scholarly journals The Simplified Nutritional Appetite Questionnaire (SNAQ) as a Screening Tool for Risk of Malnutrition: Optimal Cutoff, Factor Structure, and Validation in Healthy Community-Dwelling Older Adults

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2885 ◽  
Author(s):  
Sabrina Lau ◽  
Kalene Pek ◽  
Justin Chew ◽  
Jun Pei Lim ◽  
Noor Hafizah Ismail ◽  
...  
Keyword(s):  
Older Adults ◽  
Factor Structure ◽  
Screening Tool ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Optimal Cutoff ◽  
Healthy Community ◽  
Community Dwelling Older Adults

Malnutrition is an independent marker of adverse outcomes in older adults. While the Simplified Nutritional Appetite Questionnaire (SNAQ) for anorexia has been validated as a nutritional screening tool, its optimal cutoff and validity in healthy older adults is unclear. This study aims to determine the optimal cutoff for SNAQ in healthy community-dwelling older adults, and to examine its factor structure and validity. We studied 230 community-dwelling older adults (mean age 67.2 years) who were nonfrail (defined by Fatigue, Resistance, Ambulation, Illnesses & Loss (FRAIL) criteria). When compared against the risk of malnutrition using the Mini Nutritional Assessment (MNA), the optimal cutoff for SNAQ was ≤15 (area under receiver operating characteristic (ROC) curve: 0.706, sensitivity: 69.2%, specificity: 61.3%). Using exploratory factor analysis, we found a two-factor structure (Factor 1: Appetite Perception; Factor 2: Satiety and Intake) which accounted for 61.5% variance. SNAQ showed good convergent, discriminant and concurrent validity. In logistic regression adjusted for age, gender, education and MNA, SNAQ ≤15 was significantly associated with social frailty, unlike SNAQ ≤4 (odds ratio (OR) 1.99, p = 0.025 vs. OR 1.05, p = 0.890). Our study validates a higher cutoff of ≤15 to increase sensitivity of SNAQ for anorexia detection as a marker of malnutrition risk in healthy community-dwelling older adults, and explicates a novel two-factor structure which warrants further research.

scholarly journals Malnutrition and obesity in community-dwelling older adults: concomitant conditions? (PEN-3S study)

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Teresa Madeira ◽  
Catarina Peixoto-Plácido ◽  
Nuno Sousa-Santos ◽  
Nuno Mendonça ◽  
Osvaldo Santos ◽  
...  
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Nutritional Status ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Screening Tools ◽  
World Health ◽  
Anthropometric Measures ◽  
Community Dwelling Older Adults

AbstractBoth malnutrition (which here refers to undernutrition) and obesity are prevalent in older adults, but they are frequently seen as mutually exclusive. In fact, a low body mass index (BMI) is one of the aetiological diagnostic criteria for malnutrition. On the contrary, the concomitant presence of malnutrition and obesity has been less studied. The aim of this study was to characterise the nutritional status of community-dwelling older adults (≥ 65 years old) living in Portugal. The study included a nationally representative sample of randomly selected community-dwelling older adults. Trained nutritionists collected data through face-to-face structured interviews regarding sociodemographic characteristics, nutritional status and anthropometric measures (namely, weight and height), among other variables of the PEN-3S study. Nutritional status was assessed by the 18-item Mini Nutritional Assessment (full MNA®), in which a lower score indicates worse nutritional status. The World Health Organisation's (WHO) BMI cut-offs for adults were followed (obesity: BMI ≥ 30Kg/m2). MNA and BMI categories estimates (95% CI) were obtained using Complex Samples analysis (SPSS® 24.0). Non-difference between sexes was analysed with Chi-square tests. Complete information was available for 1110 community-dwelling participants (mean age: 75.9 ± 8.1 years; 48.9% women; 71.4% attended school for < 5 years). According to the MNA, 0.5% (95%CI: 0.2–1.7) were classified as malnourished and 16.0% (12.9–19.7) were at risk of malnutrition. Following WHO's BMI criteria, 0.6% (0.2–1.5) had a BMI ≤ 18.5Kg/m2, 41.9% (37.9–46.0) had a BMI between 25–30Kg/m2, and 36.7% (32.8–40.9) presented a BMI ≥ 30Kg/m2. The prevalence of risk of malnutrition was significantly higher for women (20.1%, 95%CI: 15.4–25.9) than men (10.4%, 7.6–14.1; p < 0.001). The prevalence of obesity was also significantly higher for women (42.2%, 35.9–48.7 versus 29.3%, 24.8–34.2; p = 0.007). Moreover, 13.9% (9.2–20.4) were simultaneously at risk of malnutrition and had a BMI ≥ 30Kg/m2, while no one in this BMI category was classified as malnourished. Although appropriate BMI cut-offs for older adults are still uncertain, these results highlight that a high BMI does not exclude the risk of malnutrition, particularly in women. Therefore, health professionals should routinely screen for malnutrition using multi-component, validated screening tools, irrespective of the BMI. In fact, malnutrition is preventable if detected on time and effective interventions exist. The concomitant presence of malnutrition and obesity may pose additional challenges to the treatment.

scholarly journals Social Frailty Is Associated With the Risk of Malnutrition Among Community-Dwelling Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 398-398
Author(s):  
Seoyoon Jane Lee ◽  
Miji Kim ◽  
Hayoung Shim ◽  
Heeeun Jung ◽  
Yuri Seo ◽  
...  
Keyword(s):  
Older Adults ◽  
Nutritional Assessment ◽  
Adult Population ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Daily Lives ◽  
Frailty Status ◽  
Social Capitals ◽  
Older Adult Population ◽  
Community Dwelling Older Adults

Abstract Social frailty does not merely affect the level of socialization, but also the means of obtaining resources for the daily lives of older adults. It is highly associated with the quality of life during advanced age. In this study, we analyzed the association between the Mini-Nutritional Assessment (MNA®) score (range 0-30) and 18 singular items and social frailty status of community-dwelling older adults. A total of 2,552 community-dwelling older adults aged 70-84 years (mean age 76.9±4.0, 51.8% female) from the Korean Frailty and Aging Cohort Study (KFACS) were assessed. The social frailty status was assessed in four categories- absence of economic resources, social resources, social activities, and social interactions. A higher MNA® score indicates better nutritional status. The prevalence of social frailty in older adults was 27.9% (mean age 78.1±4.0, 67.7% female). Approximately 40% of the participants were at risk of malnutrition or malnourished (p&lt;0.001), while socially robust group accounted for 23% (p&lt;0.001). They were at a higher risk of a lower MNA® score (odds ratio [OR] 0.90, 95% confidence interval [CI], 0.84-0.96). Socially-frail older adults have a higher possibility of not eating three full meals a day (OR 2.33, 95% CI 1.19-4.55) which increases the risk of malnutrition. In conclusion, social frailty, as a means of linking resources -including economic and social capitals- to the older adult population directly impacts the risk of malnutrition and requires an appropriate intervention.

scholarly journals LONELINESS AND HYPOCHONDRIASIS AMONG OLDER ADULTS: THE MEDIATING ROLE OF INTOLERANCE OF UNCERTAINTY AND ANXIETY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S531-S532
Author(s):  
Jenna M Moore ◽  
William P Archuleta ◽  
Jessica H Helphrey ◽  
Leah N Smith ◽  
Jennifer Sawyer ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Anxiety ◽  
Intolerance Of Uncertainty ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Mediating Role ◽  
Interview Survey ◽  
Age Range ◽  
Healthy Community ◽  
Community Dwelling Older Adults

Abstract Loneliness is prevalent among older adults and is associated with adverse outcomes for health and mortality. Additionally, researchers have suggested that loneliness may cause a person to direct attention inward and become preoccupied with bodily symptoms which may subsequently lead to health anxiety. However, little extant research has examined the association among older adults. In this study, we proposed a loneliness model of hypochondriasis in which loneliness contributes to hypochondriasis through intolerance of uncertainty and anxiety. Healthy, community-dwelling older adults (N = 280; 64.4% female; age range: 65-95; M = 76.08, SD = 7.59) completed an interview survey. Loneliness was associated with higher hypochondriasis and had an indirect effect on hypochondriasis through intolerance of uncertainty and anxiety. Lonelier older adults may have an activated threat system which prompts greater intolerance of uncertainty and anxiety and thereby results in greater hypochondriasis.

scholarly journals Circulating microRNA-125b Levels Are Associated With the Risk of Vascular Calcification in Healthy Community-Dwelling Older Adults

2021 ◽  
Vol 8 ◽  
Author(s):  
Chia-Ter Chao ◽  
Der-Sheng Han ◽  
Jenq-Wen Huang
Keyword(s):  
Older Adults ◽  
Vascular Calcification ◽  
Community Dwelling ◽  
Circulating Microrna ◽  
Optimal Cutoff ◽  
Optimal Care ◽  
Healthy Older Adults ◽  
Risk Biomarkers ◽  
Healthy Community ◽  
Community Dwelling Older Adults

Background: Vascular calcification (VC) is a subclinical manifestation of vascular disease burden among older adults, conferring an elevated mortality risk. Biomarkers capable of detecting and risk-stratifying VC associated with advanced age remains unavailable, impeding our effort to provide optimal care to geriatric patients.Objectives: In this study, we aimed to investigate whether circulating miR-125b served as a potential indicator for VC in relatively healthy older adults.Methods: Community-dwelling older adults (age ≥65) were prospectively recruited during 2017, followed by clinical features documentation and VC rating based on aortic arch calcification (AAC) and abdominal aortic calcification (AbAC). Multiple logistic regression was done to evaluate the relationship between circulating miR-125b levels, VC presence and severity, followed by selecting the optimal cutoff point for VC diagnosis.Results: A total of 343 relatively healthy older adults (median age, 73.8 years; 40% male; 59.8% having AAC) were enrolled, with a median circulating miR-125b level of 0.012 (interquartile range, 0.003–0.037). Those with more severe AAC had progressively decreasing miR-125b levels (p&lt;0.001). Multiple regression analyses showed that having higher miR-125b levels based on the median value were associated with a substantially lower risk of AAC [odds ratio (OR) 0.022, 95% confidence interval (CI) 0.011–0.044] compared to those having lower ones. An optimal cutoff of miR-125b for identifying AAC in older adults was 0.008, with a sensitivity and specificity of 0.86 and 0.80, respectively. Similar findings were obtained when using AbAC as the endpoint.Conclusions: We found that miR-125b serves as an independent indicator for VC in relatively healthy older adults, and may potentially be linked with VC pathophysiology.

scholarly journals Sarcopenia and Undernutrition Among Portuguese Older Adults: Results From Nutrition UP 65 Study

2018 ◽  
Vol 39 (3) ◽  
pp. 487-492 ◽  
Author(s):  
Ana Rita Sousa-Santos ◽  
Cláudia Afonso ◽  
Nuno Borges ◽  
Alejandro Santos ◽  
Patrícia Padrão ◽  
...  
Keyword(s):  
Older Adults ◽  
Preventive Measures ◽  
Nutritional Assessment ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Cross Sectional ◽  
European Working ◽  
Sectional Analysis ◽  
Community Dwelling Older Adults

Background: Although undernutrition and sarcopenia are common among older adults and both result in worse health outcomes, data concerning the burden of these conditions in Portuguese community-dwelling older adults are scarce. Objective: The aim of this study was to firstly describe the occurrence of sarcopenia and undernutrition among a nationwide community-dwelling sample of older adults. Methods: Using a cross-sectional analysis, 1493 Portuguese older adults age ≥65 years from the Nutrition UP 65 study were evaluated. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People, and undernutrition status was evaluated by Mini-Nutritional Assessment-Short Form. Results: Sarcopenia frequency was 11.6%, and of these, 4.4% were classified with severe sarcopenia. Furthermore, 0.8% presented sarcopenic obesity. Undernutrition frequency was 1.3%, and 14.7% of the older adults were classified as being at undernutrition risk. Conclusion: Sarcopenia is present in one-tenth of the sample. This frequency taken together with undernutrition data warrants further study and preventive measures.

scholarly journals How wearable sensors have been utilised to evaluate frailty in older adults: a systematic review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Grainne Vavasour ◽  
Oonagh M. Giggins ◽  
Julie Doyle ◽  
Daniel Kelly
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Gait Speed ◽  
Outcome Measurement ◽  
Wearable Sensors ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Ageing Population ◽  
Application Development ◽  
Community Dwelling Older Adults

Abstract Background Globally the population of older adults is increasing. It is estimated that by 2050 the number of adults over the age of 60 will represent over 21% of the world’s population. Frailty is a clinical condition associated with ageing resulting in an increase in adverse outcomes. It is considered the greatest challenge facing an ageing population affecting an estimated 16% of community-dwelling populations worldwide. Aim The aim of this systematic review is to explore how wearable sensors have been used to assess frailty in older adults. Method Electronic databases Medline, Science Direct, Scopus, and CINAHL were systematically searched March 2020 and November 2020. A search constraint of articles published in English, between January 2010 and November 2020 was applied. Papers included were primary observational studies involving; older adults aged > 60 years, used a wearable sensor to provide quantitative measurements of physical activity (PA) or mobility and a measure of frailty. Studies were excluded if they used non-wearable sensors for outcome measurement or outlined an algorithm or application development exclusively. The methodological quality of the selected studies was assessed using the Appraisal Tool for Cross-sectional Studies (AXIS). Results Twenty-nine studies examining the use of wearable sensors to assess and discriminate between stages of frailty in older adults were included. Thirteen different body-worn sensors were used in eight different body-locations. Participants were community-dwelling older adults. Studies were performed in home, laboratory or hospital settings. Postural transitions, number of steps, percentage of time in PA and intensity of PA together were the most frequently measured parameters followed closely by gait speed. All but one study demonstrated an association between PA and level of frailty. All reports of gait speed indicate correlation with frailty. Conclusions Wearable sensors have been successfully used to evaluate frailty in older adults. Further research is needed to identify a feasible, user-friendly device and body-location that can be used to identify signs of pre-frailty in community-dwelling older adults. This would facilitate early identification and targeted intervention to reduce the burden of frailty in an ageing population.

scholarly journals Diagnostic Performance and Accuracy of the MNA-SF against GLIM Criteria in Community-Dwelling Older Adults from Poland

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2183
Author(s):  
Aleksandra Kaluźniak-Szymanowska ◽  
Roma Krzymińska-Siemaszko ◽  
Marta Lewandowicz ◽  
Ewa Deskur-Śmielecka ◽  
Katarzyna Stachnik ◽  
...  
Keyword(s):  
At Risk ◽  
Diagnostic Performance ◽  
Nutritional Assessment ◽  
Short Form ◽  
Area Under The Curve ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Study Results ◽  
Community Dwelling Older Adults ◽  
Test Result

Up to 28% of elderly residents in Europe are at risk of malnutrition. As uniform diagnostic criteria for malnutrition have not been formulated, in autumn 2018, the Global Leadership Initiative on Malnutrition (GLIM) presented a consensus on its diagnosis. According to the consensus, the diagnosis of malnutrition requires a positive screening test result for the risk of malnutrition, and the presence of at least one etiologic and one phenotypic criterion. This study aimed to assess the diagnostic performance and accuracy of the Mini Nutritional Assessment—Short Form (MNA-SF) against GLIM criteria. The analysis involved 273 community-dwelling volunteers aged ≥ 60 years. All participants were screened for malnutrition with the MNA-SF questionnaire. Next, the GLIM phenotypic and etiologic criteria were assessed in all subjects. Based on the presence of at least one phenotypic and one etiologic criterion, malnutrition was diagnosed in more than one-third of participants (n = 103, 37.7%). According to the MNA-SF, only 7.3% of subjects had malnutrition, and 28.2% were at risk of malnutrition. The agreement between the MNA-SF score and the GLIM criteria were observed in only 22.3% of the population. The sensitivity and specificity of MNA-SF against the GLIM criteria were fair (59.2% and 78.8%, respectively). The area under the curve (AUC) was 0.77, indicating the fair ability of MNA-SF to diagnose malnutrition. Based on the present study results, the best solution may be an optional replacement of the screening tool in the first step of the GLIM algorithm with clinical suspicion of malnutrition.

Sign in / Sign up

Export Citation Format

Share Document