Mini Nutritional Assessment Test Research Articles

Nutritional Assessment in Outpatients with Heart Failure.

Heart failure (HF) is associated with significant alterations in body composition, including malnutrition due to insufficient intake, chronic inflammation and increased energy expenditure. Identifying the prevalence of malnutrition and the risk of sarcopenia in patients with HF is crucial to improve clinical outcomes. This cross-sectional, single-center, observational study involved 121 outpatients diagnosed with HF. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), the Malnutrition Universal Screening Tool (MUST), and the Subjective Global Rating (SGA). Sarcopenia was screened using the SARC-F (Strength, Assistance in walking, Rise from a chair, Climb stairs, Falls) questionnaire and diagnosed based on the European Working Group in Older People (EWGSOP2) criteria and functionality with the Short Performance Battery (SPPB) test. Malnutrition was diagnosed according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. The study found that 10.7% had cardiac cachexia and 45.4% of deceased patients had been in this condition (p = 0.002). Moderate-to-high risk of malnutrition was identified in 37.1%, 23.9%, and 31.4% of patients according to the MNA, MUST, and SGA tests, respectively. According to the GLIM criteria, 56.2% of patients were malnourished. Additionally, 24.8% of patients had a high probability of sarcopenia, and 57.8% were not autonomous according to SPPB. Patients with less than 30% quadriceps muscle contraction were at a high risk of sarcopenia. There is a high prevalence of malnutrition among outpatients with HF, which is associated with worse prognosis, increased risk of sarcopenia, and greater frailty. These findings underscore the importance of early nutritional and functional assessments in this population to improve clinical outcomes.

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.

Abstract 16118: Vitamin D3 Significantly Decreases Vascular Stiffness, Improving Cognitive Impairment and Sarcopenia in a Frail, Elderly Population From Buenos Aires, Argentina

Introduction: Aging is the leading risk factor for multiple chronic diseases especially cardio and cerebrovascular and for a decline in physical and mental function. Progressive stiffening arterial wall, cognitive impairment and sarcopenia are hallmarks of aging. Due to the pleiotropic actions that have been discovered in vitamin D (VD), which include vascular ,muscular and cognitive effects, we hypothesized that VD3 supplementation might decrease vascular stiffness and could have beneficial effect on mental status and sarcopenia in a frailty elderly population. Methods: We randomized 42 residents (78±6.5 yo; 24 females) from a public geriatric institution, to receive either 100,000 IU of VD3 or placebo (P) every 15 days for 6 months. Arterial stiffness (AS) was evaluated through central systolic pressure (cSYS), central pulse pressure (cPP), and the augmentation index (AIx) a measure of systemic AS derived from the ascending aortic pressure waveform; using Uscom® device. Cognitive function was evaluated using the Clock-Drawing Test (CDT), which is simple and effective for this population. Skeletal muscle strength/sarcopenia, were assess with the up and go test (UGT), muscle strength with hydraulic dynamometer, body mass index (BMI) and mini-nutritional assessment (MNA) test. Results: VD group showed a statistically significant decrease in AS vs P. VD Δ cSYS -12.3 mmHg, Δ cPP -6.7 mmHg mmHg and Δ AIx -17.8 %, for all three parameters: p<0.05. The CDT score improved in VD group (4.3 to 5.9, p <0.05) but there were no statistically significant differences in P group. Muscle strength in VD group improved significantly (from 15.1±9.4 to 18.7±3.8 Kg force/cm 2 , p<0.05) vs no difference in P group. UGT improved with statistical significance in both VD and P group. The BMI and the MNA test were also favorable for VD group although they did not reach statistical significance. Conclusions: Vitamin D3 6-months supplementation improved vascular compliance by decreasing arterial stiffness, improved cognitive performance and sarcopenia indicators in this frail elderly people. Although this was a preliminary study, a larger number of patients studies should be conducted to validated these findings and to consider VD3 supplementation in this population.

The Relationship Between Salivary Flow Rate and Malnutrition in Elderly

Purpose: This study aimed to evaluate the relationship between salivary flow rate (SFR) and nutritional status of elderly.Materials and methods: The study included 63 elderly people (20 males, 43 females, age: 70.83±6.42 years) who applied to the dentist's office. The data were collected by face-to-face interview method and sociodemographic characteristics, information on employment status and lifestyle habits of the participants were recorded in the questionnaire. To determine nutritional status, 3-day food consumption records were taken, Mini Nutritional Assessment Test (MNA) was applied and anthropometric parameters were measured. The carious teeth (DMFT) index and oral health impact scale (OHIP-14) were used to assess oral health, and unstimulated SFR was measured.
 Results: According to MNA, 23.8% of the elderly were malnourished or at risk of malnutrition. The mean SFR of the elderly was 0.40±0.31 ml/min and 15.9% of them had low SFR. The mean SFR of the elderly with normal body weight was higher than that of the obese (p

Peripheral neuropathy and lifestyle factors in women with breast cancer receiving taxane-based chemotherapy: Pathway analysis

PurposePeripheral neuropathy adversely affects the treatment process of cancer, and thus it is important to reveal the factors leading to peripheral neuropathy and to take the necessary precautions to avoid it. This study was conducted to investigate the relationship between chemotherapy-induced peripheral neuropathy (CIPN) and lifestyle factors (nutrition, physical activity and sleep quality). MethodsThis descriptive and correlational study was conducted with 108 individuals who were treated in the chemotherapy unit of a hospital between April 2021 and April 2022 in Turkey. Data were collected using the Chemotherapy-Induced Peripheral Neuropathy Assessment Tool (CIPNAT), the International Physical Activity Questionnaire (IPAQ), the Mini Nutritional Assessment Test (MNA), and the sleep level Visual Analog Scale. Number, percentages, means, and standard deviations were calculated, and multiple linear regression analysis and path analysis were conducted to analyze the data. ResultsThe results indicate that the total MET score significantly and positively predicted the sleep scale score (β = 0.24, p < 0.01), while it negatively and significantly predicted the CIPNAT score (β = −0.30, p < 0.001). In addition, both the MNA screening score and the sleep scale score significantly and negatively predicted the CIPNAT score (β = −0.25, p < 0.01, β = −0.29, p < 0.001, respectively). ConclusionsLifestyle factors (exercise, nutrition, sleep) were found to have an effect on peripheral neuropathy. It is thought that increasing the level of exercise improves sleep quality, and regular nutrition, quality sleep and increased physical activity may be effective in reducing peripheral neuropathy.

Nutritional assessment and nutritional status of centenarians (based on the materials of the study “Centenary citizen” in Moscow)

BACKGROUND: Malnutrition and micro- and macronutrient deficiencies are common in people aged 95 years and older. For timely detection of nutritional disorders, it is crucial to regularly examine centenarians and, if necessary, correct an individual patient management plan. A well-balanced diet is one of the fundamental factors for the normal functioning of the human body throughout its life. With age, for various reasons, the risk of malnutrition increases, however, the nutritional status of centenarians is currently not fully understood due to the difficulties of diagnosis.&#x0D; AIM: To evaluate nutritional status and its impact on life expectancy in patients aged 95 years and older, to identify the main determinants that affect the development of malnutrition, and to assess their impact on three-year survival of centenarians.&#x0D; MATERIALS AND METHODS: Analyzed the results of a Mini Nutritional Assessment, general and biochemical blood tests (including such parameters as hemoglobin levels, iron levels, total protein, albumin, vitamin B12, vitamin D, folic acid) in non-institutionalized people aged 95 and older living in Moscow. All studies were conducted at home in the presence of relatives and/or social workers after signing a voluntary informed consent.&#x0D; RESULTS: The study included 82 people, mean age (98.31.89) years; 87.8% were women. Of all the study participants, 56.1% (n=46) were at risk of developing malnutrition, and 11% (n=9) had malnutrition syndrome. Among the 64 participants who took the blood test, anemia was diagnosed in 71.9% (n=46), with macrocytic in 10.9% (n=5), normocytic in 84.8% (n=39), and microcytic in 4.3% (n=2) of patients. Hypoalbuminemia was identified in 16.9% (n=11 of 65) of participants. Of the 50 people who were screened for vitamin D levels, vitamin D deficiency was found in 98% (n=49 out of 50). The following factors influenced survival: a Mini Nutritional Assessment score of more than 24 reduces the risk of 3-year death by 72% (odds ratio (OR) 0.28, confidence interval (CI) 0.10.8), anemia increases the adverse risk by 3 times (OR=3.1, CI 1.18.9). The main clinical conditions associated with a higher risk of developing malnutrition were anemia (OR=3.1, CI 1.18.9) and chewing problems (OR=2.8, CI 0.97.8).&#x0D; CONCLUSIONS: Conducting a nutrition assessment and drawing up a program for the prevention of malnutrition syndrome in centenarians will improve the quality of life and increase life expectancy.

Examining the Nutrition, Oral Mucositis, and Gastrointestinal System Symptoms of Intensive Care Units Patients Receiving Enteral and Parenteral Nutrition.

This descriptive study aims to examine the complications that might develop in patients who receive enteral or parenteral nutrition treatment in intensive care unit in this process and to examine the nutritional status, oral mucositis, and gastrointestinal system symptoms among patients who receive enteral or parenteral nutrition treatment in intensive care unit. A sample of this study consists of 104 patients who received enteral or parenteral nutrition treatment in intensive care units between January and June 2019. The data were collected face to face by using Sociodemographic Form, constipation severity scale, Mini Nutritional Assessment Scale, Mucositis Assessment Scale, visual analog scale, and gastrointestinal system Symptoms Scale. The results were calculated as numbers, percentage, SD, and mean values. Among the participating patients, 67.4% were older than 65 years, 55.8% were female, 42.3% were receiving treatment in internal medicine intensive care units, and 43.4% had severe mucositis. It was determined that 31.7% of the patients receiving treatment in intensive care units required nutrition treatment. It was determined that patients receiving parenteral nutrition had more symptoms such as gastrointestinal system symptoms, mucositis, constipation, and colonic inertia. It was determined that when compared to the patients receiving enteral nutrition, the patients receiving parenteral nutrition had higher scores in mucositis, visual analog scale pain, Mini Nutritional Assessment Test, constipation, obstructive defecation, colonic inertia, and gastrointestinal symptom total scores.

Effects of COVID-19 Lockdown on Nutritional, Functional and Frailty Biomarkers of People Living in Nursing Homes. A Prospective Study.

Nursing home residences suffered a lockdown from the beginning of the COVID-19 pandemic. The present study prospectively evaluates the frailty, functional, and nutritional statuses of nursing home residents. Three hundred and one residents from three nursing homes took part in the study. Frailty status was measured using the FRAIL scale. Functional status was evaluated using the Barthel Index. Additionally, Short Physical Performance Batter (SPPB), SARC-F, hand-grip strength, and gait speed were also evaluated. Nutritional status was determined using the mini nutritional assessment test (MNA) and several anthropometrical and biochemical markers. Mini Nutritional Assessment test scores decreased in 20% throughout the confinement (p < .001). Barthel index, SPPB and SARC-F scores also decreased, although to a lesser extent, reflecting a decrease in functional capacity. However, both anthropometric parameters, hand grip strength and gait speed, remained stable throughout confinement (p > .050 in all cases). Morning cortisol secretion significantly decreased by 40% from baseline to post-confinement. A significant reduction in daily cortisol variability was observed, which may suggest increased distress. Fifty-six residents died during the period of confinement (81.4% survival rate). Sex, FRAIL and Barthel Index scores were significant predictors of resident survival. After the first COVID-19 blockade, several alterations in residents' frailty markers were observed, which were small and potentially reversible. However, many of the residents were pre-frail after the lockdown. This fact highlights the need for preventive strategies to reduce the impact of future social and physical stressors on these vulnerable individuals.

Circulating levels of endothelial progenitor cells are associated with better cognitive function in older adults with glucagon-like peptide 1 receptor agonist-treated type 2 diabetes

AimsTo evaluate cognitive function in subjects with type 2 diabetes (T2D) treated with glucagon-like peptide 1 receptor agonist (GLP-1RA) plus metformin or metformin alone and its association with endothelial progenitor cells (EPCs). MethodsAdults with T2D treated with GLP-1RA plus metformin (GLP-1RA + MET) or MET alone for at least 12 months were included. Montreal Cognitive Assessment test (MoCA), Mini-Mental State Examination (MMSE), Mini Nutritional Assessment (MNA) and disability tests were administered. Circulating levels of seven EPCs phenotypes were measured by flow cytometry. ResultsA total of 154 elderly patients were included, of whom 78 in GLP-1RA + MET group and 76 in MET group. The GLP-1RA + MET group showed better cognitive function as indicated by a significant higher MoCA and MMSE scores, and higher levels of CD34+ CD133+, CD133+ KDR+, and CD34+ CD133+ KDR+ as compared with MET group. The number of CD34+ CD133+ KDR+ cells was an independent predictor of higher MoCA, MMSE and MNA scores. ConclusionsPeople with T2D on GLP-1RA + MET treatment had better cognitive function and higher circulating levels of EPCs as compared with those on MET alone warranting further studies to understand the interrelationship between EPCs, GLP-RA treatment and cognitive health.

Physical function, nutritional status, and quality of life before and after chemotherapy in patients with malignant lymphoma.

This study investigates the efficacy of and gender differences in exercise therapy in patients with malignant lymphoma undergoing chemotherapy. Twenty-six patients (13 men, 13 women) received physical therapy (based on the Borg Scale 13) during hospitalization. Physical function was measured using grip and knee extension strength, 6-minute walking distance, and body composition; nutritional status assessed via Mini Nutritional Assessment (MNA®); and serum albumin levels analyzed. Fatigue was evaluated using the Brief Fatigue Inventory, and health-related quality of life was assessed with the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36v2). The analysis of all patients indicated that the right grip strength, skeletal muscle mass, skeletal muscle index, and leg muscle mass significantly decreased, whereas the serum albumin level, MNA® score, and scores of many items of the SF-36v2 significantly increased after chemotherapy. In a gender-specific analysis, only men showed significant declines in the skeletal muscle mass and skeletal muscle index, and improvement in the MNA® score after chemotherapy. In the SF-36v2, there were significant improvements in general health and physical component summary scores among men, and general health and mental component summary scores among women. Exercise therapy at a Borg Scale intensity of 13 may not prevent muscle mass decline in patients with malignant lymphoma, especially male patients. In addition, this study revealed that there is a gender difference in the effect of exercise therapy on quality of life. Thus, gender should be considered in exercise therapy for patients with malignant lymphoma.

Assessing the Nutritional Status of Community-Dwelling Elderly Registered with Family Medicine Centers

Introduction: Malnutrition is a serious health problem that threatens the health of individuals, with a prevalence rate of 5–15% among community-dwelling elderly people. This study aimed to assess the prevalence of malnutrition among community-dwelling elderly people in primary care using the Mini Nutritional Assessment test and to analyse its relationship with sociodemographic characteristics and geriatric syndromes. Materials and Method: Data of 248 out of 826 elderly patients registered at family medicine centers were analyzed. Malnutrition was assessed using the Mini Nutritional Assessment test, and sociodemographic characteristics and geriatric syndromes were assessed using an interviewer-administered questionnaire. Results: This study included 248 participants aged 72.51±5.85 years, 50.4% (n=125) of whom were males. The Mini Nutritional Assessment results showed that 85.9% (n=213) had a normal nutritional status and 14.1% (n=35) were malnourished or at risk of malnutrition. Malnutrition was statistically significantly associated with income status (p =0.003), body mass index (p =0.002), hearing and vision loss (p =0.011; p ≤0.049, respectively), history of falls (p =0.001), oral health (p =0.001), and polypharmacy (p =0.010). Conclusion: Malnutrition rates are low among community-based elderly individuals in family medicine centers. To prevent malnutrition and its related diseases, family medicine physicians play an important role in facilitating early screening, and thus minimizing the risk of increased malnutrition rates increase and irreversible damage. So Mini Nutritional Assessment should be applied at primary health care. Keywords: Malnutrition; Aged; Primary Health Care.

Evaluation of malnutrition frequency and related factors of geriatric patients in need of home healthcare

The nutritional status of frail elderly people receiving home health services should be evaluated. This study aimed to determine the nutritional status of patients aged ≥65 years registered in the Home Healthcare Services unit and investigate the factors that may be associated with malnutrition. This cross-sectional descriptive study was conducted during routine visits to patients and their caregivers. A total of 161 patients were asked to fill in surveys asking about sociodemographic characteristics, patient history, and clinical status. Anthropometric measurements were taken from all patients. The Mini Nutritional Assessment Short Form was applied to the patients for screening purposes. Patients who scored ≤11 on the Mini Nutritional Assessment Short Form were then asked to complete the full Mini Nutritional Assessment form. According to the Mini Nutritional Assessment Short Form and Mini Nutritional Assessment tests, almost half of the elderly patients included in the study (49.7%, n=161) were malnourished or at risk of malnutrition. Analyses showed that those who had COVID-19 [odds ratio (OR): 9.423, 95%CI 2.448-36.273) and those diagnosed with dementia/depression (OR: 8.688, 95%CI 3.246-23.255) were more likely to be malnourished, whereas those with diabetes (OR: 0.235, 95%CI 0.084-0.657) were less likely to have malnutrition. Strikingly, those who were fed by caregivers (OR: 15.061, 95%CI 3.617-62.710) were also more likely to be malnourished than those with self-feeding ability. Malnutrition or the risk of malnutrition is common in elderly patients receiving home care services. Many factors can have an impact on malnutrition.

Comparison of the predictive performance of Logistic regression, BP neural network and support vector machine model for the risk of acute exacerbation of readmission in elderly patients with chronic obstructive pulmonary disease within 30 days

To compare the effectiveness of Logistic regression, BP neural network and support vector machine models in the prediction of 30-day risk of readmission in elderly patients with an exacerbation of chronic obstructive pulmonary disease (COPD) and to provide a scientific basis for the screening and prevention of high-risk patients with readmission. The COPD patient survey questionnaire was made, including the general data questionnaire, modified Medical Research Council dyspnea scale (mMRC), activities of daily living (ADL), the geriatric depression scale, the mini nutritional assessment-short form (MNA-SF) and COPD assessment test (CAT). Elderly COPD patients were selected from the department of respiratory medicine of 13 general hospitals in Ningxia from April 2019 to August 2020 by convenience sampling method, and they were followed up 30 days after discharge. To explore the risk factors of patient readmission, Logistic regression model, BP neural network model and support vector machine models were constructed based on the risk factors. According to the ratio of the training set to the testing set of 7:3, the model was divided into the training set sample and the testing set sample. The prediction efficiency of the model was compared by the precision rate, recall rate and accuracy rate, F1 index and the area under the receiver operator characteristic curve (AUC). A total of 1 120 patients were investigated, including 879 non-readmission patients and 241 readmission patients. Univariate regression analysis showed that there were statistically significant differences in age, education level, smoking status, proportion of diabetes and coronary heart disease, hospitalization times of acute exacerbation of COPD in the past 1 year, seasonal factors and long-term home oxygen therapy, regular medication, proportion of rehabilitation exercise, course of disease, ADL, depression status, mMRC, nutritional status between non-readmission patients and readmission patients. Binary Logistic regression analysis showed that education level, smoking status, coronary heart disease, hospitalization times of acute exacerbation of COPD in the past 1 year, seasonal factors, whether long-term home oxygen therapy, whether regular medication, nutritional status were the risk factors for 30-day acute exacerbation of readmission in elderly patients with COPD. The training set showed that the accuracy rate of Logistic regression model, BP neural network model and support vector machine models were 70.95%, 76.51% and 84.78%, respectively. The recall rates were 79.55%, 86.36% and 88.64%, respectively. The accuracy rates were 87.81%, 90.81% and 93.82%, respectively. F1 indexes were 0.75, 0.81 and 0.87, respectively. The AUC were 0.850, 0.893 and 0.921, respectively. The testing set showed that the precision rate of Logistic regression model, BP neural network model and support vector machine model were 78.38%, 80.65% and 88.57%, respectively. The recall rates were 70.73%, 60.98% and 75.61%, respectively. The accuracy rates were 85.82%, 84.40% and 90.07%, respectively. F1 indexes were 0.74, 0.69 and 0.82, respectively. The AUC were 0.814, 0.775 and 0.858, respectively. Comparing with Logistic regression and BP neural network, support vector machine model has better prediction effect, and can effectively predict the risk of acute exacerbation of readmission in elderly patients with COPD within 30 days.

Functional Constipation in Elderly and Related Determinant Risk Factors: Malnutrition and Dietary Intake

Aim The objective of this study was to evaluate the relationship between FC and physical activity, dietary intake and malnutrition in the elderly. Method A cross-sectional study was conducted on 883 adults aged >65 years from nursing homes and community health centers in Turkey. Constipation status was evaluated according to Rome IV criteria and Bristol Stool Form Scale. Dietary intake was assessed using a food consumption record (24-hour food recall). The dietary energy and nutrients were analyzed using the "Nutrition Information Systems Package Program”. The nutritional status of participants was evaluated using the Mini-Nutritional Assessment (MNA) test. The International Physical Activity Questionnaire (IPAQ, short form) was used to assess physical activity status. Results Among the 883 participants, 29.6% were classified into the FC group (32.2% of females, 25.8% of males). The FC group had significantly lower total energy, fluid, water, protein, carbohydrate, magnesium, zinc, phosphorus, potassium, soluble fiber, insoluble fiber, total fiber, and fiber (g)/1000 kcal intake than the non-FC group (p < 0.05). The multivariate logistic regression analysis showed that total dietary fiber intake was significantly associated with a lower prevalence of FC (OR: 0.98, 95% Cl: 0.96–0.99). According to MNA, participants at risk of malnutrition (OR: 5.21, 95% Cl: 3.09–9.77) and malnourished participants (OR: 3.03, 95% Cl: 1.62–5.68) had a greater likelihood of FC compared with normal participants. Participants in the middle lower quartile of water intake (OR: 0.63, 95% CI: 0.42–0.95) had a decreased likelihood of FC compared with participants in the lowest quartile. Conclusion FC is a common gastrointestinal disorder among the elderly in Turkey. Low dietary fiber intake, low water intake and malnutrition were important risk factors associated with FC in the elderly.

The Edinburgh feeding evaluation in dementia (EdFED) scale: ATurkish validity and reliability study.

The present study aimed to adapt the Edinburgh Feeding Evaluation in Dementia (EdFED) Scale to Turkish. This methodological study was reported using STARD (The STAndards for Reporting of Diagnostic Accuracy). The sample included 200 people with dementia. The data were obtained using the Personal Information Form, the Edinburgh Feeding Evaluation in Dementia Scale, and the Mini Nutritional Assessment Test. For the Turkish adaptation of the scale, construct validity (confirmatory factor analysis), criterion validity (concurrent scale validity) and reliability analysis (Cronbach's α coefficient, item-total score correlation) were performed, respectively. The three-factor model in the original scale was verified. The content validity index was 0.95. The Cronbach's α coefficient factors were as follows: 'Indicators of Patient Difficulty' α=0.81, 'Patient's Need for Assistance' α=0.79 and 'Indicators of Feeding Difficulty' α=0.64, respectively. When the CFA fit indexes were examined, the model fit values were good. The three-factor structure was verified, compared with the original model and was compatible. No modification was needed in the model. The Edinburgh Feeding Evaluation in Dementia Scale Turkish version provides reliable and valid measures of feeding difficulties in people with dementia. It has satisfactory psychometric properties and is suitable to use in clinical practice. Feeding is one of the most neglected subjects in caring for people with dementia. Screening is recommended to evaluate feeding and malnutrition, but, to our knowledge, there is no tool/scale to evaluate the feeding of the dementia patient in Turkish. The EdFED scale can serve healthcare professionals and caregivers as a practical tool for feeding difficulties in people with dementia.

Prevalence and factors associated with malnutrition in hospitalized patients with proximal femur fracture: Experience at Hospital Universitari Mutua Terrassa

IntroductionMalnutrition is commonly associated with elderly patients with femoral fractures. Approximately 50% of hospitalized patients with a femoral fracture are malnourished or at risk of malnourishment. This situation may have a negative impact on outcomes and results for these patients. Malnourishment has been associated with an increased risk of complications, mortality, poor recovery, and delayed length of stay. MethodA retrospective observational study was conducted at our institution to evaluate the prevalence of malnutrition or risk of malnourishment in 766 hospitalized patients from January 2016 to December 2019. Furthermore, we identified factors that are associated with malnutrition. We also compared length of stay and mortality according to the degree of malnutrition. ResultsThe mean age for patients included was 84.6 years and 75% of patients were female. The Mini Nutritional Assessment test results showed 7.9% of patients were malnourished and 31.5% at risk of malnourishment. ConclusionsOur study results indicate a high prevalence of malnutrition and risk of malnourishment in hospitalized elderly patients with a femoral fracture.

A Pilot Cross-Sectional Study on Oral Health and Nutritional Status of Institutionalized Older Adults: A Focus on Sarcopenia.

The global population aged over 60 will double by 2050. This pilot cross-sectional study aims at evaluating nutritional and oral health status and the prevalence of sarcopenia in older adults living in an Italian residential aged care facility. Thirty-two adults aged ≥65 years were included. Individual sociodemographic data and nutritional and oral health data were collected. For sarcopenia diagnosis, muscle mass, physical performance, muscle strength and anthropometric parameters were recorded. Participants underwent a nutritional screening and a dental examination. Mini Nutritional Assessment and masticatory mixing ability test were performed. The results showed that men recorded a hand strength significantly higher than that of women, 25.5 ± 7.2 Kg vs. 12.8 ± 5.9 Kg (p < 0.01), respectively. Gait speed test showed that only 20.8% of the participants had a speed of more than 0.8 m/s. A strong negative correlation between masticatory performance and the number of missing teeth was detected (r = −0.84, 95% C.I. [−0.92; −0.69], p < 0.01). Overall, a high percentage of institutionalized older adults were diagnosed as being sarcopenic. Poor oral health in older adults is a major general health problem as it may restrict both food selection and nutrient intake, representing a risk factor for sarcopenia, although longitudinal studies are needed to confirm this relationship.

Nutritional status assessment in Alzheimer disease and its influence on disease progression

IntroductionNutritional deficiencies are frequent in Alzheimer disease (AD), even in early stages. Nutritional impairment (NI) may be associated with faster disease progression. The objective of this study was to describe the frequency of NI and the associated risk factors at the time of diagnosis and to analyse its influence on subsequent progression. MethodsWe performed a prospective, multicentre, observational study of patients recently diagnosed with prodromal AD (pAD) or dementia due to AD (ADd). Two clinical assessments were conducted over a period of 18 months. The Mini Nutritional Assessment test (MNA; score range, 0-30; cut-off point for NI, < 24) was used to estimate nutritional status. Progression was defined as an increase of ≥ 3 points on the Clinical Dementia Rating-sum of boxes test. ResultsThe sample included 50 patients with pAD (mean [standard deviation] age, 76.1 [5.3] years; 68% women), and 127 with ADd (80 [5.9] years; 72.4% women). A total of 141 (79.7%) completed both evaluations. The prevalence of NI was 28.2% (24% for pAD, 29.9% for ADd; P = .43), with the majority (92%) at risk of malnutrition. NI was associated with female sex (odds ratio [OR]: 4.2; 95% confidence interval [CI]: 1.7-10.5; P < .001) and greater behavioural involvement (OR: 5.8; 95% CI: 2.6-12.7; P < .001). A larger proportion of patients with progression was observed among those with NI than among those with normal nutritional status (50% vs 28.7%, P < .05; ADd: 53.6% vs 31.8%, P < .05; pAD: 41.7% vs 22.9%, P = .21). Greater cognitive impairment (OR: 2.1; 95% CI: 1.03-4.4; P < .05) and NI (OR: 2.4; 95% CI: 1.1-5.1; P < .05) were independent risk factors for disease progression. ConclusionsNI is highly prevalent in patients with AD. Assessing nutritional status at the time of diagnosis may enable identification of patients at greater risk of disease progression.

GLIM criteria for the evaluation of nutrition in palliative care patients, a comparison of MNA-SF and NRS-2002

Introduction: A major cause of mortality and morbidity, malnutrition also increases the duration of hospital stay and costs. Therefore, the early diagnosis and detection of those patients at risk is important. Many malnutrition screening tests are available for the detection of those patients. The validity and reliability of the commonly used tests, Nutritional Risk Screening (NRS)-2002 and Mini Nutritional Assessment (MNA) have been proven in the diagnosis of malnutrition in hospitalized patients. A new malnutrition diagnostic criterion called the Global Leadership Initiative on Malnutrition (GLIM) was created by an initiative of the same name as these criteria in 2018. The aim of the present study is to evaluate the differences and superiority of MNA, NRS-2002 screening tests and GLIM criteria in patients hospitalized in palliative care with a diagnosis of malnutrition.&#x0D; &#x0D; Material and method: 148 patients who were hospitalized in palliative care due to clinical malnutrition were included in the study. MNA, NRS-2002 and GLIM screening tests filled out by dieticians for each patient within the first 48 hours of hospitalization. Within the framework of GLIM criteria, patients were recorded for weight loss from phenotypic criteria based on information obtained from their relatives (more than five percent in the last six months or ten percent or more over the last six months). Hand dynamometer and calf circumference measurements were made to show muscle loss. Hand grip power was measured three times in both hands using a Jamar Digital Hand Dynamometer and the highest value was recorded. Hand grip power cut-off value was accepted as

Epidemiology of geriatric syndromes among older people residing in six old-age homes of Delhi-NCR.

The frequency of geriatric syndromes (GSs) such as cognitive impairment (CI), depression, and malnutrition among older people residing in old-age homes (OAHs) of Delhi-National Capital Territory Region (NCR) has not been reported. The availability of such data determines the quality of health care. The present study aims to assess the frequency of GS among residents of six OAHs in Delhi-NCR. The study was carried out after obtaining informed written consent from all participants. The team comprising doctors, physiotherapists, and nurses visited the OAHs and assessed GSs using a psychometrically validated screening tool ICT-BRIEF 30. Other standard tools such as Snellen's chart, whisper voice test, mini nutritional assessment, time up and go test score, Mini-Cog, and geriatric depression scale 5 were used to assess vision, hearing, nutrition, mobility, cognition, and mood, respectively. Out of 131 participants, low vision was observed in 69.47%, hearing impairment in 20.61%, malnutrition in 12.9%, risk of fall in 18.32%, CI in 46.56%, and depression in 62.59% of the participants. Hearing impairment was found to be significantly associated with quality of life and cognition. The present study from Delhi showed high frequency of vision impairment, CI, frailty, depression, and malnutrition in older people residing in OAHs. 20% of the participants had functional loss due to various reasons. Hence, the owner/caretaker of OAHs of Delhi/NCR needs to be proactive in screening the residents for various GSs to provide quality care to the residents.