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15 pages, 994 KiB

Open AccessArticle

A Novel Digital Nutrition Diary for Geriatric Patients at High Risk of Frailty Syndrome

by Patrick Elfert, Julia Berndt, Louisa Dierkes, Marco Eichelberg, Norbert Rösch, Andreas Hein and Rebecca Diekmann

Nutrients 2022, 14(3), 400; https://doi.org/10.3390/nu14030400 - 18 Jan 2022

Viewed by 2349

Abstract

Due to the physical, psychological, or socioeconomic changes that accompany aging, many people will be affected by geriatric frailty syndrome, which can lead to multimorbidity and premature death. Nutrition counseling is often used to prevent and intervene in frailty syndrome, especially in geriatric [...] Read more.

Due to the physical, psychological, or socioeconomic changes that accompany aging, many people will be affected by geriatric frailty syndrome, which can lead to multimorbidity and premature death. Nutrition counseling is often used to prevent and intervene in frailty syndrome, especially in geriatric rehabilitation. To this end, the consumption behavior of geriatric patients is recorded using paper-based, as well as retrospective memory logs in face-to-face interviews between patients and nutritionists. To simplify this procedure, a digital nutrition diary was developed that is specially adapted to the needs of geriatric patients (>=70 years), enabling them to record their consumption behavior themselves. In an initial study (Study 1), conducted in a geriatric rehabilitation division with twelve subjects (ten male, two female, mean age 79.2

\pm 5.9

years), feedback about the usability of the digital nutrition diary, and how to improve it, was surveyed. In addition, the usability of an activity tracker and a body composition scale was surveyed to determine whether geriatric patients are generally able to use these devices. In a second study (Study 2), also conducted in the geriatric rehabilitation division, this time with sixteen subjects (ten male, six female, mean age 79.3

\pm 3.9

years), the usability of the digital nutrition diary was surveyed again to evaluate its modifications based on the feedback from Study 1. In Study 1, the usability rating of the system (0–100) was 82.5 for the activity tracker, 29.71 for the body composition scale, and 51.66 initially for the digital nutrition diary, which increased to 76.41 in Study 2. Full article

(This article belongs to the Special Issue Nutritional Status of Older Adults)

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14 pages, 313 KiB

Open AccessArticle

Haplotypes in the GC, CYP2R1 and CYP24A1 Genes and Biomarkers of Bone Mineral Metabolism in Older Adults

by Ana Fernández-Araque, Andrea Giaquinta-Aranda, Carmelo Moreno-Sainz, María Cruz Martínez-Martínez, Verónica Velasco-González, María Sainz-Gil, Luis H. Martín-Arias, Silvia Carretero-Molinero, Miguel García-Hidalgo and Zoraida Verde

Nutrients 2022, 14(2), 259; https://doi.org/10.3390/nu14020259 - 08 Jan 2022

Viewed by 1627

Abstract

Candidate gene studies have analyzed the effect of specific vitamin D pathway genes on vitamin D availability; however, it is not clear whether genetic variants also affect overall bone metabolism. This study evaluated the association between genetic polymorphisms in GC, CYP2R1 and [...] Read more.

Candidate gene studies have analyzed the effect of specific vitamin D pathway genes on vitamin D availability; however, it is not clear whether genetic variants also affect overall bone metabolism. This study evaluated the association between genetic polymorphisms in GC, CYP2R1 and CYP24A1 and serum levels of total 25(OH)D, iPTH and other mineral metabolism biomarkers (albumin, total calcium and phosphorus) in a sample of 273 older Spanish adults. We observed a significant difference between CYP2R1 rs10741657 codominant model and total 25(OH)D levels after adjusting them by gender (p = 0.024). In addition, the two SNPs in the GC gene (rs4588 and rs2282679) were identified significantly associated with iPTH and creatinine serum levels. In the case of phosphorus, we observed an association with GC SNPs in dominant model. We found a relationship between haplotype 2 and 25(OH)D levels, haplotype 4 and iPTH serum levels and haplotype 7 and phosphorus levels. In conclusion, genetic variants in CYP2R1 and GC could be predictive of 25(OH)D and iPTH serum levels, respectively, in older Caucasian adults. The current study confirmed the role of iPTH as one of the most sensitive biomarkers of vitamin D activity in vivo. Full article

(This article belongs to the Special Issue Nutritional Status of Older Adults)

12 pages, 610 KiB

Open AccessArticle

Nutritional Status and Serum Levels of Micronutrients in an Elderly Group Who Participate in the Program for Complementary Food in Older People (PACAM) from the Metropolitan Region, Santiago de Chile

by Migdalia Caridad Arazo-Rusindo, Rommy N. Zúñiga, Pablo Cortés-Segovia, Sergio Benavides-Valenzuela, Francisco Pérez-Bravo, Oscar Castillo-Valenzuela and María Salomé Mariotti-Celis

Nutrients 2022, 14(1), 3; https://doi.org/10.3390/nu14010003 - 21 Dec 2021

Cited by 7 | Viewed by 3345

Abstract

The increase in the Chilean elderly population has promoted public policies to favor an adequate nutrition in later life. This study evaluated the nutritional status, micronutrients intake and serum micronutrients levels of an elderly group beneficiary of the PACAM from the Metropolitan Region, [...] Read more.

The increase in the Chilean elderly population has promoted public policies to favor an adequate nutrition in later life. This study evaluated the nutritional status, micronutrients intake and serum micronutrients levels of an elderly group beneficiary of the PACAM from the Metropolitan Region, Santiago de Chile. Anthropometric and dietary survey (24 h food recalls) were assessed in 182 elderly individuals (60 and 80 years old). Blood serum collection was used to measure the micronutrient status. The sample was comprised by 12.6%, 46.1%, 28.0% and 13.2% of underweight, normal weight, overweight and obese subjects, respectively. Women presented 11% of underweight, 45% of normal weight and 44% of overweight and obese, while men—18%, 50% and 32%, respectively. Only the 63% of the elderlies consumed PACAM foods, reaching average daily intakes below (50%) the recommended daily serving. Serum deficiencies of 25-hydroxyvitamin D (88%), vitamin B₁₂ (33%) and calcium (36%) were observed, being the highest ones in the PACAM foods women (60–75 years old). Chilean elderlies presented mainly a normal weight; however, an important proportion of overweight/obese subjects was observed. Although PACAM foods consumption significantly increased the micronutrient intake, it was not enough to ensure an adequate serum micronutrient levels in the elderly. Full article

(This article belongs to the Special Issue Nutritional Status of Older Adults)

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11 pages, 1345 KiB

Open AccessArticle

Socioeconomic Risk Factors of Poor Nutritional Status in Polish Elderly Population: The Results of PolSenior2 Study

by Roma Krzymińska-Siemaszko, Ewa Deskur-Śmielecka, Aleksandra Kaluźniak-Szymanowska, Beata Kaczmarek, Hanna Kujawska-Danecka, Alicja Klich-Rączka, Małgorzata Mossakowska, Sylwia Małgorzewicz, Lechosław B. Dworak, Tomasz Kostka, Jerzy Chudek and Katarzyna Wieczorowska-Tobis

Nutrients 2021, 13(12), 4388; https://doi.org/10.3390/nu13124388 - 08 Dec 2021

Cited by 9 | Viewed by 3496

Abstract

Poor nutritional status (PNS) threatens successful aging. Identifying potentially modifiable predictors of PNS is essential for elaborating a preventive strategy for the population at risk. To assess the prevalence of PNS in the Polish elderly population and analyze its socioeconomic correlates based on [...] Read more.

Poor nutritional status (PNS) threatens successful aging. Identifying potentially modifiable predictors of PNS is essential for elaborating a preventive strategy for the population at risk. To assess the prevalence of PNS in the Polish elderly population and analyze its socioeconomic correlates based on the data from the nationwide PolSenior2 project. Special emphasis was put on potentially modifiable factors among the identified PNS predictors. Nutritional status was assessed in 5698 community-dwelling older adults with the Mini Nutritional Assessment–Short Form. We evaluated the effect of age, sex, level of education, marital status, place of residence, subjective loneliness, and self-reported poverty on the nutritional status of the studied subjects. PNS was found in 25.3% of studied subjects (27.7% women and 21.9% men; p < 0.001). Female sex, older age, unmarried status (in men), subjective loneliness, and self-reported poverty were independent correlates of PNS. The two last above-mentioned predictors were identified as potentially modifiable. Based on our results, we recommend preventive interventions (e.g., performing regular screening), particularly in unmarried (men), poorly educated individuals, self-reporting poverty, complaining of loneliness, and the oldest old. PNS preventive strategies should include social support (both emotional and instrumental) to reduce the effect of poverty and subjective loneliness. Full article

(This article belongs to the Special Issue Nutritional Status of Older Adults)

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17 pages, 876 KiB

Open AccessArticle

Cognitive Frailty in Thai Community-Dwelling Elderly: Prevalence and Its Association with Malnutrition

by Mathuramat Seesen, Wachiranun Sirikul, Jetsada Ruangsuriya, Jiranan Griffiths and Penprapa Siviroj

Nutrients 2021, 13(12), 4239; https://doi.org/10.3390/nu13124239 - 25 Nov 2021

Cited by 17 | Viewed by 4168

Abstract

Cognitive frailty (CF) is defined by the coexistence of physical frailty and mild cognitive impairment. Malnutrition is an underlying factor of age-related conditions including physical frailty. However, the evidence associating malnutrition and cognitive frailty is limited. This cross-sectional study aimed to determine the [...] Read more.

Cognitive frailty (CF) is defined by the coexistence of physical frailty and mild cognitive impairment. Malnutrition is an underlying factor of age-related conditions including physical frailty. However, the evidence associating malnutrition and cognitive frailty is limited. This cross-sectional study aimed to determine the association between malnutrition and CF in the elderly. A total of 373 participants aged 65–84 years were enrolled after excluding those who were suspected to have dementia and depression. Then, 61 CF and 45 normal participants were randomly selected to measure serum prealbumin level. Cognitive function was assessed using the Montreal Cognitive Assessment-Basic (MoCA-B). Modified Fried’s criteria were used to define physical frailty. Nutritional status was evaluated by the Mini Nutritional Assessment–short form (MNA-SF), serum prealbumin, and anthropometric measurements. The prevalence of CF was 28.72%. Malnourished status by MNA-SF category (aOR = 2.81, 95%CI: 1.18–6.67) and MNA-SF score (aOR = 0.84, 95%CI = 0.74–0.94) were independently associated with CF. However, there was no correlation between CF and malnutrition assessed by serum prealbumin level and anthropometric measurements. Other independent risk factors of CF were advanced age (aOR = 1.06, 95%CI: 1.02–1.11) and educational level below high school (aOR = 6.77, 95%CI: 1.99–23.01). Malnutrition was associated with CF among Thai elderly. High-risk groups who are old and poorly educated should receive early screening and nutritional interventions. Full article

(This article belongs to the Special Issue Nutritional Status of Older Adults)

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13 pages, 1335 KiB

Open AccessArticle

Does a 12-Month Transitional Care Model Intervention by Geriatric-Experienced Care Professionals Improve Nutritional Status of Older Patients after Hospital Discharge? A Randomized Controlled Trial

by Neshat Chareh, Anja Rappl, Martina Rimmele, Klaus Wingenfeld, Ellen Freiberger, Cornel C. Sieber and Dorothee Volkert

Nutrients 2021, 13(9), 3023; https://doi.org/10.3390/nu13093023 - 29 Aug 2021

Cited by 1 | Viewed by 2587

Abstract

At hospital discharge, many older patients are at health and nutritional risk, indicating a requirement for ongoing care. We aim to evaluate the effects of comprehensive individualized care by geriatric-experienced care professionals, the so-called “pathfinders”, on nutritional status (NS) of older patients after [...] Read more.

At hospital discharge, many older patients are at health and nutritional risk, indicating a requirement for ongoing care. We aim to evaluate the effects of comprehensive individualized care by geriatric-experienced care professionals, the so-called “pathfinders”, on nutritional status (NS) of older patients after discharge. A total of 244 patients (median age 81.0 years) without major cognitive impairment were randomized to Intervention Group (IG: 123) or Control Group (CG: 121) for a 12-month intervention, with up to 7 home visits and 11 phone calls. The comprehensive individualized care contained nutritional advice, when required. The intervention effect after three (T3m) and 12 (T12m) months on change in MNA-SF (Mini Nutritional Assessment-Short Form) and BMI was evaluated by Univariate General Linear Model (ANOVA), adjusted for age, sex, living situation, and activities of daily living. At baseline, mean MNA-SF did not differ between IG and CG (10.7 ± 2.6 vs. 11.2 ± 2.5, p = 0.148); however, mean BMI was significantly lower in IG compared to CG (27.2 ± 4.7 vs. 28.8 ± 4.8 kg/m², p = 0.012). At T3m, mean change did not differ significantly between the groups, neither in MNA-SF (0.6; 95%CI: −0.1–1.3 vs. 0.4; −0.3–1.1, p = 0.708) nor in BMI (−0.2; −0.6–0.1 vs. 0.0; −0.4–0.4 kg/m², p = 0.290). At T12m, mean change of MNA-SF was significantly higher in IG than in CG (1.4; 0.5–2.3 vs. 0.0; −0.9–0.8; p = 0.012). BMI remained unchanged in IG, whereas it slightly declined in CG (0.0; −0.7–0.6 vs. −0.9; −1.6–−0.2 kg/m², p = 0.034). We observed rather small effects of comprehensive individualized care by pathfinders on NS in older patients 12 months after discharge. For more pronounced effects nutrition expertise might be needed. Full article

(This article belongs to the Special Issue Nutritional Status of Older Adults)

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10 pages, 257 KiB

Open AccessFeature PaperArticle

The Relevance of Obesity for Activities of Daily Living in Geriatric Rehabilitation Patients

by Julia Wojzischke, Jürgen M. Bauer, Andreas Hein and Rebecca Diekmann

Nutrients 2021, 13(7), 2292; https://doi.org/10.3390/nu13072292 - 01 Jul 2021

Cited by 2 | Viewed by 2586

Abstract

The obesity pandemic has reached old age but the effect of obesity on functional recovery in geriatric rehabilitation patients has not been investigated to date. In this prospective cohort study, patients admitted into geriatric rehabilitation were consecutively included between September 2015 and September [...] Read more.

The obesity pandemic has reached old age but the effect of obesity on functional recovery in geriatric rehabilitation patients has not been investigated to date. In this prospective cohort study, patients admitted into geriatric rehabilitation were consecutively included between September 2015 and September 2016, aged ≥70 years. Individual activities of daily living were documented by the Barthel index (BI, 0–100 points). Obesity was assessed by the measurement of body mass index (BMI, kg/m²), waist circumference (WC, cm) and percentage of body fat mass (%FM) based on triceps’ skinfold thickness at admission (t1), discharge (t2) and six months after discharge (t3). A total of 122 patients were included in the analysis. Prevalence of obesity according to BMI, WC and %FM was 33.6%, 83.6% and 71.3% respectively. Patients with a high WC and patients with a high BMI had lower BI values at t1, t2, t3 and the improvement in BI (t1–t2, t2–t3) was lower than in those with low WC and low BMI, but without statistical significance. In multiple regression analysis, BMI, WC and %FM were not associated with BI at t3 and improvement of BI (t2–t3). Obesity was highly prevalent in geriatric rehabilitation patients, but it was not associated with BI during the 6-month follow-up. Full article

(This article belongs to the Special Issue Nutritional Status of Older Adults)

9 pages, 398 KiB

Open AccessArticle

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

by Aleksandra Kaluźniak-Szymanowska, Roma Krzymińska-Siemaszko, Marta Lewandowicz, Ewa Deskur-Śmielecka, Katarzyna Stachnik and Katarzyna Wieczorowska-Tobis

Nutrients 2021, 13(7), 2183; https://doi.org/10.3390/nu13072183 - 24 Jun 2021

Cited by 10 | Viewed by 2618

Abstract

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, [...] Read more.

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. Full article

(This article belongs to the Special Issue Nutritional Status of Older Adults)

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14 pages, 953 KiB

Open AccessArticle

Usual Protein Intake Amount and Sources of Nursing Home Residents with (Risk of) Malnutrition and Effects of an Individualized Nutritional Intervention: An enable Study

by Johanna Seemer, Dorothee Volkert, Daniela Fleckenstein-Sußmann, Stephanie Bader-Mittermaier, Cornel Christian Sieber and Eva Kiesswetter

Nutrients 2021, 13(7), 2168; https://doi.org/10.3390/nu13072168 - 24 Jun 2021

Cited by 4 | Viewed by 3786

Abstract

Nursing home (NH) residents with (risk of) malnutrition are at particular risk of low protein intake (PI). The aim of the present analysis was (1) to characterize usual PI (total amount/day (d) and meal, sources/d and meal) of NH residents with (risk of) [...] Read more.

Nursing home (NH) residents with (risk of) malnutrition are at particular risk of low protein intake (PI). The aim of the present analysis was (1) to characterize usual PI (total amount/day (d) and meal, sources/d and meal) of NH residents with (risk of) malnutrition and (2) to evaluate the effects of an individualized nutritional intervention on usual PI. Forty residents (75% female, 85 ± 8 years) with (risk of) malnutrition and inadequate dietary intake received 6 weeks of usual care followed by 6 weeks of intervention. During the intervention phase, an additional 29 ± 11 g/d from a protein-energy drink and/or 2 protein creams were offered to compensate for individual energy and/or protein deficiencies. PI was assessed with two 3-day-weighing records in each phase and assigned to 4 meals and 12 sources. During the usual care phase, mean PI was 41 ± 10 g/d. Lunch and dinner contributed 31 ± 11% and 32 ± 9% to daily intake, respectively. Dairy products (median 9 (interquartile range 6–14) g/d), starchy foods (7 (5–10) g/d) and meat/meat products (6 (3–9) g/d) were the main protein sources in usual PI. During the intervention phase, an additional 18 ± 10 g/d were consumed. Daily PI from usual sources did not differ between usual care and intervention phase (41 ± 10 g/d vs. 42 ± 11 g/d, p = 0.434). In conclusion, daily and per meal PI were very low in NH residents with (risk of) malnutrition, highlighting the importance of adequate intervention strategies. An individualized intervention successfully increased PI without affecting protein intake from usual sources. Full article

(This article belongs to the Special Issue Nutritional Status of Older Adults)

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15 pages, 857 KiB

Open AccessArticle

Detecting Impending Malnutrition of (Pre-) Frail Older Adults in Domestic Smart Home Environments

by Björn Friedrich, Jürgen M. Bauer, Andreas Hein and Rebecca Diekmann

Nutrients 2021, 13(6), 1955; https://doi.org/10.3390/nu13061955 - 07 Jun 2021

Cited by 1 | Viewed by 2477

Abstract

Malnutrition is a well-known risk factor for deteriorated physical function, disability and loss in independence in older adults. An unintended loss in body weight of more than 5% in 3 months is one indicator for malnutrition. In this study we examined the relationship [...] Read more.

Malnutrition is a well-known risk factor for deteriorated physical function, disability and loss in independence in older adults. An unintended loss in body weight of more than 5% in 3 months is one indicator for malnutrition. In this study we examined the relationship between meal preparation time, hand grip strength, and body weight in order to map impending nutritional problems using ambient sensors. Data were collected in the domestic environments of 20 (pre-) frail older adults aged 85.75 y (Standard Deviation: 5.19 y) over 10-months of observation. Collecting included physical function and nutritional status of the participants and meal preparation time by a combination of motion and power sensor events. Analysis was done by rank correlation of hand grip strength, body weight, and meal preparation time. Ten participants aged 85.1 years (Standard Deviation: 4.6 y) were included. The results show a significant correlation (≥0.99) of the meal preparation time with the hand grip strength. This result validated the meal preparation time as a suitable measure for analysing the correlation between meal preparation time and body weight, and a significant correlation (≥0.99) found. Hence the meal preparation time could be used as an indicator for malnutrition. However, causalities have to be conducted by further clinical studies. Full article

(This article belongs to the Special Issue Nutritional Status of Older Adults)

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11 pages, 606 KiB

Open AccessArticle

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

by Ke-Vin Chang, Wei-Ting Wu, Lan-Rong Chen, Hsin-I Wang, Tyng-Guey Wang and Der-Sheng Han

Nutrients 2021, 13(6), 1821; https://doi.org/10.3390/nu13061821 - 27 May 2021

Cited by 23 | Viewed by 3840

Abstract

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 [...] Read more.

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. Full article

(This article belongs to the Special Issue Nutritional Status of Older Adults)

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9 pages, 614 KiB

Open AccessArticle

Measured and Predicted Resting Energy Expenditure in Malnourished Older Hospitalized Patients: A Cross-Sectional and Longitudinal Comparison

by Maryam Pourhassan, Diana Daubert and Rainer Wirth

Nutrients 2020, 12(8), 2240; https://doi.org/10.3390/nu12082240 - 27 Jul 2020

Cited by 6 | Viewed by 2237

Abstract

A number of equations have been proposed to predict resting energy expenditure (REE). The role of nutritional status in the accuracy and validity of the REE predicted in older patients has been paid less attention. We aimed to compare REE measured by indirect [...] Read more.

A number of equations have been proposed to predict resting energy expenditure (REE). The role of nutritional status in the accuracy and validity of the REE predicted in older patients has been paid less attention. We aimed to compare REE measured by indirect calorimetry (IC) and REE predicted by the Harris–Benedict formula in malnourished older hospitalized patients. Twenty-three malnourished older patients (age range 67–93 years, 65% women) participated in this prospective longitudinal observational study. Malnutrition was defined as Mini Nutritional Assessment Long Form (MNA-SF) score of less than 17. REE was measured (REE_measured) and predicted (REE_predicted) on admission and at discharge. REE_predicted within ±10% of the REE_measured was considered as accuracy. Nutritional support was provided to all malnourished patients during hospitalization. All patients were malnourished with a median MNA-LF score of 14. REE_measured and REE_predicted increased significantly during 2-week nutritional therapy (+212.6 kcal and +19.5 kcal, respectively). Mean REE_predicted (1190.4 kcal) was significantly higher than REE_measured (967.5 kcal) on admission (p < 0.001). This difference disappeared at discharge (p = 0.713). The average REE_predicted exceeded the REE_measured on admission and at discharge by 29% and 11%, respectively. The magnitude of difference between REE_measured and REE_predicted increased along with the degree of malnutrition (r = 0.42, p = 0.042) as deviations ranged from −582 to +310 kcal/day in severe to mildly malnourished patients, respectively. REE_predicted by the Harris–Benedict formula is not accurate in malnourished older hospitalized patients. REE measured by IC is considered precise, but it may not represent the true energy requirements to recover from malnutrition. Therefore, the effect of malnutrition on measured REE must be taken into account when estimating energy needs in these patients. Full article

(This article belongs to the Special Issue Nutritional Status of Older Adults)

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20 pages, 971 KiB

Open AccessReview

Interventions to Improve Hydration in Older Adults: A Systematic Review and Meta-Analysis

by Chevonne Bruno, Annaleise Collier, Margaret Holyday and Kelly Lambert

Nutrients 2021, 13(10), 3640; https://doi.org/10.3390/nu13103640 - 18 Oct 2021

Cited by 13 | Viewed by 8376

Abstract

Dehydration is common in the elderly, especially when hospitalised. This study investigated the impact of interventions to improve hydration in acutely unwell or institutionalised older adults for hydration and hydration linked events (constipation, falls, urinary tract infections) as well as patient satisfaction. Four [...] Read more.

Dehydration is common in the elderly, especially when hospitalised. This study investigated the impact of interventions to improve hydration in acutely unwell or institutionalised older adults for hydration and hydration linked events (constipation, falls, urinary tract infections) as well as patient satisfaction. Four databases were searched from inception to 13 May 2020 for studies of interventions to improve hydration. Nineteen studies (978 participants) were included and two studies (165 participants) were meta-analysed. Behavioural interventions were associated with a significant improvement in hydration. Environmental, multifaceted and nutritional interventions had mixed success. Meta-analysis indicated that groups receiving interventions to improve hydration consumed 300.93 mL more fluid per day than those in the usual care groups (95% CI: 289.27 mL, 312.59 mL; I² = 0%, p < 0.00001). Overall, there is limited evidence describing interventions to improve hydration in acutely unwell or institutionalised older adults. Behavioural interventions appear promising. High-quality studies using validated rather than subjective methods of assessing hydration are needed to determine effective interventions. Full article

(This article belongs to the Special Issue Nutritional Status of Older Adults)

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