Journal of Nutrition in Gerontology and Geriatrics最新文献

Congregate Nutrition Services have long been a pillar of public health assistance, championing the independence and community engagement of older Americans. The advent of COVID-19, however, restricted access to these services due to the closure of physical locations. In response, Lanakila Meals on Wheels initiated a virtual congregate meal program, Kūpuna U, in collaboration with community partners in Honolulu County. The program combined grab-and-go or home-delivered meals with virtual and in-person classes to improve both nutrition and socialization for older adults. This study aimed to capture participant feedback to assess and enhance the Kūpuna U program, developing it as a flexible and scalable congregate meal solution applicable nationwide. Five focus group discussions were conducted with program participants (n = 34). The majority of participants were female (74%), Asian (73%), and living alone (56%). Participants found the program beneficial, enhancing their nutrition, social engagement, and learning experiences on various topics tailored for older adults. Supportive staff played a crucial role in motivating participants to stay engaged. Participants also identified potential enhancements to the program, including more activities and courses, expanded hours, additional in-person options at various locations, and culturally tailored meals.

Motoric eating difficulties affecting the ability to eat according to established norms may result in loss of autonomy, reduced food intake and decreased social interaction. Finger food meals may affect the ability to eat independently and were therefore compared to regular meals for older adults >65 years with major motoric eating difficulties. In this pilot study the screening instrument MEOF-II, including additional questions about use of cutlery and fingers, was used to collect data regarding autonomy, food intake and social interaction through observations. Five women and one man participated in the study. Results showed that finger food meals facilitated autonomous eating since the participants were able to eat independently without relying on help from others. Less energy was spent on eating, which allowed for social interaction. However, finger food meals entail unfamiliar norms and culinary rules which may hinder eating; this is an important factor to consider in the implementation of such meals. Further studies on finger foods for older adults may consider larger and diverse cohorts, including healthy older adults, those with motoric difficulties and those with early stages of cognitive decline. Also, a wider variety of finger foods for specific cultural preferences and situations may be considered.

Weight loss may benefit older adults with obesity. However, it is unknown whether individuals with different frailty phenotypes have different outcomes following weight loss. Community-dwelling adults aged ≥65 (n = 53) with a body mass index ≥30 kg/m² were recruited for a six-month, single-arm, technology-based weight loss study. A 45-item frailty index identified frailty status using subjective and objective measures from a baseline geriatric assessment. At baseline, n = 22 participants were classified as pre-frail (41.5%) and n = 31 were frail (58.5%), with no differences in demographic characteristics. While weight decreased significantly in both groups (pre-frail: 90.8 ± 2.7 kg to 85.5 ± 2.4 kg (p < 0.001); frail: 102.7 ± 3.4 kg to 98.5 ± 3.3 kg (p < 0.001), no differences were observed between groups for changes in weight (p = 0.30), appendicular lean mass/height² (p = 0.47), or fat-free mass (p = 0.06). Older adults with obesity can safely lose weight irrespective of frailty status using a technology-based approach. Further investigation is needed to determine whether the impact of specific lifestyle interventions differ by frailty status.

The underweight status among older adults in India and its association with other health risks has received little attention. Using nationally representative data from the first wave of the Longitudinal Aging Study in India (LASI, 2017-18), this study examined the underweight status among the Indian older adults and investigated its relationship with various health outcomes. The effective sample size of this study was 28,050 older adults aged 60 years or above. Multivariable logistic and linear regression models were employed to meet the objectives of the study. Underweight status was found to be negatively associated functional health, cognitive function, and grip strength. However, no significant association was observed between underweight status and depressive symptoms. Moreover, socioeconomic, demographic, and geographic factors were identified as strong determinants of underweight status among Indian older adults. India has implemented a wide range of nutrition policies that primarily focus on children, mothers, and adolescents. While these policies are important, it is equally crucial to develop interventions specifically tailored for adults and older adults.

Factors allowing rural, community-dwelling 80+ year-olds to thrive remain unexplored. Isolation can impact this vulnerable population. In this study, patients were prospectively surveyed for age, gender, cohabitation (self, spouse, family) and location (suburban, rural, and isolated). Mini-nutritional assessment short form (MNA-SF) and BMI were obtained. A p < 0.05 represented statistical significance. Patients (n = 167) were mostly female (120; 71.9%) with an average overweight BMI (26.5) and low-normal MNA-SF scores (11.8). Most live alone (49.7%), followed by spousal (31.7%) and family (18.6%) cohabitation. Over 80% are rural (71) or rural-isolated (67), and of these, 83% had normal nutrition. Self-habitation correlated with lower MNA-SF scores (p = 0.02). Normal BMIs correlated with family cohabitation (OR = 0.90 [CI: 0.82-0.99]) and nourished MNA-SF scores with spousal cohabitation (OR = 1.69; CI: 1.15-2.47) rather than living alone. Self-habitation increases vulnerability to obesity and malnutrition. Interventions should aim to maintain independence while improving the effects of habitation on nutrition.

Dietary assessments are important clinical tools used by Registered Dietitians (RDs). Current methods pose barriers to accurately assess the nutritional intake of older adults due to age-related increases in risk for cognitive decline and more complex health histories. Our qualitative study explored whether implementing Voice assistant systems (VAS) could improve current dietary recall from the perspective of 20 RDs. RDs believed the implementing VAS in dietary assessments of older adults could potentially improve patient accuracy in reporting food intake, recalling portion sizes, and increasing patient-provider efficiency during clinic visits. RDs reported that low technology literacy in older adults could be a barrier to implementation. Our study provides a better understanding of how VAS can better meet the needs of both older adults and RDs in managing and assessing dietary intake.

While food and eating are important determinants of health, there is limited information on how they affect quality of life (QOL). This study aimed to understand (1) the factors that impact QOL, (2) the effect of food and eating on QOL, from the perspective of community-dwelling older adults. Twenty-five older adults completed semi-structured interviews. The constant comparative method was used to assign codes to participant's responses and organize them into categories, which were used to form a conceptual framework. Five main themes emerged showing factors affecting QOL: health and vitality; independence; mental and emotional well-being; socialization and support; and activities. Four themes were identified demonstrating how food and eating affect QOL: food access and choice; food preparation; health and vitality; and food enjoyment. Relationships between themes suggest food and eating have a broad effect on factors impacting QOL. To develop and tailor community interventions to improve older adults' QOL, measurement tools should include these effects.

We aimed to examine the association of food consumption patterns, measured by dietary diversity score (DDS) or food consumption score (FCS), with handgrip strength (HGS) among adults aged ≥55 years in Indonesia. This is a cross-sectional study involving 4351 middle-aged and older adults from the Indonesian Family Life Survey Fifth Wave (IFLS-5), collected in 2014-2015. A weighted linear regression model was used to examine the association of DDS or FCS with HGS in crude and adjusted models. In the adjusted models and compared to those with low DDS or poor FCS, those with medium/high DDS and borderline/acceptable FCS were associated with a higher mean of HGS. Good food consumption patterns, as reflected by high DDS or acceptable FCS, were shown to be significantly associated with stronger HGS among adults aged 55 years or above. More targeted nutritional interventions to promote good food consumption patterns may help improve HGS among middle-aged and older adults in Indonesia.

The Congregate Nutrition Services support efforts to keep older Americans independent and engaged in their communities. We examined participants' self-reported reasons for initially attending the congregate meals program and whether reasons differed by participant characteristics. Descriptive statistics and tests of differences were used to compare participants (n = 1,072). Individuals attended congregate meals for several reasons, with the top two being socialization (36.3%) and age- or health-related reasons (18.7%). Those attending for socialization were less likely to be lower income, have food insecurity, or live with 3+ ADL limitations while participants who first attended due to age or health-related reasons were more likely to be low income, food insecure, and from historically marginalized populations. Health and social service professionals and community organizations could expand data collection on older adults in their communities and partner with congregate meal providers to encourage participation for individuals with unmet nutritional, health, and socialization needs.

Older adults are the fastest growing population in the United States. This group is at risk for developing chronic diseases resulting from high nutritional risk. The objective of this study was to assess nutritional risks and their key predictors among older adults. In this cross-sectional study, the Dietary Screening Tool, the Nutrition Self-efficacy Scale, food security, perceived health, and sociodemographics were measured. A total of 475, English-speaking adults, 50 years of age or older, residing in Maryland and attending senior congregate sites, participated in the study (urban n = 215, rural n = 260). Results showed 88.8% of participants were classified as being nutritionally 'at risk' or 'possible' risk. Higher education level, higher nutrition self-efficacy, and food security were significant predictors associated with lower nutritional risk among older adults. Implementing suitable and effective nutrition interventions requires assessing diet and identifying the needs specific to older adult populations. Utilizing appropriate screening tools is an important step in improving overall diets and may reduce barriers to adopting healthy eating behaviors in this population.