Irma H.J. Everink, Stefan Grund, Petra Benzinger, Anne de Vries, Adam L. Gordon, Janneke P. van Wijngaarden, Jürgen M. Bauer, Jos M.G.A. Schols
Many patients in geriatric rehabilitation (GR) are physically frail at the time of admission and suffer from malnutrition and sarcopenia, which may worsen rehabilitation outcomes. This study aims to obtain insight into the current nutritional care practices in GR facilities across Europe. Methods: In this cross-sectional study, a questionnaire focused on nutritional care practices in GR was distributed across experts in EUGMS member countries. Data were analyzed by using descriptive statistics. Results: In total, 109 respondents working in 25 European countries participated, and the results showed that not all GR patients were screened and treated for malnutrition, and not all participants used (inter)national guidelines when performing nutritional care. The results also showed variations across European geographical areas related to screening and treatment of malnutrition, sarcopenia, and frailty. Even though the participants underlined the importance of dedicating time to nutritional care, they experienced barriers in its implementation, which were mostly due to a lack of resources. Conclusion: As malnutrition, sarcopenia, and frailty are often present in patients admitted to GR, in addition to being interrelated, it is recommended to develop an integrated approach to screening and treatment of all three clinical problems.
{"title":"Nutritional Care Practices in Geriatric Rehabilitation Facilities across Europe: A Cross-Sectional Study","authors":"Irma H.J. Everink, Stefan Grund, Petra Benzinger, Anne de Vries, Adam L. Gordon, Janneke P. van Wijngaarden, Jürgen M. Bauer, Jos M.G.A. Schols","doi":"10.1159/000531901","DOIUrl":"https://doi.org/10.1159/000531901","url":null,"abstract":"Many patients in geriatric rehabilitation (GR) are physically frail at the time of admission and suffer from malnutrition and sarcopenia, which may worsen rehabilitation outcomes. This study aims to obtain insight into the current nutritional care practices in GR facilities across Europe. Methods: In this cross-sectional study, a questionnaire focused on nutritional care practices in GR was distributed across experts in EUGMS member countries. Data were analyzed by using descriptive statistics. Results: In total, 109 respondents working in 25 European countries participated, and the results showed that not all GR patients were screened and treated for malnutrition, and not all participants used (inter)national guidelines when performing nutritional care. The results also showed variations across European geographical areas related to screening and treatment of malnutrition, sarcopenia, and frailty. Even though the participants underlined the importance of dedicating time to nutritional care, they experienced barriers in its implementation, which were mostly due to a lack of resources. Conclusion: As malnutrition, sarcopenia, and frailty are often present in patients admitted to GR, in addition to being interrelated, it is recommended to develop an integrated approach to screening and treatment of all three clinical problems.","PeriodicalId":17887,"journal":{"name":"Kompass Autoimmun","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136363562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The development of coagulation disorders can be dangerous and fatal in the older people, especially those with multiple medical conditions. Vitamin K-dependent coagulation disorders are easily overlooked when anticoagulant drugs are not used and the patient shows no signs of bleeding. Case presentation: We report a case of a 71-year-old male suffering from pulmonary infection with severe coagulation disorder without bleeding symptoms. He also had a history of Parkinson’s disease, Alzheimer’s disease and cardiac insufficiency. Coagulation tests were normal at the time of admission, prothrombin time (PT) is 13.9 (normal, 9.5–13.1) seconds and the activated partial thromboplastin time (APTT) is 30.2 (normal, 25.1–36.5) seconds. But it turned severely abnormal after 20 days (PT: 136.1 s, APTT: 54.8 s). However, no anticoagulants such as warfarin was used and no bleeding symptoms were observed. Subsequent mixing studies with normal plasma showed a decrease in prothrombin times. Vitamin K deficiency was thought to be the cause of coagulation disorders considering long-term antibiotic therapy, especially cephalosporins, inadequate diet and abnormal liver function. After supplementation with 20 mg of vitamin K, coagulation dysfunction was rescued the next day and serious consequences were effectively prevented.
{"title":"Neglected Vitamin K Deficiency Causing Coagulation Dysfunction in an Older Patient with Pneumonia: A Case Report","authors":"Qiaoping Wu, Lufeng Wang, Rongqing Zhao","doi":"10.1159/000531893","DOIUrl":"https://doi.org/10.1159/000531893","url":null,"abstract":"<b>Background:</b> The development of coagulation disorders can be dangerous and fatal in the older people, especially those with multiple medical conditions. Vitamin K-dependent coagulation disorders are easily overlooked when anticoagulant drugs are not used and the patient shows no signs of bleeding. <b>Case presentation:</b> We report a case of a 71-year-old male suffering from pulmonary infection with severe coagulation disorder without bleeding symptoms. He also had a history of Parkinson’s disease, Alzheimer’s disease and cardiac insufficiency. Coagulation tests were normal at the time of admission, prothrombin time (PT) is 13.9 (normal, 9.5–13.1) seconds and the activated partial thromboplastin time (APTT) is 30.2 (normal, 25.1–36.5) seconds. But it turned severely abnormal after 20 days (PT: 136.1 s, APTT: 54.8 s). However, no anticoagulants such as warfarin was used and no bleeding symptoms were observed. Subsequent mixing studies with normal plasma showed a decrease in prothrombin times. Vitamin K deficiency was thought to be the cause of coagulation disorders considering long-term antibiotic therapy, especially cephalosporins, inadequate diet and abnormal liver function. After supplementation with 20 mg of vitamin K, coagulation dysfunction was rescued the next day and serious consequences were effectively prevented.","PeriodicalId":17887,"journal":{"name":"Kompass Autoimmun","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136363564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Multiple factors affect cognitive health, such as age-related changes in the brain, injuries, mood disorders, substance abuse, and diseases. While some cannot be changed, evidence exists of many potentially possibly modifiable lifestyle factors: diet, physical activity, cognitive and social engagement, smoking and alcohol consumption which may stabilize or improve declining cognitive function. In nutrition, the focus has been mainly on its role in brain development in the early years. There is a strong emerging need to identify the role of diet and nutrition factors on age-related cognitive decline, which will open up the use of new approaches for prevention, treatment or management of age-related disorders and maintaining a good quality of life among older adults. While data on effect of high protein diets is not consistent, low-fat diets are protective against cognitive decline. Several micronutrients like B group vitamins and iron, as well as many polyphenols play a crucial role in cognitive health. Mediterranean, Nordic, DASH, and MIND diets are linked to a lower risk of cognitive decline and dementia. The relationship between the gut microbiome and brain function through the gut-brain axis has led to the emergence of data on the beneficial effects of dietary fibers and probiotics through the management of gut microbes. A "whole diet" approach as well as macro- and micro-nutrient intake levels that have protective effects against cardiovascular diseases are most likely to be effective against neurodegenerative disorders too. Young adulthood and middle age are crucial periods for determining cognitive health in old age. The importance of cardio metabolic risk factors such as obesity and hypertension, smoking and physical inactivity that develop in middle age suggest that preventive approaches are required for target populations in their 40s and 50s, much before they develop dementia. The commonality of dementia risk with cardiovascular and diabetes risk suggests that dementia could be added to present non-communicable disease management programs in primary healthcare and broader public health programs.
{"title":"Maintaining Optimal Cognitive Health in Older Age: The Role of Public Health Dietitians","authors":"Amanda Avery","doi":"10.1159/000533541","DOIUrl":"https://doi.org/10.1159/000533541","url":null,"abstract":"Multiple factors affect cognitive health, such as age-related changes in the brain, injuries, mood disorders, substance abuse, and diseases. While some cannot be changed, evidence exists of many potentially possibly modifiable lifestyle factors: diet, physical activity, cognitive and social engagement, smoking and alcohol consumption which may stabilize or improve declining cognitive function. In nutrition, the focus has been mainly on its role in brain development in the early years. There is a strong emerging need to identify the role of diet and nutrition factors on age-related cognitive decline, which will open up the use of new approaches for prevention, treatment or management of age-related disorders and maintaining a good quality of life among older adults. While data on effect of high protein diets is not consistent, low-fat diets are protective against cognitive decline. Several micronutrients like B group vitamins and iron, as well as many polyphenols play a crucial role in cognitive health. Mediterranean, Nordic, DASH, and MIND diets are linked to a lower risk of cognitive decline and dementia. The relationship between the gut microbiome and brain function through the gut-brain axis has led to the emergence of data on the beneficial effects of dietary fibers and probiotics through the management of gut microbes. A &quot;whole diet&quot; approach as well as macro- and micro-nutrient intake levels that have protective effects against cardiovascular diseases are most likely to be effective against neurodegenerative disorders too. Young adulthood and middle age are crucial periods for determining cognitive health in old age. The importance of cardio metabolic risk factors such as obesity and hypertension, smoking and physical inactivity that develop in middle age suggest that preventive approaches are required for target populations in their 40s and 50s, much before they develop dementia. The commonality of dementia risk with cardiovascular and diabetes risk suggests that dementia could be added to present non-communicable disease management programs in primary healthcare and broader public health programs.","PeriodicalId":17887,"journal":{"name":"Kompass Autoimmun","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136363565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: Spinal sarcopenia is a multifactorial disorder associated with atrophy and fatty changes in paraspinal muscles. Interventional studies for spinal sarcopenia are limited. We aimed to evaluate the effectiveness of a combined exercise and nutrition intervention for the treatment of spinal sarcopenia. Methods: 35 community-dwelling older women diagnosed with spinal sarcopenia in a previous cohort study were included. The 12-week combined intervention consisted of back extensor strengthening exercises and protein supplementation. The following outcomes were measured at baseline (week 0), after the intervention (week 12), and follow-up (week 24): conventional variables of sarcopenia (appendicular skeletal muscle mass, handgrip strength, 6-meter gait speed, and short physical performance battery); lumbar extensor muscle mass; lumbar extensor muscle volume and signal intensity; back extensor isokinetic strength; and back performance scale. We used the intention-to-treat analysis method, and repeated measures analysis of variance was used to analyze the data. Results: Of the total 35 potential participants, 26 older women participated in the study (mean age 72.5 ± 4.0 years old). After 12 weeks of combined exercise and nutrition intervention, there were no changes in the appendicular skeletal muscle mass, lumbar extensor muscle mass, volume, or signal intensity. Handgrip strength and back extensor isokinetic strength did not change significantly. Short physical performance battery significantly increased (P = 0.042) from 11.46 ± 0.86 to 11.77 ± 0.53 at week 12 and 11.82 ± 0.40 at week 24. The back performance scale sum score also significantly improved (P = 0.034) from 2.68 ± 1.81 to 1.95 ± 1.21 at week 12 and 2.09 ± 1.34 at week 24.
{"title":"Nutrition and Physical Activity in the Elderly","authors":"Camelia-Florina Ştefănescu","doi":"10.1159/000533176","DOIUrl":"https://doi.org/10.1159/000533176","url":null,"abstract":"<b>Purpose:</b> Spinal sarcopenia is a multifactorial disorder associated with atrophy and fatty changes in paraspinal muscles. Interventional studies for spinal sarcopenia are limited. We aimed to evaluate the effectiveness of a combined exercise and nutrition intervention for the treatment of spinal sarcopenia. <b>Methods:</b> 35 community-dwelling older women diagnosed with spinal sarcopenia in a previous cohort study were included. The 12-week combined intervention consisted of back extensor strengthening exercises and protein supplementation. The following outcomes were measured at baseline (week 0), after the intervention (week 12), and follow-up (week 24): conventional variables of sarcopenia (appendicular skeletal muscle mass, handgrip strength, 6-meter gait speed, and short physical performance battery); lumbar extensor muscle mass; lumbar extensor muscle volume and signal intensity; back extensor isokinetic strength; and back performance scale. We used the intention-to-treat analysis method, and repeated measures analysis of variance was used to analyze the data. <b>Results:</b> Of the total 35 potential participants, 26 older women participated in the study (mean age 72.5 ± 4.0 years old). After 12 weeks of combined exercise and nutrition intervention, there were no changes in the appendicular skeletal muscle mass, lumbar extensor muscle mass, volume, or signal intensity. Handgrip strength and back extensor isokinetic strength did not change significantly. Short physical performance battery significantly increased (P = 0.042) from 11.46 ± 0.86 to 11.77 ± 0.53 at week 12 and 11.82 ± 0.40 at week 24. The back performance scale sum score also significantly improved (P = 0.034) from 2.68 ± 1.81 to 1.95 ± 1.21 at week 12 and 2.09 ± 1.34 at week 24.","PeriodicalId":17887,"journal":{"name":"Kompass Autoimmun","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136363563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
With the global population growth seen in recent decades, the population aging phenomenon has reached high proportions throughout the world. This has brought about unprecedented challenges with respect to meeting the specific needs of this large segment of the population. As highlighted by the European Commission, economies, welfare and health systems, as well as housing and infrastructure have suffered globally due to the impact of demographic changes [1]. This said, increased longevity is a notable achievement of modern society, and a longer life should represent the opportunity to live more years in good health and with a high quality of life, contributing to one’s family and community. Unfortunately, data analysis shows that the number of years lived in good health does not match the longer-life tendency, and the additional years are frequently lived with disability and several chronic illnesses [2, 3]. Ageing is a complex biological phenomenon influenced by a multitude of heterogenous factors, experienced in very different ways by each individual person. While the different determinants of the aging process have been extensively researched in recent years, understanding healthy ageing remains an enormous challenge. Since a good nutritional status is vital for good health, diets such as the Mediterranean diet and bal-
{"title":"Nutrition and Older Adults – the Need for a More Comprehensive Approach","authors":"Cecília Medeiros de Morais","doi":"10.1159/000533511","DOIUrl":"https://doi.org/10.1159/000533511","url":null,"abstract":"With the global population growth seen in recent decades, the population aging phenomenon has reached high proportions throughout the world. This has brought about unprecedented challenges with respect to meeting the specific needs of this large segment of the population. As highlighted by the European Commission, economies, welfare and health systems, as well as housing and infrastructure have suffered globally due to the impact of demographic changes [1]. This said, increased longevity is a notable achievement of modern society, and a longer life should represent the opportunity to live more years in good health and with a high quality of life, contributing to one’s family and community. Unfortunately, data analysis shows that the number of years lived in good health does not match the longer-life tendency, and the additional years are frequently lived with disability and several chronic illnesses [2, 3]. Ageing is a complex biological phenomenon influenced by a multitude of heterogenous factors, experienced in very different ways by each individual person. While the different determinants of the aging process have been extensively researched in recent years, understanding healthy ageing remains an enormous challenge. Since a good nutritional status is vital for good health, diets such as the Mediterranean diet and bal-","PeriodicalId":17887,"journal":{"name":"Kompass Autoimmun","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135097070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sechs Fragen an die Trägerin des Rudolf-Schoen-Preises 2022 der Stiftung der Deutschen Gesellschaft für Rheumatologie","authors":"","doi":"10.1159/000531398","DOIUrl":"https://doi.org/10.1159/000531398","url":null,"abstract":"","PeriodicalId":17887,"journal":{"name":"Kompass Autoimmun","volume":"169 1","pages":"129 - 130"},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72791149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Upadacitinib: Krankheitskontrolle bei RA im Praxisalltag","authors":"","doi":"10.1159/000531905","DOIUrl":"https://doi.org/10.1159/000531905","url":null,"abstract":"","PeriodicalId":17887,"journal":{"name":"Kompass Autoimmun","volume":"32 1","pages":"131 - 131"},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82332316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Milliarden von Nervenzellen, die die graue Substanz in unserem Gehirn bilden, ermöglichen uns Bewegung. Sie sind millionenfach miteinander verschaltet durch tiefer im Gehirn verlaufende Nervenfasern, Axone genannt. Viele dieser Axone sind von einem zellulären «Isolierband» umwickelt. Die Isolierschicht besteht aus Myelin, einer fettreichen Substanz, die Axone in bis zu 150 Schichten umhüllt. Axone und Myelin bilden zusammen die sogenannte weiße Substanz. In regelmäßigen Abständen weisen die Myelinscheiden eine kleine Lücke auf, die als Ranvierscher Schnürring bezeichnet werden. Wird ein Signal mittels eines elektrischen Nervenimpulses von einer Zelle zur nächsten übermittelt, springt dieser regelrecht von einem Schnürring zum nächsten. Dies macht die Kommunikation veränderungen fanden die Forschenden in dem scheinbar normalen Gewebe auch zelluläre Marker für eine Entzündung. «Wir sehen sehr deutlich, dass bei MS ultrastrukturelle Veränderungen der weißen Substanz mit chronischen Entzündungen im Gehirn zusammenhängen. Beide krankhaften Auffälligkeiten könnten zum Fortschreiten der Krankheit beitragen», erklärt Möbius.
{"title":"Spektrum Autoimmun – wissenswert, kompakt, anregend","authors":"Kompass Autoimmun","doi":"10.1159/000531830","DOIUrl":"https://doi.org/10.1159/000531830","url":null,"abstract":"Milliarden von Nervenzellen, die die graue Substanz in unserem Gehirn bilden, ermöglichen uns Bewegung. Sie sind millionenfach miteinander verschaltet durch tiefer im Gehirn verlaufende Nervenfasern, Axone genannt. Viele dieser Axone sind von einem zellulären «Isolierband» umwickelt. Die Isolierschicht besteht aus Myelin, einer fettreichen Substanz, die Axone in bis zu 150 Schichten umhüllt. Axone und Myelin bilden zusammen die sogenannte weiße Substanz. In regelmäßigen Abständen weisen die Myelinscheiden eine kleine Lücke auf, die als Ranvierscher Schnürring bezeichnet werden. Wird ein Signal mittels eines elektrischen Nervenimpulses von einer Zelle zur nächsten übermittelt, springt dieser regelrecht von einem Schnürring zum nächsten. Dies macht die Kommunikation veränderungen fanden die Forschenden in dem scheinbar normalen Gewebe auch zelluläre Marker für eine Entzündung. «Wir sehen sehr deutlich, dass bei MS ultrastrukturelle Veränderungen der weißen Substanz mit chronischen Entzündungen im Gehirn zusammenhängen. Beide krankhaften Auffälligkeiten könnten zum Fortschreiten der Krankheit beitragen», erklärt Möbius.","PeriodicalId":17887,"journal":{"name":"Kompass Autoimmun","volume":"62 1","pages":"143 - 146"},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81000092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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