Mini Nutritional Assessment Score Research Articles

Effectiveness of dietary intervention in geriatric patients receiving new complete dentures: A randomized controlled trial

Aim: This study aimed to evaluate the effectiveness of a tailored progressive dietary intervention against the standard care instructions on the nutritional status and nutrient intake in geriatric patients receiving new complete dentures. Settings and Design: Randomized controlled trial. Materials and Methods: A randomized controlled trial was conducted on completely edentulous patients seeking complete dentures. The participants were randomly allocated into two groups, and each group received a separate set of advice. The cognitive function was assessed using the mini–mental state examination (MMSE) form. The outcome measures were assessed at the baseline and 3 months after denture insertion. The Mini Nutritional Assessment (MNA) form was used to evaluate the nutritional status and the nutrient intake was calculated by a 3-day 24-h dietary recall and fed into the DietCal software. Statistical Analysis Used: The analysis was done using the independent sample t-test, paired sample t-test, and analysis of co-variance. The significance level was set at 0.05 for all tests. Results: In total, 68 participants completed the trial. There were no significant differences in food intake between the two groups at baseline. However, at 3-month follow-up, the intervention group displayed a statistically significant improvement in body mass index (BMI) compared to the control group. Although the nutrient intake such as protein, dietary fiber, total fat, calcium, carbohydrate, energy, iron, and Vitamin B12 was higher in the intervention group than in the control group, it was not statistically significant. Conclusion: Simple, tailored dietary intervention with prosthetic restoration of the edentulous patients significantly improved BMI and MNA scores.

C-reactive protein/albumin ratio as a novel predictor for nutritional status of geriatric patients.

The C-reactive protein to albumin ratio (CAR) is a novel parameter that has been reported as a significant prognostic marker in some diseases. The purpose of the present research was to investigate the predictive value of this ratio with regard to nutritional status in geriatric patients. A total of 154 geriatric patients (age ≥65 years) who consecutively presented to the internal medicine outpatient clinic were included in this cross-sectional study. The Mini Nutritional Assessment (MNA) was used as a reference to determine the nutritional status of the patients. Based on the MNA results, the patients were divided into two groups: normal nutrition and malnourished or at risk of malnutrition. The median CAR of malnourished patients or those at risk of malnutrition was significantly higher than that of patients with normal nutritional status (p=.012). A significant negative correlation was also observed between the MNA score and the CAR (r=-0.196, p=.015). The receiver operating characteristic curve analysis indicated that the CAR was a significant predictor of malnourishment or the risk of malnutrition (p=.012). The CAR could predict which geriatric patients were malnourished or at risk of malnutrition. CAR may be used as a new tool in the nutritional screening of geriatric patients.

Sarcopenia and Associated Factors in Adults Aged 40 and Above: A Study Conducted in Primary Healthcare.

Sarcopenia, characterized by progressive skeletal muscle loss, has emerged as a significant public health concern, with a global prevalence of 10-27%. While traditionally studied in geriatric populations, recent evidence indicates its impact on individuals aged 40 and above, with early manifestations of muscle decline. Primary care settings play a pivotal role in the early identification and management of sarcopenia, facilitating timely diagnosis and intervention. This study aims to evaluate the prevalence of sarcopenia and its associated factors among individuals aged 40 and above attending a family medicine outpatient clinic. A cross-sectional study was conducted in a family medicine outpatient clinic, including participants aged 40 and above. Participants underwent handgrip strength measurements, calf circumference measurements, and a 4-m walking test. Based on the criteria of the European Working Group on Sarcopenia in Older People 2 (EGSWOP2), individuals with sarcopenia and those at risk of sarcopenia were identified. The Mini Nutritional Assessment (MNA) was used to assess nutritional status. Sociodemographic characteristics, comorbidities, and laboratory values were recorded. A comparison was made between individuals with normal muscle strength and those at risk of sarcopenia. Among 213 individuals, 33 (15.4%) were at risk of sarcopenia (probable sarcopenia), and 12 (5.6%) were diagnosed with sarcopenia. There was a negative correlation observed between age and muscle strength (r=-0,339, p<0,001), and positive correlation was found between muscle strength and MNA score (r=0.301, p<0.001). Individuals with higher education and income levels exhibited higher muscle strength. Participants at risk of sarcopenia had higher prevalence rates of comorbidities such as diabetes mellitus (DM), chronic kidney disease, and cardiovascular disease (p=0.20, p<0.01, p=0.015, respectively). Our study highlights the prevalence and associated factors of sarcopenia in individuals aged 40 and above emphasizing the need for screening and intervention strategies in primary care settings. The study findings support the role of primary care in addressing sarcopenia and improving patient outcomes.

The Impact of Malnutrition on Chronic Obstructive Pulmonary Disease (COPD) Outcomes: The Predictive Value of the Mini Nutritional Assessment (MNA) versus Acute Exacerbations in Patients with Highly Complex COPD and Its Clinical and Prognostic Implications.

Current management of COPD is predominantly focused on respiratory aspects. A multidimensional assessment including nutritional assessment, quality of life and disability provides a more reliable perspective of the true complexity of COPD patients. This was a prospective observational study of 120 elderly COPD patients at high risk of acute exacerbations. The Mini Nutritional Assessment (MNA) was administered in addition to the usual respiratory assessment. The primary outcome was a composite of moderate or severe acute exacerbations during 52 weeks of follow-up. The median MNA Short Form (SF) score was 11 (8-12), 39 participants (32.50%) had a normal nutritional status, 57 (47.5%) were at risk of malnutrition and 24 (20%) were malnourished. Our multivariate linear regression models showed that the MNA score was associated with dyspnea and respiratory symptom severity, assessed by the Modified British Medical Research Council (mMRC) scale and the COPD Assessment Test (CAT) score, with spirometric variables, in particular with the severity of airflow limitation based on the value of FEV1, and with poorer QoL, as assessed by the EQ-5D-3 questionnaire. Competing risk analysis according to nutritional status based on the MNA Total Score showed that COPD participants "at risk of malnutrition" and "malnourished" had a higher risk of moderate to severe acute exacerbations with sub-hazard ratios of 3.08 (1.40-6.80), p = 0.015, and 4.64 (1.71-12.55), p = 0.0002, respectively. Our study confirms the importance of assessing nutritional status in elderly COPD patients and its prognostic value.

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.

Nutritional Status and Health-Related Quality of Life among Home-Dwelling Older Adults Aged 75 Years: The PORI75 Study.

Malnutrition in older people has been considered as a health concern associated with a range of implications for health and functional ability. However, evidence of nutrition and health-related quality of life (HRQoL) among older people is limited. The aim of this study was to study the associations between nutritional status and HRQoL among home-dwelling older adults aged 75 years. In this cross-sectional study, we studied 75-year-old home-dwelling residents who participated in PORI75 preventive health screenings in 2020 and completed the full Mini Nutritional Assessment (MNA). The participants' HRQoL was measured using the 15D instrument. Altogether, 462 participants (60% women) were included. Of these, 11% had decreased nutritional status (MNA score < 24); 12.7% were women and 8.6% were men, with no difference between the sexes (p = 0.17). A relationship was found between HRQoL and the MNA: a decreased MNA score was associated with decreased HRQoL (p < 0.001, r = 0.45, 95% CI: 0.38 to 0.53). All 15 HRQoL dimensions (except hearing) were associated with the MNA score. Among the men, the association was stronger compared to the women, especially when the MNA score was <24, indicating decreased nutritional status. In conclusion, impaired nutritional status seems to be associated with impaired HRQoL among 75-year-old people living at home, especially among men.

Family caregivers’ better nutritional status is associated with care recipients’ better nutritional status

Background and aimsA high proportion of older care recipients (CRs) face malnutrition and risk of malnutrition, affecting their functional abilities and posing challenges for caregiving. The aim of this study was to assess the risk for malnutrition among older CRs and the associated characteristics of both CRs and family caregivers (FCs) with nutritional status of CRs. MethodsA cross-sectional study consisted of 120 CRs (≥65 years) and their 118 FCs (≥60 years). Nutritional status was assessed with the Mini Nutritional Assessment (MNA). ResultsThe majority (63%) of the CRs had a risk of malnutrition (MNA score 17-23.5), and 7% had malnutrition (MNA score < 17). The CRs had significantly lower MNA scores compared to their FCs (p<0.001). The multivariate linear regression analysis showed that CRs’ higher number of comorbidities (B = -0.37, p = 0.013) and higher P-hs-CRP (B= -0.10, p = 0.047) were associated with their decreased MNA scores. There was a positive association between CRs’ hand grip strength (B = 0.11, p = 0.004) and FCs’ MNA scores (B = 0.41, p = 0.004) with MNA scores of the CRs. ConclusionMalnutrition and risk of malnutrition are common concerns in older CRs, especially those with a higher number of comorbidities and low-grade inflammation. Regular assessment of the nutritional status of both older CRs and FCs is justified, as FCs’ better nutritional status is associated with better nutritional status of CR. Clinical Trial Registration numberClinicalTrials.gov NCT04003493

Association of muscle health impairment and atherosclerosis with major osteoporotic fracture risk in Taiwanese Vegetarians.

Despite the beneficial effects of "vegetarian style" diet on atherosclerosis, it is also proven potentially detrimental to bone health. The influence of muscle health or atherosclerosis on major osteoporotic fracture (MOF) risk in vegetarians has rarely been explored. This prospective study aimed to investigate an association of MOF risk with muscle health and atherosclerosis in vegetarians. We conducted a questionnaire survey with the Mini-Nutritional Assessment (MNA) on 39 vegetarians. The 10-year probability of MOF was determined using the Taiwanese Fracture Risk Assessment (FRAX®) calculator. Appendicular skeletal muscle (ASM) mass and bone mineral density were measured with dual-energy X-ray absorptiometry. Physical performance was evaluated using the 6-min walk test (6MWT). Common carotid artery intima-media thickness (ccIMT) was determined using sonography. Serum levels of parathyroid hormone (PTH), Vitamin D, adiponectin, and leptin were measured. Eleven (28.2%) of 39 vegetarians had a moderate-high risk of MOF, defined by FRAX-calculated risk ≥10%. These subjects had lower ASM (P < 0.005) and 6MWT distances (P < 0.01) but greater ccIMT than those with low risk. The MOF risk was negatively correlated with ASM (r = -0.51, P < 0.001) and 6MWT distances (r = -0.62, P < 0.001) but positively correlated with ccIMT (r = 0.56, P < 0.001). Linear regression analysis revealed that MOF risk scores were negatively associated with ASM and 6MWT distance while positively associated with ccIMT. There was no significant association of MOF risk with MNA scores, serum levels of PTH, Vitamin D, adiponectin, or leptin. Decreased ASM mass, reduced physical performance, and atherosclerosis are significantly associated with MOF risk in vegetarians.

Self-reported exhaustion and a 4-item physical frailty index to predict the incidence of major complications after onco-geriatric surgery

BackgroundThe aim of this study was to analyze four pre-operative physical frailty indicators from a geriatric assessment (GA) independently and combined in a physical frailty index, in their ability to predict postoperative 30 d-complications. Materials and methodsIn this secondary analysis of data from the published PERATECS study (ClinicalTrials.gov: NCT01278537), the predictive value of four physical frailty indicators from a defined GA battery was examined with univariable and multivariate logistic regression models in a sample of 493 onco-geriatric surgical patients. The primary endpoint was incidence of major (Clavien–Dindo ≥ grade 2 [CD ≥ 2]) complications within 30 postoperative days.Predictors of the first model included self-reported exhaustion (SRE), body mass index (BMI), Timed Up-and-Go (TUG) and handgrip strength (HGS) independently, and a second model combined these four items as a Physical Frailty Index (4i-PFI). Both regression models were adjusted for age, gender, American Society of Anesthesiologists (ASA) status, tumor sites, duration of surgery time and Mini Nutritional Assessment (MNA) score. ResultsA total of 233 patients (47 %) developed CD ≥ 2 complications. In addition to ASA score, length of surgery, and gynecological and upper gastrointestinal tumor sites, the first model showed that SRE (OR 1.866) predicted CD ≥ 2 complications, but not TUG, BMI and HGS. In the second model, the 4i-PFI predicted CD ≥ 2 complications (OR pre-frail = 1.808, frail = 3.787). ConclusionsPhysical frailty indicators as SRE revealed a better ability to predict CD ≥ 2 complications than BMI, TUG and HGS. However, prediction of CD ≥ 2 complications was enhanced when these parameters were combined in a novel 4i-PFI.

#2080 Prevalence and development of sarcopenia in chronic hemodialysis patients, a single center, prospective, observational study

Abstract Background and Aims Sarcopenia is a progressive muscle disease (muscle failure) associated with age and various factors including chronic kidney disease that increases the risk of falls, fractures, and mortality. We aimed to analyze the prevalence of sarcopenia and other related problems, such as nutrition or physical fitness, in a group of patients in a chronic dialysis program. Method In our dialysis center, we conducted a prospective observational study to monitor the prevalence and development of sarcopenia. We performed repeated SARC-F (simple five-item questionnaire), grip strength, bioimpedance analysis of body composition, short physical performance battery (SPPB), muscle sonography and MNA (Mini Nutritional Assessment) in chronic hemodialysis patients. Here we report the cross-sectional results of the prevalence of probable sarcopenia (according to the recommendations, enough to trigger assessment of causes and start intervention) defined by EWGSOP2 (the European Working Group on Sarcopenia in Older People), risk of malnutrition, physical fitness, and its development in 1 year follow up. Results The median age in our cohort was 64 years (IQR 16.5). We examined 58 patients (36 men and 22 women) who signed informed consent in the period from 1 October 2020 to 31 January 2023. The prevalence of probable sarcopenia was 20.7%. A higher prevalence was observed in women than in men (27.3% vs 16.7%, P = 0.505), in patients ≥65 years than in the &amp;lt;65 years (26.5% vs 8.3%, P = 0.102) and in the group of patients more than one year on dialysis compared to the group up to one year (27.8% vs 4.5%, P = 0.039). We observed reduced physical performance (SPPB test) in 20 subjects (34.5%) and risk of malnutrition according to MNA in 33 subjects (56.9%). Seven of 29 evaluated patients (24.1%) had a worsening of physical performance (SPPB) after one year. Ten out of 29 patients (34.5%) had worsened MNA scores; the prevalence of malnutrition risk in this group remained the same (51.7%). The development of other parameters did not lead to significant conclusions, given the heterogeneity of characteristics and the relatively small number of subjects. Conclusion Sarcopenia is a serious and potentially impactful problem. The prevalence of probable sarcopenia in our cohort was 20.7% and was higher, although not statistically significant, in women, in patients ≥65 years of age and in patients more than one year on dialysis.

ADMA, neutrophil to lymphocyte, platelet to lymphocyte ratios and phase angle: effects on inflammation and nutrition in hemodialysis patients

Objectives: Neutrophil/lymphocyte ration (NLR) and platelet/lymphocyte ratio (PLR) levels can be used as systemic infallamotory parameters. Asymmetric dimethyl arginine (ADMA) inhibits endothelial nitric oxide synthase. Phase Angle (PhA) is a potential paremeter to screen for inflammatory abnormalities. In present study we aimed to determine the relations between NLR, PLR, ADMA, and PhA in terms of early markers for nutritonal status in addition to their well-known role in inflammation. Methods: A total of 89 patients undergoing maintenance hemodialysis 3 days a week at least 6 months were enrolled. To assess nutritional status, we performed the dietary questionnaire and mini nutritional assessment score (MNAS). ADMA was measured by ELISA. NLR and PLR are calculated from monthly complete blood count tests. Patients were divided into 2 groups accordng to NLR levels as group 1 (NLR≥4.6; n=48) ve and group 2 (NLR&amp;lt;4.6, n=41). Results: The mean ADMA level was 0.03±0.01 µmol/L, the mean PhA was 7.2±1.1º. In subgroup analysis, MNAS, albumin levels and phase angle of patients in group 1 were lower and CRP, PLR, ADMA levels were higher when compared to group 2. In correlation analysis, NLO was positively correlated with PLR, CRP and ADMA however negatively correlated with albumin and PhA levels. In regression analysis, NLR, PLR and ADMA were detected as independent predictors of MNAS. Conclusion: In conclusion our study suggests that NLR, PLR and ADMA are independent predictors for nutritional status and inflammation in patients ongoing hemodialysis.

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

Malnutrition and Related Factors in Older Patients With Gastrointestinal Cancer Receiving Chemotherapy.

Objectives The incidence and mortality of gastrointestinal (GI) malignancies increase exponentially with age. Malnutrition is a documented poor prognostic factor in older patients with cancer. There is insufficient data about the prevalence of malnutrition and associated factors in older patients with GI cancer. Thus, we aimed to investigate the prevalence of malnutrition and related factors among older patients with GI cancer. Methods A total of 121 patients aged over 70 years diagnosed with various types of GI cancers applied to the medical oncology clinic included in this cross-sectional study. We evaluated the nutrition status with a mini-nutritional assessment (MNA) score. Results The prevalence of malnutrition was 76 (62.8%) in our study population. The mean age was 76.5 (range 70 to 90 years), and 71 (58.6%) were male. In the multivariate logistic regression model, lower BMI (OR: 3.379, 95% CI: 1.465-7.812,p= 0.005), having gastroesophageal cancer (OR: 5.797, 95% CI: 2.387-14.091,p<0.001), treating with palliative chemotherapy (OR: 4.597, 95% CI: 1.799-11.772,p= 0.002), and frailty according to G8 score (OR: 10.798, 95% CI: 4.495-25.924,p<0.001) were associated with malnutrition. Conclusions Our study revealed that palliative chemotherapy, low BMI, frailty, and gastroesophageal cancer are risk factors for malnutrition in older patients with GI cancer. Physicians need to be aware of patients who may be at risk for malnutrition. Patients at risk of malnutrition may benefit from interventions to enhance their nutrition. Further studies consisting of larger cohorts are needed to determine malnutrition and related factors in older patients with cancer.

An investigation into the potential association between nutrition and Alzheimer's disease.

Malnutrition is the most common nutritional issue in Alzheimer's disease (AD) patients, but there is still a lack of a comprehensive evaluation of the nutritional status in AD patients. This study aimed to determine the potential association of various nutritional indices with AD at different stages. Subjects, including individuals with normal cognition (NC) and patients diagnosed with AD, were consecutively enrolled in this cross-sectional study. Demographics, body composition, dietary patterns, nutritional assessment scales and nutrition-related laboratory variables were collected. Binary logistics regression analyses and receiver operating characteristic (ROC) curves were used to indicate the association between nutrition-related variables and AD at different stages. Totals of 266 subjects, including 73 subjects with NC, 72 subjects with mild cognitive impairment due to AD (AD-MCI) and 121 subjects with dementia due to AD (AD-D) were included. There was no significant difference in dietary patterns, including Mediterranean diet and Mediterranean-DASH diet intervention for neurodegenerative delay (MIND) diet between the three groups. Lower BMI value, smaller hip and calf circumferences, lower Mini Nutritional Assessment (MNA) and Geriatric Nutritional Risk Index (GNRI) scores, and lower levels of total protein, albumin, globulin, and apolipoprotein A1 were associated with AD (all p < 0.05). Total protein and albumin levels had the greatest ability to distinguish AD from non-AD (AUC 0.80, 95% CI 0.74-0.84, p < 0.001), increased by combining calf circumference, MNA score and albumin level (AUC 0.83, 95% CI 0.77-0.88, p < 0.001). Albumin level had the greatest ability to distinguish NC from AD-MCI (AUC 0.75, 95% CI 0.67-0.82, p < 0.001), and MNA score greatest ability to distinguish AD-MCI from AD-D (AUC 0.72, 95% CI 0.65-0.78, p < 0.001). Nutritional status of AD patients is significantly compromised compared with normal controls, and tends to be worsened with AD progresses. Early identification and intervention of individuals with nutritional risk or malnutrition may be significantly beneficial for reducing the risk, development, and progression of AD.

Exploring the interplay of frailty, physical function, physical activity, nutritional status, and their association with quality of life and depressive symptoms in older adults with the frailty phenotype.

This study aimed to explore the interplay between frailty, physical function, physical activity, nutritional status, and their impact on the quality of life and depressive status in older adults with frailty. A cross-sectional study involving 235 pre-frail/frail older adults residing in Spanish communities was conducted. Frailty was assessed using Fried's criteria, physical function was evaluated using the Short Physical Performance Battery, and physical activity levels were measured via wrist-worn accelerometers. Nutritional status was determined using the Mini-Nutritional Assessment alongside anthropometric measurements. Quality of life was gauged using the EuroQoL 5-Dimension 5-Level, while depressive status was assessed using the Yesavage 15-item Geriatric Depression Scale. Multivariate linear regression and logistic regression analyses were employed to elucidate the associations of these factors with quality of life and depression. Our findings revealed significant correlations between various factors and quality of life. Notably, reported fatigue (β=-0.276, p=0.002), performance in the 4-m gait test (β=-0.242, p=0.001), the score on the short version of the Mini-Nutritional Assessment (β=0.312, p=0.002), and engagement in light physical activity (β=0.180, p=0.023) were all found to be associated with quality of life. In terms of depressive symptoms, the Mini-Nutritional Assessment score emerged as a protective factor (Odds ratio, OR: 0.812, p<0.001), as did participation in moderate physical activity (OR: 0.988, p=0.028). Conversely, fatigue (OR: 3.277, p=0.003) and a slow gait speed (OR: 1.136, p=0.045) were identified as risk factors for depressive symptoms. This study underscores the detrimental association of fatigue and slow gait speed on both quality of life and depressive status among older adults with frailty. In contrast, engaging in physical activity and addressing malnutrition risk emerge as critical protective factors for enhancing quality of life and ameliorating depressive symptoms in this population. This is a study that uses cross-sectional data from a trial registered at ClinicalTrials.gov (Identifier: NCT05610605).

Prevalence and risk factors of cognitive frailty among pre-frail and frail older adults in nursing homes.

The purpose of this research was to stratify the level of frailty to examine the risk factors associated with reversible cognitive frailty (RCF) and potentially reversible cognitive frailty (PRCF) in nursing homes to provide a basis for hierarchical management in different stages of frailty. The study was a cross-sectional study conducted from September to November 2022; 504 people were selected by stratified random sampling after convenience selection from the Home for the Aged Guangzhou. The structured questionnaire survey was conducted through face-to-face interviews using the general data questionnaire, Fried Frailty Phenotype, Montreal Cognitive Assessment Scale. In total, 452 individuals were included for analysis. A total of 229 cases (50.7%) were PRCF, 70 (15.5%) were RCF. Multivariate logistic regression analysis showed that in pre-frailty, the Geriatric Depression Scale (GDS-15) score (odds ratio (OR) 1.802; 95% CI 1.308-2.483), Instrumental Activities of Daily Living Scale (IADL) score (0.352; 0.135-0.918) and energy (0.288; 0.110-0.755) were influencing factors of RCF. GDS-15 score (1.805; 1.320-2.468), IADL score (0.268; 0.105-0.682), energy (0.377; 0.150-0.947), lack of intellectual activity (6.118; 1.067-35.070), admission time(>3 years) (9.969; 1.893-52.495) and low education (3.465; 1.211-9.912) were influencing factors of PRCF. However, RCF with frailty was associated with the Short-Form Mini-Nutritional Assessment (MNA-SF) score (0.301; 0.123-0.739) and low education time (0 ~ 12 years) (0.021; 0.001-0.826). PRCF with frailty was associated with age (1.327; 1.081-1.629) and weekly exercise time (0.987; 0.979-0.995). The prevalence of RCF and PRCF was high among pre-frail and frail older adults in nursing homes. Different levels of frailty had different influencing factors for RCF and PRCF. Depression, daily living ability, energy, intellectual activity, admission time, education level, nutrition status, age and exercise time were associated with RCF and PRCF. Hierarchical management and intervention should be implemented for different stages of frailty to prevent or delay the progression of cognitive frailty.

The Mini Nutritional Assessment combined with body fat for detecting the risk of sarcopenia and sarcopenic obesity in metabolic syndrome.

Malnutrition is a key factor in metabolic syndrome (MS) and sarcopenia, assessing the nutritional status of these patients is a pressing issue. The purpose of this study was to clarify sarcopenia and sarcopenic obesity in patients with MS based on nutritional status. This was a case-control study between MS/non-MS. Body composition was measured by dual-energy X-ray absorptiometry. Muscle function was assessed by handgrip strength, five times sit-to-stand test, gait speed test and short physical performance battery (SPPB). The Mini Nutritional Assessment (MNA) was performed to assess the nutritional status in the participants in this study. Overall, a total of 56 % and 13 % of participants suffered from possible sarcopenia and sarcopenia, respectively. There was a higher rate of possible sarcopenic obesity in the MS group than in the non-MS group (48·9 % v. 24·7 %, P < 0·01), and all the sarcopenia participants in the MS group had sarcopenic obesity. MNA score was significantly associated with sarcopenia status (P < 0·01). The MNA combined with body fat score showed better acceptable discrimination for detecting sarcopenic obesity and sarcopenia in MS (AUC = 0·70, 95 % CI 0·53, 0·86). In summary, there was a higher prevalence of possible sarcopenic obesity in MS, and all the MS patients with sarcopenia had sarcopenic obesity in the present study. We suggest that the MNA should be combined with body fat percentage to assess the nutritional status of MS participants, and it also serves as a good indicator for sarcopenia and sarcopenic obesity in MS.

Nutritional status of hospitalized elderly patients in Ethiopia: a cross-sectional study of an important yet neglected problem in clinical practice.

Malnutrition is a common geriatric syndrome affecting approximately half of the older population with a more pronounced occurrence rate in those hospitalized. It affects the physiology, and results in poor humanistic and clinical outcomes. In Africa, particularly in Ethiopia, albeit multiple studies are available on malnutrition in non-hospitalized older population, similar studies in inpatient settings are scarce. Therefore, this study was conducted with the intention to quantify the prevalence of malnutrition in older patients on inpatient admission and determine its associated factors. A total of 157 older inpatients aged 60 years and above were included in the present study. The data collection format was developed after an in-depth review of relevant literatures. The full Mini-Nutritional Assessment (MNA) tool was employed to assess the nutritional status on admission. Data completeness was checked thoroughly. Descriptive statistics and logistic regression analysis were conducted using STATA 15.0. The area under the receiver operating characteristic curve (ROC), Hosmer-Lemeshow test, and classification table were computed to evaluate the final model goodness-of-fit. Of the total study subjects, 81% were malnourished (MNA score <17) and 17% were at risk for malnutrition (MNA score of 17.5-23.5). However, upon review of the patients' medical charts, malnutrition diagnosis was recorded in only two patients. Rural residence (AOR = 2.823, 95%CI: 1.088, 7.324), self-reported financial dependence for expenses (AOR = 4.733, 95%CI: 1.011, 22.162), and partial dependence in functional autonomy on admission (AOR = 3.689, 95%CI: 1.190, 11.433) significantly increased the risk of malnutrition. The area under the ROC curve (0.754) and the Hosmer-Lemeshow test (p = 0.7564) indicated that the final model reasonably fits the data. The model`s sensitivity is 96.85%. In the present study, an alarmingly high prevalence of malnutrition was identified older inpatients. The problem went undiagnosed in a similar percentage of patients. Several available literatures indicate the presence of an association between nutritional status and patient outcomes, thus strict nutritional screening at inpatient admission and intervention are recommended with special emphasis for those from rural areas, with financial dependence, and with functional impairment on admission.

Assessment of Oral Health-related Quality of Life and Nutritional Status in Institutionalized Elderly Goan Population: A Descriptive, Cross-sectional Study

Background: The geriatric population is continuously at risk for nutritional deficiency and malnutrition, especially in developing countries like India. The aim of this study was to determine if the oral health-related quality of life is associated with malnutrition among the institutionalized elderly Goan population. Materials and Methods: A cross-sectional study was conducted among the institutionalized elderly in Goa. The elderly was assessed by a 12-item Geriatric Oral Health Assessment Index (GOHAI) questionnaire and the Mini Nutritional Assessment (MNA) test. Descriptive statistics were used to analyze the data using the SPSS version 21. Results: There were 102 elderly participants, of which 60.8% were females. The majority of study subjects (83%) were between the age group of 65 and 74 years. Among the assessed subjects, nearly 55.9% of them had a total score of GOHAI between 12 and 57 which was categorized as “needed dental care.” As per MNA, 32.4% had adequate nutrition, 65.7% were at risk of malnutrition, and the remaining 2% of subjects were malnourished. There was a significant correlation between GOHAI and MNA scores. Conclusion: In the elderly, nutritional status played a significant role in the oral health quality of life. The geriatric denture population is particularly vulnerable to compromised nutritional health.

Sarcopenia, but not malnutrition, is associated with fear of falling in older patients with dementia.

Fear of falling (FoF) is common in patients with cognitive impairment. However, the role of sarcopenia and malnutrition, which are two important factors that cause falls, on FoF is unknown. The aim of this study was to explore the association between FoF and malnutrition and sarcopenia in older patients with dementia. Two hundred and sixty-six dementia patients underwent comprehensive geriatric assessment. The Falls Efficacy Scale-International (FES-I) was applied to assign and classify FoF. Scores for the FES-I scale were categorized as ≥28, 20-27, or 16-19, representing high concern, moderate, and no or low concern about FoF, respectively. Mini Nutritional Assessment (MNA) scores <17, 17-23.5, or >23.5 were categorized as malnutrition, malnutrition risk, and well-nourished, respectively. Sarcopenia was defined using the SARC-F tool. SARC-F score ≥4 was categorized as sarcopenia. Serum folate, Vitamin B12, and Vitamin D deficiencies were also evaluated. The relationship between FoF groups and nutritional status, presence of sarcopenia, and micronutrient status was evaluated. The mean age was 80.83±6.61 years. The prevalence of moderate and high FoF in dementia patients was 51%. There was a significant difference in terms of cerebrovascular events, the history of falling, instrumental and basic activities of daily living (IADL and BADL), MNA, and SARC-F scores between the FoF groups (p<0.05). The association between sarcopenia and FoF persisted in multivariable analysis adjusted for MNA scores, cerebrovascular events, falls history, BADL, and IADL (OR=2.67, 95% CI: 1.50-4.50), but there was no significant association between malnutrition/micronutrient deficiencies and FoF (p>0.05). Sarcopenia is associated with the severity of FoF, but malnutrition or micronutrient deficiencies are not associated with the severity of FoF in older patients with dementia.