Journal of Nutrition in Gerontology and Geriatrics最新文献

Background & aims: Age-related macular degeneration (AMD) stands as the leading cause of visual impairment and blindness in developed nations. The Age-Related Eye Disease Study 2 (AREDS 2) conclusively demonstrated the advantages of vitamin and mineral supplementation in either preventing or slowing down the progression of AMD. This survey was crafted to evaluate the utilization of nutritional supplements and to gauge the knowledge, attitudes, and practices of patients with AMD. The aim was to identify factors predicting adherence and explore the public health implications.

Methods: A cross-sectorial study was conducted involving 148 patients through a survey carried out at a tertiary-level hospital. The survey focused on patients with AMD who were candidates for nutritional supplements.

Results: The primary outcome was the rate of adherence to AREDS recommendations, which was found to be 83%. Female gender (P = 0.038), effective medication regimen management (P < 0.01), and higher levels of education (P < 0.01) emerged as independent factors significantly associated with adherence.

Conclusions: While ophthalmologists play a crucial role in addressing neovascular complications of AMD, they also bear the responsibility of promoting patient adherence to AREDS supplements. Achieving optimal compliance requires addressing the multifaceted factors identified in this study, with specific attention to patients' educational backgrounds and informational requirements.

The Mediterranean diet has been linked to preserving physical function, but studies on its impact on physical function decline in older adults have shown mixed results. This longitudinal study used a large sample of community-dwelling older women from the Women's Health Initiative Long Life Study to examine this relationship. We assessed 4516 older women (mean age at baseline = 78.97), including a subsample of 849 women who reported currently having diabetes. Data on physical function, measured by the SF-36 Physical Function subscale, were collected annually from 2012-2019. Adherence to the Mediterranean diet was measured using alternative Mediterranean diet (aMED) scores between 2012 and 2013. Results indicated that higher aMED scores were associated with better physical function at baseline in the general sample (4.89 to 8.23 points) and in the diabetes subsample (5.37 to 8.97 points) over eight years. However, adherence to the Mediterranean diet did not affect the rate of physical function decline. Future research should include longitudinal dietary assessments, a broader age range, and detailed information on diabetes duration.

Bis-octanoyl-(R)-1,3-butanediol (BO-BD) is a novel ketone ester (KE) ingredient which increases blood beta-hydroxybutyrate (BHB) concentration rapidly after ingestion. KE is hypothesized to improve function in older adults. Whilst many studies have investigated KE in young adults, they have not been studied in healthy older adults (HOA), for whom age-related differences in metabolism may alter the effects. This randomized, observational, open-label study in HOA (n = 30, 50% male, age = 76.5y) aimed to elucidate tolerance, blood BHB and glucose concentrations for 4h following consumption of either 12.5 or 25 g of BO-BD formulated in ready-to-drink beverage (n = 30), and re-constituted powder (n = 21) with a meal. All study interventions were well tolerated, and increased blood BHB, inducing nutritional ketosis (≥0.5 mM) until the end of the study. Peak BHB concentration (C_max) and incremental area under the curve (iAUC) were significantly greater with 25 vs 12.5 g of BO-BD in both formulations. There were no significant differences in C_max or iAUC between formulations. Blood glucose increased in all conditions following the meal, with no consistent significant differences between conditions. These results demonstrate that both powder and beverage formulations of the KE, BO-BD, induce ketosis in HOA adults, facilitating future research on functional effects of KE in aging.

Purpose: Polypharmacy (PP) and malnutrition are two conditions that frequently occur in older patient groups. In this retrospective cross-sectional study, we aimed to investigate the relationship between nutrition and PP in a cohort of older outpatients from Northern Sardinia, Italy.

Methods: A database of 619 outpatients undergoing a specific drug therapy during the examination was analyzed. A multivariable analysis was performed using a logistic regression model, in which a dichotomized MNA score was the dependent variable, according to several covariates.

Results: Exposure to ≥ five drugs was associated with a higher risk of malnutrition among males and females, as well as a higher risk of overt malnutrition among males and females compared to those exposed to four or fewer drugs. In addition, depression significantly increased the risk of malnutrition in both sexes, whereas cognitive status and comorbidity did not. Moreover, the effect of PP on nutritional status was statistically significant only for the global component of the MNA score.

Conclusions: The present study detected a significant association between PP and an increased risk of malnutrition. Depressed mood was an additional independent predictor, whereas cognitive status and comorbidity did not reveal a significant association.

Upon entering long-term care (LTC) homes, residents relinquish control over their daily life choices, which may influence life satisfaction. This study explored hypothesized relationships among the concepts of person-centered care, locus of control (LOC), and life satisfaction of LTC residents. Survey data were collected and analyzed from 154 residents of 16 skilled nursing facilities in the Midwest. Data were analyzed using structural equation modeling to examine relationships among person-centered care, life satisfaction, food-related life satisfaction, health LOC and food-related control. Results indicated food-related life satisfaction was influenced by perceived person-centered care and life satisfaction. Health LOC and person-centered care affected life satisfaction. Support for the use of person-centered care practices was demonstrated in LTC. The results suggest that older adults in LTC should be encouraged to participate in food-related decision-making to support life satisfaction.

The Supplemental Nutrition Assistance Program (SNAP) is the nation's largest safety net program helping older adults achieve food security. However, 3 out of 5 qualified older adults do not participate in SNAP. We explored why older adults in Missouri do not seek SNAP benefits and to understand changes needed to enhance SNAP participation. We conducted focus group discussions and interviews with national and regional key informants, older adult SNAP participants and SNAP-eligible nonparticipants, and food bank outreach staff. Discussions and interviews were recorded and transcribed verbatim to explore common themes. Older adults, key informants and outreach staff reported challenges faced when applying for and using SNAP, including feelings of shame. Older adults commented that benefit amounts don't increase proportionally to increasing food costs. Other barriers included difficulties applying due to challenges using or lack of access to technology and gathering the necessary information to apply. Although food insecurity and poor nutrition are serious problems among older adults, several challenges keep seniors from taking advantage of SNAP. Findings suggest that streamlining the application process and establishing the Elderly Simplified Application could help enhance SNAP participation. Education and increased outreach efforts could also help improve awareness about SNAP among older adults.

Background: Metabolic syndrome poses a significant public health challenge globally, particularly among older adults. Dietary patterns play a crucial role in the development and management of metabolic syndrome. However, to our knowledge, no evidence exists regarding the association between dietary patterns and metabolic syndrome among the Mexican older adult population. Thus, the objective of the present study is to assess the association between dietary patterns and metabolic syndrome in Mexican older adults.

Methods: This cross-sectional study utilized data from the Mexican National Health and Nutrition Survey 2016 to investigate the relationship between dietary patterns and metabolic syndrome in 804 OA (aged ≥60 years). Dietary patterns were derived using factor analysis, and metabolic syndrome was defined based on established criteria. Logistic regression models were employed to assess associations, adjusting for potential confounders.

Results: Three dietary patterns were identified: a "Westernized" pattern characterized by high consumption of processed meat, red meat, and saturated fats; a "Transitional" pattern high in fresh vegetables and fruits; and a "Prudent" pattern high in fish and low-fat dairy products. The "Westernized" pattern exhibited a positive association with metabolic syndrome, while the "Prudent" pattern showed a negative association. The associations remained significant after adjusting for confounders. Biological mechanisms linking the "Westernized" pattern to metabolic syndrome include chronic inflammation, endothelial dysfunction, and dyslipidemia induced by components such as processed meats and soft drinks.

Conclusion: Our study highlights the importance of dietary patterns in influencing metabolic syndrome risk among Mexican older adults. Promoting dietary patterns rich in fish, vegetables, and legumes while reducing consumption of processed meats and sugary beverages may offer significant health benefits in this population. Further prospective studies are needed to confirm these findings and inform targeted interventions for metabolic syndrome prevention and management in older adults.

Malnutrition is observed in approximately 20-50% of hospitals and long-term care facilities. We examined the effects of malted rice amazake beverage on the nutritional status and gut microbiome of older patients and residents in an integrated long-term care facility; 13 older patients and residents (84.6 ± 9.3 years) were prescribed 35 g of malted rice amazake daily for six weeks. Gut microbiome analysis, body composition and blood biochemistry test results, defecation surveys, dietary intake, and medications were recorded before and after the intervention. After the intervention, the Geriatric Nutritional Risk Index (GNRI) increased from 83.6 ± 9.1 points to 86.0 ± 9.8 points, and serum albumin increased from 3.3 ± 0.5 g/dL to 3.4 ± 0.5 g/dL. The α-diversity of gut bacteria increased from 390.1 ± 89.4 before to 447.2 ± 108.1, and the abundance of Desulfovibrio decreased from 0.76 ± 0.47% to 0.56 ± 0.60%. ΔGNRI showed a positive correlation with ΔBifidobacterium and ΔBarnesiella, but a negative correlation with ΔKlebsiella. Consumption of malted rice amazake for six weeks improved the GNRI and altered the gut microbiome of older patients and residents at moderate risk of nutritional disorders. Malted rice amazake may be a new way to improve nutrition because it has a high nutritional value, mainly in terms of carbohydrates, and improves the gut microbiome.

The purpose of the current study is to examine the association between hydration status and cognitive function in middle-aged and older adults, drawing from a large, nationally representative sample in the United States and using a comprehensive set of executive function performance measures. We utilized data from the Health and Retirement Study to conduct twelve, three-stage hierarchical regressions on hydration status and executive function performance of older adults. Cognitive performance scores on the Trail Making A, Symbol Digit Modalities, and Letter Cancellation tests significantly differed by hydration status, and these outcomes follow a curvilinear pattern, such that performance scores are lower for those who are hyper-hydrated or dehydrated relative to those who are euhydrated or near-dehydration. Our study's findings are consistent with prior studies examining the impact of serum osmolarity on cognitive performance. Specifically, a curvilinear pattern was associated with speed of processing tests of executive function. Overall, hydration status is associated with curvilinear patterns of performance on executive function measures, specifically Trail Making A, Symbol Digit Modalities, and Letter Cancellation Tests.

Our aim was to capture the perspectives of emergency food system (EFS) partners, providers, and rural older adults who receive emergency foods on their experiences throughout the COVID-19 pandemic. We conducted in-depth semi-structured qualitative interviews with partners in Minnesota's EFS (n = 9), rural emergency food providers (n = 5), and rural older adults who receive emergency food (n = 14) between July 2022 and February 2023. We used template analysis, a rapid qualitative method, to identify recurring perspectives across interviews. The pandemic required shifts in how providers delivered services, but their established networks, their adaptability, and substantial support enabled them to make necessary pivots. Challenges include increasing use with decreasing support, labor capacity, and the need for quality foods. Concerns about inflation-driven food insecurity and increasing reliance on the EFS were common in the context of sunsetting pandemic-related programs. Our results support that the substantial support provided throughout the pandemic enabled the EFS to continue providing services and meeting the needs of underserved populations, such as rural older adults. Policymakers should reinstate or extend the pandemic-era strategies that supported household food security and enabled the EFS to continue providing services.