MNA Score Research Articles

Comprehensive assessment of elderly population in North India during era of SARS-CoV-2 pandemic

Background: Elderly form a vulnerable population, during SARS-CoV-2 pandemic they are especially at risk due to immuno-senescence and increased number of comorbidities. The aim of this study was to assess the nutritional, physical and mental status of elderly living in urban areas of north India during the lockdown period.Methods: A questionnaire was made in Google forms based on R-MAPP and MNA Score. The assessment was carried out using telecommunication and self-assessment Google forms.Results: Amongst the elderly people, 91% suffered from comorbidities (e.g. hypertension and diabetes) with 37% having >2 comorbidities. The 8% of elderly were underweight, 45% were normal and 47% were overweight as per BMI. Out of total, 5% elderly were malnourished, 26% were at risk of mal nutritional and 69% had normal nutritional status. 38% of elderly observed a change in eating pattern during lockdown which included eating healthier food for many and increased snacking in some. The water intake was below 1.5 litres in 29%, 1.75-2.5 litres in 47% and >2.5 litres in 24% of the study population. Twenty percent suffered from high levels of anxiety and stress during this lock down period. Five percent of these had very high levels of stress or anxiety. Some were in the extreme range. Twenty six percent complained of loneliness.Conclusions: The elderly population needs to be actively monitored for physical and mental wellbeing during lockdown periods by applying algorithms that effectively use telemedicine as a tool for regular check-ups.

ANALYSIS OF MENU PLANNING, CONSUMPTION ENERGY DENSITY RELATIONSHIPS AND FOOD LEFTOVERS OF THE ELDERLY NUTRITIONAL STATUS IN SOCIAL ORPHANS

<p><strong><em>Background: </em></strong><em>The most important thing in giving food to the elderly is that the food served must meet the nutritional needs, the food served is given regularly in small portions but often, the food must be gradual and varied so as not to cause boredom, the food must be according to doctor's instructions for certain elderly and food must be soft. The elderly who live in the Werdha Nursing Home are faced with a different situation than before they lived in an orphanage. This causes the elderly to make adjustments so that their needs can be fulfilled. Health conditions in the elderly stage are largely determined by the quality and quantity of nutritional intake.<strong>Objective: </strong>This study aims to determine the analysis of menu planning, the relationship of energy consumption density and food waste to the nutritional status of the elderly at the Social Home<strong> Method: </strong>This study was an observational study of cross-sectional study design. Sampling was done by purposive sampling technique with a total of 50 elderly respondents. Bivariate analysis using Chi-Square statistical tests. <strong>Results: </strong>Planning the menu at the Social Home is carried out once a year with a seven-day menu cycle compiled by a Puskesmas Nutritionist and has a menu structure consisting of the frequency of feeding 3 main meals and 2 interludes. The application in feeding has not been adjusted to the menu made by a Nutritionist. Most respondents were aged 60-74 years (elderly). Correlation test results showed that there was no relationship between energy consumption density with the nutritional status of the elderly ( p = 0.589 ) (p> 0.05) and there was a relationship between food waste and the nutritional status of the elderly (p = 0.010 ) (p <0.05). <strong>Conclusion: </strong>Some menu planning at the Social Institution was carried out and some did not meet the factors that influenced menu planning at the institution. There is a relationship between food waste with the nutritional status of the elderly, the main factor affecting nutritional status is food intake. This is because not only because of the small amount of food left (<20%) which causes the risk of malnutrition, but there are other factors based on the questions and the results of the MNA score.</em><em> </em></p>

Lipid and glucose metabolism in centenarians: risk factors of cardiovascular diseases and frailty

Aim: to assess the most important metabolic factors in centenarians and their impact on prognosis Materials and methods. It was a longitudinal study, including 64 centenarians (95 years and older), who live in Moscow. Complex geriatric assessment (FRAIL, IADL-C, MNA, GDS-15 and МOCA scores) and blood tests (HbA1c, cholesterol, LDL, HDL and TG) were performed. In 3 years we contacted patients’ relatives or social workers to find out about patients’ status. Results. Mean age of the patients was 98,3±1,9 years. We found out that 34,4% of the patients were frail. Cognitive impairments of different severity were presented in 84,4% of the patients. The median lipids values were as follows: cholesterol — 4,8 [4,2 ;5,8], TG — 0.97 [0,8; 1.2], HDL — 1.3 [4.2; 5,8), LDL — 3,1 [2,6; 3,7], HbA1c — 5,8 [5,6; 6,1]. In 59% of the patients HbA1c was below 6%; 33% had concentrations between 6% and 6,4%, and only in 8% we found HbA1c higher than 6,5%. No correlation was also found between HbA1c values and lipids profile. Comparing survivors and non-survivors groups we did not find any significant differences in total cholesterol, LDL, HDL and HbA1c (p<0,005). While comparing functional status with metabolic profile we discovered positive correlation (r= 0.834) between total cholesterol and index of instrumental activity, and between LDL and IADL as well as MNA score (r=0.732 and 0.634 respectively). Conclusions. In centenarians usual prognostic factors such as HbA1c and lipids do not have any impact on prognosis but they influence functional status and QoL. Further investigations of metabolic status in super old persons are needed to personalize their lifestyle and treatment goals.

Evaluation of Oral Nutritional Supplementation in the Management of Frailty among the Elderly at Facilities of Community Care for the Elderly.

Adequate nutritional intake in elderly individuals improves frailty. Elderly individuals may exhibit improvements in frailty with the use of community care facilities. Therefore, this study evaluated the effects of nutritional intervention in elderly subjects at community care facilities receiving oral nutritional supplements (ONSs) and determined their nutritional status. Sixty-two elderly individuals using community care facilities were divided into the experimental group (EG) (before [n = 31]/after [n = 28]) and control group (CG) (before [n = 31]/after [n = 25]). Subjects in both groups were treated with ONSs (200 mL/200 kcal) for 90 days. However, those in the EG received the product with increased protein; vitamins A, C, D, and E; phosphorus; calcium; and zinc. The data collected included anthropometric data, dietary assessment findings, frailty status (Korean version of the Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight questionnaire), and nutritional status (Mini Nutritional Assessment, MNA). The changes in the two groups were analyzed using the Mann–Whitney U Wilcoxon signed-rank test. Nutritional intervention increased the weight, body mass index, and lean body mass in the EG (p < 0.05). Protein, calcium, and iron levels increased only in the EG (p < 0.05). The MNA score increased and sum of frailty indicators improved in the EG, and the increase in the MNA score in the EG was greater than that in the CG. This study verified the improved anthropometric data and dietary intake in the EG. Thus, the higher number of pre-frailty elderly individuals at facilities of community care indicates the need for adequate nutritional supplementation for frailty management.

Association between kidney function, nutritional status and anthropometric measures in older people

BackgroundDifferent mechanisms connect the nutritional status with the occurrence and the course of chronic kidney disease (CKD). The end-stage renal disease is complicated by catabolic inflammatory reactions and cachexia which leads to malnutrition (undernutrition). On the other hand, obesity is an important risk factor for the development and acceleration of CKD.MethodsIn the SCOPE study, community-dwelling persons aged 75 years and over, from 6 European countries and Israel were examined at the baseline phase. We assessed the relationship between anthropometric measures (Body Mass Index (BMI), circumferences of arm (AC), waist (WC), hip (HC), and calf (CC), waist-to-hip ratio - WHR, waist-to-height ratio - WHtR, risk of malnutrition (Mini Nutritional Assessment - MNA), serum albumin) and estimated glomerular filtration rate (eGFR) calculated by Berlin Initiative Study (BIS) equation.ResultsWe studied 2151 subjects (932 men and 1219 women) with a mean age of 79.5 ± 5.9 years. A total of 1333 (62%) participants had CKD (GRF < 60 ml/min/1.73 m2). Negative correlations between eGFR and weight, AC, WC, HC, CC, BMI, WHtR were observed. Positive correlation occurred between eGFR and MNA score (Spearman’s rho = 0.11) and albumin concentration (rho = 0.09). Higher weight, AC, WC, HC, CC, BMI and WHtR increased the odds ratio of CKD; higher MNA (OR = 0.98, 95% CI 0.94–1.0) and higher serum albumin (OR = 0.73, 95% CI 0.53–1.0) were weakly associated with reduced odds. The risk of malnutrition was the highest with eGFR < 30 as compared to eGFR > 60 (OR = 2.95, 95%CI = 1.77–4.94 for MNA < 24; OR = 5.54, 95%CI = 1.66–18.5 for hypoalbuminemia < 3.5 g/dL).ConclusionThe population of community dwelling people aged 75+ with CKD shows general features of overweight and obesity with a small prevalence of malnutrition. For anthropometric measures, the strongest association with eGFR and the highest odds of CKD were identified using WC, HC, CC and WHtR. Albumin level and MNA, but not MNA Short Form, indicated an increased odds of malnutrition with a decrease in eGFR.

The association between dietary patterns and nutritional status in community-dwelling older adults-the PEN-3S study.

Diet plays a key role in the ageing process. Despite this, little is known about the effect of dietary patterns on older adults' nutritional status. The main aim of this study was to analyse the association between a posteriori derived dietary patterns (DPs) and nutritional status among community dwellers aged ≥65. Cross-sectional study including a representative sample of the community-dwelling Portuguese population aged ≥65 (n = 849, mean age 74.1 years old). Data were collected through computer-assisted, face-to-face interviews. Dietary patterns were derived a posteriori based on two 24-h recalls by a latent class transition model. Nutritional status was assessed by the Mini Nutritional Assessment (MNA®) and measured body mass index (BMI). Associations were estimated by regression models. MNA score was reversed and log-transformed considering its skewed distribution. Two DPs were identified: 22.0% of the studied population followed a 'Protein-based foods' DP (highest consumption of legumes, meats and sweets), and 59.1% followed a 'Mediterranean' DP (highest consumption of vegetables, fruits, dairy, cereals/tubers, bread, fishery and olive oil). Moreover, 18.9% switched between those patterns ('In-between' DP). After adjustment, the 'Protein-based foods' DP was associated with better MNA score (EXP(β) = 0.716, 95% CI 0.533, 0.962), compared to the 'Mediterranean' DP, particularly for total energy intake up to 2200 kcal/day. No significant associations were found between DPs and BMI. A protein-based pattern is associated with lower malnutrition risk in older adults, when considering an adequate energy intake. This should be taken into account when designing and disseminating food-based guidelines for healthy ageing.

Effects of Polypharmacy on Appetite and Malnutrition Risk Among Institutionalized Lebanese Older Adults - Preliminary Results

Abstract Objectives We aimed to assess the polypharmacy effect on appetite and malnutrition risk among Lebanese nursing home residents. We hypothesized that polypharmacy will be associated to lower appetite and increased of malnutrition. Methods A cross-sectional pilot study was carried out in two nursing homes in the North-Lebanon region. Fifty-three older adults (OA) aged 60 and above were recruited and were interviewed face-to-face. A general questionnaire was administered to gather information about their socio-demographics, dietary habits and physical activity routine. Appetite was evaluated by the Simplified Nutritional Appetite Questionnaire (SNAQ) validated for use with nursing homes residents. The participants' nutritional status was assessed using the Short Form of the Mini-Nutritional Assessment (MNA-SF). Polypharmacy was determined if OA were taking 5 or more medications. Information about attitudes towards the use, the number and the cost of medications was also collected. Differences in SNAQ and MNA scores based on polypharmacy were tested using Independent t-tests. Logistic regression was performed to assess the association between polypharmacy and nutritional status after adjusting for several factors. Results Our sample constituted of 49.1% females with an average age of 67.6 ± 3.8 and BMI of 22.3 ± 1.7 kg/m2. The majority were widowed (79.2%) and had a low level of education (85% elementary education). Regarding the MNA scores, 33% had a normal nutritional status while 59% were at risk of malnutrition and 8% were malnourished, with an average MNA score of 10.1 ± 2.2. The average SNAQ score was 11.0 ± 3.3, with 85% scoring ≤14, indicating an significant risk of at least 5% weight loss withing 6 months. Regarding medication use, 50.9% of OA take at least 5 drugs/d with an average of 4.3 ± 2 drugs. Independent t-tests showed that MNA scores were significantly lower in those taking 5 drugs/d vs those taking less (9.4 ± 2.5 vs 10.8 ± 1.6, P = .024) while no significant difference was observed for SNAQ scores (10.3 ± 2.9 vs 11.6 ± 3.6, P = .13). Logistic regressions did not show any significant association between polypharmacy and MNA or SNAQ categories. Conclusions Lower MNA scores were observed in OA taking ≥5 drugs/d indicating a higher risk of malnutrition with polypharmacy. This is significant since malnutrition can further worsen the aging process. Funding Sources N/A.

Impact of the comprehensive geriatric assessment on treatment decision in geriatric oncology

BackgroundThe comprehensive geriatric assessment (CGA) is the gold standard in geriatric oncology to identify patients at high risk of adverse outcomes and optimize cancer and overall management. Many studies have demonstrated that CGA could modify oncologic treatment decision. However, there is little knowledge on which domains of the CGA are associated with this change. Moreover, the impact of frailty and physical performance on change in cancer treatment plan has been rarely assessed.MethodsThis is a cross-sectional study of older patients with solid or hematologic cancer referred by oncologists for a geriatric evaluation before cancer treatment. A comprehensive geriatric assessment was performed by a multidisciplinary team to provide guidance for treatment decision. We performed a multivariate analysis to identify CGA domains associated with change in cancer treatment plan.ResultsFour hundred eighteen patients, mean age 82.8 ± 5.5, were included between October 2011 and January 2016, and 384 of them were referred with an initial cancer treatment plan. This initial cancer treatment plan was changed in 64 patients (16.7%). In multivariate analysis, CGA domains associated with change in cancer treatment plan were cognitive impairment according to the MMSE score (p = 0.020), malnutrition according to the MNA score (p = 0.023), and low physical performance according to the Short Physical Performance Battery (p = 0.010).ConclusionCognition, malnutrition and low physical performance are significantly associated with change in cancer treatment plan in older adults with cancer. More studies are needed to evaluate their association with survival, treatment toxicity and quality of life. The role of physical performance should be specifically explored.

Prevalence and factors associated with frailty in hospitalized older patients

BackgroundFrailty is a multidimensional syndrome that leads to an increase of an age-related disorder of several physiological systems, and cognitive abilities decline. The aim of this study was to evaluate the prevalence of frailty among older persons in Belgium and we examined the factors associated with frailty with a principal focus en cognitive, dietary status, and inflammatory parameters.MethodsA total of 124 participants (90 women, 34 men; age: mean ± SD: 85.9 ± 5.5 years) were studied, recruited from the Geriatrics department, Belgium. Nutritional, cognitive status and physical activity were assessed using Mini Mental State Examination score (MMSE), Mini Nutritional Assessment score (MNA), and Katz score, respectively. Frailty syndrome was evaluated using the modified Short Emergency Geriatric Assessment (SEGA) score. Medication and medical history were recorded. Analyzed biochemical parameters included C-reactive protein (CRP), complete blood count, blood creatinine, vitamin D level, and serum protein electrophoresis. According to SEGA score, participants were divided into non-frail (n = 19), frail (n = 25) and severely frail patients (n = 80).ResultsThe SEGA score was inversely correlated with MMSE, MNA and Katz score. SEGA.score was negatively correlated to albumin levels (r = − 0.30; p < 0.001) and positively correlated to CRP, polypharmacy and age (r = 0.28, r = 0.37, r = 0.33 and p < 0.01 respectively). Logistic regression showed a strong association between frailty, Katz score, dementia, polypharmacy and living in nursing home.ConclusionOur results provide useful information for understanding mechanisms of frailty. This will help to develop preventive strategies for the elderly at the pre-frailty stage.

Analysis of inflammatory markers and hormones in old cancer patients: A descriptive study.

Advanced cancers are associated with a chronic inflammation, especially high interleukin-6 (IL-6) and with various levels of adipokines (leptin and adiponectin), while ghrelin counteracts the anorexigenic effect of leptin in cancer-induced anorexia-cachexia syndrome. We aimed to understand how IL-6, adipokines and ghrelin plasma levels could be influenced by cancer on the one hand, and by age, frailty, and nutritional status in old cancer patients on the other hand. Ninety-nine patients aged 79[76-83] years old were included. Sixty-six percent had advanced stages of cancer, and 34% had cachexia. Fifty percent were at risk of malnutrition, and 10% had overt malnutrition. None of the variables studied was significantly correlated with the advanced stage, or cachexia. In multiple regression, the only parameter significantly and positively associated with age was adiponectin (p=0.008). Despite a high prevalence of frailty in our study, we did not find any independent association of frailty (assessed by G8) with IL-6, leptin, adiponectin, or ghrelin in multivariate analysis. We observed that a low albumin level was independently associated with a higher level of IL-6 (p<0.0001), but not with the MNA score. However, leptin showed a positive correlation with BMI (p<0.0001), confirming the persistence of a relationship between leptin and adiposity, even in older cancer patients. Finally, high IL-6 level was associated with a higher mortality rate (p=0.027). In conclusion, IL-6, leptin, adiponectin, and ghrelin are not associated with advanced stages of cancer or cancer-induced cachexia in older subjects with cancer, but they are significantly correlated with anthropometric factors and body composition.

Integrating Geriatric Assessment and Genetic Profiling to Personalize Therapy Selection in Older Adults with Acute Myeloid Leukemia (AML)

Introduction: Geriatric assessment can predict the risk of toxicities of chemotherapy in older adults. Genetic risk categories correlate with survival following intensive chemotherapy in AML. Integrating geriatric assessment for patient profiling and genetic profiling of leukemic cells represents an innovative precision medicine approach to personalize therapy selection in older adults with AML. We report results of a pre-planned interim analysis of a pragmatic phase II trial using such strategy that has an overarching goal to reduce early mortality (NCT03226418). Methods: Patients ≥60 years with a new diagnosis of AML underwent geriatric assessment prior to initiation of treatment. Geriatric assessment of physical function, cognitive function and comorbidity burden were used to determine fitness for intensive chemotherapy (Table 1). Additional assessment included Karnofsky Performance Scale (KPS), Patient Health Questionnaire-9 (PHQ-9), and Mini Nutritional Assessment-Short Form (MNA). Genetic profiling for therapy selection relied on karyotyping and followed the 2017 European LeukemiaNet criteria. While available mutation test results were incorporated to risk stratify, the study did not require to wait for the results prior to therapy initiation given an anticipated turnaround time of 1-2 weeks for mutation test results. Therapy selection followed the algorithm demonstrated in Figure 1. Patients with good or intermediate-risk AML received intensive chemotherapy such as 7+3 +/- gemtuzumab or midostaurin if determined to be fit. Patients with high-risk AML received low-intensity chemotherapy such as a hypomethylating agent with or without novel drugs, or CPX 351 if they were fit and met the FDA-approved indications. Patients with organ dysfunction (e.g. creatinine ≥2 mg/dl) and those requiring chemotherapy for other malignancy received low-intensity chemotherapy. Chemotherapy at diagnosis or follow up could be administered in community oncology settings. Patients were followed for assessment of quality of life, functional and oncologic outcomes. Results: Between July 2017-June 2019, a total of 31 patients (including 1 MDS patient considered screen failure) were enrolled. The pre-planned interim analysis results are based on the first 27 AML patients. Baseline characteristics included a median age of 70 years (range 60-84 years), 56% female, 96% white, and a median KPS of 80% (range 60-100%). As presented in Table 1, over half of the patients had ≥3 comorbidities, impairment in objective physical function (short physical performance battery) and Montreal Cognitive Assessment. Additionally, 67% had poor nutritional status (MNA score of ≤11) and 26% had abnormal depression screen (PHQ-9 score of ≥10). Risk categories included adverse (64%), intermediate (16%), and good-risk AML (20%). Patients had one or more of the following mutations: FLT3 ITD (11%), NPM1 (22%), biallelic CEBPA (4%), IDH1 (15%), IDH2 (8%), RUNX1 (15%), ASXL1 (22%), and TP53 (19%). Three patients received intensive chemotherapy; CPX 351 (n=2) or 7+3+ gemtuzumab (n=1). Other patients received decitabine or azacitidine alone (n=16), azacitidine and venetoclax (n=5) or decitabine and midostaurin (n=3). The median time from diagnosis to therapy initiation was 7 days (0-20 days) whereas the median time from enrollment to therapy initiation was 2 days (range 0-9). Mortality at 30 days from diagnosis was 3.7% (95% confidence interval, CI 0.7-18.3%) and at 90 days was 29.6% (95% CI 15.9-48.5%). Mortality compared favorably to an unmatched historical cohort of patients ≥60 years treated at our center between 2011-2016, where 30-day mortality was 30% (95% CI 22-40%) and 90-day was 41% (95% CI 32-52%) (Future Oncol. 2019;15:1989-95). Conclusions: Our model to personalize AML therapy selection represents an innovative approach to precision medicine that incorporates both geriatric assessment for patient profiling and genetic profiling of leukemia cells. Geriatric assessment demonstrated high frequency of impairment in objective physical and cognitive function. Patients were able to start therapy within a median of 2 days following enrollment. Pragmatic aspects of the trial included broad eligibility criteria and co-management of patients with community oncologists. Our pre-planned interim analysis data appear promising with lower rates of early mortality compared to unmatched historical controls. Disclosures Bhatt: Pfizer: Consultancy; CSL Behring: Consultancy; Agios: Consultancy; Abbvie: Consultancy; Partner therapeutics: Consultancy; Incyte: Consultancy, Research Funding; Tolero Pharmaceuticals: Research Funding; National Marrow Donor Program: Consultancy. Al-Kadhimi:Celldex Biotech: Other: Stocks; Seattle Genetics: Other: Stocks. Armitage:Oncology Analytics: Consultancy; Partner Therapeutics: Consultancy; Samus Therapeutics: Consultancy; Ascentage: Consultancy; Tesaro bio: Membership on an entity's Board of Directors or advisory committees; Union Pacific: Consultancy. Holstein:GSK: Consultancy; Genentech: Membership on an entity's Board of Directors or advisory committees; Sorrento: Consultancy; Celgene: Consultancy; Takeda: Membership on an entity's Board of Directors or advisory committees; Adaptive Biotechnologies: Membership on an entity's Board of Directors or advisory committees. Gundabolu:Samus Therapeutics: Research Funding; Jazz pharmaceuticals: Consultancy; Pfizer: Consultancy; Novartis: Consultancy. OffLabel Disclosure: Single agent azacitidine and decitabine as well as decitabine in combination with midostaurin are not approved by the US FDA for acute myeloid leukemia.

197 Role of a Dietitian in a Specialist Memory Assessment and Support Service - Improving Brain Health

Abstract Background Dementia cases are rising nationally due to our ageing population and is associated with a multitude of nutritional consequences. Both obesity and malnutrition are strongly implicated in the progression of cognitive decline. From diagnosis onwards, nutritional intervention is important to improve patient outcomes. Methods In order to highlight the important role of a dietitian, a retrospective analysis of 142 patients attending the tertiary memory assessment and support service from 2018 to 2019 was performed. Demographic, cognitive, anthropometric, and nutritional data was compiled from the case note review and biochemical laboratory results. This data was analysed using Microsoft Excel (2013) to study prevalence and relationships of variables in this cohort. Results A significant proportion of this population were overweight (41.2%) and obese (18.6%). Nearly half the population were at risk of malnutrition (44.1%) or malnourished (3.9%). In this cohort, 18.6% were characterised as frail. Only one individual had a severe clinical dementia rating score (CDR), 19.2% had a moderate and 28.2% had a mild CDR. Half (50.5%) of participants had some level of abnormal eating habits. Higher prevalence of malnutrition, frailty and higher CDR was associated with increased age. Up to 60% of those with normal nutritional status had a CDR of 0 or 0.5. As MNA score worsened, the incidence of robust individuals decreased linearly. Prevalence of frailty increased as CDR score increased. Of those with a mild CDR, 70% were overweight or obese. Those with high Cambridge Behavioural-Inventory (CBI-R) eating habit scores generally had lower CDRs. Conclusion Patients attending the memory service are experiencing a multitude of nutritional challenges such as disordered eating habits, overweight and obesity, malnutrition risk and frailty which are associated with cognitive decline and worse health outcomes. Nutritional support and dietetic input as part of the post-diagnostic care-pathway is required to promote brain health and mitigate unnecessary decline.

Changes in Nutritional Status and Musculoskeletal Health in a Geriatric Post-Fall Care Plan Setting.

Understanding how changes in nutritional status influence musculoskeletal recovery after falling remains unclear. We explored associations between changes in nutritional status and musculoskeletal health in 106 community-dwelling older adults aged ≥65 years, who attended the Falls and Fractures Clinic at Sunshine Hospital in St Albans, Australia after falling. At baseline and after 6 months, individuals were assessed for Mini Nutritional Assessment (MNA®), grip strength, gait speed, Timed Up and Go (TUG) test, Short Physical Performance Battery (SPPB), and bone turnover marker levels. Associations were examined using multiple linear regression, adjusted for baseline covariates and post-fall care plans. Over 6 months, the prevalence of malnutrition or risk thereof decreased from 29% to 15% using MNA <24/30. Specifically, 20 individuals (19%) improved, 7 (7%) deteriorated, and 73 (69%) maintained nutritional status, including 65 (61%) who remained well-nourished and 8 (8%) who remained malnourished/at risk. A 1-point increase in MNA score over 6 months was associated with an increase of 0.20 points (95% confidence interval 0.10, 0.31, p < 0.001) in SPPB score. Improvement in nutritional status was associated with improvement in physical performance, providing a basis for interventional studies to ascertain causality and evaluate nutritional models of care for post-fall functional recovery in older adults.

Associations Between Dental Occlusion and Nutritional Status in Community-Dwelling Older Adults (P01-017-19)

ObjectivesThis study explored associations between dental occlusion and nutritional status in community dwelling older adults. MethodsThis cross-sectional study utilized data from electronic health records (EHR) of new patients (>65 years), who presented for care at the Rutgers School of Dental Medicine between June 1, 2015 and June 30, 2018. The self-administered Mini Nutritional Assessment (Self-MNA) score (as a measure of nutritional status), clinical and demographic information were obtained from the EHR. Tooth number and location were recorded based on odontogram and digital radiographs. Spearman’s rho, Kruskal-Wallis, and Chi Square tests were used to explore relationships between variables. ResultsOf the 238 records reviewed, complete data (MNA score, tooth number and location) were available for 140 (58.8%). The mean age of participants was 72.78 years (SD = 5.58); 55% were female. The mean MNA score was 12.15 (SD = 2.14); 24.3% were at risk for malnutrition, and 5% were malnourished. The mean number of teeth (excluding 3rd molars) was 17.01 (SD = 8.72); 21.4% had 0–9 teeth, 30% had 10–19 teeth, and 48.6% had 20–28 teeth. Thirty-five % had no posterior occlusion (POP); 27.1% had no anterior occlusion (AOP).MNA score was weakly but significantly correlated with number of POP (r = 0.21, P = 0.02). Those with 10–19 teeth had significantly lower MNA scores then those with 20 or more teeth (P = 0.003). Being at risk of malnutrition or malnourished was associated with having 10–19 teeth, while normal nutritional status was associated with having 20 or more teeth (P = 0.02). ConclusionsIn this sample of older adults, those with 10–19 teeth were more likely to be at risk of malnutrition or malnourished. Similarly, as number of POP decreased, MNA score decreased. Research utilizing a larger sample to further explore the relationships between tooth loss and nutritional status is warranted. Funding SourcesSackler Institute for Nutritional Sciences, New York Academy of Science.

Nutritional status and body fat mass: Determinants of sarcopenia in community-dwelling older adults.

Sarcopenia is defined as the old age syndrome characterized by profound decline in muscle mass and function. This study aimed to investigate the prevalence of sarcopenia and its risk factors in older adults. Totally, 501 older people aged 65 years and older were recruited. Sarcopenia was defined according to the criteria of the Asian Working Group for Sarcopenia (AWGS). For obtaining Skeletal Muscle mass Index (SMI), body composition was evaluated using Bioelectrical Impedance Analysis (BIA). Muscle strength and physical performance were measured by Handgrip Strength (HGS) and Gait Speed (GS), respectively. Nutritional status, physical activity level, and biochemical indicators were assessed, as well. The prevalence of sarcopenia was 20.8%. Multiple logistic regression models of the predictors of decline in the components of sarcopenia showed that older age, low Body Mass Index (BMI), and serum albumin level were associated with a higher risk of low SMI. Low serum albumin level and older age were also predictive of low HGS. Besides, old age, high body fat mass, and low BMI were the risk factors of low GS. Conversely, increased Calf Circumference (CC) was protective against low SMI and GS. Finally, older age, male gender, low BMI, decreased mini-nutritional assessment score, low serum albumin level, and high body fat were associated with a higher risk of sarcopenia, whereas higher CC reduced its risk. The prevalence of sarcopenia is high among elderly individuals. This study underlined that sarcopenia might develop in older adults with impaired nutritional status and high body fat mass. Further studies could evaluate the effects of appropriate nutritional interventions on sarcopenia management and prevention.

Associations Between Nutritional Status and Health-Related Quality of Life Among Long-Term Care Residents in Helsinki

ObjectivesWe evaluated the associations between nutritional status and health-related quality-of-life (HRQoL) among older long-term care residents in Helsinki.Design and participantsAll 3767 older (≥65 years) long-term care residents in Helsinki in 2017 were invited to participate in this cross-sectional study. After refusals and exclusions of residents without sufficient information, 2160 residents remained.MeasurementsData on characteristics, nutritional status (Mini Nutritional Assessment, MNA) and HRQoL (15D) were collected by trained nurses.ResultsOf the participants, 64% were at-risk of malnutrition and 18% suffered from malnutrition. Residents in the “malnourished” group were more dependent in activities of daily living (ADL) functioning, suffered more often from dementia, had lower cognitive level, used less medications, and were eating more often inadequately. HRQoL was statistically significantly associated with MNA total score in both female and male residents. There was a curvilinear correlation between MNA and 15D score in females: 0.50 (95% CI 0.46 to 0.53) and males: 0.56 (95% CI 0.50 to 0.61). In partial correlation analysis, all dimensions of 15D, except for sleeping and breathing, were positively associated with MNA score. In these analyses no significant differences emerged between males and females when the results were adjusted for age and dementia.ConclusionsNutrition plays an important role in HRQoL among older long-term care residents.

Untangling the relationship between fat distribution, nutritional status and Parkinson\u2019s disease severity

BackgroundParkinson’s disease (PD) is responsible for significant changes in body composition.AimsWe aimed to test the association between PD severity and fat distribution patterns, and to investigate the potential modifier effect of nutritional status in this association.MethodsWe enrolled 195 PD subjects consecutively admitted to a university geriatric day hospital. All participants underwent comprehensive clinical evaluation, including assessment of total and regional body composition (dual-energy X-ray absorptiometry, DXA), body mass index, nutritional status (Mini-Nutritional Assessment, MNA), motor disease severity (UPDRS III), comorbidities, and pharmacotherapy.ResultsThe fully adjusted linear regression model showed a negative association between UPDRS III and total body fat in kg and percentage (respectively, B − 0.79; 95% CI − 1.54 to − 0.05 and B − 0.55; 95% CI − 1.04 to − 0.05), percentage android fat (B − 1.07; 95% CI − 1.75 to − 0.39), trunk–leg fat ratio (B − 0.02; 95% CI − 0.04 to − 0.01), trunk–limb fat ratio (B − 0.01; 95% CI − 0.06 to − 0.01) and android–gynoid fat ratio (B − 0.01; 95% CI − 0.03 to − 0.01). After stratification by MNA score, all the parameters of android-like fat distribution resulted negatively associated (p < 0.001 for all) with UPDRS III, but only among subjects with a MNA < 23.5 (risk of malnutrition or malnutrition).ConclusionWe found a negative association between severity of motor impairment and total fat mass in PD, more specific with respect to an android pattern of fat distribution. This association seems to be driven by nutritional status, and is significant only among patients at risk of malnutrition or with overt malnutrition.

Survival and quality of life in elderly patients in conservative management

IntroductionConservative Management (CM) has become a therapeutic option in Advanced Chronic Kidney Disease in the elderly. However, there is a lack of evidence about prognosis of these patients in terms of survival and health related quality of life (HRQoL). ObjectiveEstablish predictive variables associated with mortality and analyse HRQoL in CM patients. Patients and methodsProspective cohort study. An assessment of renal function parameters and a comprehensive geriatric assessment were made, including: analysis of comorbidity, functional, cognitive, fragility, nutritional, social and HRQoL status. Results82 patients with a mean age of 84 years and significant pluripathology were studied: 56% had history of vascular event and Charlson >8. The mortality rate was 23/1000 patients per month, with a homogeneous mortality rate after 6 months.Survival differed significantly depending on whether they presented with a previous vascular event (36.7 vs. 14.8; p=0.028), Charlson score≥10 (42 vs. 17; p=0.002), functional status (48.4 vs. 19; p=0.002) and fragility (27 vs. 10; p=0.05). Mortality predictors included eGFR and proteinuria, the presence of previous vascular events, Charlson comorbidity score, malnutrition-inflammation parameters (albumin and MNA score), degree of dependency, physical HRQoL and increase of PTH level. The presence of previous vascular event, comorbidity, decreased albumin and elevated PTH were independent predictors of mortality. HRQoL remained stable over time and no significant worsening occurred during treatment. ConclusionsHaving knowledge of the factors associated with mortality and HRQoL assessment can be a useful tool to helping decision making during CM. Previous vascular events, comorbidity, decreased albumin and increased PTH were independent predictors of mortality.

HUBUNGAN KECENDERUNGAN DEPRESI DENGAN STATUS GIZI PADA LANSIA DI UPTD GRIYA WERDHA SURABAYA&lt;br&gt;&lt;i&gt;[Correlation of Depression Tendency and Nutritional Status of Elderly in UPTD Griya Werdha Surabaya]&lt;/i&gt;

Malnutrition is one of the causes of health problems in the elderly. Nutritional status of the elderly can be affected by many factors, such as food intake, comorbidities, drugs consumption, physical activity, and depression. Depression status has a relationship with the nutritional status of the elderly by influencing the intake of the elderly. The purpose of this study was analyze the correlation and the risk of depression tendency with elderly nutritional status at UPTD Griya Werdha Surabaya. This study was a case-control design. The number of respondents were 30 elderly consist of 15 elderly in each case and control groups. The case group was elderly who had MNA score &lt;24 points, while the control group was elderly who had MNA score of ≥24 points. Depression were measured by Short Geriatric Depression Scale (GDS). Spearman correlation test was used to analyze the data. Most of the elderly do not experience depression (GDS&lt;5). There was a correlation between depression with nutritional status of the elderly (p=0.007). Depression elderly were 9.75 times more likely to malnourished than nutritional status [OR=9.75, 95% CI =`1.63 (1.45-1.81)]. Nutritional status was correlated with the tendency of depression in the elderly. It is necessary to increase more activities at the UPTD Griya Werdha Surabaya to reduce the risk of depression among elderly.

Nutrition assessment of elderly residing in urban areas and urban slum: A hospital based comparative study

Background: In Maharashtra the elderly population is 9.9 % of the total state population (Census 2011). There is a need to highlight the nutritional problems being faced by the elderly in India. Early detection of malnutrition and timely interventions can help to reduce morbidity in the long run. Aims &amp;Objectives: To find the prevalence of malnutrition in elderly and compare nutritional status of elderly residing in an urban area and urban slum. Material &amp; Methods: This was a cross sectional hospital-based study. Data was collected from the civil OPD and ex-service men OPD of the hospital each having a catchment population from urban slum and urban area respectively. A total of 331 patients &gt; 60 years of age were included. Nutritional status was assessed using the MNA, MUST and GNRI. Serum albumin levels were measured using colorimetric method. Results: The overall prevalence of malnutrition and at risk as per MNA score was 168 (50.7%). Out of 331 subjects, 209 belonged to urban slums and remaining 122 were from urban area. The gender and age distribution were comparable in both groups. The mean BMI of subjects from slum area was significantly lower as compared to urban group (22.3+ 5.3 vs 26.3+ 4.5) p&lt;0.001. Proportion of elderly who had MNA score below 24 was significantly higher in the slum area (p&lt;0.05). Proportion of elderly with mid arm circumference and calf circumference below the cut off of 22 cm and 31 cm respectively was significantly higher in slum area (p&lt;0.05). Serum albumin levels were comparable in both groups. Mean BMI of elderly in urban area was &gt;25Kg/m2. Conclusion: The overall prevalence of malnutrition was high. The nutritional status of elderly in urban slum was significantly worse than that of elderly in urban area.