scholarly journals Hip Fracture Patients in Geriatric Rehabilitation Show Poor Nutritional Status, Dietary Intake and Muscle Health

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2528
Author(s):  
Inge Groenendijk ◽  
Charlotte S. Kramer ◽  
Laura M. den Boeft ◽  
Hans S. M. Hobbelen ◽  
Gert-Jan van der Putten ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Nutritional Status ◽  
Dietary Intake ◽  
Muscle Mass ◽  
Handgrip Strength ◽  
Mini Nutritional Assessment ◽  
Geriatric Rehabilitation ◽  
Dietary Reference Intake ◽  
Poor Nutritional Status ◽  
Muscle Health

The aim of this study was to gain insight into the nutritional status, dietary intake and muscle health of older Dutch hip fracture patients to prevent recurrent fractures and to underpin rehabilitation programs. This cross-sectional study enrolled 40 hip fracture patients (mean ± SD age 82 ± 8.0 years) from geriatric rehabilitation wards of two nursing homes in the Netherlands. Assessments included nutritional status (Mini Nutritional Assessment), dietary intake on three non-consecutive days which were compared with Dietary Reference Intake values, and handgrip strength. Muscle mass was measured using Bioelectrical Impedance Analysis and ultrasound scans of the rectus femoris. Malnutrition or risk of malnutrition was present in 73% of participants. Mean energy, protein, fibre and polyunsaturated fat intakes were significantly below the recommendations, while saturated fat was significantly above the UL. Protein intake was <0.8 in 46% and <1.2 g/(kg·day) in 92%. Regarding micronutrients, mean intakes of calcium, vitamin D, potassium, magnesium and selenium were significantly below the recommendations. The prevalence of low muscle mass, low handgrip strength and sarcopenia were 35%, 27% and 10%, respectively. In conclusion, a poor nutritional status, dietary intake and muscle health are common in older hip fracture patients in geriatric rehabilitation wards.

scholarly journals Inadequate Intake of Energy and Nutrients Is Common in Older Family Caregivers

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2763
Author(s):  
Sohvi Koponen ◽  
Irma Nykänen ◽  
Roosa-Maria Savela ◽  
Tarja Välimäki ◽  
Anna Liisa Suominen ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Dietary Intake ◽  
Family Caregivers ◽  
Nutrient Intake ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Food Record ◽  
Poor Nutritional Status ◽  
Energy And Nutrient Intake

The aim of this study was to investigate the nutritional status, determinants of nutritional status, and adequacy of energy and nutrient intake of older family caregivers (FC). Nutritional status was measured using the Mini Nutritional Assessment (MNA), plasma albumin, plasma pre-albumin, and blood hemoglobin concentrations. Dietary intake was assessed with a three-day food record. Comorbidity (B −0.283, 95% CI: −0.492, −0.073), quality of life (B 0.045, 95% CI: 0.018, 0.072) and energy intake (B 0.001, 95% CI: 0.000, 0.002) were significantly associated with the MNA scores of the older FCs (n = 125). It was common for FCs to have lower than recommended intakes of energy and several nutrients, independent of the risk of malnutrition assessed by the MNA. Over half of the FCs had inadequate intake of protein, vitamin A, folate, and fiber, and 25–40% of the FCs had a low intake of vitamin D, vitamin E, thiamine, magnesium, iron, and selenium. It is important to follow both the nutritional status and dietary intake of older FCs regularly to find those with lower than recommended nutrient intake and to avoid poor nutritional status and its adverse effects hampering their ability to serve as FCs.

scholarly journals Impact of Rehabilitation Dose on Nutritional Status at Discharge from a Convalescent Rehabilitation Ward in Malnourished Patients with Hip Fracture

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 722
Author(s):  
Yusuke Ito ◽  
Hidetaka Wakabayashi ◽  
Shinta Nishioka ◽  
Shin Nomura ◽  
Ryo Momosaki
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Hip Fracture ◽  
Nutritional Status ◽  
Logistic Regression Analysis ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
Functional Independence ◽  
Rehabilitation Ward ◽  
The Impact

The object of this study is to determine the impact of the rehabilitation dose on the nutritional status at discharge from a convalescent rehabilitation ward in malnourished patients with hip fracture. This retrospective case-control study involved malnourished patients with hip fracture aged 65 years or older who had been admitted to a convalescent rehabilitation ward and whose data were registered in the Japan Rehabilitation Nutrition Database. The primary outcome was nutritional status at discharge. Patients were classified according to whether nutritional status was improved or not at discharge, according to the Mini Nutritional Assessment-Short Form® (MNA-SF) score. The association between improved nutritional status and rehabilitation dose was assessed by a logistic regression analysis. Data were available for 145 patients (27 men, 118 women; mean age 85.1 ± 7.9 years). Daily rehabilitation dose was 109.5 (median 94.6–116.2) min and the MNA-SF score at admission was 5 (median 4–6). Nutritional status was improved in 97 patients and not improved in 48. Logistic regression analysis showed the following factors to be independently associated with nutritional status at discharge: Functional Independence Measure score (OR 1.042, 95% CI 1.016–1.068), energy intake (OR 1.002 CI 1.000–1.004), daily rehabilitation dose (OR 1.023, 95% CI 1.002–1.045), and length of hospital stay (OR 1.026, 95% CI 1.003–1.049). The daily rehabilitation dose in malnourished patients with hip fracture may positively impact nutritional status at discharge.

A High Masticatory Muscle Tone Predicts the Risk of Malnutrition and Frailty in Inpatient Older Adults: A Cross-Sectional Study

Gerontology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Yin-Hwa Shih ◽  
Zhen-Rong Hong ◽  
Shih-Min Hsia ◽  
Shang-Yu Yang ◽  
Tzong-Ming Shieh
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Nutritional Status ◽  
Masseter Muscle ◽  
Muscle Tone ◽  
Handgrip Strength ◽  
Muscle Performance ◽  
Masticatory Muscle ◽  
Masticatory Performance ◽  
Poor Nutritional Status

<b><i>Introduction:</i></b> The prevalence of malnutrition among inpatient older adults is as high as 20∼50%. Masticatory performance is known to affect the nutritional status of individuals. However, an objective measurement to reflect the real status of masticatory muscle performance is lacking at the bedside. <b><i>Methods:</i></b> This pilot study analyzed the masticatory performance using surface electromyography (sEMG) of masticatory muscles that measures both muscle strength and muscle tone at the bedside. The nutritional status was measured using the Mini Nutritional Assessment tool. The handgrip strength was measured using a hand dynamometer. The statistical data were analyzed using SPSS 25 software. <b><i>Results:</i></b> The data revealed that female inpatient older adults more frequently had substandard handgrip strength (<i>p</i> = 0.028), an at-risk and poor nutritional status (<i>p</i> = 0.005), and a higher masseter muscle tone (<i>p</i> = 0.024). Inpatient older adults with an at-risk and poor nutritional status had an older age (<i>p</i> = 0.016), lower handgrip strength (<i>p</i> = 0.001), and higher average masseter muscle tone (<i>p</i> = 0.01). A high masseter muscle tone predicted the risk of having an at-risk and poor nutritional status. The at-risk or poor nutritional status predicted having a substandard handgrip strength by 5-fold. <b><i>Conclusions:</i></b> A high masticatory muscle tone predicts malnutrition and frailty. Medical professionals should combat masticatory dysfunction-induced malnutrition by detecting masticatory muscle performance using sEMG and referring patients to dental professionals. Additionally, encouraging inpatient older adults to perform oral motor exercise is recommended.

scholarly journals Association between the Dietary Inflammatory Index and Risk of Frailty in Older Individuals with Poor Nutritional Status

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1363 ◽  
Author(s):  
Doyeon Kim ◽  
Yongsoon Park
Keyword(s):  
Nutritional Status ◽  
Multinomial Logistic Regression ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Cardiovascular Health Study ◽  
Dietary Inflammatory Index ◽  
Older Individuals ◽  
Inflammatory Index ◽  
Increased Risk ◽  
Poor Nutritional Status

Both inflammation and poor nutritional status are major risk factors of frailty, and the dietary inflammatory index (DII) has been suggested as being associated with the risk of frailty. The present study aimed to investigate whether DII scores were positively associated with the risk of frailty in older individuals, particularly those with poor nutritional status. In total, 321 community-dwelling older individuals aged 70–85 years were recruited and categorized as non-frail, pre-frail, and frail according to the Cardiovascular Health Study index. DII scores were calculated based on 24-h dietary recall, and nutritional status was assessed using the Mini Nutritional Assessment. Multinomial logistic regression analysis showed that DII scores were positively associated with the risk of frailty in older individuals (odds ratio, OR 1.64, 95% confidence interval, 95% CI 1.25–2.17), particularly those with poor nutritional status (OR 1.68, 95% CI 1.21–2.34). Among the frailty criteria, weight loss (OR 1.29, 95% CI 1.03–1.60), low walking speed (OR 1.33, 95% CI 1.10–1.61), and low grip strength (OR 1.34, 95% CI 1.13–1.60) were associated with DII scores. In addition, the optimal DII cut-off score for frailty was ≥0.93 (sensitivity 71%; specificity: 72%; area under the receiver operating characteristic curve, AUC = 0.792). The present study showed that a pro-inflammatory diet was associated with increased risk of frailty, particularly in older individuals with poor nutritional status. Future randomized controlled trials with a low DII diet for the prevention of frailty are needed to confirm our finding.

scholarly journals Nutritional Status Is Associated with Function, Physical Performance and Falls in Older Adults Admitted to Geriatric Rehabilitation: A Retrospective Cohort Study

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2855
Author(s):  
Miriam Urquiza ◽  
Naiara Fernandez ◽  
Ismene Arrinda ◽  
Irati Sierra ◽  
Jon Irazusta ◽  
...  
Keyword(s):  
Cohort Study ◽  
Nutritional Status ◽  
Physical Performance ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
Geriatric Rehabilitation ◽  
Physical Measurements ◽  
The Impact

Nutritional status is relevant to functional recovery in patients after an acute process requiring rehabilitation. Nevertheless, little is known about the impact of malnutrition on geriatric rehabilitation. This study aimed to determine the association between nutritional status at admission and the evolution of functional and physical outcomes, as well as the capability of nutritional status to identify fallers among patients admitted to geriatric rehabilitation for different reasons. This was a retrospective cohort study of 375 patients. Data collected included age, gender, diagnosis at admission, comorbidities, cognitive and nutritional status, functional and physical measurements, length of stay, mortality and falls. Orthogeriatric patients with worse nutritional status according to the Mini Nutritional Assessment-Short Form (MNA-SF) had a significantly lower Barthel Index at admission and discharge with worse functional gain and poorer outcomes in the Short Physical Performance Battery (SPPB). However, in hospital-deconditioned patients, the MNA-SF score was not significantly associated with functional and physical recovery. Poor nutritional status at admission increased the risk of experiencing at least one fall during rehabilitation in orthogeriatric patients. However, hospital-deconditioned patients who fell had better SPPB scores than those who did not fall. Our results demonstrate the importance of nutritional status in the clinical evolution of orthogeriatric patients throughout the rehabilitation process.

scholarly journals Nutritional Status and Body Composition of Independently Living Older Adults in a Snowy Region of Japan

2017 ◽  
Vol 3 ◽  
pp. 233372141770685 ◽  
Author(s):  
Tomoko Shimoda ◽  
Teppei Suzuki ◽  
Noriko Takahashi ◽  
Kaori Tsutsumi ◽  
Mina Samukawa ◽  
...  
Keyword(s):  
Older Adults ◽  
Body Composition ◽  
Nutritional Status ◽  
Dietary Intake ◽  
Muscle Mass ◽  
Dietary Habits ◽  
Health Indicators ◽  
Health Expectancy ◽  
Term Care ◽  
Lifestyle Diseases

Lifestyle diseases, which are associated with nutrition, account for 30% of elderly requiring long-term care. To increase health expectancy among Japan’s rapidly aging population, we investigated the nutritional status and body composition of elderly adults living in a region subject to heavy snowfall, to identify pertinent health indicators. The dietary habits of 288 local residents aged ≥50 years were analyzed using body composition and a brief-type self-administered diet history questionnaire. Body mass index of all residents was normal. Basal metabolic rate (BMR) and muscle mass were reduced in the older group. Dietary habits did not differ with age among men, but older women had significantly higher dietary intake. BMR and muscle mass declined with age, even when dietary intake was sustained. Despite sufficient dietary intake, independently living older adults demonstrate less efficient use of food with age. Interventions to reduce excessive sodium and protein intake are required.

scholarly journals Body composition of women with and without dynapenia defined by different cut-off points

2021 ◽  
Vol 34 ◽  
Author(s):  
Lucas dos SANTOS ◽  
Camille Giehl Martins MIRANDA ◽  
Tasso Carvalho Barberino de SOUZA ◽  
Thais Alves BRITO ◽  
Marcos Henrique FERNANDES ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Composition ◽  
Nutritional Status ◽  
Postmenopausal Women ◽  
Muscle Mass ◽  
Handgrip Strength ◽  
The Body ◽  
Electrical Bioimpedance ◽  
Central Fat ◽  
The Mean

ABSTRACT Objective To compare body composition of postmenopausal women with and without dynapenia, defined by different cut-off points. Methods Body composition was assessed by electrical bioimpedance and the nutritional status by the body mass index. Dynapenia was diagnosed according to handgrip strength, using the following cut-off points: handgrip strength <16kgf and <20 kgf. Results A total of 171 women (50 to 92 years of age) participated in the investigation. The mean age of non-dynapenic and dynapenic women (handgrip strength <20kgf) was 69.4±8.2 and 74.5±8.2 years, respectively. The mean age of women with dynapenia (handgrip strength <16kgf) was 75.0±10.1 years and non-dynapenic women, 71.1±8.2 years. It was found that dynapenic women, with handgrip strength <20 and <16kgf, had an average of 2.38 and 2.47kg less muscle mass respectively, when compared to non-dynapenic women (p<0.05). However, there was no difference in muscle mass between the different dynapenic groups. Non-dynapenic women (handgrip strength ≥20kgf) had more total (3.55kg) and central fat (1.47kg) (p<0.05). Conclusion Dynapenic women, diagnosed considering both cutoff points, had less total and segmental muscle mass compared to non-dynapenic women. In addition, dynapenic women with handgrip strength <20kgf had lower total and trunk adiposity.

scholarly journals Handgrip Strength Cut-Off Values for the Undernutrition Risk Screening among Elderly Men and Women in Bosnia and Herzegovina

2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Maja Račić ◽  
Jelena Pavlović ◽  
Nedeljka Ivković
Keyword(s):  
Nursing Home ◽  
Nutritional Status ◽  
Bosnia And Herzegovina ◽  
Nutritional Assessment ◽  
Handgrip Strength ◽  
Nursing Home Residents ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Men And Women ◽  
Screen Ii

Objectives. To determine the optimal cut-off points of handgrip strength (HGS) to identify the undernutrition risk among individuals older than 65 years of age in Bosnia and Herzegovina. Design. Cross-sectional study. Setting. Towns of Sarajevo, Foca, Rogatica, and Pale in Bosnia and Herzegovina. Participants. 300 community-dwelling older adults and 146 nursing home residents. Comprehensive Geriatric multidimensional assessment (CGA) was carried out to evaluate general health, functional, and cognitive capabilities. Nutritional status and undernutrition risk were assessed by Mini Nutritional Assessment (MNA) and Seniors in the Community: risk evaluation for eating and nutrition, version II (SCREEN II). HGS was measured with a Smedley dynamometer. Results. According to the classification of nutritional status by MNA, 42% of community-dwelling men and 39% of community-dwelling women were at undernutrition risk. The undernutrition risk was significantly higher among nursing home residing men (89%) and women (78%) (p<0.001). When nutritional status was assessed by SCREEN II, 100% on nursing home residents, 86% of community-dwelling men and 80% of women were identified as having a high risk for undernutrition. Per MNA, HGS cut-off thresholds were 23.50 kgF (65–74 years) and 19.50 kgF (≥75 years) for men; 15.50 kgF (65–74 years) and 13.50 kgF (≥75 years) for women. Per SCREEN II, cut-points were 28.50 kgF (65–74 years) and 24.50 kgF (≥75 years) for men; 24.50 kgF (65–74 years), 19.50 kgF (≥75 years for women). Conclusion. HGS can be a useful instrument to identify undernutrition risk among the elderly patients. This study provides threshold for men and women older than 65 years of age in Bosnia and Herzegovina.

scholarly journals Determinants of participation in a post-hospitalization physical exercise program for older adults

2020 ◽  
Author(s):  
Miriam Urquiza ◽  
Iñaki Echeverria ◽  
Ariadna Besga ◽  
Maria Amasene ◽  
Idoia Labayen ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Exercise ◽  
Nutritional Status ◽  
Multivariate Regression ◽  
Older Patients ◽  
Exercise Program ◽  
Mini Nutritional Assessment ◽  
Cognitive Status ◽  
Exercise Interventions ◽  
Poor Nutritional Status

Abstract BACKGROUND: Older patients often experience a decline in functional and cognitive status after hospitalization. Although interventions involving physical exercise are effective in improving functional performance, participation in physical exercise interventions among older individuals is low. We aimed to identify the factors that contribute to exercise refusal among post-hospitalized older patients.METHODS: A cross-sectional study of recruitment data from a randomized controlled trial was conducted involving 495 hospitalized people ≥70 years old. Sociodemographic and clinical data were obtained from the Basque Public Health System database. We determined physical function with the Short Physical Performance Battery (SPPB), nutritional status with the Mini-Nutritional Assessment, frailty according to the Fried phenotype criteria, and cognitive function with the Short Portable Mental Status Questionnaire (SPMSQ). Student’s t, Mann-Whitney U, or chi-squared tests were applied for bivariate analysis. Parameters significantly associated with participation were introduced in a logistic multivariate regression model.RESULTS: Among the analyzed patients, 88.8% declined participation in the physical exercise program. Multivariate regression revealed that older age (OR: 1.13; 95% CI: 1.07 - 1.19), poor nutritional status (OR: 0.81; 95% CI: 0.69 - 0.95), and reduced home accessibility (OR: 0.27; 95% CI: 0.08 - 0.94) were predictors of participation refusal. Moreover, patients who declined participation had worse performance on the SPPB (P < 0.05) and its tests of balance, leg strength, and walking speed (P < 0.05). No differences were found between groups in other variables. CONCLUSIONS: This study confirms low participation of older adults in a post-hospitalization physical exercise program. Non-participation was associated with increased age, poor nutritional status, and reduced home accessibility. Our findings support the need for intervention design that accounts for these factors to increase older patient participation in beneficial exercise programs.TRIAL REGISTRATION: ACTRN12619000093189 (retrospectively registered): Registered January 22, 2019.

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