Nutritional Status Of Older Adults Research Articles

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<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<0.001), carbohydrate (p=0.013), protein (p<0.001), and fat (p<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.

A national cross-sectional study on breakfast skipping-related factors and comparison of nutritional status according to breakfast skipping in older adults based on the 8th Korea National Health and Nutrition Examination Survey (KNHANES, 2020)

ObjectivesThis study aimed to compare the distinct socio-ecological characteristics, nutritional status, and nutrient intake quality of the older adults based on breakfast skipping (EBF, eating breakfast vs. SBF, skipping breakfast). This study also investigated the association between breakfast skipping, socioecological features, and quality of nutrient consumption. MethodFrom the 8th Korea National Health and Nutrition Examination Survey (KNHANES, 2020), data of 92,093 subjects aged ≥ 65 years old (male: 43,910 and female: 48,183) having data with eating habits, such as nutrient intake and skipping breakfast were analyzed. ResultsThe average age of SBF was markedly lower than EBF. EBF had a lower employed status, education level, heavy alcohol intake frequency, smoking, and eating out regularly than SBF. Compared to EBF, SBF showed a significantly higher BMI and waist circumference. Moreover, EBF showed a markedly higher average intake in energy, protein, fiber, calcium, and iron compared with SBF, while SBF had a noticeably higher mean intake in fat, saturated fat, and sugar. In addition, SBF had a significantly reduced mean adequacy ratio (MAR, adjusted OR: 0.260 [95% CI: 0.245−0.276]) and the value of index nutritional quality (INQ, adjusted OR: 0.847 [95% CI: 0.799−0.898]) compared with EBF. DiscussionThere were distinct socioecological features and nutritional conditions of older adults relying on breakfast skipping; and a strong association between breakfast skipping, socioecological parameters, and nutrient intake quality. These observations provide the significance of breakfast skipping in the nutritional status of older adults and offer fundamental information for nutritional education and implications for older adults.

The healthy eating index for older adults: adaptation of the 2015 healthy eating index considering dietary guidelines for healthy aging.

The Healthy Eating Index (HEI) is a comprehensive measure to assess diet quality. Because of the various factors that influence the nutritional status of older adults, there is a need to adapt an index that assesses the quality of the diet considering the dietary requirements of aging and health promotion. This study aimed to adapt the HEI for older adults, considering their needs for healthy eating. Food consumption data was collected by means of three non-consecutive 24-hour food recalls (R24h). For the adaptation of the Healthy Eating Index for Older Adults (HEI-OA), the components and scoring methodology of HEI-2015 were maintained and Brazilian food intake recommendations for the older population were used, which are in line with international recommendations. The validity of the HEI-OA was assessed by four ideal diets, Mann-Whitney's test, Spearman's correlation analysis and Cronbach's coefficient. Content validity of the HEI-OA was confirmed by the maximum score for diets recommended to older adults and by the score between groups with known differences in diet quality. The HEI-OA total score did not correlate with total energy intake (TEI - total energy value: r = -0.141, p > 0.05). The total HEI-OA score showed a statistically significant correlation with several nutrients. These correlations allowed identifying that these nutrients are closely related to the components of the HEI-OA. The internal consistency value for the HEI-OA total score was 0.327, similar to the 2005 and 2010 versions of the HEI. The HEI was successfully adapted for use with older adults, presenting validity and reliability. The HEI-OA can be used to assess diet quality in line with international dietary guidelines for healthy aging.

Comparative analysis of nutritional status among institutionalised and community-dwelling elderly women and its association with mental health status and cognitive function.

Population pyramids are significantly impacted by the global phenomena of ageing. It has been reported that depression and cognitive function have an impact on the nutritional status of older adults. Depression is the most common psychiatric problem in old age, and cognitive deterioration is frequently observed in this age group. This descriptive and comparative study set out to compare the cognitive abilities, nutritional health and depression status of older adults who lived in community settings and in assisted living facilities. A total of 250 older women (125 from institutionalised old age home and 125 from community) participated in a cross-sectional study (residing at Rajarhat, Newtown area). The lengthy version of the Mini Nutritional Assessment tool (MNA®) was used to evaluate the participants' nutritional status. The Geriatric Depression Scale (GDS 30) was used to evaluate the severity of the depression. Using the Folstein Mini-Mental State Examination (MMSE), cognitive function was assessed. Using SPSS software, the Chi-square, Kruskal-Wallis test, and Spearman's rho correlation coefficient were computed. In the present study, it was observed that only 30.4% of the respondents who are community-dwelling elderly had normal MNA score, whereas 69.6% were at risk of malnutrition or already malnourished. Considering institutionalised elderly it was observed that only 7.2% were normal and 92.8% were malnourished/at risk of malnutrition. Statistically significant association was observed between nutritional status and mental health status (P = 0.00) as well as cognitive function (P = 0.00) among old age home residing elderly. Among the community-dwelling elderly mental health status has significant association with their nutritional status (P = 0.00) and cognitive function (P = 0.00) as well. Community-dwelling elderly were relatively healthy compared to old age home residents. Maintaining the nutritional, cognitive, and mental health of institutionalised and community-dwelling elderly women requires the implementation of physical and cognitive stimulation activities as well as interventions targeted at improving a healthy diet.

Associations Between Food Insufficiency, SNAP Participation Status, and Variability of Nutritional Status in Older Adults: A 10-Year Longitudinal Study

Associations Between Food Insufficiency, SNAP Participation Status, and Variability of Nutritional Status in Older Adults: A 10-Year Longitudinal Study

Nutritional Care for Adults in Nursing Homes: A Scoping Review.

The need for improved nutrition in older adults requiring care has been acknowledged, but, to the best of our knowledge, there is a lack of systematic review and integration of nutritional care studies with older adults in nursing homes. This scoping review aimed to examine the scope and nature of nutritional care research for older adults in nursing homes and to identify research gaps, following the guidelines of the Joanna Briggs Institute. We found varied nutritional care for older adults living in nursing homes, including individualized sessions, such as nutrition counseling, the addition of foods and preparations for increased nutritional intake, and the maintenance of an eating environment, such as feeding assistance and calling. The nutritional care identified in this scoping review also included studies that have improved the nutritional status of older adults in nursing homes by implementing educational programs for care staff. For future research on effective nutritional care for older adults in nursing homes, we suggest evaluating both short- and long-term intervention effects with an adequate sample size.

Taste assessment as a part of geriatric nutritional care: Potential implications for clinical practice

IntroductionAging is related to decrease in taste perception. As appetite is considered crucial for maintenance of proper nutritional status of older adults, its decrease during aging raises questions about its relation to gustatory functions and further prevention possibilities. Aim of the studyThe aim was to assess the characteristics and eating behaviors of the patients who reported a self-perceived reduction in taste perception in the context of appetite. Material and methodsThis semi-qualitative study was conducted between November 2021 and March 2022 in the Department of Internal Medicine and Geriatrics of the University Hospital in Krakow. Patients were assessed using an original appetite assessment scale, which allowed for an in-depth interview on areas related to the decline in gustatory function. Additionally, nutritional assessment was performed using Mini Nutritional Assessment and Council on Nutrition Appetite Questionnaire (CNAQ) and anthropometric measurements. ResultsThe most common characteristics of patients with gustatory dysfunction were early satiety, decreased appetite in the three months prior to the study and polypharmacy. A significant difference was observed in the CNAQ scores between the group of patients with and without gustatory dysfunction. ConclusionCareful identification of patients presenting with gustatory dysfunction can provide an important cue for an individualised approach aimed at preventing malnutrition. In our work, we suggest the areas that can be addressed during a nutritional interview to enable the selection of an optimal approach.

Effectiveness of the online-based comprehensive cognitive training application, Smart Brain, for community-dwelling older adults with dementia: a randomized controlled trial.

The fourth industrial revolution has brought about developments in information and communication technologies for interventions in older adults with dementia. Currently, most interventions focus on single interventions. However, community-dwelling older adults with dementia require comprehensive cognitive interventions, and clinical studies analyzing the effects of comprehensive interventions based on randomized controlled trials are lacking. The aim of the study was to examine the effects of an information and communication technology-based comprehensive cognitive training program, Smart Brain, on multi-domain function among community-dwelling older adults with dementia. This was a two-group, randomized, controlled trial. This study was conducted at participant's home. We analyzed older adults with dementia. Participants were randomly allocated to either the intervention group (N.=30) or the control group (N.=30). Older adults with dementia in the intervention group received 8 weeks of Smart Brain comprehensive cognitive training using a tablet, whereas the control group received a similar tablet but without the training. We measured the outcomes at baseline, and at 4 and 8 weeks. Cognitive function, depression, quality of life, balance confidence, physical ability, nutrition, and caregiver burden were compared between groups. In the intervention group, cognitive function statistically increased from baseline to both week 4 (2.03; 95% CI 1.26 to 2.81) and week 8 (2.70; 95% CI 1.76 to 3.64). Depression was statistically different from week 0 to week 8 (-1.67, 95% CI -2.85 to -0.48). Physical ability statistically increased from baseline to both week 4 (-0.85; 95% CI 1.49 to -0.20) and week 8 (-1.44; 95% CI -2.29 to -0.59). Nutrition statistically increased from baseline to both week 4 (0.67; 95% CI 0.05 to 1.28) and week 8 (1.10; 95% CI 0.36 to 1.84). Smart Brain significantly improved cognitive function, reduced depression, and enhanced physical and nutritional status in older adults with dementia. This demonstrates its potential as an effective non-pharmacological intervention in community-based dementia care. Smart Brain's personalized approach, which integrates user-specific preferences and expert guidance, enhances engagement and goal achievement in dementia care. This enhances self-esteem and clinical outcomes, demonstrates the application's potential to innovate rehabilitation practices.

Sarcopenia and poor nutritional status in older adults

Background & aimsThe association between sarcopenia and malnutrition has been poorly studied in the older population. The purpose of this study is to address the association between sarcopenia, according to different validated definitions, and nutritional status in a large population of community-dwelling older adults. MethodsObservational, cross-sectional study of the Geriatric Frailty Clinic (GFC) for Assessment of Frailty and Prevention of Disability, held by the “Gérontopôle” of the Toulouse University Hospital. Patients aged above 65 years who benefitted from a Dual X-ray Densitometry (DXA) during their assessment at the GFC from June 5th 2013 to January 28th 2020 were included. Sarcopenia was defined according to proposed validated definitions. The Mini Nutritional Assessment (MNA) was used to stratify nutritional status, and identify patients with a poor nutritional status (at risk of malnutrition or malnourished, MNA <24). Multiple logistic regression analyses were performed between MNA and each sarcopenia definition adjusted for confounders. ResultsAmong the 938 patients with DXA data, a total of 809 (86.2%) subjects were included in the analysis (mean age 81.8 ± 6.9 years, 527 females (65.1%)). Prevalence of sarcopenia ranged from 12.6% to 44.9%, according to various definitions. Overall 244 (30.2%) of the patients had a poor nutritional status (MNA-score <24), Baumgartner and Newman definitions of sarcopenia were both associated with low MNA-scores (OR=4.69, CI 3.15-6.98 and OR=2.30, CI 1.55-3.14, respectively), EWGSOP2 “confirmed sarcopenia” definition was also associated with low MNA-scores (OR=3.68, CI 2.30-5.89), as well as for the lean mass definition according EWGSOP2 cut-off (OR 5.22 CI 3.52-7.73). Both FNIH and EWGSOP2 “probable sarcopenia” definitions were not associated with the risk of malnutrition. ConclusionsIn this study, the prevalence of sarcopenia ranged from 12.6 to 44.9% according to various definitions. A score of MNA under 24, was associated with almost all of the sarcopenia definitions. This study reinforces the concept that malnutrition and sarcopenia are strictly related. When facing malnutrition in daily clinical practice, body composition should be assessed and the proposed nutritional intervention should be tailored by these results in order to prevent the onset of late-life disability.

Nutritional status of the older adults in nursing homes: A cross-sectional study.

To investigate the nutritional status of older adults in nursing homes in Chongqing, China, compare and analyse the differences in the physical condition, cognitive function and social-related factors of older adults with different nutritional statuses. Malnurtition in the older people has become a priority concer, and the incidence and factors associated with malnutrition vary somewhat by healthcare setting. In Chongqing ,China, there is lack of research on malnutrition of the older people in nursing homes. Here, we investigated the incidence of malnutrition and analysed the associated factors. A cross-sectional study. From January to April 2023, a cross-sectional survey was conducted in three nursing homes in Chongqing, China. Participants completed a series of questionnaires, including the Demographic Information Questionnaire which included age, gender, education level, previous occupation, marital status and other information. The survey also included validated non-demographic instruments [Short-Form Mini-Nutritional Assessment (MNA-SF), Barthel Index (BI) and Mini-mental State Examination (MMSE)] to identify related impact factors. The Guidelines for cross-sectional studies were used in this study (Data S1). 209 older adults aged 60 and over participated in this study, of whom 121 were women and 88 were men. The average (SD) age of the participants was 84.7 (6.3) years. Of the participants, 46.4% were classified as well nourished. About 39.2% were at risk of malnutrition and 14.4% were malnourished. Compared to those who were well nourished, those who were malnourished or at risk of becoming malnourished were more likely to suffer from comorbidities, polypharmacy, a higher risk of falling, ADL dependence and to receive more nutritional interventions. However, there are no significant differences after adjustment for age, education level, previous occupation, marital status, length of stay, and type of health care payment. Malnutrition is a common problem among older adults innursing homes in Chongqing, China. There are certain differences in physical conditions and nutritional interventions among older adults withdifferent nutritional status. This study suggests that the problem of malnutrition is very prominent in nursing homes in Chongqing, China. Cognitive impairment, impaired activities of daily living, fall risk and nutritional intervention need to be prevalent in older adults with (risk of) malnutrition.

Animal and vegetable protein intake and malnutrition in older adults: a multicohort study.

Malnutrition is a global concern in older adults, as it negatively affects morbidity and mortality. While higher animal protein intake may help prevent and treat malnutrition, it might also increase the risk of chronic diseases and death. Conversely, vegetable protein intake might have a lower anabolic effect and not be as effective to improve nutritional status. We studied whether animal and vegetable protein intake are associated with changes in nutritional status in older adults. We used pooled data from two Spanish cohorts: the Seniors-ENRICA 1 and Seniors-ENRICA 2. 2,965 community-dwelling adults aged 62-92 years. Protein intake was estimated at baseline via an electronic, validated diet history. Nutritional status was assessed at baseline and after 2.6 years with the GLIM (Global Leadership Initiative on Malnutrition) phenotypic criteria: weight loss, low body mass index, and reduced muscle mass. The odds of improvements in nutritional status were assessed with logistic regression models, extensively adjusted for potential confounders. Higher animal and vegetable protein intake were associated with improvements in nutritional status [odds ratios (95% confidence intervals) per 0.25 g/kg/day were 1.15 (1.00, 1.32) and 1.77 (1.35, 2.32), respectively]. Cereal protein intake drove most of the latter association [2.07 (1.44, 2.98)]. Replacing 0.25 g/kg/day of total animal protein, meat, or fish protein (but not dairy or egg protein) with vegetable protein was associated with improvements in nutritional status [1.54 (1.13, 2.09), 1.70 (1.20, 2.41), and 1.77 (1.18, 2.64), respectively]. Higher animal and, especially, vegetable protein intake were associated with improvements in nutritional status in older adults. Replacing total animal protein, meat, or fish protein with vegetable protein may help improve malnutrition.

Snack Provision Practice in Long-Term Care Hospitals and Facilities in Korea.

The study aimed to investigate the basic data to derive plans for snack provision to improve the nutritional status of older adults living in long-term care facilities (LFs) or long-term care hospitals (LHs). The 252 respondents (118 from LHs and 134 from LFs) were included in the study. The questionnaire of nationwide cross-sectional survey was developed by the authors and registered dietitians. The written questionnaire was sent to the food service managers across 800 LFs or LHs. The online survey was introduced using the online platform and network site for dietitians. More than 70% of live-in and non-live-in LFs provided snacks, which were mainly provided one to two times a day. Most institutions provided fruits one to three times a week. The main considerations when providing fruit were in the order of residents' preference, cost, and ease of consumption. The reasons for not serving fruit included cost and differences in the residents' eating and mastication abilities. Most institutions also provided dairy products at a frequency of one to three times a week. The reasons for not serving dairy products included cost and the lack of awareness of the need to provide them. To improve the quality of life and the offer benefits of fruits and dairy products to older people, efforts are needed to propose a plan to expand the provision of snacks in appropriate quantities and varieties.

Factors associated with body mass index in a cohort of older adults: Structural equation modeling analysis.

Considering the interrelationship between the multiple determinants of nutritional status, analyses are needed to estimate direct and mediated effects between the variables that influence body mass index (BMI) in older adults. We aimed to verify the direct and indirect effects of sociodemographic, behavioral and health conditions on the BMI of older adults in the community. This is a longitudinal study based on data collection in 2015 and 2020. Descriptive analysis and Structural Equation Modeling were performed, considering p<0.05. The sample consisted of 220 older adults with a mean baseline age of 68.86 years (± 7.10). Direct associations of higher BMI value with younger age, higher monthly family income, greater functional disability to perform instrumental activities of daily living and greater number of morbidities were found. In addition, education, gender, moderate to vigorous physical activity were indirectly associated with high BMI. These findings provide insights into the complex relationship of multiple determinants of nutritional status in older adults and support the design of public health policies that consider the specificities of this population group.

Cuidado a idosos com perda de peso não intencional: percepções de profissionais da Atenção Primária em São Paulo, SP, Brasil

Aging involves biological changes such as unintentional weight loss. This study aimed to understand primary care professionals’ perceptions of the nutritional status of older adults who are users of Primary Care Units, emphasizing unintentional weight loss and identifying possibilities for intervention by the interprofessional team. Seventeen individual interviews and one focus group were conducted in 2019 with health professionals in São Paulo, Brazil. Data were transcribed, submitted to thematic content analysis, and discussed in triangulation. Participants demonstrated difficulty in identifying older adults with unintentional weight loss. Challenges for care included food insecurity and problems in the work process in Primary Care, while possibilities for care involved health education, interprofessionality, and intersectoral work.

Exploring the Nutrition-Related Health of the Ageing Population in Fiji: A Narrative Review.

Fijis' older population aged 55 years and over makes up 14% of the total population and is expected to reach 20% by 2050. This narrative review aimed to examine the health and nutrition status of the aging population of Fiji and sociodemographic determinants. A search strategy was conducted throughout databases, and gray literature from relevant websites was searched. Due to the limited evidence regarding the nutrition, health, and socio-economic factors that impact the aging population in Fiji the inclusion criteria were broad and included both genders (male and female), all publications up until December 2022, all study designs, and gray literature (government/institutional reports, conference proceedings, guidelines, Act, and Policies) . There was no filter for date applied in the search criteria. Studies that did not meet the search criteria were excluded. 20 documents including published articles were included for analysis and result synthesis. Life expectancy at birth for the Fiji population is 68 years. A significant annual increase in mortality rate from endocrine, nutritional, and metabolic diseases has been observed in women aged 75+ but not older men. Women of low-income status are more at risk than men. However, as most investigations aggregate those ≥18 years, there is a lack of information on older adults (≥65 years) health and nutrition status. To improve the health status of older adults, an understanding of the nutritional status of older adults is warranted, especially concerning lifestyle and sociodemographic determinants.

Perception of Nutrition in Adults with Sickle Cell Disease: Concept Elicitation of Nutritional Status and the Mini Nutrition Assessment

Introduction Sickle Cell Disease (SCD) is a genetic disorder that causes recurrent vaso-occlusive pain events, functional impairment, and nutritional deficiencies due to increased metabolic demands. Prior studies have highlighted nutritional issues in people with SCD, such as micronutrient and macronutrient deficiencies, low body mass index (BMI), and a recent rise in obese adults with SCD. In older adults in the general population, evaluation and management of nutritional status is essential since malnutrition can weaken the immune system and increase the risk of hospitalization and death. Despite the importance of nutrition, little is known about the best way to evaluate nutritional status in older adults with SCD. To identify a relevant yet efficient method to evaluate nutritional status, we conducted content elicitation interviews to describe how younger and older adults conceptualized nutrition. Based on the content of the interviews, we piloted a brief nutritional survey called the Mini Nutritional Assessment (MNA); a common nutritional measure in geriatric assessments. Methods As standard practice for concept elicitation, we conducted semi-structured interviews with adults SCD in 4 separate focus groups: two groups of young adults age 18-39 and two groups of older adults age ≥ 40 years. Participants were asked about their perception of the construct of nutrition as part of a longer concept elicitation interview assessing the content validity of the Sickle Cell Disease Functional Assessment (SCD-FA), which is the geriatric assessment for adults with SCD. After focus group transcripts were analyzed using rapid qualitative analysis, we administered the MNA to a separate cohort of adults with SCD, since its content on macronutrients and hydration was consistent with how adults with SCD conceptualized nutrition. The scores on the 6-item MNA-Short Form (MNA-SF) range from 0 to 14 with higher scores indicating better nutritional status. Scores 12-14 indicate a normal nutritional status, 8-11 indicate at risk for malnutrition, and 0-7 indicate a malnourished state. Results The 4 focus group interviews included 6 younger adults (age 18-39) and 8 older adults (age ≥ 40 years) with SCD. Participants were 57% females and 79% had severe SCD genotype (HbSS or HbSβnull-thalassemia). In the focus groups, participants described a healthy diet as one that included the major food groups, which were generally defined as protein, fruits and vegetables, and starches/carbs. The majority discussed the importance of adequate hydration to reduce the risk of pain crises. Additionally, participants reported trying to substitute water for soda, juice, and caffeine containing beverages. Many participants stated that a healthy diet involved limited processed foods and sugars. Despite knowledge of the characteristics of a “healthy” diet, some participants expressed difficulty maintaining this diet. Based on these qualitative results, we selected the MNA to evaluate nutrition since it included items on hydration and assessed intake of various food groups as described by focus group participants. We administered the MNA-SF to a cohort of 88 adults with SCD and 81 had complete data to score the MNA-SF. The mean score for the MNA-SF for all participants was 11.7 ± 1.8 (younger adults 11.6 ± 1.9 and older adults 11.9 ± 1.8; p= 0.44). The MNA-SF identified 40% (n=34) as being at risk of malnutrition [36% of older adults and 46% younger adults]. Two participants were identified as being malnourished (1 younger and 1 older adult). On remaining MNA items (Table 1), 25% of participants reported decreased food intake with 17% having only 1 meal/day. Most participants (85%) consumed ≥ 1 serving of protein/day and 75% had ≥ 2 servings of fruits or vegetables/day. Most participants (68%) drank &amp;gt; 5 cups of water/day. Results were similar for younger and older adults with SCD. Conclusion Data from the focus group interviews revealed that BMI and unintentional weight loss measures alone did not comprehensively capture how people with SCD perceived the concept of nutrition. Incorporating the MNA-SF enhanced measurement of the nutritional domain in the SCD-FA by capturing data on food intake and hydration. In future studies we will assess the construct validity of the full MNA in a larger sample to identify older adults with SCD who would benefit most from nutritional interventions.

Meta-analysis and moderator analysis of the prevalence of malnutrition and malnutrition risk among older adults with dementia

BackgroundAging and dementia are common and closely related health problems in older adults, affecting their ability to maintain a healthy diet and ultimately resulting in malnutrition. ObjectiveIn this study, we estimated the global prevalence of malnutrition and malnutrition risk in older adults with dementia. DesignMeta-analysis. Data sourcesEmbase, Ovid MEDLINE, PubMed, CINAHL, Scopus, and Web of Science were comprehensively searched for articles published from database inception to October 2022. MethodsPooled prevalence analysis was conducted using a generalized linear mixed model and a random-effects model. I2 and Cochran's Q statistics were used for identifying heterogeneity. Publication bias was evaluated using Peters' regression test and a funnel plot. Moderator analyses were conducted to investigate variations in the prevalence estimates of the included studies. All statistical analyses were conducted using R software. ResultsA total of 16 studies involving a total of 6513 older adults with dementia were included in the analysis. The results indicated that 32.52 % (95 % confidence interval: 19.55–45.49) of all included older adults with dementia had malnutrition, whereas 46.80 % (95 % confidence interval: 38.90–54.70) had a risk of malnutrition. The prevalence of malnutrition was found to be high among older patients living in institutionalized settings (46.59 %) and those with Alzheimer's disease (12.26 %). The factors moderating the prevalence of malnutrition included adequate vitamin B12 consumption, risk behaviors, medical comorbidities, and certain neuropsychiatric symptoms. The prevalence of malnutrition risk was high among women (29.84 %) and patients with Alzheimer's disease (26.29 %). The factors moderating the prevalence of malnutrition risk included total cholesterol level, vitamin B12 consumption, risk behaviors, medical comorbidities, and certain neuropsychiatric symptoms. ConclusionsApproximately one-third of older adults with dementia are malnourished and nearly half of older adults are at a risk of malnutrition. Encouraging collaboration among health-care professionals and ensuring early assessment and effective management of malnutrition are crucial for maintaining a favorable nutritional status in older adults with dementia. RegistrationThis study was registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42022369329). Tweetable abstractGlobally, approximately 32.52 % of older adults with dementia are malnourished and approximately 46.80 % are at a risk of malnutrition.

Asociación de fuerza prensil y extensores de rodilla con estado nutricional de adultos mayores pertenecientes a la comunidad

AimTo determine the association of hand grip strength and knee extensor strength with the nutritional status of community-dwelling older adults. Material and methodsObservational cross-sectional study. Weight and height of 847 older adults were analyzed according to body mass index and classified into four nutritional categories according to the Chilean Ministry of Health. Hand grip and knee extensors strength for both extremities were evaluated. Strength was normalized by body mass. Spearman's correlation between body mass index and muscle strength was used. ResultsThe sample was 582 women, 265 men and an average age of 71.72±7.09. The women had a BMI of 30.03±5.48 and the men of 27.64 ± 4.05, the most numerous category was normal weight (n = 288) and the lowest low weight (n = 74). Hand grip strength presented a higher correlation than knee extensors, specifically, right hand grip strength (r: −0.40). The highest correlation and significance were presented by the obese category for all strength measurements, with right hand grip strength being the highest (r: −0.29). ConclusionsThe increase in the nutritional status of older adults has a negative influence on muscle strength. The best association between body mass index and muscle strength was the right hand grip. The finding of the increase in life expectancy as the nutritional status of the sample decreases stands out. Future studies are needed to generate percentiles and normalized values in the Chilean population.

Longitudinal Associations Between ATPase Inhibitory Factor 1, Growth Differentiation Factor-15, and Nutritional Status in Older Adults From the MAPT Study.

Weight and appetite regulation have been associated with the expression and secretion of ATPase inhibitory factor 1 (IF1) and growth differentiation factor-15 (GDF-15), 2 potential biomarkers for age-related mitochondrial dysfunction. The aim was to explore the associations between these biomarkers and nutritional variables in the Multidomain Alzheimer Preventive Trial study. IF1 and GDF-15 plasma levels were quantified at 1-year follow-up. The nutritional status was measured using the Mini Nutritional Assessment (MNA) score variation between baseline and 1- and 2-year visits; appetite loss was extracted from the MNA. Bodyweight was measured every 6 months until the third year and then yearly until the fifth year of follow-up, and weight loss was established if the loss was greater than 5% or 10% within the past 6 or 12 months, respectively. Bidirectional associations of IF1 and GDF-15 levels with malnutrition, appetite, and weight loss were examined. The interactions between individual IF1 and GDF-15 with sex were explored. Four hundred and forty-eight participants had MNA data and 1 045 had weight loss data. All the associations between IF1 levels and the MNA score, appetite loss, and weight loss were nonsignificant. Higher GDF-15 levels were cross-sectionally associated with appetite loss at the first year of follow-up, and the GDF-15 highest quartile was associated with nearly 80% higher risks of weight loss over 4 years. Interactions between IF1 and GDF-15 levels, and between these 2 markers and sex were not significantly associated with the outcomes. GDF-15 plasma levels were related to key malnutrition criteria.

Nutritional status of older adults in India: An exploration of the role of oral health and food insecurity factors

BackgroundIn this study, we attempted to generate insights into the determinants of nutritional status among older adults in India by exploring the role of factors including oral health, food insecurity, socioeconomic, demographic and health-related variables. The study also examined the moderating role of tooth loss with the association between chewing ability and nutritional status. MethodsThe data was obtained from Longitudinal Ageing Study India (LASI) – Wave 1 (2017-18). The sample consisted of 27,411 older adults (Male = 13, 232; Female = 14, 179) aged 60 years and above. In addition to descriptive and bivariate analysis, we employed multinominal logistic regression analysis. ResultThere was a significant association between the ability to chew solid food and tooth loss in the nutritional status of older adults. It was further revealed that tooth loss acted as a moderator (aRRR = 1.50, 95 % CI: 1.08–2.08) between the chewing ability and the risk of being underweight. The weight loss due to food insecurity increased the relative risk ratio of being underweight (aRRR = 1.58, 95 % CI: 1.25–2.00). Further evidence showed that self-rated health (SRH), Instrumental Activities of Daily Living (IADL), morbidity status and socioeconomic factors had a significant role in determining the nutritional status among older adults. ConclusionChewing ability, tooth loss, and food insecurity determine nutritional status among older adults. It is suggested to care for oral and general physical health as these factors increase the risk of nutritional deficits. Also, policy measures should be strengthened to address the specific health and food security needs of older adults from vulnerable socioeconomic circumstances.