scholarly journals Suboptimal Tongue Pressure Is Associated with Risk of Malnutrition in Community-Dwelling Older Individuals

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1821
Author(s):  
Ke-Vin Chang ◽  
Wei-Ting Wu ◽  
Lan-Rong Chen ◽  
Hsin-I Wang ◽  
Tyng-Guey Wang ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Odds Ratio ◽  
Handgrip Strength ◽  
Community Dwelling ◽  
Nutrition Status ◽  
Tongue Pressure ◽  
Older Individuals ◽  
Crude Odds Ratio ◽  
The Third ◽  
Increased Risk

The tongue plays an important role in swallowing, and its dysfunction theoretically leads to inadequate oral intake and subsequent malnutrition. This study aimed to explore how different levels of tongue pressure are related to malnutrition among community-dwelling older individuals. The target population was community-dwelling adults aged ≥ 65 years. Tongue pressure was measured using the Iowa Oral Performance Instrument, whereas the mini nutrition assessment (MNA) test was administered to determine the nutritional status. A full MNA score of less than 24 points was defined as risk of malnutrition. Multivariate logistic regression analyses were conducted to calculate the odds ratio (OR) of risk of malnutrition among different quartiles of tongue pressure. Among the 362 participants, 26 (7.1%) were classified as having risk of malnutrition. Body weight, body mass index, handgrip strength, skeletal muscle mass index, sum MNA score, and serum levels of albumin were lower in the malnutrition risk groups than in the normal nutrition status group. A positive correlation was identified between tongue pressure and the MNA score (r = 0.143, p < 0.01). Treating the subgroup of the highest quartile of tongue pressure as the reference, the crude odds ratio (OR) of having risk of malnutrition was 5.37 (95% CI, 1.14–25.28) in the subgroup at the third quartile, 3.10 (95% CI, 0.60–15.84) in the subgroup at the second quartile, and 3.95 (95% CI, 0.81–19.15) in the subgroup at the lowest quartile. After adjustment for age and sex, the subgroup in the third quartile still presented with a significantly higher risk (OR, 4.85; 95% CI, 1.02–22.99) of risk of malnutrition. Compared with the subgroup at the highest quartile of tongue pressure, the crude OR for all the subgroups in the lower three quartiles was 4.17 (95% CI, 0.96–18.04), showing borderline significance (p = 0.05). In conclusion, we found hints for an association between decreased tongue pressure and an increased risk of malnutrition in community-dwelling older individuals. Older people with suboptimal tongue pressure should undergo a thorough assessment of their nutritional status and swallowing function for the early identification of subclinical malnutrition and dysphagia.

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 Nutrition Mediates the Relationship between Osteosarcopenia and Frailty: A Pathway Analysis

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2957 ◽  
Author(s):  
Justin Chew ◽  
Audrey Yeo ◽  
Suzanne Yew ◽  
Cai Ning Tan ◽  
Jun Pei Lim ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Pathway Analysis ◽  
Nutritional Assessment ◽  
Handgrip Strength ◽  
Mini Nutritional Assessment ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Effect Estimate ◽  
Increased Risk ◽  
The Relationship

Osteosarcopenia is associated with increased risk of adverse outcomes such as falls and fractures. Its association with frailty is less well-described, particularly in independent community-dwelling older adults. Although nutrition plays a crucial role in maintaining bone and muscle health, the complex relationship between osteosarcopenia and nutrition in the pathogenesis of frailty remains to be elucidated. In this cross-sectional analysis of 230 independent, community-dwelling individuals (mean age 67.2 ± 7.4 years), we examined the associations between osteosarcopenia with nutritional status and frailty, and the mediating role of nutrition in the association between osteosarcopenia and frailty. Osteosarcopenia was defined as fulfilling both the Asian Working Group for Sarcopenia 2019 consensus definition (low relative appendicular skeletal muscle mass adjusted for height, in the presence of either of either low handgrip strength or slow gait speed) and T-score ≤ −2.5 SD on bone mineral densitometry. We assessed frailty using the modified Fried criteria and nutrition using the Mini-Nutritional Assessment. We performed multiple linear regression, followed by pathway analysis to ascertain whether nutrition mediates the relationship between osteosarcopenia and frailty. Our study population comprised: 27 (11.7%) osteosarcopenic, 35 (15.2%) sarcopenic, 36 (15.7%) osteoporotic and 132 (57.4%) normal (neither osteosarcopenic, sarcopenic nor osteoporotic). Osteosarcopenia (β = 1.1, 95% CI 0.86–1.4) and sarcopenia (β = 1.1, 95% CI 0.90–1.4) were significantly associated with frailty, but not osteoporosis. Nutrition mediated the association between osteosarcopenia and frailty (indirect effect estimate 0.09, bootstrap 95% CI 0.01–0.22). In conclusion, osteosarcopenia is associated with frailty and poorer nutritional status, with nutrition mediating the association between osteosarcopenia and frailty. Our findings support early nutritional assessment and intervention in osteosarcopenia to mitigate the risk of frailty.

scholarly journals DENTITION AND MALNUTRITION RISK IN COMMUNITYDWELLING OLDER ADULTS

2018 ◽  
pp. 1-8
Author(s):  
R. Zelig ◽  
L. Byham-Gray ◽  
S.R. Singer ◽  
E.R. Hoskin ◽  
A. Fleisch Marcus ◽  
...  
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Nutritional Status ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Nutrition Status ◽  
Cross Sectional ◽  
Increased Risk ◽  
The Impact

Background and Objective: Older adults are at risk for both impaired oral health and suboptimal nutritional status. The objective of this study was to explore the relationships between malnutrition risk and missing teeth in community-dwelling older adults. Design: This was a retrospective cross-sectional analysis of data obtained from the electronic health records of 107 patients aged 65 and older who attended an urban northeast US dental school clinic between June 1, 2015 and July 15, 2016. Odontograms and radiographs were used to identify teeth numbers and locations; malnutrition risk was calculated using the Self-Mini Nutritional Assessment (Self-MNA). Relationships between numbers of teeth and malnutrition risk were assessed using bivariate logistic regression. Results: Participants (N=107) were 72.6 years (SD=5.6) of age; 50.5% were female. Mean Self-MNA score was 12.3 (SD=2.0) reflective of normal nutrition status; 20.6% were at risk for malnutrition, 4.7% were malnourished. Greater than 87% were partially or completely edentulous. Those with 10-19 teeth had lower Self-MNA scores (mean=11.6, SD=2.5) than those with 0-9 teeth (mean=12.7, SD=1.3) or 20 or more teeth (mean=12.6, SD=1.8) and had an increased risk for malnutrition (OR=2.5, p=0.076). Conclusion: The majority of this sample of older adults were partially edentulous and of normal nutritional status. Those with 10-19 teeth were more likely to be at risk for malnutrition. Further studies are needed to examine relationships between tooth loss and malnutrition risk and the impact of impaired dentition on the eating experience in a larger sample and to inform clinical practice.

scholarly journals A Two-Year Longitudinal Study of the Association between Oral Frailty and Deteriorating Nutritional Status among Community-Dwelling Older Adults

2020 ◽  
Vol 18 (1) ◽  
pp. 213
Author(s):  
Masanori Iwasaki ◽  
Keiko Motokawa ◽  
Yutaka Watanabe ◽  
Maki Shirobe ◽  
Hiroki Inagaki ◽  
...  
Keyword(s):  
Older Adults ◽  
Oral Health ◽  
Nutritional Status ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Tongue Pressure ◽  
Increased Risk ◽  
Community Dwelling Older Adults ◽  
Oral Frailty

Background: Limited longitudinal studies exist to evaluate whether poor oral health and functions affect the incidence of deteriorating nutritional status. We investigated if there were longitudinal associations between oral frailty, defined as accumulated deficits in oral health, and deteriorating nutritional status among community-dwelling older adults. Methods: The study population consisted of 191 men and 275 women (mean age, 76.4 years) from the Takashimadaira Study. Multifaced oral health assessment was performed at baseline, and oral frailty was defined as having ≥3 of the following six components: fewer teeth, low masticatory performance, low articulatory oral motor skill, low tongue pressure, and difficulties in chewing and swallowing. Nutritional status assessment was performed at baseline and two-year follow-up using the Mini Nutritional Assessment®-Short Form (MNA®-SF). Deteriorating nutritional status was defined as a decline in the nutritional status categories based on the MNA®-SF score during the study period. The association between oral frailty and deteriorating nutritional status was assessed using logistic regression analyses. Results: Oral frailty was observed in 67 (14.4%) participants at baseline. During the study, 58 (12.4%) participants exhibited deteriorating nutritional status. After adjusting for potential confounders, oral frailty was significantly associated with deteriorating nutritional status (adjusted odds ratio, 2.24; 95% confidence interval, 1.08–4.63). Conclusion: Community-dwelling older adults with oral frailty had an increased risk of deteriorating nutritional status.

scholarly journals Changes in Health Behaviors, Mental and Physical Health among Older Adults under Severe Lockdown Restrictions during the COVID-19 Pandemic in Spain

2021 ◽  
Vol 18 (13) ◽  
pp. 7067
Author(s):  
Esther García-Esquinas ◽  
Rosario Ortolá ◽  
Iago Gine-Vázquez ◽  
José A. Carnicero ◽  
Asier Mañas ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Older Adults ◽  
Social Isolation ◽  
Community Dwelling ◽  
Housing Conditions ◽  
Older Individuals ◽  
Lifestyle Risk Factors ◽  
Increased Risk ◽  
Lifestyle Risk

We used data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain collected through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning of the COVID-19 lockdown. On average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet, or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Males, older adults with greater social isolation or greater feelings of loneliness, those with poorer housing conditions, as well as those with a higher prevalence of chronic morbidities were at increased risk of developing unhealthier lifestyles or mental health declines with confinement. On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement. If another lockdown were imposed during this or future pandemics, public health programs should specially address the needs of older individuals with male sex, greater social isolation, sub-optimal housing conditions, and chronic morbidities because of their greater vulnerability to the enacted movement restrictions.

The Effect of Sarcopenia on Outcomes in Geriatric Blunt Trauma

2017 ◽  
Vol 83 (11) ◽  
pp. 1203-1208 ◽  
Author(s):  
Mahdi Malekpour ◽  
Kelly Bridgham ◽  
Kathryn Jaap ◽  
Ryan Erwin ◽  
Kenneth Widom ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Confidence Interval ◽  
Blunt Trauma ◽  
Odds Ratio ◽  
Lumbar Vertebra ◽  
Objective Measure ◽  
Trauma Patients ◽  
The Third ◽  
Increased Risk ◽  
Axial Ct

Elderly patients are at a higher risk of morbidity and mortality after trauma, which is reflected through higher frailty indices. Data collection using existing frailty indices is often not possible because of brain injury, dementia, or inability to communicate with the patient. Sarcopenia is a reliable objective measure for frailty that can be readily assessed in CT imaging. In this study, we aimed to evaluate the effect of sarcopenia on the outcomes of geriatric blunt trauma patients. Left psoas area (LPA) was measured at the level of the third lumbar vertebra on the axial CT images. LPA was normalized for height (LPA mm2/m2) and after stratification by gender, sarcopenia was defined as LPA measurements in the lowest quartile. A total of 1175 patients consisting of 597 males and 578 females were studied. LPAs below 242.6 mm2/m2 in males and below 187.8 mm2/m2 in females were considered to be sarcopenic. We found sarcopenia in 149 males and 145 females. In multivariate analysis, sarcopenia was associated with a higher risk of in-hospital mortality (odds ratio [OR]: 1.61, 95% confidence interval [CI]: 1.01–2.56) and a higher risk of discharge to less favorable destinations (OR: 1.42, 95% CI: 1.05–1.97). Lastly, sarcopenic patients had an increased risk of prolonged hospitalization (hazard ratio: 1.21, 95% CI: 1.04–1.40).

scholarly journals EFFECT OF FULL VACCINATION AND POST-COVID OLFACTORY DYSFUNCTION IN RECOVERED COVID-19 PATIENT. A RETROSPECTIVE LONGITUDINAL STUDY WITH PROPENSITY MATCHING.

2022 ◽  
Author(s):  
Bumi Herman ◽  
Pramon Viwattanakulvanid ◽  
Azhar Dzulhadj ◽  
Aye Chan Oo ◽  
Karina Patricia ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Neck Surgery ◽  
Olfactory Dysfunction ◽  
P Value ◽  
Online Questionnaire ◽  
Crude Odds Ratio ◽  
Symptomatic Disease ◽  
Increased Risk ◽  
Viral Vaccine ◽  
Propensity Matching

Background Symptoms after Coronavirus Disease (COVID-19) infection affect the quality of life of its survivor especially to the special senses including olfactory function. It is important to prevent the disability at an earlier stage. Vaccination as key prevention has been proven to be effective in reducing symptomatic disease and severity. However, the effects of vaccination on post COVID symptoms have not been evaluated. This study aimed to evaluate the possible protection of full vaccination and the occurrence of post-COVID olfactory dysfunction, specifically anosmia, and hyposmia in patients who were diagnosed with COVID-19. Method A longitudinal analysis using the retrospective cohort of the Indonesian patient-based Post-COVID-19 survey collected from July 2021 until December 2021, involving COVID-19 Patients confirmed by Real-Time Polymerase Chain Reaction (RT-PCR) and/or Antigen test. Variables including demography, comorbidities, health behavior, type of vaccine, symptoms, and treatment were collected through an online questionnaire based on the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). Participants were matched (1:1) using propensity matching score into two exposure statuses, infected 1)>14 days of full vaccination and 2)<14 days or incomplete or unvaccinated. The olfactory dysfunction was assessed two weeks and four weeks after negative conversion with PCR using a self-measured olfactory questionnaire (MOQ). The Generalized Estimating Equation (GEE) was performed to assess the effect of full vaccination on post-COVID-19 olfactory dysfunction. The Receiver Operating Characteristic determined the sensitivity and specificity of the cutoff value of the days from fully vaccinated to diagnosis and the olfactory dysfunction. Results A total of 442 participants were extracted from the cohort and inoculated with the inactivated viral vaccine (99.5%). The prevalence of olfactory dysfunction in two weeks was 9.95% and 5.43% after four weeks. Adjusted by other variables, people who were infected >14 days after being fully vaccinated had a 69% (adjusted Odds Ratio / aOR 0.31 95% CI 0.102-0.941) probability of developing olfactory dysfunction. Longer days of fully vaccinated to infection are associated with increased risk (aOR 1.012 95% CI 1.002-1.022 p-value 0.015). A cut-off of 88 days of full vaccination-to-diagnosis duration has Area Under Curve (AUC) of 0.693 (p=0.002), the sensitivity of 73.9%, and specificity of 63.3% in differentiating the olfactory dysfunction event in two weeks after COVID-19 with a crude odds ratio of 4.852 (95% CI 1.831-12.855 p=0.001) Conclusion After 14 days of full vaccination, the protective effect could reduce the chance of post-COVID olfactory dysfunction although a longer full vaccination-to-diagnosis duration increases the risk. It is important to consider a booster shot starting from 89 days after the last dose in those who received the inactivated viral regimen.

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 Effect of successful aging on mortality in older individuals: The PALA study

2014 ◽  
Vol 8 (2) ◽  
pp. 182-186 ◽  
Author(s):  
Ana Luiza Camozzato ◽  
Claudia Godinho ◽  
Márcia Lorena Fagundes Chaves
Keyword(s):  
Mortality Rate ◽  
Successful Aging ◽  
Healthy Aging ◽  
Causes Of Death ◽  
Cox Regression ◽  
Normal Aging ◽  
Community Dwelling ◽  
Older Individuals ◽  
Increased Risk ◽  
The Impact

ABSTRACT The definition of successful aging and identification of predictors have been extensively reviewed, less attention however, has been given to the role of this condition on mortality. Objective: To evaluate the effect of aging status (normal or successful) on mortality in a South Brazilian population-based cohort, adjusted for sociodemographic and clinical variables, and to report the mortality rate and causes of death in this population. Methods: The baseline sample comprised 345 community-dwelling, independent and healthy Southern Brazilian older individuals who were followed for 12 years. Clinical, socio-demographic, functional and cognitive variables were assessed at baseline and during the follow-up. At baseline, 214 participants fulfilled criteria for successful aging, and 131 for normal aging. The main outcome was death. Results: The Cox regression model showed an increased risk for mortality in subjects with normal aging (HR=1.9; p=0.003) adjusted by age (HR=1.1; p<0.001) and by sex (HR=1.9; p=0.002). The overall mortality rate was 41% and the rate was significantly lower among successful than normal agers (p=0.001). The main causes of death were cardiovascular disease and cancer. Conclusion: Our main finding was an increased risk of mortality among normal in comparison with successful aging subjects, emphasizing the impact of the heterogeneity of the healthy aging process on mortality.

scholarly journals Does Masticatory Ability Contribute to Nutritional Status in Older Individuals?

2020 ◽  
Vol 17 (20) ◽  
pp. 7373
Author(s):  
Keiko Fujimoto ◽  
Hideki Suito ◽  
Kan Nagao ◽  
Tetsuo Ichikawa
Keyword(s):  
Nutritional Status ◽  
Satisfaction Score ◽  
Tongue Pressure ◽  
Primary Role ◽  
Older Individuals ◽  
Masticatory Efficiency ◽  
Subjective Assessments ◽  
Masticatory Ability ◽  
Ability Tests

Mastication plays a primary role in the process of eating. Hence, compromised masticatory ability may affect the nutrition and quality of life, which are particularly important concerns among older individuals. It remains unclear how is the masticatory ability assessed regarding the nutritional status. We examined the effect of various oral factors on three masticatory ability tests conducted among older individuals. A total of 100 older individuals were enrolled in this study. Body mass index (BMI) as an indicator of nutritional status; and age, sex, and the number of occlusal and molar occlusal supports as clinical attributes were recorded. Three masticatory ability tests (masticatory efficiency, masticatory score, and satisfaction with mastication) were conducted, and tongue pressure, cheek pressure, and occlusal force were assessed as oral functions. A significant but weak correlation was found between masticatory efficiency and the masticatory score, but not between masticatory efficiency and satisfaction score. Objective masticatory efficiency was strongly associated with objective oral factors, whereas subjective assessments of masticatory ability (masticatory score and satisfaction score) were not. Furthermore, BMI was significantly associated with subjective assessments of masticatory ability but not with objective masticatory efficiency. Both subjective and objective assessments of masticatory ability, along with considerations of nutritional formulations, are required for the maintenance and improvement of nutritional status in older individuals.

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