Mini Nutritional Assessment Short Form Research Articles

Oral Frailty as a Risk Factor for Malnutrition and Sarcopenia in Patients on Hemodialysis: A Prospective Cohort Study.

Oral frailty is a concept that encompasses various aspects of impaired oral function in elderly people, leading to reduced food intake and less dietary diversity, which can result in sarcopenia and physical frailty. However, there have been no studies on the relationship between oral frailty and malnutrition, sarcopenia, and physical frailty in patients on hemodialysis (HD). This prospective observational cohort study assessed the oral status of patients on HD. The patients were divided into an oral frailty group and non-oral frailty group using the Oral Frailty Index-8. Malnutrition was assessed using the Geriatric Nutritional Risk Index (GNRI), the Nutritional Risk Index for Japanese Hemodialysis Patients (NRI-JH), and the Short-Form Mini-Nutritional Assessment (MNA-SF). Sarcopenia was assessed using the Asian Working Group for Sarcopenia 2019's criteria. Physical frailty was assessed using the Japanese version of the Cardiovascular Health Study criteria. One year later, the changes in nutritional status, sarcopenia, and physical frailty risk categories were compared between the oral frailty and non-oral frailty groups. The study enrolled 201 patients (non-oral frailty group, 123; oral frailty group, 78). After 1 year, the oral frailty group had a significantly higher proportion of patients with worsening nutrition status (GNRI, p = 0.0011; NRI-JH, p = 0.0019; MNA-SF, p < 0.001) and sarcopenia (p = 0.0024). There was no significant between-group difference in the proportion of patients in a worse risk category for physical frailty after 1 year. Oral frailty predicts future malnutrition and the progression of sarcopenia in HD patients. In particular, our results strongly suggested that oral frailty was a strong determinant of worsening malnutrition and sarcopenia in HD patients aged ≥65 years.

Development and validation of a dynamic nomogram for high care dependency during the hospital-family transition periods in older stroke patients

BackgroundThis research aimed to develop and validate a dynamic nomogram for predicting the risk of high care dependency during the hospital-family transition periods in older stroke patients.Methods309 older stroke patients in the hospital-family transition periods who were treated in the Department of Neurology outpatient clinics of three general hospitals in Jinzhou, Liaoning Province from June to December 2023 were selected as the training set. The patients were investigated with the General Patient Information Questionnaire, the Care Dependency Scale (CDS), the Tilburg Frailty Inventory (TFI), the Hamilton Anxiety Rating Scale (HAMA), the Hamilton Depression Rating Scale-17 (HAMD-17), and the Mini Nutrition Assessment Short Form (MNA-SF). Lasso-logistic regression analysis was used to screen the risk factors for high care dependency in older stroke patients during the hospital-family transition period, and a dynamic nomogram model was constructed. The model was uploaded in the form of a web page based on Shiny apps. The Bootstrap method was employed to repeat the process 1000 times for internal validation. The model’s predictive efficacy was assessed using the calibration plot, decision curve analysis curve (DCA), and area under the curve (AUC) of the receiver operator characteristic (ROC) curve. A total of 133 older stroke patients during the hospital-family transition periods who visited the outpatient department of Neurology of three general hospitals in Jinzhou from January to March 2024 were selected as the validation set for external validation of the model.ResultsBased on the history of stroke, chronic disease, falls in the past 6 months, depression, malnutrition, and frailty, build a dynamic nomogram. The AUC under the ROC curves of the training set was 0.830 (95% CI: 0.784–0.875), and that of the validation set was 0.833 (95% CI: 0.766-0.900). The calibration curve was close to the ideal curve, and DCA results confirmed that the nomogram performed well in terms of clinical applicability.ConclusionThe online dynamic nomogram constructed in this study has good specificity, sensitivity, and clinical practicability, which can be applied to senior stroke patients as a prediction and assessment tool for high care dependency. It is of great significance to guide the development of early intervention strategies, optimize resource allocation, and reduce the care burden on families and society.

The association between early postoperative food intake and postoperative hospital length of stay in patients undergoing cardiac surgery: A retrospective observational single-center study

Background & AimsPerioperative nutritional status is critical during the postoperative recovery process in patients undergoing cardiac surgery. Several studies on patients undergoing cardiac surgery have reported low energy intake in early postoperative food intake via oral nutrition; however, no study has shown an association of low energy intake with postoperative hospital length of stay (LOS). This study aimed to determine whether early postoperative low food intake was associated with prolonged postoperative hospital LOS in patients undergoing cardiac surgery. MethodsThis was a retrospective, observational, single-center study conducted in patients aged ≥18 years undergoing elective cardiac surgery from January 1, 2020, to May 31, 2023. Patients were categorized by food intake as food intake < 50% (low food intake group) and ≥ 50% (adequate food intake group) at lunch on postoperative day (POD) 3. The primary outcome of this study was the postoperative hospital LOS. A generalized linear model was used to examine the association between food intake and postoperative hospital LOS using the following explanatory variables: age, European System for Cardiac Operative Risk Evaluation (EuroSCORE) II value, preoperative risk of malnutrition, activities of daily living status, Sequential Organ Failure Assessment score, and C-reactive protein level. ResultsOf the 315 patients, 104 (33.0%) had a food intake of <50% on POD3. There were no significant differences in age, sex, EuroSCORE II value, and comorbidities between the two groups. Patients in the low-food intake group had a significantly lower Barthel Index (6.7% vs. 1.4%, p = 0.017) and a higher malnutrition risk according to the Mini Nutritional Assessment Short Form score (40.4% vs. 28.2%, p = 0.043). Food intake of <50% on POD3 was associated with prolonged postoperative hospital LOS (β = 1.135 [95% confidence interval: 1.004–1.262], p = 0.018). ConclusionsLow food intake on POD3 is associated with prolonged postoperative hospital LOS in patients undergoing elective cardiac surgery. Early postoperative food intake should be closely monitored in patients after elective cardiac surgery.

Investigating Frailty, Polypharmacy, Malnutrition, Chronic Conditions, and Quality of Life in Older Adults: Large Population-Based Study.

Aging, a significant public health issue, is associated with multiple concurrent chronic diseases and aging-related conditions (geriatric syndromes). This study aims to investigate the impact of age and chronic conditions on geriatric syndromes and the intercorrelations between multiple geriatric syndromes and quality of life (QoL) in older adults (aged ≥65 years) at the population level. A large representative sample was randomly selected from a county in China, Feidong, with 17 towns and 811,867 residents. Multiple chronic conditions, geriatric syndromes (frailty, polypharmacy, and malnutrition), and QoL were assessed and compared. Associations of demographic information and chronic conditions with geriatric conditions and QoL in older adults were assessed using multivariable-adjusted logistic regression. Intercorrelations between age, multiple geriatric syndromes, and QoL were investigated using both correlation analysis and restricted cubic splines-based multivariable-adjusted dose-response analysis. Older adults comprised 43.42% (3668/8447) of the entire study population. The prevalence of frailty, premalnutrition or malnutrition, polypharmacy, and impaired QoL (median age 73, IQR 69-78 years; 1871/3668, 51% men) was 8.26% (303/3668), 15.59% (572/3668), 3.22% (118/3668), and 10.8% (396/3668), respectively. Different age and sex subgroups mostly had similar prevalence of geriatric syndromes (except that frailty occurred more often with older age). Premalnutrition or malnutrition were associated with a lower frequency of obesity and a higher frequency of constipation, polypharmacy with a higher frequency of diabetes and constipation, frailty with a higher frequency of constipation and hernia, and impaired QoL with a higher frequency of hypertension, diabetes, physical disability, and constipation. Mini Nutritional Assessment-Short Form, Groningen Frailty Indicator, and EQ-5D-5L scores, as well as the number of medications used, mostly predicted each other and QoL. Impaired QoL was associated with a higher frequency of frailty, premalnutrition or malnutrition, and polypharmacy, and frailty with a higher frequency of premalnutrition or malnutrition and polypharmacy. At a 1.5-year follow-up, impaired QoL was linked to polypharmacy and frailty at baseline, premalnutrition or malnutrition and polypharmacy were associated with frailty at baseline, and frailty was linked to both premalnutrition or malnutrition and polypharmacy at baseline. Causal mediation analyses showed that frailty mediated the link between polypharmacy and worse QoL and that polypharmacy mediated the link between frailty and worse QoL. In this large population-based study of older adults, multiple chronic conditions were associated with ≥1 of the investigated geriatric syndromes. Geriatric syndromes were mostly intercorrelated with, and well predictive of, each other and QoL; and causal relationships existed between geriatric syndromes and QoL, with other geriatric syndromes being mediators. The findings might be biased by residual confounding factors. It is important to perform personalized geriatric syndrome assessments stratified by chronic condition; active prevention of, or intervention for, any syndrome might help to reduce the others and improve QoL.

Effect of Cognitive Decline on Mandibular Movement during Mastication in Nursing Home Residents.

Background: Many studies have reported on the relationship between cognitive and masticatory functions. However, it remains unclear how the mandibular movements change during chewing in facility residents as dementia progresses. This study aimed to investigate the relationship between a kinematic analysis of mandibular movement during mastication and cognitive function in facility residents. Methods: Sixty-three participants were included from two long-term care facilities. The primary outcome variable was the kinematic data of mandibular movement during mastication. The participants chewed rice crackers, and their faces were recorded during this motion. The partial correlation coefficient between kinematic data and cognitive function was calculated. Furthermore, group comparisons were performed after dividing the participants into three groups based on their cognitive function. Results: Circular motion frequency was significantly correlated with the ABC dementia scale, even after adjusting for the appendicular skeletal muscle index, Eichner index, and short-form mini-nutritional assessment. The cycle and circular motion frequencies were markedly lower in the severe dementia group than in the mild dementia group. Conclusions: With declining cognitive function, mandibular movements during mastication decrease in circular motion and increase in linear motion. Additionally, our results suggested that residents with severe cognitive impairment had more linear mandibular motions during mastication than those with mild cognitive impairment. This may make it more difficult for residents with cognitive decline to ingest normal solid foods.

Construction of frailty and risk prediction models in maintenance hemodialysis patients: a cross-sectional study.

As the prevalence of diabetic nephropathy and hypertensive nephropathy increases with age in mainland China, the number of patients with end-stage renal disease is increasing, leading to an increase in the number of patients receiving maintenance hemodialysis. Considering the harmful effects of frailty on the health of maintenance hemodialysis patients, this study aims to identify hemodialysis patients at risk for frailty at an early stage, in order to prevent or delay the progression of frailty in the early stage, so as to prevent the adverse consequences of frailty. A total of 479 patients admitted to the blood purification centers of two grade tertiary hospitals in Anhui Province, China, using convenient sampling. The Frailty Scale, the SARC-F questionnaire, the Simplified Food Appetite Questionnaire (SNAQ) and the mini nutritional assessment short-form (MNA-SF) were used in the study. Pearson correlation analysis was used to explore the correlation among the frailty influencing factors. The incidence of frailty was 24.0% among 479 Chinese hemodialysis patients. Gender (p < 0.05), Malnutrition (p < 0.001), sarcopenia (p < 0.001), and feel tired after dialysis (p < 0.001) were highly correlated with frailty in Chinese hemodialysis patients. Serum albumin concentration (p < 0.05) was a protective factor of frailty. This survey shows that frailty was highly prevalent among Chinese hemodialysis patients. Medical staff and their families should make early judgments and carry out interventions on the risk of frailty.

Evaluation of Nutrition, Pressure Ulcer and Fall Risk Status and Related Factors in Individuals Receiving Home Health Care Services

Objective: In this study, the aim is to evaluate the factors associated with nutrition, pressure ulcers, and fall risks in individuals receiving home health care. Methods: A retrospective study was designed by examining the files of the patients registered in the Home Health Care. Mini Nutritional Assessment Short Form, Modified Norton Scale and Itaki Fall Risk Scale scores were recorded. Results: The study included 334 patients. 197 (59%) of them were female and the mean age was 74.15±16.12 (min: 18, max: 101). The most common chronic diseases was hypertension (HT) (n=167, 50%), whereas the two most common comorbidities were DM and HT (n=77,23.1%). Patients receiving home health care were found to be at risk for malnutrition, pressure ulcers and falls. Being semi-bedridden and wheelchair bound were found to be predictors for the risk of developing pressure ulcers according to regression analysis results. Also it was identified that the age and dependency levels of the patients receiving home health care explained 12% of the falling behaviours of the older people. Conclusion: Necessary warnings should be given at every visit, so that receiving home health care should not be neglected in terms of risks and preventive measures should be taken for this patient group.

Dietetic Needs in a Memory Assessment &amp; Support Service (MASS) – A Retrospective Analysis

Abstract Background Nutrition issues can occur in all stages of cognitive impairment, but individual needs may not always be promptly identified. Aim To evaluate dietetic needs of this cohort. Methods Retrospective service evaluation of first 50 referrals to a MASS Senior Dietitian, including comparison of nutrition-screening tools validated for older persons: Mini Nutritional Assessment-Short Form (MNA-SF)1 and Malnutrition Universal Screening Tool (MUST)2. Results The first 50 dietetics referrals (total 126 consults) representing 16% of MASS clients in this period. Nutrition screening: MNA-SF MUST ≤ 7 18% malnourished/high risk ≥ 2 34% 8-11 72% at risk of malnutrition 1 32% 12-14 10% not nutritionally at risk 0 34% So MNA-SF identified 90% as malnourished or at risk, while this was 66% with MUST. Individually tailored advice included: Resolution of key issue and discharged (17), 2 clients deceased. Remainder (31) ongoing dietetic follow-up. Conclusion For those with memory impairment early and regular nutrition assessment is important, and the MNA-SF tool is appropriate. Expert Dietetic advice is necessary at all stages of memory impairment.

ICOP Dietetics – The First Year

Abstract Background All clients referred to Integrated Care for Older Persons (ICOP) for falls, frailty or functional decline have a Comprehensive Geriatric Assessment (CGA) including nutrition screening, which may trigger dietetic referral. Methods Retrospective analysis of initial year of a Senior Dietitian (0.5WTE). Results 172 referrals - representing 28% of ICOP clients. 14 did not engage. Age 56-95, Clinical Frailty Scale 3-8 (median 5). 304 consults: 40% one consultation, 40% 1-2 reviews, 20% 3-6 reviews. Nutrition screening Mini Nutritional Assessment-Short Form (MNA-SF)1 score ≤ 7 16% malnourished, 8-11 55% at risk of malnutrition, 12-14 29% not nutritionally at risk. So, 71% categorised as either malnourished or nutritionally at risk. While not assessed in all cases, probable sarcopenia2 was documented in 42% clients using grip strength. Individually tailored advice included (n=158): 141 discharged after individualised dietetic advice. Seven clients deceased. Remainder (nine) ongoing. Conclusion Those attending ICOP have a high prevalence of nutrition concerns, nutrition screening is important, and expert dietetic advice is essential to ensure guidance is evidence-based and resources are appropriate.

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.

Factors Influencing Malnutrition Among Older Adult Residents in the Western Region of Saudi Arabia: Sex Differential Study.

The global population of older adults is on the rise. As people age, their physical functions gradually decline, leading to a decrease in the overall functioning of different organ systems. Due to these changes, older individuals are at a higher risk of encountering various adverse health outcomes and complications, such as malnutrition. This study aims to investigate the prevalence of malnutrition and its associated factors among older adults dwelling in the western region of Saudi Arabia. We have analyzed these factors separately for both men and women to understand any potential sex differences. A nonrandomized cross-sectional study was conducted for older adults aged ≥60 years in the western region of Saudi Arabia. Personal information was obtained through a closed questionnaire. The Mini Nutritional Assessment Short Form was used to determine the malnutrition status of older adults. Consequently, the individuals were divided into 2 groups: normal and malnourished. To assess the risk factors related to malnutrition, the odds ratio (OR) and 95% CI were determined using a binary logistic regression. The prevalence of malnutrition in men and women was around 7% and 5%, respectively. Potential risk factors related to malnutrition in men were higher age (OR 1.263, 95% CI 1.086-1.468; P=.002), being widowed (OR 8.392, 95% CI 1.002-70.258; P=.049), and having dental problems (OR 9.408, 95% CI 1.863-47.514; P=.007). On the other hand, risk factors associated with malnutrition in women were lower BMI (OR 0.843, 95% CI 0.747-0.952; P=.006) and being disabled (OR 18.089, 95% CI 0.747-0.952; P=.006). The findings of this study provide important insights into the risk factors for malnutrition among older adults in the western region of Saudi Arabia. While the overall prevalence of malnutrition was relatively low, the analysis revealed distinct risk factors for older men and women. Interventions developed based on the identified risk factors may prove effective in addressing the issue of malnutrition within this population.

Relationship Between Oral Hypofunction and Nutritional Status in Patients Treated With Maxillofacial Prostheses.

Introduction Patients who have jaw or tongue defects owing to head and neck cancer or congenital disease suffer from oral dysfunction such as speech, swallowing, and mastication. Although maxillofacial prostheses are applied to improve oral functions, their oral functions remain compromised compared to those of patients without jaw or tongue defects. On the other hand, it has been reported that oral hypofunction could lead to malnutrition in the general elderly. However, to date, no reports have evaluated the relationship between oral function and nutritional status in patients with maxillofacial prostheses. In this study, we comprehensively evaluated oral function according to the examination items for oral hypofunction. We assessed which functions were related to nutritional status in patients with jaw defects caused by tumors or congenital diseases who are candidates for maxillofacial prosthetic treatment. Methods Patients who underwent prosthetic treatment at the Department of Maxillofacial Prosthodontics, Aichi-Gakuin University Dental Hospital, between May 2021 and January 2024 and who were doing well were included in the study. Oral function was assessed with seven tests according to the criteria of the Japanese Society of Geriatric Dentistry, and nutritional status was evaluated using the Mini Nutritional Assessment Short-Form (MNA-SF). Patients were classified according to age and type of deficiency. Additionally, the presence or absence of oral hypofunction and malnutrition or risk of malnutrition were assessed. The impact of oral hypofunction tests and defect status on the risk of malnutrition was evaluated using a logistic regression model. Results Oral hypofunction and malnutrition or risk of malnutrition were more frequent in the elderly group by age. Regarding the type of defect, the rate of oral hypofunction and malnutrition or risk of malnutrition was highest in the tongue defect group. Results of the logistic regression analysis indicated that nutritional status was associated with tongue deficiency, tongue-lip motor function, tongue pressure, and swallowing function. Conclusion The nutritional status of maxillofacial prosthetic wearers was associated with oral hypofunction. Particularly, malnutrition and risk of malnutrition were increased with tongue defects and deficiencies in tongue-lip motor function, tongue pressure, and swallowing.

Malnutrition and other associated factors among the hospitalized elderly in Vietnam: A cross-sectional study.

Malnutrition is common among older inpatients and can lead to severe consequences such as disability, assisted living, increased mortality, and prolonged hospital stays. Given the rapidly aging population in Vietnam, limited data is available regarding the nutritional status of the geriatric. This research aimed to determine the prevalence of malnutrition and associated factors among the hospitalized elderly. A prospective observational study with a cross-sectional design was conducted on 108 older inpatients at University Medical Center in Ho Chi Minh City, Vietnam. Patients aged 60 years or older admitted to the hospital were recruited. Malnutrition was assessed using a validated Mini Nutritional Assessment Short Form. Sociodemographic characteristics were measured using interview-administered questionnaires. Data about patients' biochemical parameters were retrieved from records with the newest results. Among 108 hospitalized patients (mean age 74.6 ± 9.8 years; 50% female), 72.2% of patients had malnutrition (n = 78) while 27.8% had normal nutritional status (n = 30). Age group, education level, cohabitation, serum albumin, hand-drip strength, physical inactivity, and frailty were associated with malnutrition. The prevalence of malnutrition in the elderly accounts for a very high proportion. Nutritional status assessment is essential for the elderly; therefore, more attention should be paid to those risk factors in old age health care in order to improve medical outcomes.

Impact of an oral nutritional supplement on nutritional status in older adults with malnutrition: A randomized controlled trial

Background: The aging population is expanding at an unprecedented rate, leading to a significant increase in the prevalence of malnutrition among older adults. Oral Nutritional Supplements (ONS) have emerged as a widely accepted strategy to address the nutritional needs of this demographic. Objective: This study aimed to evaluate the impact of an ONS on the nutritional status of malnourished older adults. Methods: This was an open-label, randomized-controlled, parallel-group, single-centered study. Recruitment criteria were age ≥60 years, and mini nutrition assessment-short form (MNA-SF) score ≤11. A total of 50 participants were randomly assigned to the intervention (IG) and control (CG) groups (1:1 ratio). The IG received 200 mL of ONS as a bedtime drink for 12 weeks, while the CG received 200 mL of water. Nutrition status, biochemical analysis, and dietary assessment were performed at the beginning and end of the study. Results: Forty-two participants (IG: n=20, and CG: n=22) completed the study. After 12 weeks, the IG showed a significant improvement in the MNA-SF score (p&lt;0.001) compared to the CG (p=0.118). The IG experienced a substantial increment in the vitamin D level (p=0.002). No significant improvements were found in the serum albumin and haemoglobin levels in either group. The intervention led to significant increases in daily intake of energy (p&lt;0.001), carbohydrate (p=0.013), protein (p&lt;0.001), and fat (p&lt;0.001) in comparison to the control group. Conclusion: Supplementing with an ONS, along with a regular diet, significantly improved nutritional status, some biochemical parameters, and daily intake of energy and macronutrients in older adults with malnutrition.

Survey on the knowledge and practices in anorexia of aging diagnosis and management in Japan.

Anorexia of aging (AA) is a condition in older adults that includes loss of appetite and reduced food intake. There is a lack of detailed analysis of the potential influence of educational initiatives in addressing AA. This study aimed to clarify the current state of knowledge and practice regarding AA and its relationship with the availability of continuing education opportunities among Japanese healthcare professionals involved in treating older patients. The Japan Geriatrics Society and the Japanese Association on Sarcopenia and Frailty, in collaboration with the Society on Sarcopenia, Cachexia, and Wasting Disorders, conducted an online questionnaire survey on the knowledge and practices in AA detection and management. Questions were asked in the areas of demographics, screening, definition/diagnosis, treatment, referral, and awareness, with those who 'participate' in continuing education and professional development programmes in nutrition for their patients were classified as the 'education group' and those who 'do not participate' were classified as the 'non-education group'. The results for each question were compared. The analysis included 870 participants (physicians, 48%; registered dietitians, 16%; rehabilitation therapists, 14%; pharmacists, 12%; nurses, 6%; and other professionals, 5%). The education group (45%) was more likely than the non-education group (55%) to use the Mini-Nutritional Assessment Short Form (MNA-SF) to screen for AA (49% vs. 27%) and less likely not to use a validated tool (33% vs. 47%). More participants used evidence-based tools and materials for AA care (38% vs. 12%), and fewer used their clinical judgement (23% vs. 35%) or were unaware of the tools and materials (9% vs. 23%). The proportion using a team of professionals experienced in AA care were 47% and 24% of the education and non-education groups, respectively. By profession, few physicians used specific validated tools and resources for AA screening and treatment. More than half of the dietitians used the MNA-SF regardless of training opportunity availability. Regarding professional availability and team use, differences in educational opportunities were particularly large among physicians. Participation in continuing education programmes on nutrition is associated with responsiveness to AA screening and treatment and the availability of a team of professionals, which may influence the quality of AA treatment. Nutrition education may support the confidence of healthcare professionals working with older adults in AA with complex clinical signs and encourage them to conduct evidence-based practice.

Relationship Between Endothelial Function, Vital Parameters, and Cognitive Performance in Community Dwellers with Subjective Cognitive Decline: An Observational Study with Six Months Follow Up.

With advancing age, cognitive decline is frequently associated with endothelial dysfunction, but data on vascular performance prior to the onset of mild cognitive impairment (MCI) is scarce. To investigate the relationship between endothelial function, vital parameters and cognitive performance in older adults with subjective cognitive decline (SCD). Forty-five volunteers aged 65 years and older with SCD underwent comprehensive geriatric assessment-based prognosis evaluation by means of the Multidimensional Prognostic Index (MPI), full neuropsychological examination and peripheral arterial tonometry measurement by means of EndoPAT™2000 to evaluate endothelial flexibility and vital parameters. Six months after initial evaluation, participants were contacted by phone and a telephone-administered version of the MPI (TELE-MPI) was conducted. Fifteen study participants scored below the cutoff score of 26 on the Montreal Cognitive Assessment, suggesting MCI (26.56±2.23). Nominal significant correlations were found between heart rate (HR) and trail making test (TMT) A (β= -0.49, p = 0.03), between heart rate variability (HRV) and TMT B (β= 0.78, p = 0.041), between power of low-frequency band (LF) HRV and Mini Nutritional Assessment-Short Form (β= 0.007, p = 0.037) as well as between augmentation index (AI) and CogState Detection Test (β= 0.002, p = 0.034). HR, HRV, and AI, but not endothelial flexibility are associated with cognitive performance in SCD and suspected MCI patients and may serve as clinical biomarkers in the early diagnosis of neurodegenerative disorders with advancing age.

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.

Prevalence of mild cognitive impairment and its association with malnutrition in older Chinese adults in the community.

This study aims to characterize the prevalence and associated factors of cognitive impairment in older adults within Chinese community settings. Research exploring the interrelation between malnutrition and cognitive impairment in the older adult community-dwelling population is scarce. The impact of nutritional status on cognitive function in aging adults has not been definitively established. A cross-sectional survey was conducted in one urban and one rural community in Chengdu, China, from October 2022 to March 2023. The sample included 706 older adults. Logistic regression was utilized to determine independent risk factors for mild cognitive impairment (MCI). The study found a significant prevalence of MCI at 32.0% among the older adult population. Among those suffering from malnutrition, 55.6% were affected by MCI. The logistic regression analysis indicated that malnutrition risk (OR = 2.192, 95% CI 1.431 to 3.357, p < 0.001), rural residence (OR = 1.475, 95% CI 1.003 to 2.170, p = 0.048), age (70-79 years old; OR = 2.425, 95% CI 1.611 to 3.651, p < 0.001; ≥80 years old: OR = 4.773, 95% CI 2.571 to 8.859, p < 0.001), male (OR = 1.584, 95% CI 1.085 to 2.313, p = 0.017), middle education level (OR = 0.986, 95% CI 1.627 to 5.482, p < 0.001), and ADL dependence (OR = 1.810, 95% CI 1.158 to 2.827, p = 0.009) were significantly associated with the occurrence of MCI. The findings indicate a widespread occurrence of MCI in community-dwelling older Chinese adults. The association between malnutrition, as measured by the Mini Nutritional Assessment-Short Form (MNA-SF), and cognitive decline is evident. Older adult individuals with nutritional risk, advancing age, rural residence, male gender, moderate education, and ADL dependency are at increased likelihood of developing MCI. Longitudinal research is needed to clarify the temporal relationships between MCI, demographic factors, and whether improvements in nutritional status or ADL can reduce the incidence of MCI in this population.

Reliability and validity of Chinese version of the Simplified Nutritional Appetite Questionnaire (SNAQ) in community-dwelling old people

ObjectiveTo investigate the reliability and validity of the Chinese version of simplified nutritional appetite questionnaire (SNAQ). MethodsThe SNAQ was translated and back-translated for the study population. We surveyed 122 community-dwelling residents aged ≥60 years in Beijing's residential communities. Participants underwent face-to-face surveys including the SNAQ, mini-nutritional assessment short-form (MNA-SF), FRAIL scale, Sarcopenia-Five (SCAR-F), 15-item Geriatric Depression Scale (GDS-15), 7-item Generalized Anxiety Disorder (GAD-7), 8-item Oral Frailty Index (OFI-8), 10-item Eating Assessment Tool (EAT-10), and Mini-Mental State Examination (MMSE). Cronbach's alpha was used to measure the internal consistency and the relationship between individual items. The construct validity was verified using the KMO-Bartlett. Concurrent validity was established to validate measures of the same constructs. ResultsCronbach's alpha measured the internal consistency of the questionnaire at 0.694. The split-half reliability stood at 0.725. The construct validity of the SNAQ was confirmed using a KMO-Bartlett value of 0.648 (P <0.001). The MNA-SF, as validation benchmark, has a correlation coefficient of 0.345 (P =0.001). ConclusionThe Chinese version of the SNAQ has good reliability and validity for older adults in community settings.

2324 Feasibility of screening for frailty, sarcopenia and nutritional status in elective surgery for colorectal cancer

Abstract Introduction Preoperative frailty is a key determinant of post-surgical outcomes and often co-exists with sarcopenia and malnutrition. Older patients account for a significant proportion of patients undergoing surgery for colorectal cancer and are therefore more likely to be affected by these risk factors. Methods Patients aged 65 and over undergoing planned surgery for colorectal cancer were recruited across five sites. Participants were screened preoperatively using the Clinical Frailty Scale (CFS) and Groningen Frailty Indicator (GFI). Nutritional status was assessed using the short form mini nutritional assessment (MNA-SF) and participant collection of spot urine samples to objectively measure habitual dietary intake. Sarcopenia was assessed through grip strength, gait speed and psoas muscle measurement using preoperative CT imaging. The non-radiological screening measures were repeated eight-weeks postoperatively, with additional urine samples collected in the first and fourth weeks. Results Forty-three participants (mean age 76 years, 60% male) were recruited, of which 32% were frail. Using the mini-nutritional assessment 42% of participants were identified as at risk of malnutrition and 9% as malnourished. Urine assessment of habitual dietary intake is ongoing. There was a high prevalence of sarcopenia - 67% determined by hand grip strength and 42% by CT analysis. Mean length of stay following surgery was 6.9 days. 28% of participants were unable to complete the in-person post-operative follow up due to ill health, poor appetite and exhaustion. Conclusions This ongoing study has demonstrated the feasibility of incorporating frailty, nutritional status and sarcopenia screening alongside routine clinical care, in older adults undergoing surgery. However, retaining participants in observational studies during postoperative periods of convalescence, or whilst undergoing adjuvant treatment, is challenging. This study has also highlighted the potential of home urine sampling as a viable method of dietary assessment within community settings to aid malnutrition screening.