed without a Comprehensive Geriatric Assessment (CGA). On the other side, CGA is a time-consuming and complex instrument, sothat Geriatric 8 (G8) has been proposed as a more feasible screening tool to identify patients who could benefit from a CGAevaluation. G8 consists of 8 questions (patient age + 7 items derived from the Mini Nutritional Assessment questionnaire). A G8 score ≤ 14 is considered associated with frailty and risk of malnutrition. Another screening test is Bioelectrical Impedance Analysis (Bioimpedentiometry, BIA), which enables to evaluate the nutritional status through a specific parameter known as Phase angle (PhA). This study is aimed at assessing the ability of G8 alone or in combination with PhA to detect elderly cancer patients at higher risk for malnutrition who cannot undergo immediate anticancer treatments. A total of 289 cancer patients (168 men and 121 women) aged ≥ 70years old were enrolled and performed both G8 test, body mass index (BMI) and BIA assessments. A concurrent G8 score ≤ 14 and PhA < 5 defined subjects most exposed to the risk of malnutrition. An association between BMI and G8 (p < 0.001, OR 1.54) and a clinically significant relationship between G8 and PhA (p = 0.013) were observed. G8 can be used to identify patients at risk for malnutrition who would benefit from comprehensive CGA. The concurrent use of G8 and BIA presents a higher power in discriminating subjects at higher risk of malnutrition than a single test. This study suggests the need for routine assessment of nutritional status in cancer patients using combinations of methods, in order to implement strategies for individually-tailored care before starting any treatment.

Assessment of nutritional status of elderly in rural field practice area of Jhalawar medical college, Jhalawar, India

Background: Worldwide, the population of elderly people is constantly increasing. Elderly population is at risk of under nutrition due to age related physical, cognitive, functional decline and lack of financial support. Malnutrition contributes to decline in health status, increased utilization of healthcare services and increased mortality. Aim of this study was to assess nutritional status of the elderly by MNA and to find association between nutritional status and socio- demographic profile of elderly. Methods: After ethical approval, a community based cross sectional study was conducted among elderly people residing at Mandawar village, rural field practice area of JMC, Jhalawar during August to October 2022. Complete enumeration technique was used to enrolled participants in study. Door to door household survey was conducted using predesigned questionnaire. Nutritional status was assessed by using standard mini nutritional assessment questionnaire. The data was analyzed through SPSS28.0 (trail version). Results: Out of 287 elderlies, 139 (48.4%) were male and 148 (51.6%) were female. According to MNA, 73 (25.4%) were found malnourished while 119 (41.4%) were at risk of malnutrition and 95 (33.1%) were well nourished. A statistically significant (p&lt;0.05) association was found between nutritional status with increasing age, gender, marital status, education, occupation, morbidity, financial dependance and substance abuse. Conclusions: This study showed that malnutrition has multidimensional background. So, to improve nutritional status of elderly approach should be focus on those who are older, illiterate or low educational status, female gender and financially dependance.

Relationship of Inflammatory Parameters and Nutritional Status in Cancer Patients.

Chronic inflammation and cytokine storm can cause uncontrolled events in cancer. Pro-inflammatory molecules released by malignant cells send signals to the brain, liver, and neuroendocrine cells, interfering with appetite and promoting anorexia. Malnutrition in cancer patients is associated with increased treatment toxicity, reduced physical efficiency, and decreased survival. Therefore, early recognition of malnutrition could improve quality of life, treatment compliance, and survival. The aim of the study was to explore the relationship between inflammatory parameters with disease stage and nutritional status in patients with solid cancers. We screened 77 consecutive patients from 3 clinical Institutions in Sicily, Italy, with solid tumors who were either in follow-up after curative treatment or being treated for metastatic disease using the Mini Nutritional Assessment (MNA) questionnaire. Inflammatory parameters, including interleukin 6 (IL6), C-reactive protein (CRP), β2-microglobulin, ferritin, and transferrin were evaluated. A statistically significant difference was found in mean values of IL6, CRP, β2-microglobulin, ferritin, and transferrin between patients without evidence of disease and metastatic patients. Among the metastatic group, there was a significant difference in mean values of these inflammatory parameters between patients with malnutrition and those with normal nutritional status. The difference in average IL6, CRP, β2-microglobulin, and ferritin between patients at risk of malnutrition and those with normal nutritional status was also significant. However, the difference between patients at risk of malnutrition and those with malnutrition was not significant. IL6, CRP, transferrin, ferritin, and β2-microglobulin are functional inflammatory parameters that indicate risk of malnutrition and support the MNA screening test to identify patients with solid tumors who require nutritional support.

The impact of a pilot telehealth coaching intervention to improve caregiver stress and well-being and to increase dietary protein intake of caregivers and their family members with dementia - Interrupted by COVID-19.

The prevalence of dementia is growing as the population and longevity increase. Caregivers of adults with dementia report stress and fatigue and often neglect their health. They also indicate the need for information to address health-related issues, including nutritional problems, of their family members with dementia (FMWD). This study examined the impact of coaching to improve family caregiver (FCG) stress and well-being and to increase the protein intake of both FCGs and their FMWD. All participants received nutrition education including a protein prescription (1.2g/kg body weight/day) and FCGs received stress-reduction materials. Coached-group randomized participants also received weekly diet coaching and stress-reduction coaching. At baseline and 8weeks, anthropometrics, a mini-nutritional assessment questionnaire, and diet (protein intake) were assessed in FCGs and FMWD; well-being, fatigue and strain were assessed in FCGs. Repeated two words measures analysis of variance and Fisher's exact tests examined within group and intervention effects. Twenty-five FCGs (13 coached group, 12 not-coached group) and 23 FMWD (12 coached group, 11 not-coached group) completed the study. No significant differences were found between coached and not-coached FCGs and FMWD at baseline. After 8- weeks, FCGs' protein intake significantly increased from 1.00 ± 0.17 to 1.35 ± 0.23g/kg/body weight in the coached group and from 0.91 ± 0.19 to 1.01 ± 0.33g/kg/body weight in the not-coached group; there was also an intervention effect (p=.01, η2 = .24). The percentage of FCGs with baseline protein intake less than prescription guidelines and with an end-of-study protein intake meeting/exceeding the prescription significantly differed, with 60% of coached FCGs versus 10% of not coached FCGs meeting the prescription. No intervention effects were shown for protein intake in FMWD or for well-being, fatigue or strain among FCGs. Diet coaching with nutrition education successfully assisted FCGs with improving their protein intake versus nutrition education alone.

Polypharmacy in the Elderly: A Double-Edged Sword

Aim: Polypharmacy is a very important geriatric syndrome related to critical health conditions. The purpose of this study is to research the association of polypharmacy with comprehensive geriatric assessment’s (CGA) various parameters which are indicators of health and life quality in older individuals. Material and Methods: 515 older adults admitted to a university hospital were included in this cross-sectional study. Along with CGA, European Quality of Life (EQ-5D) was performed on the participants. Geriatric Depression Scale (GDS) was used to evaluate depressive symptoms. Daily living activities were assessed by using Lawton &amp;amp; Brody index of Instrumental Activities of Daily Living (IADL) and Katz Index of Activities of Daily Living (ADL). The Full Mini-Nutritional Assessment (MNA) questionnaire was performed to evaluate nutritional status. Results: The participants’ mean age was 72.2±6.3 years and 58.6% of them were female. 242 participants using 5 or more drugs were included in the polypharmacy group. The polypharmacy group had lower IADL, MNA, EQ-5D, Hand Grip Strength (HGS), and gait speed scores and higher GDS scores compared to those without polypharmacy. According to the correlation analysis results, the number of the medications had a moderate positive correlation with GDS scores and a moderate negative correlation with EQ-5D and MNA. Conclusion: As the number of medications increases; patients tend to have depression, malnutrition, and a decline in functional status. Polypharmacy also impairs the quality of life. We should address polypharmacy as a crucial health problem, optimize the number of medications and thereby make the health condition better.

Six-Month Synbio® Administration Affects Nutritional and Inflammatory Parameters of Older Adults Included in the PROBIOSENIOR Project

The physiological changes associated with ageing contribute to the incidence of diseases, morbidity, and mortality. For modern society, it is essential to find solutions to improve elderly people's health and quality of life. Among promising strategies, the PROBIOSENIOR project proposed a daily six-month supplementation with new probiotic functional foods and nutraceuticals. The aim of this work was to evaluate the modulating effects of the probiotic diet on inflammatory markers and nutritional status. Ninety-seven elderly volunteers were randomly assigned to either a placebo-diet group or a probiotic-diet group (SYNBIO®). Faeces, urine, and blood samples were collected before and after the supplementation to determine serum cytokines, biogenic amines, and inflammation markers. Comparing the results obtained before and after the intervention, probiotic supplementations significantly decreased the TNF-α circulating levels and significantly increased those of IGF-1. Biogenic-amine levels showed high variability, with significant variation only for histamine that decreased after the probiotic supplementation. The supplementation influenced the serum concentration of some crucial cytokines (IL-6, IL-8, and MIP-1α) that significantly decreased in the probiotic group. In addition, the Mini Nutritional Assessment questionnaire revealed that the probiotic-supplemented group had a significant improvement in nutritional status. In conclusion, the PROBIOSENIOR project demonstrated how SYNBIO® supplementation may positively influence some nutritional and inflammatory parameters in the elderly.

Sarcopenia, obesity, and their association with selected behavioral factors in active older adults.

Introduction: The number of obese people in the world is increasing, as is the number of sarcopenic people among the older adults. Although both states are concerning, they can be positively influenced by selected behavioral factors such as adequate nutrition and physical activity. We were interested in the prevalence of sarcopenic obesity in active older people and the influence of behavioral factors on this phenomenon. Methods: The study included 38 older adults (21 women) with a mean age of 75.3 ± 5.0 years. Sarcopenic parameters were determined with different tests: Handgrip Test, Chair Stand Test, Gait Speed, Timed Up and Go Test, and Short Physical Performance Battery. Body composition was measured by dual-energy x-ray absorptiometry. Physical activity level was measured using accelerometers, and nutritional status was assessed using the Mini-Nutritional Assessment and MEDLIFE Index questionnaire. Results: Of all included active participants (the average number of steps per day was 8,916 ± 3,543), 47.4% of them were obese. Of all included women, 52.4% were obese. Sarcopenic obesity was found in three (7.9%) participants. Nutritional status correlated with strength of lower extremities and physical performance tests (gait speed, Timed Up and Go Test and Short Physical performance battery). Higher number of steps per day positively correlates with physical performance. Discussion: Interestingly, we did not find any correlation between the main obesity parameter such as percent body fat or body mass index (and thus sarcopenic obesity) and any of the selected behavioral factors (physical activity, sedentary behavior, or dietary habits). In conclusion, reaching the recommended levels of physical activity in older adults may not be sufficient to prevent the occurrence of obesity and sarcopenic obesity.

The Strong Correlation Between Pain Interference and Abnormal Nutritional Status in Older Adults With Chronic Musculoskeletal Pain.

Musculoskeletal pain, one of the most common issues faced by older adults, has multidimensional effects including an increased risk of malnutrition. Therefore, this study aimed to investigate the association between pain interference and nutritional status in older adults with chronic musculoskeletal pain. In this cross-sectional study, data were collected from older adults (age: >60 years) using the brief pain inventory and mini nutritional assessment questionnaire. The correlation between pain interference, pain severity, and nutritional status was assessed using the chi-square test and Spearman's rank correlation. Multiple logistic regression analysis was used to analyze the variables associated with abnormal nutrition status. Overall 241 older adults were recruited in the study. The median (IQR) age of the participants was 70 (11) years, pain severity subscale was 4.2 (1.8), and pain interference subscale was 3.3 (3.1). Abnormal nutritional status was positively correlated with pain interference (Odds ratio [OR]: 1.26; 95% confidence interval [CI]: 1.08-1.48; P = .004), pain severity (OR: 1.25; 95% CI: 1.02-1.53; P = .034), age (OR 1.06; 95% CI: 1.01-1.11, P = .011), and hypertension (OR = 2.17; 95% CI: 1.11-4.26; P = .024). This study reports a strong correlation between pain interference and nutritional status. Therefore, pain interference can be a useful pain assessment tool to indicate risk of abnormal nutritional status in older adults. In addition, related factors, including age, underweight, and hypertension, were associated with a higher risk of malnutrition.

Do Determinants of Quality of Life Differ in Older People Living in the Community and Nursing Homes?

Objectives: The aim of the present study was to examine and compare the relationship between nutritional status, physical activity (PA) level, concomitant chronic diseases, and quality of life (QoL) in community-dwelling (CD) older people and nursing home (NH) residents. Material and Methods: One hundred NH residents aged 60 years and above and one hundred sex- and age-matched CD older adults were examined. The QoL was examined with the EuroQol-5D questionnaire. Nutritional status was assessed with the Mini Nutritional Assessment questionnaire (MNA), anthropometric measures, and bioimpedance analysis (BIA). The 7-Day Recall Questionnaire and the Stanford Usual Activity Questionnaire were performed to evaluate the PA energy expenditure level (PA-EE) and the health-related behaviours (PA-HRB), respectively. Results: CD subjects presented a significantly higher self-assessment in the VAS scale in comparison with NH residents (CD: 65.3 ± 19.4 vs. NH 58.2 ± 21.4; p < 0.05), but there were no differences within the five dimensions of QoL. In NH patients, the VAS scale was not correlated with any of the variables evaluating the nutritional status and body composition, while in the CD group correlated positively with MNA (rS = 0.36; p < 0.001), % of FFM (rS = 0.22; p< 0.05), body density (rS = 0.22; p < 0.05) and negatively with % of FM (rS = −0.22; p < 0.05). In an institutional environment, only concomitant diseases (mainly urinary incontinence) were found as independent determinants for QoL. In the community, independent determinants of QoL besides concomitant diseases (mainly ischaemic heart disease) were nutritional status or PA-HRB. Conclusions: Determinants of QoL are different depending on the living environment the older adults. Proper nutritional status and beneficial PA behaviours, are crucial for higher QoL of CD elderly, while for NH residents, the main determinants of QoL are chronic conditions.

Effect of Dysphagia on the Older Adults' Nutritional Status and Meal Pattern.

Dysphagia is a widespread clinical condition among older adults. Although known as a risk factor for nutritional status and dehydration, dysphagia also affects meal patterns. This study aimed to determine the relationship between dysphagia and undernutrition, as well as dietary consumption patterns in older adults. 268 older adults (144 women, 124 men) were included in the study. Mini Nutritional Assessment (MNA), dysphagia assessment (EAT-10), oral examination, and Semi-quantitative Food Frequency Questionnaire (SFFQ) were used for collecting data. Odds ratio and Chi square were used to compare independent variables in subjects with and without undernutrition as well as those who intake texture modified and non-texture modified diet. Mean age of the undernutrition and normal nutrition groups was 68.9 ± 6.1 and 68.8 ± 6.0 years, respectively. The undernutrition group's activities of daily living (ADL) were 19.7 ± 0.9, and the normal nutrition group was 19.8 ± 0.7. Older adults with dysphagia were 4.8 times more likely to experience undernutrition than older adults without dysphagia (95% CI = 1.75-13.13, P = .002). There was a statistically difference between the meal patterns among the dysphagic older adult group and the normal-swallowing older adults' group at the .05 level. According to this study, dysphagia was associated with the nutritional status of older adults and dietary patterns. The study results suggested some recommendations for dental health personnel on oral care related to dietary consumption and dietary patterns in older adults.

The relationship between malnutrition and neutrophil-to-lymphocyte ratio in hospitalized older patient.

Aging is characterized by appetite loss and cachexia, i.e., factors that contribute to malnutrition. An inflammation marker, neutrophil-to-lymphocyte ratio (NLR), is a significant prognostic predictor of many geriatric syndromes. We aim to determine the association between NLR and malnutrition. We designed a retrospective study on hospitalized patients in the geriatric unit of a university hospital between January 2019 and January 2021. Demographic data, chronic diseases, history of smoking, length of hospital stay, number of drugs, laboratory and further examinations, and comprehensive geriatric assessment scores were recorded from the hospital data system. The nutritional status of the patients was evaluated using the mini-nutritional assessment (MNA) questionnaire. Of the 220 patients, 121 (55 %) were female, and the mean age was 77.9 ± 7.3 years. According to the MNA, 60 % (n = 132) were malnourished or at risk of malnutrition. As many as 47.3 % (n = 104) of the patients had depressive symptoms, and 41.4 % (n = 91) were cognitively impaired. The mean age (79.3 ± 7.3), NLR, and GDS scores were significantly higher, and MMSE scores were significantly lower in malnourished patients or in those at risk of malnutrition as compared to patients with normal nutritional status. We showed that NLR (OR: 1.248; 95% CI: 1.066‒1.461; p=0.006), age (OR: 1.056; 95% CI: 1.005‒1.109; p=0.031), depressive symptoms (OR: 1.225; 95% CI: 1.096‒1.369; p 4.5, with a sensitivity of 37.9 %, specificity of 85.2 %, negative predictive value of 47.8 %, and positive predictive value of 79.4 %. NLR, age, depressive symptoms, and cognitive impairment were independently associated risk factors for malnutrition. NLR may be a useful nutritional marker for evaluating the nutritional status of hospitalized geriatric patients (Tab. 4, Fig. 1, Ref. 28). Text in PDF www.elis.sk Keywords: malnutrition, neutrophil-to-lymphocyte ratio, geriatric syndromes, inpatient, older adults.