Mini Nutritional Assessment-Short Form Score Research Articles

Predicting sarcopenia in community-dwelling older adults through comprehensive physical fitness tests.

Sarcopenia is typically assessed through hand grip strength, walking speed, and chair stand tests. However, it has been inadequately examined in terms of other physical fitness (PF) components in community-dwelling older adults. Thus, in this study, we explored factors influencing the risk of sarcopenia in community-dwelling older adults. In addition, we analyzed the clinicodemographic characteristics of older adults with or without sarcopenia and investigated the effect of sex on their PF. This cross-sectional study included 745 older adults from a community health promotion program in Taiwan. Their clinicodemographic characteristics were recorded. PF was assessed through various tests, such as hand grip strength evaluation, 8-foot up-and-go test (8-UGT), 2-min step test, and 6-m walk test. PF and factors influencing sarcopenia risk were compared between older adults with sarcopenia (sarcopenia group) and those without it (nonsarcopenia group). A logistic regression model was performed to identify key factors associated with sarcopenia. Its predictive performance was evaluated by calculating the area under the receiver operating characteristic curve (ROC) curve. Regardless of sex, the sarcopenia group performed worse in almost all components of PF-for example, upper and lower limb muscular strength and endurance, cardiopulmonary fitness, and balance-than did the nonsarcopenia group. However, for men, no significant between-group difference was observed in flexibility. The logistic regression model indicated age (odds ratio [OR]: 1.107), sex (OR: 2.881), Mini Nutritional Assessment-Short Form scores (OR: 0.690), and performance in 8-UGT (OR: 1.346) as factors influencing the risk of sarcopenia. The model exhibited excellent discriminative ability in predicting sarcopenia, as indicated by an area under the curve value of 0.867 (95% confidence interval: 0.827-0.906; p < 0.05). Older adults without sarcopenia tend to outperform those with sarcopenia in almost all PF measures, regardless of sex. Older age, male sex, low Mini Nutritional Assessment-Short Form scores, and poor performance in 8-UGT are associated with a high risk of sarcopenia.

Mini nutritional assessment short form as a predictor of mortality among older adults with dementia residing in group homes: A 5-year longitudinal study

Many people with dementia frequently experience various health-related problems and are known to have poor nutritional status. However, very few studies have examined the nutritional status of dementia residents in group homes, which play an important role in a society-wide system of support for people with dementia, or the relationship between nutritional status and long-term prognosis. This study was conducted to determine the nutritional status of group-home residents and to examine the relationship between nutritional status and the 5-year survival rate. Participant characteristic (e.g., age, sex, body mass index, and medical history) and Mini Nutritional Assessment-Short Form (MNA-SF), Barthel index (BI), and Clinical Dementia Rating (CDR) data were collected from 79 older people (12 men/67 women; mean age: 88.3±5.5 years) residing in 5 group homes as a baseline survey. Mortality data were obtained from medical records using an endline survey. The nutritional status of the participants using the MNA-SF was normal, at risk of malnutrition, and malnourished in 15.2% (n=12), 69.6% (n=55), and 15.2% (n=12) of participants, respectively. Following the survey, mortality data were collected for 5 years, and the 5-year survival rates were 64.3% in those with normal nutritional status, 30.4% in those at risk of malnutrition, and 9.1% in the malnourished group, with a significant difference observed in the Kaplan-Meier analysis (p<0.001). The hazard ratio for the MNA-SF scores and survival rates adjusted for sex, age, BI, and CDR were significant 0.80 [0.69-0.93, p=0.003]. This study showed that 84.8% of patients with dementia residing in group homes were malnourished or at risk of malnutrition and that low MNA-SF levels were an independent determinant of the 5-year survival rate.

Clinical profiles of older adults in French Caribbean nursing homes: a descriptive cross-sectional study.

Nursing homes in the Caribbean are scarce and the characteristics of their residents have not been previously documented. This study aimed to describe the clinical profiles of residents living in nursing homes in Guadeloupe and Martinique (French West Indies). This is a cross-sectional study of the baseline screening data from the KASEHPAD (Karukera Study of Ageing in nursing homes) study. Clinical characteristics and geriatric scale scores, including the Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE), Mini Nutritional Assessment Short-Form (MNA-SF) and Short Physical Performance Battery (SPPB) were collected and analysed. A total of 332 older adults were recruited between September 2020 and November 2022. The mean age of the residents was 81.3 ± 10.1, with a male-female ratio of 1:1. Diabetes was reported in 28.3% of the residents, hypertension in 66.6% and heart disease in 18.4%. Dementia was diagnosed in 52.3% of the residents and 74.9% had a MMSE score ≤18. The prevalence of Parkinson's disease was 9.0%. Additionally, 18.4% were unable to perform any basic activities of daily living (ADL score of 0). The prevalence of physical impairment (SPPB < 8) was 90.0%. One-quarter of the residents were classified as undernourished (MNA-SF score ≤ 7). Residents in Caribbean nursing homes are younger than in metropolitan France, whereas they present quite similar clinical profiles. Notably, a high prevalence of diabetes, cardiovascular diseases and neurodegenerative diseases was observed. This study represents a preliminary effort to address the knowledge gap regarding the aging trajectories of older adults in the Caribbean and could guide the development of future nursing homes in these countries.

The mediating role of nutritional indicators in the association between estimated glomerular filtration rate and cognitive impairment in older adults.

Cognitive impairment (CI) is common in older adults, especially those with renal dysfunction. We aimed to investigate the complex relationships among renal function, nutritional status, and CI in older people free from late chronic kidney disease (CKD) and severe CI. A study of older people (≥60 years old) with an estimated glomerular filtration rate (eGFR) of >30 mL/min/1.73 m2 and Montreal Cognitive Assessment (MoCA) scores of >10 (n = 237) was conducted at Beijing Tongren Hospital. Their eGFR was determined using the CKD-EPI-cr-Cysc equation. Cognitive function was evaluated with the MoCA. We tested the relationship between eGFR and MoCA scores using Spearman correlation analysis and multivariate logistic regression analysis. We then conducted a mediation analysis to figure out the mediating roles of nutritional indicators (Mini Nutritional Assessment-Short Form (MNA-SF) scores, albumin (ALB), and haemoglobin (HGB)) between the eGFR and MoCA scores. The incidence of CI was 48.5% (115/237) in older people. Spearman correlation analysis revealed that the better the kidney function, the better the cognitive function (R = 0.297, P < 0.001). Multivariate logistic regression analysis revealed that eGFR decrease per 15 mL/min/1.73 m2 (OR: 1.415, 95% confidence interval: 1.055-1.896, P = 0.020) was related to CI after adjusting for age and sex. However, the eGFR was not associated with cognitive decline after adjusting for nutritional indicators, behavioural risk factors, other biomarkers, and chronic conditions, suggesting that eGFR is not independently associated with CI. Mediation analysis revealed that the MNA-SF scores (a*b = 0.006 (0.0002-0.012)) and HGB (a*b = 0.008 (0.001-0.017)) were mediating factors between the eGFR and MoCA scores. A decline in renal function can directly lead to CI and can also exacerbate cognitive deficits through intermediary factors such as MNA-SF scores and HGB. Therefore, correcting anaemia and improving nutritional status are significantly important for enhancing cognitive function in older patients, especially those with renal dysfunction.

Relationship between Improvement in Physical Activity and Three Nutritional Assessment Indicators in Patients Admitted to a Convalescent Rehabilitation Ward.

We investigated the relationship between three nutritional indicators, the Mini Nutritional Assessment-Short Form (MNA-SF), Geriatric Nutritional Risk Index (GNRI), and Controlling Nutrition Status (CONUT), and physical activity at discharge in patients admitted to convalescent rehabilitation wards. The study included 1601 patients (77 ± 12 years, male 46.2%) discharged from convalescent rehabilitation wards between April 2018 and September 2023. MNA-SF, GNRI, and CONUT scores were obtained on admission. Patients were divided into two groups according to their level of Functional Independence Measure (FIM) walk score at discharge. The walking group (n = 1181, FIM walk score ≥ 5, 76 ± 13 years, male 47.2%) was significantly younger than the wheelchair group (n = 420, 79 ± 12 years, FIM walk score < 5, male 43.8%) and had significantly higher MNA-SF (6.5 ± 2.5 vs. 4.7 ± 2.4) and GNRI (93.1 ± 12.4 vs. 86.7 ± 10.9) scores and significantly lower CONUT (3.1 ± 2.3 vs. 3.9 ± 2.3) scores than the wheelchair group (all p < 0.01). Multivariate logistic regression analysis showed that age, handgrip strength, Functional Oral Intake Scale, and MNA-SF score were independently associated with walking ability at discharge (all p < 0.01). In addition, MNA-SF scores were independently associated with Rehabilitation Effectiveness. These results suggest that nutritional status, particularly MNA-SF scores on admission, is associated with improvement of physical activity at discharge.

Malnutrition and Its Determinants among Older Adults Living in French Caribbean Nursing Homes: A Cross-Sectional Study.

This study aimed to assess the prevalence of malnutrition and its determinants in older adults living in French Caribbean nursing homes. This cross-sectional study was taken from the KASEHAD (Karukera Study of Ageing in EHPAD) study. Nutritional status was assessed with the Mini Nutritional Assessment Short-Form (MNA-SF). Clinical characteristics and scores on geriatric scales (Mini-Mental State Examination (MMSE), Activities of Daily Living (ADL), Short Physical Performance Battery (SPPB), Center for Epidemiologic Studies-Depression (CESD) and Questionnaire Quality of Life Alzheimer's Disease (QoL-AD)) were extracted. Bivariate analysis and logistic models adjusted were performed to test the association between nutritional status and both socio-demographic variables and geriatric scales. A total of 332 older adults from six nursing homes were included in the KASEHPAD study. Among the participants, 319 had an MNA-SF score. The mean age was 81.3 ± 10.6 years, and half of the participants were men. The frequency of malnutrition (MNA-SF ≤ 7) was 27.6% (95% confidence interval (CI): 22.0-32.5) (n = 88). Based on the multivariable analysis, a low MMSE was associated with malnutrition (OR: 0.81 (0.68-0.92); p = 0.015) and there was a borderline significant link between a higher CESD score and malnutrition (OR: 1.05 (1.00-1.12); p = 0.07). Cognitive decline and a tendency toward depression were associated with malnutrition in nursing homes in the French West Indies. Although this study cannot establish causal relationships, the identification of these three geriatric syndromes in nursing homes is crucial for preventing adverse health events.

Effect of nutritional status on adverse clinical events in elderly patients with nonvalvular atrial fibrillation: A retrospective cohort study.

To explore the influence of nutritional status on adverse clinical events in elderly patients with nonvalvular atrial fibrillation. This retrospective observational cohort study included 196 patients, 75-102-years-old, with nonvalvular atrial fibrillation, hospitalized in our hospital. The nutritional status was assessed using Mini-Nutritional Assessment-Short Form (MNA-SF). Patients with MNA-SF scores of 0-11 and 12-14 were included in the malnutrition and nonmalnutrition groups, respectively. The average age of the malnutrition group was higher than that of the nonmalnutrition group, and the levels of body mass index (BMI), hemoglobin (HGB), and albumin (ALB) were significantly lower than those of the nonmalnutrition group, with statistical significance (p < .05). The incidence of all-cause death in the malnutrition group was higher than that in the nonmalnutrition group (p = .007). Kaplan-Meier curve indicated that malnutrition patients have a higher risk of all-cause death (log-rank test, p = .001) and major bleeding events (p = .017). Multivariate Cox proportional hazard regression analysis corrected for confounders showed that malnutrition was an independent risk factor of all-cause death (HR = 1.780, 95%CI:1.039-3.050, p = .036). The malnutrition group had a significantly high incidence of major bleeding than the nonmalnutrition group (p = .026), and there was no significant difference in the proportion of anticoagulation therapy (p = .082) and the incidence of ischemic stroke/systemic embolism (p = .310) between the two groups. Malnutrition is an independent risk factor of all-cause death in elderly patients with atrial fibrillation. The incidence of major bleeding in malnourished elderly patients with atrial fibrillation is high, and the benefit of anticoagulation therapy is not obvious.

Usefulness of the mini nutritional assessment short-form for evaluating nutritional status in patients with nontuberculous mycobacterial pulmonary disease: a prospective cross-sectional study

BackgroundAlthough the Mini Nutritional Assessment (MNA) is recognized as a useful tool for evaluating nutritional status in patients with various diseases, its applicability in patients with nontuberculous mycobacterial pulmonary disease (NTM-PD) remains undetermined.MethodsWe designed a prospective cross-sectional study to investigate whether the MNA Short-Form (MNA-SF) score can serve as a screening tool to assess the nutritional status of patients with NTM-PD. The MNA-SF was conducted upon patient enrollment, and correlation analyses were performed to compare MNA-SF scores with other nutritional measurements and disease severity. Multivariable logistic regression analyses were conducted to evaluate the association between MNA-SF scores and NTM-PD severity.ResultsThe 194 patients with NTM-PD included in the analysis had a median age of 65.0 (59.0–69.0) years; 59.3% (n = 115) had low MNA-SF scores (< 12). The low MNA-SF group exhibited a lower body mass index (19.7 vs. 22.4 kg/m2, p < 0.001) and fat-free mass index (14.7 vs. 15.6 kg/m2, p < 0.001) than the normal MNA-SF group, as well as higher incidences of sarcopenia (20.0% vs. 6.3%, p = 0.008) and adipopenia (35.7% vs. 5.1%, p < 0.001). However, no significant differences in calorie and protein intakes were observed between the two groups. Low MNA-SF scores were associated with radiographic severity (adjusted odds ratio 2.72, 95% confidence interval 1.38–5.36) but not with forced vital capacity.ConclusionsThe MNA-SF can effectively assess the nutritional status of patients with NTM-PD and can serve as an important clinical indicator in NTM-PD where treatment timing is determined by clinical judgment.

Comparison of the performance of different nutritional indicators for predicting poststroke depression in older adults with ischemic stroke

ObjectiveThis study aimed to investigate the relationships between three different nutritional indicators and poststroke depression (PSD) and to analyze the performance of these nutritional indicators in predicting the occurrence of PSD in older adults with ischemic stroke to provide a reference for nurses to identify high-risk patients with PSD early, optimize stroke management, and improve patient prognosis. MethodsThis cohort study prospectively included 239 older adults with ischemic stroke in the Department of Neurology of a hospital in Shenzhen from September 2022 to May 2023. The nutritional status of the patients were evaluated by laboratory indicators, the Mini Nutritional Assessment Short Form (MNA-SF), and the Geriatric Nutrition Risk Index (GNRI). The Hospital Anxiety and Depression Scale-Depression (HADS-D) was used to evaluate PSD. A self-designed questionnaire was used to collect demographic information and disease-related information. Binary logistic regression analysis was performed to analyze factors related to PSD, and receiver operating characteristic curve analysis was also used to compare the performance of these nutritional indicators. ResultsA total of 239 older adults with ischemic stroke were included; the mean age was 71.10 ± 7.41 years, and 66.5% (159/239) were males. The incidence of PSD was 32.6% (78/239). The incidence of PSD in the low-value group was significantly greater than that in the high-value group according to the different nutritional indices, and the difference was statistically significant (all P < 0.05). Binary logistic regression analysis revealed that the albumin (ALB) level (OR = 0.681; 95% CI, 0.508–0.913; P = 0.010), GNRI score (OR = 1.238; 95% CI, 1.034–1.483; P = 0.020), and MNA-SF score (OR = 0.708; 95% CI, 0.614–0.815; P < 0.001) were influencing factors for PSD in this population (P < 0.05). Combined with the ALB, GNRI, and MNA-SF, the area under the ROC curve for predicting the incidence of PSD in older adults with ischemic stroke was the largest and had a high degree of differentiation (AUC, 0.738; sensitivity, 75.6%; specificity, 60.9%). ConclusionThe nutritional indices ALB, GNRI, and MNA-SF can be used as auxiliary tools to predict the risk of PSD in older adults with ischemic stroke malnutrition. Further validation by nurses in a more diverse patient population is needed to demonstrate the accuracy of the predictions.

#1619 Factors associated with malnutrition in the very elderly with chronic kidney disease

Abstract Background and Aims The presence of malnutrition in elderly patients with chronic kidney disease (CKD) is associated with adverse events such as mortality, functional decline, and worse outcomes during hospital admission. However, it is not well defined which subgroups would benefit most from nutritional screening, especially considering the difficulty in obtaining certain nutritional parameters like weight in dependent patients. The objective of this study is to identify which factors are associated with a higher risk of malnutrition in very elderly patients with CKD admitted for acute illness, belonging to the PANCERC cohort. Method Cross-sectional observational study conducted with patients ≥85 years old with CKD admitted to an Acute Geriatric Unit due to acute illness over a period of four months. Variables: age, sex, institutionalization, previous Barthel Index (BI), previous Lawton Index (LI), dementia (defined by Reisberg's GDS≥4), frailty (FRAIL scale ≥3), polypharmacy (≥5 drugs), comorbidities (degree of CKD, hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation (AF), anemia, chronic heart failure (CHF), pressure/vascular ulcers, Charlson Comorbidity Index (CCI)), nutritional parameters (Mini Nutritional Assessment-Short Form (MNA-SF), body mass index (BMI), serum cholesterol and albumin), estimated glomerular filtration rate by CKD-EPI (eGFRCKD-EPI) at admission. Malnutrition was defined by a score of ≤7 on the MNA-SF. The chi-square test and t-test were used to analyze the association with the outcome variable. Subsequently, a stepwise logistic regression analysis was conducted to identify factors independently associated with malnutrition. Results 407 patients were recruited, mean age 90.7±4.1 years, 68.1% female. 32.4% were institutionalized. Previous BI was 59.1 ± 32.3 (BI ≥90 28.7%, BI 60-85 26.3%, BI 40-55 10.6%, BI &amp;lt;40 34.4%); previous LI was 1.7 ± 2 (6.9% LI ≥6, 8.4% LI 4-5, 83.3% LI≤3). 28.3% had dementia. 66.6% were frail, and 90.9% presented polypharmacy. CKD stage: G3a (37.6%), G3b (44.2%), G4 (17.7%), G5 (0.5%). Comorbidities: hypertension (90.7%), CHF (68.3%), anemia (57.5%), dyslipidemia (53.8%), AF (54.5%), diabetes mellitus (37.8), pressure/vascular ulcers (11.1%). The CCI was 2.9 ± 1.8. The mean eGFRCKD-EPI at admission was 37.9 ± 16.6 mL/min/1.73 m2. MNA-SF score was 9.5±2.4 (18.4% malnutrition), and average BMI was 28±5.5 kg/m2 (29% obesity). 30.5% had dysphagia (18.7% nectar texture, 11.8% pudding texture). The mean serum cholesterol and albumin were 156.3±47.7 mg/dL and 35.5±4.6 g/L. Variables associated with malnutrition were female sex (OR 2.1 [1.1 to 3.9; p=0.019]), BI&amp;lt;40 (OR 8.8 [5 to 15.7; p &amp;lt; 0.001]), LI ≤3 (OR 1.3 [1.3 to 1.4]; p &amp;lt; 0.001]), dementia (OR 8.3 [4.7 to 14.6; p &amp;lt; 0.001]), frailty (OR 2.4 [1.1 to 5; p = 0.023]), nectar texture dysphagia (OR 2 [1.1 to 3.6; p = 0.018]), pudding texture dysphagia (OR 5 [2.6 to 9.6; p &amp;lt; 0.001]), institutionalization (OR 2.5 [1.5 to 4.2; p=0.001]), pressure/vascular ulcers (OR 4.5 [2.3 to 8.7; p &amp;lt; 0.001]), BMI (−2.7 [−4.1 to −1.3; p &amp;lt; 0.001]), albumin (−3.1 [−4.3 to −2; p &amp;lt; 0.001]). After adjusting for significant variables, factors that acted as independent predictors of malnutrition were: frailty (OR 3.5 [1.1 to 10.7; p = 0.028]), pressure/vascular ulcers (OR 4.7 [1.5 to 15; p=0.009]), BMI (OR 0.87 [0.81 to 0.94; p=0.001]), pudding texture dysphagia (OR 3 [1 to 8.7; p=0.047]), dementia (OR 8.6 [3.3 to 22.4; p &amp;lt; 0.001]), BI&amp;lt;40 (OR 2.6 [1 to 6.8; p = 0.045]). Conclusion

#2904 Chronic kidney disease staging in the very old: the role of cystatin C

Abstract Background and Aims Over the past decade, an unanswered question has emerged: which is the best equation for estimating glomerular filtration rate (eGFR) in older patients with chronic kidney disease (CKD)? Despite the lack of consensus, cystatin C appears to hold promise, as it is not influenced by factors often affected in the very elderly, such as muscle mass or protein intake, offsetting the limitations of creatinine-dependent formulas. This may have implications for correctly classifying patients across the different stages of CKD. The aim of this study is to analyze the concordance between different eGFR formulas and the Chronic Kidney Disease Epidemiology Collaboration formula combining the use of creatinine and cystatin C (CKD-EPIcr-cys), which is recommended by the European Renal Best Practice Group. Method A cross-sectional observational study was conducted with patients ≥85 years old with CKD admitted to an Acute Geriatric Unit due to acute illness over a period of four months. Variables included age, sex, previous Barthel Index (BI), dementia (defined by Reisberg's GDS≥4), frailty (FRAIL scale ≥3), polypharmacy (≥5 drugs), comorbidities (degree of CKD according to CKD-EPI, hypertension, diabetes mellitus, dyslipidemia, chronic heart failure (CHF), Charlson Comorbidity Index (CCI)), nutritional and laboratory parameters (Mini Nutritional Assessment-Short Form (MNA-SF), body mass index (BMI), serum cholesterol and albumin, glucose, glycated hemoglobin), and estimated glomerular filtration rate at admission by CKD-EPIcr-cys, CKD-EPIcys, CKD-EPI, MDRD and Cockcroft-Gault. The intra-class correlation coefficient (ICC) and the Kappa index were used to analyze concordance. Results A total of 407 patients were recruited, with a mean age of 90.7±4.1 years, 68.1% female. The previous BI was 59.1±32.3. Dementia was present in 28.3%. Frailty was noted in 66.6%, and polypharmacy in 90.9%. CKD stage: G3a (37.6%), G3b (44.2%), G4 (17.7%), G5 (0.5%). Comorbidities included hypertension (90.7%), CHF (68.3%), dyslipidemia (53.8%), and diabetes mellitus (37.8). The CCI was 2.9±1.8. MNA-SF score was 9.5±2.4 (18.4% malnutrition), and average BMI was 28±5.5 kg/m2 (29% obesity). The mean values for cholesterol, albumin, glucose, and glycated hemoglobin were 156.3±47.7 mg/dL, 35.5±4.6 g/L, 126.1±91.3 mg/dL, and 5.9±2%, respectively. The eGFR at admission according to CKD-EPIcr-cys was 31.9±12.2 mL/min/1.73 m2, while using CKD-EPI, CKD-EPIcys, MDRD, and Cockcroft-Gault were 37.5±14.5 mL/min/1.73 m2, 28.2±12.1 mL/min/1.73 m2, 42.8±16 mL/min/1.73 m2, and 30.4±11.7 mL/min/1.73 m2, respectively. The formulas showed high concordance with CKD-EPIcr-cys: CKD-EPI (ICC=0.90 [0.52 to 0.96; p &amp;lt; 0.001]), CKD-EPIcys (ICC=0.94 [0.79 to 0.97; p &amp;lt; 0.001]), MDRD (ICC=0.80 [-0.14 to 0.94; p &amp;lt; 0.001]), Cockcroft-Gault (ICC=0.86 [0.82 to 0.88; p &amp;lt; 0.001]). However, when comparing stratification into different stages of CKD, the concordance with the various formulas was lower: CKD-EPI (k=0.4; p &amp;lt; 0.001), CKD-EPIcys (k=0.59; p &amp;lt; 0.001), MDRD (k=0.12; p &amp;lt; 0.001), Cockcroft-Gault (k=0.4; p &amp;lt; 0.001). When referencing CKD-EPIcr-cys, it is notable that only 34.3% of patients were correctly classified using MDRD, followed by CKD-EPI (57.1%), Cockcroft-Gault (59.8%), and CKD-EPIcys (73%). Specifically, of the patients classified as stage G4 according to CKD-EPIcr-cys, there was a reclassification to stage G3b in 2.1% (CKD-EPIcys), 18.1% (Cockcroft-Gault), 33.3% (CKD-EPI), and 52.1% (MDRD). Conclusion

The associations between nutritional status and physical frailty and Alzheimer's disease plasma biomarkers in older cognitively unimpaired adults with positive of amyloid-β PET

Background & AimsIt has been revealed good nutritional status and no physical frailty, which are modifiable lifestyle factors, are linked to less cognitive decline and a lower risk of Alzheimer’s disease (AD). We aimed to investigate the associations between nutritional status and physical frailty and plasma AD biomarkers, especially the Tau-associated biomarkers in older cognitively unimpaired (CU) adults with higher β-amyloid (Aβ) burden. MethodsThe nutritional status and physical frailty were assessed via Mini-Nutritional Assessment Short-Form (MNA-SF) and Fried frailty index. The participants underwent the examination of plasma AD biomarkers and 18F-florbetapir PET scan as well as 18F-MK6240 PET in the validation cohort. Correlation and multiple linear regression analyses were used to investigate the associations between nutritional status and frailty and AD biomarkers. ResultsTwo cohorts were included in our study. A total of 129 participants with Aβ-PET positive were enrolled in the development cohort. Multiple linear regression analysis showed MNA-SF scores, normal nutritional status, Fried frailty index scores, frailty and some domains of frailty including weight loss, maximal grip strength and exhaustion were associated with plasma p-Tau-181. Furthermore, weight loss, Fried frailty index scores and frailty were associated with higher Aβ-PET standard uptake value ratio. We further performed subgroup analyses stratified by age, sex and apolipoprotein E ε4 genotype to investigate the beneficial characteristics of nutrition and frailty in the special subgroups. Validation cohort contained 38 Aβ-PET positive participants. MNA-SF scores, normal nutritional status, Fried frailty index scores and frailty were associated with Tau burden evaluated by 18F-MK6240 PET Braak-like stages. ConclusionsOur data indicates that normal nutritional status and no physical frailty may be associated with expected trend of plasma AD biomarkers, especially less Tau pathology in older CU adults with Aβ deposition. Adjusting to these characteristics of nutrition and physical frailty may help reduce the risk of AD development.

Relationship between cachexia and short physical performance battery scores in patients with heart failure attending comprehensive outpatient cardiac rehabilitation.

Heart failure (HF) can cause metabolic imbalances, leading to anabolic resistance and increased energy expenditure, which often results in weight loss and cachexia. Comprehensive cardiac rehabilitation (CR), including exercise, nutritional support, and risk management, is crucial for enhancing the health and quality of life of patients with HF and is expected to play a central role in the prevention and treatment of HF-associated cachexia. However, the prevalence of cachexia in patients with HF undergoing comprehensive outpatient CR is currently unknown, and the detailed characteristics including of motor function of such patients remain undefined. Therefore, this cross-sectional study aimed to investigate the prevalence and characteristics of cachexia and the relationship between cachexia and lower limb motor function in patients with HF undergoing outpatient CR. This study included 115 consecutive patients with HF (43% male; mean age, 78 ± 8years) who underwent comprehensive outpatient CR. The cachexia status was assessed according to the definition proposed by the Asian Working Group on Cachexia in 2023. The Short Physical Performance Battery (SPPB) and Mini Nutritional Assessment Short-Form (MNA-SF) were used to evaluate motor function of the lower limbs and nutritional status, respectively. Multivariate logistic regression analyses were used to examine the potential relationship between cachexia and low SPPB scores (≤ 9 points). The prevalence of cachexia was 30% in this study. Compared with those without cachexia, patients with cachexia were significantly older and showed notable reductions in body mass index, MNA-SF scores, handgrip strength, gait speed, and SPPB scores. A multivariate logistic regression analysis, adjusted for confounders, revealed that both age (odds ratio [OR], 1.129; 95% confidence interval [CI], 1.034-1.248; P = 0.016) and presence of cachexia (OR, 3.783; 95% CI, 1.213-11.796; P = 0.022) were independently associated with low SPPB scores. These findings highlight the importance of focusing on cachexia in patients with HF as part of a comprehensive outpatient CR and may be crucial in developing treatments to improve lower limb motor function in patients with HF who develops cachexia.

Targeted metabolomic profiles of serum amino acids are independently correlated with malnutrition in older adults.

Malnutrition is a common geriatric syndrome that is closely associated with adverse clinical outcomes and poses significant harm to older adults. Early assessment of nutritional status plays a crucial role in preventing and intervening in cases of malnutrition. However, there is currently a lack of measurable methods and biomarkers to evaluate malnutrition in older adults accurately. The aim of this study is to investigate the independent correlation between serum levels of amino acids and malnutrition in older adults, and to identify effective metabolomics biomarkers that can aid in the early detection of geriatric malnutrition. A total of 254 geriatric medical examination participants from Beijing Hospital were included in the study, consisting of 182 individuals with normal nutritional status (Normal group) and 72 patients at risk of malnutrition or already malnourished (MN group). Malnutrition was assessed using the Mini-Nutritional Assessment Short-Form (MNA-SF). Demographic data were collected, and muscle-related and lipid indexes were determined. Serum amino acid concentrations were measured using isotope dilution liquid chromatography-tandem mass spectrometry (LC-MS/MS). The correlation between serum amino acid levels and malnutrition was analyzed using non-parametric tests, partial correlation analysis, linear regression, and logistic regression. The geriatric MN group exhibited significantly lower serum aromatic amino acid levels (P < 0.05) compared to the normal group. A positive correlation was observed between serum aromatic amino acid levels and the MNA-SF score (P = 0.002), as well as with known biomarkers of malnutrition such as body mass index (BMI) (P < 0.001) and hemoglobin (HGB) (P = 0.005). Multivariable logistic or linear regression analyses showed that aromatic amino acid levels were negatively correlated with MN and positively correlated with the MNA-SF score, after adjusting for some confounding factors, such as age, gender, BMI, smoking status, history of dyslipidemia, diabetes mellitus and frailty. Stratified analyses revealed that these trends were more pronounced in individuals without a history of frailty compared to those with a history of frailty, and there was an interaction between aromatic amino acid levels and frailty history (P = 0.004). Our study suggests that serum aromatic amino acids are independently associated with malnutrition in older adults. These results have important implications for identifying potential biomarkers to predict geriatric malnutrition or monitor its progression and severity, as malnutrition can result in poor clinical outcomes.

Undernutrition in obese older adults by fat percentage

ObjectiveThe prevalence of obesity by fat percentage has seen a steady increase in older adults in recent years, secondary to increases in fat mass in body composition, even in healthy aging. Malnutrition is a common geriatric syndrome with serious clinical outcomes. Increases in fat mass and waist circumference with healthy aging should not prevent the risk of malnutrition from being masked. Malnutrition is often ignored in obese older people due to low BMI cut-off values in many screening tests. The present study seeks to raise awareness of the need to assess the frequency of undernutrition and related factors in obese older adults.MethodsThe data of 2013 community-dwelling patients aged ≥ 60 years who applied to a university geriatrics outpatient clinic between April 2012 and November 2022 were analyzed retrospectively, of which 296 were found to be obese based on fat percentage and were included in the study. Demographic data and the presence of any geriatric syndromes were obtained retrospectively from the patient files, functional status was assessed using the KATZ Activities of Daily Living (ADL) Scale and the LAWTON-BRODY Instrumental Activities of Daily Living Scale (IADL); frailty was screened using FRAIL-scale; and the sample was assessed for malnutrition using the Mini Nutritional Assessment-Short Form (MNA-SF), with undernutrition defined as an MNA-SF score of ≤11.\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\le 11.$$\\end{document} The patients’ fat percentage and weight were measured using a bioimpedance analyzer. Fatty obesity was defined using the Zoico methodology (fat percentage ≥\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\ge$$\\end{document} 27.3% for males, ≥\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\ge$$\\end{document} 40.7% for females),\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$,$$\\end{document} handgrip strength (HGS) was measured using a hand dynamometer, and probable sarcopenia was defined as low HGS based on regional cut-off values (35 kg for males, 20 kg for females).ResultsThe mean age of the 296 fatty obese older adults (102 males/194 females) was 74.4 + 6.5 years, and the median fat was 42.2% (27.4–59.5). Undernutrition was detected in 19.6% of the patients based on MNA-SF screening. A univariate analysis revealed age, sex, educational status, daily physical activity status, depression, difficulty in swallowing, chewing difficulty, probable sarcopenia, number of chronic diseases, and IADL to be associated with undernutrition, while a multivariate logistic regression analysis revealed depression [OR = 3.662, 95% CI (1.448–9.013), p = 0.005] and daily physical activity status [OR:0.601, 95% CI (0.417–0.867), p = 0.006] to be independently associated with malnutrition in obese older adults based on fat percentage.Conclusion The present study clarifies the significance of undernutrition in obese older adults also in our country, and recommends undernutrition screening to be carried out, by fat percentage, on obese older adults, especially with depression and low daily physical activity.

Poor nutritional status is associated with the severity of omicron infection in the older adults

BackgroundThe Omicron wave of Coronavirus disease 2019 (COVID-19) remains the dominant strain worldwide. The studies of nutritional status in geriatric people with COVID-19 Omicron variant are limited. Thus, the aim of this study was to investigate the incidence of poor nutritional status among Omicron infected older patients, and to explore the correlation between the nutritional status and the severity of Omicron infection in older patients.MethodsThis is a retrospective cross-sectional study. According to the clinical symptoms, patients were divided into two groups: mild and moderate to severe. Mini Nutritional Assessment short-form (MNA-SF) was conducted when patients were admitted and poor nutritional status was defined as MNA-SF score of 0–11. The inflammatory markers including neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and systemic inflammatory index (SII) were calculated and compared between two groups.ResultsTotal of 324 patients were enrolled, with median [interquartile range (IQR)] age of 73 (17) years. Overall, 241 cases were mild, 83 cases were moderate to severe at the time of diagnosis and that 54.3% of patients had poor nutritional status. Patients with poor nutritional status were found to be older (P < 0.001) and less vaccinated (P < 0.001), with a longer virus shedding duration (P = 0.022), more comorbidities (≥ 2) (P = 0.004) and higher value of NLR (P < 0.001), PLR (P < 0.001) and SII (P = 0.012). Vaccination, cycle threshold value in ORF1ab gene (OR CT value) and female, higher MNA-SF score was negatively connected with probability of moderate to severe infection. For every 1 score increase in MNA-SF, the odds ratio of moderate to severe infection decreased by 14.8% [adjusted odds ratio (aOR), 0.852; 95% confidence interval (CI): 0.734–0.988; P = 0.034].ConclusionsOlder patients with poor nutritional status are more likely to develop moderate to severe Omicron infection.

Association between oral health status and functional independence measure on admission in convalescent hospitalized patients

BackgroundOral health management has become increasingly important for acute inpatients. Older patients often require extended periods of medical care, and oral health management is necessary in the convalescent period following the acute period. During the convalescent period, oral health management remains unclear as convalescent hospitals have limited dental resources, and effective dental care must be provided if the objective of hospitalization is to improve life functions. This study aimed to clarify the relationship between daily functioning and oral health status at the time of admission to a convalescent hospital to aid in improving daily functioning in the convalescent period.MethodsWe included patients admitted to the rehabilitation department of a specific convalescent hospital from January to December 2021. A total of 375 patients were included in the study, with complete data records. At admission, we gathered information from the medical records, including the patient’s age, sex, primary disease, Charlson Comorbidity Index, Mini Nutritional Assessment Short-Form (MNA-SF), Functional Oral Intake Scale (FOIS), Functional Independence Measure (FIM), number of teeth, and Oral Health Assessment Tool (OHAT). Statistical analysis was conducted using SPSS Ver. 27, with a significance level of 5%.ResultsThe mean age of the 375 participants (189 men and 186 women) was 75.0 ± 12.1 years (range, 42–97 years), and over 80% were > 65 years. About 30% of major diseases could be attributed to strokes and fractures, followed by spinal cord and spine diseases. In non-stroke patients, multiple regression analysis using FIM motor, FIM cognitive, and FIM and OHAT total scores as objective variables showed that higher total scores of MNA-SF, FOIS, and lower modified Rankin Scale and OHAT were significantly associated with better FIMs. Lower OHAT scores were significantly associated with lower FOIS and MNA-SF scores, male sex, having fewer teeth, and poor dietary patterns.ConclusionsThe convalescent period is an opportune time to provide intensive dental care due to the generally stable condition and extended hospital stay. Our results suggest that oral health management, such as dysphagia rehabilitation and denture treatment, is important for maintaining and improving independence, a key objective of convalescent rehabilitation, and malnutrition improvement.

Nutrition and Isolation in a Rural US Population over 80 Years Old: A Descriptive Analysis of a Vulnerable Population

Factors allowing rural, community-dwelling 80+ year-olds to thrive remain unexplored. Isolation can impact this vulnerable population. In this study, patients were prospectively surveyed for age, gender, cohabitation (self, spouse, family) and location (suburban, rural, and isolated). Mini-nutritional assessment short form (MNA-SF) and BMI were obtained. A p < 0.05 represented statistical significance. Patients (n = 167) were mostly female (120; 71.9%) with an average overweight BMI (26.5) and low-normal MNA-SF scores (11.8). Most live alone (49.7%), followed by spousal (31.7%) and family (18.6%) cohabitation. Over 80% are rural (71) or rural-isolated (67), and of these, 83% had normal nutrition. Self-habitation correlated with lower MNA-SF scores (p = 0.02). Normal BMIs correlated with family cohabitation (OR = 0.90 [CI: 0.82-0.99]) and nourished MNA-SF scores with spousal cohabitation (OR = 1.69; CI: 1.15-2.47) rather than living alone. Self-habitation increases vulnerability to obesity and malnutrition. Interventions should aim to maintain independence while improving the effects of habitation on nutrition.

Malnutrition and its determinants among older adults living in foster families in Guadeloupe (French West Indies). A cross-sectional study.

Foster families may represent an alternative model for dependent older adults in many countries where nursing homes are insufficiently developed. This study aimed to assess the prevalence of malnutrition and its determinants in older adults living in foster families in Guadeloupe (French West Indies). This cross-sectional study was gathered from the KASAF (Karukera Study of Ageing in Foster families) study (n = 107, 41M/66F, Mdn 81.8 years). Nutritional status was assessed with the Mini Nutritional Assessment Short-Form (MNA-SF). Clinical characteristics and scores on geriatric scales (Mini-Mental State Examination (MMSE), Activities of Daily Living (ADL), Short Physical Performance Battery (SPPB), Center for Epidemiologic Studies- Depression (CESD) and Questionnaire Quality of Life Alzheimer's Disease (QoL-AD)) were extracted. Bivariate analysis and logistic models adjusted for age and gender were performed to test the association of nutritional status with socio-demographic variables and geriatric scales. Thirty (28.0%) older adults were malnourished (MNA-SF score ≤7). In bivariate analysis, malnutrition was associated with an increased prevalence of cardiovascular diseases (46.7% versus 19.5%, p = 0.004), the presence of hemiplegia (30.0% versus 6.5%, p = 0.003), a poorer cognitive status (MMSE score 4.7 ± 7.1versus 9.7 ± 10.7; p = 0.031), higher risk of depression (CESD score 27.3 ± 23.0 versus 13.5 ± 14.4; p = 0.035) and dependency (ADL score 1.9 ± 1.9 versus 2.3 ± 2.1; p<0.001). Malnutrition was also associated with lower caregivers'rating of QoL (QoL-AD score 21.8 ± 6.4 versus 26.0 ± 5.7; p = 0.001) but not by older adult's rating (24.1 ± 11.2 versus 28.3 ± 7.7; p = 0.156). Similar associations were observed in logistic models adjusted for age and gender. Malnutrition was common among foster families for older adults. Special attention towards the prevention and treatment of malnutrition in older adults from cardiovascular diseases, cognitive impairment, dependency and depression is necessary in this model of dependency support.

Association between oral health and nutritional status among older patients requiring long-term care who received home-visit dental care.

This study examined the association between oral health and nutritional status among older patients receiving home-visit dental care. This study enrolled 110 older patients (age ≥65 years) requiring long-term care who received home-visit dental care. The oral health indicators evaluated included number of teeth, occlusal support, number of functional teeth, tongue pressure, tongue coating index (TCI), and rinsing ability. Nutritional indicators included skeletal muscle mass index (SMI) and the mini-nutritional assessment short-form (MNA-SF). A multivariate modified Poisson regression analysis (adjusted for age, sex, medical history, care level, and housing type) was used to calculate prevalence ratios and 95% confidence intervals (CIs). The prevalence ratio for low SMI was not significantly higher for patients with ≥20 teeth than for those with 1-19 or no teeth. Number of teeth was not significantly associated with MNA-SF score. A high TCI score (2.15, 95% CI: 1.07-4.32) and poor rinsing ability (2.32, 95% CI: 1.25-4.30) were significantly associated with low SMI. High TCI scores were associated with low scores in MNA-SF categories (1.25, 95% CI: 1.01-1.55). TCI and rinsing ability, rather than number of teeth, were associated with nutritional status in older patients requiring long-term care.