Journal of Nutrition in Gerontology and Geriatrics最新文献

We examined the association between dietary potassium intake and all-cause and cause-specific mortality among community-dwelling older adults. Potassium intake was assessed with a food frequency questionnaire administered to 1,363 older adults (mean age 71.0 ± 10.6 years). Cox proportional hazard regressions estimated hazard ratios for sex-specific quintiles of calorie-adjusted potassium in relation to all-cause and cause-specific (cardiovascular disease, CVD, and stroke) mortality, adjusting for numerous covariates. There were 855 deaths (63% mortality) during the 20-year follow-up. Relative to the third quintile, potassium intake in the lowest quintile only was associated with increased risk of all-cause mortality (fully-adjusted hazard ratio 1.33; 95% CI 1.06, 1.67). Potassium intake was not significantly associated with CVD or stroke mortality. These results suggest that low potassium intake is associated with increased risk of mortality independent of overall health status. Ensuring adequate potassium in the diet may be an important strategy for reducing risk of earlier mortality among older adults.

Research has suggested that family caregivers of older people with dementia often find it difficult to maintain a healthy diet due to the stress of their daily routine, putting them at increased risk of developing lifestyle-related diseases. The present qualitative study aims to clarify the factors that affect the dietary habits of family caregivers of older people with dementia. A total of 21 family caregivers of outpatients with dementia took part in interviews about their diet during a hospital visit in Japan. Qualitative content analysis was used to systematically identify ideas and patterns emerging from the interview data. The data suggest that dementia care helps family caregivers become more conscious of their own dietary lifestyle choices and increases communication opportunities. On the other hand, caregiver burden was found to have a negative influence on the quality and level of interest in dietary choices of caregivers. Providing timely and useful information on care services to family caregivers who might have hesitated to use them in the past was suggested as a useful initiative to relieve caregiver burden. This study clarified five themes related to the eating habits of family caregivers.

The objective of this systematic review is to assess whether old people should be actively involved in activities related to meals to support quality of life, nutritional status and functional abilities related to meals. Two electronic databases Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effectiveness were searched, supported by PubMed citation, snowball searches. Eleven primary studies were included. The quality was low. No studies assessed the effect on health-related quality of life. Three types of interventions to support activities related to meals were identified: Meal-related activities to facilitate improved autonomy seemed to overall improve nutritional intake, physical and social function related to meals, plus mealtime coping. Interventions of encouragement and reinforcement by staff to facilitate independence in eating seemed to have beneficial effect on nutritional intake and physical function related to meals. Interventions using food preparation and cooking to support participation seemed to have beneficial effects on social function related to meals and mealtime coping. There is an urgent need for good quality, adequately powered studies in this area and among old people in all health care settings.

Food insecurity, life events, and emotional eating can influence dietary patterns. However, their interaction among older adults requires further investigation. This mixed-method, interdisciplinary project included 7 focus groups and a cross-sectional survey (n = 55) to evaluate these factors among older adults (60-102 years of age) living in rural Ohio communities. Qualitative data highlighted critical life events, emotions and personal relationships, food insecurity, and learning how to do more with less, and resilience in dietary patterns. The majority of the participants were overweight or obese. Food insecurity, frequency of congregate meals, and age were associated with emotional eating. Attributes of diet quality correlated with emotional eating and food insecurity. Future work should address the unique needs of older adults by expanding food assistance programs, while including the older adult's perspectives with regard to life experiences, the value of social support, personal relationships, and honoring food preferences, particularly nutrient-dense foods.

This study was a 12-week feasibility weight-loss intervention consisting of caloric restriction and aerobic/resistance exercise in older adults with obesity (body mass index ≥ 30 kg/m²) in a geographically isolated area. Primary outcomes assessed weight and physical function. Mean age was 71.0 ± 5.1 years (67% female). Individuals completed 100% of all assessments, attended 88% of the physical therapy classes and 89% of the nutrition sessions. Level of satisfaction (5-point Likert) was high (5.0, 1 - low; 5 - high). Weight decreased from 93.7 ± 9.7 to 89.4 ± 4.0 kg (p < 0.001). Mean BMI and waist circumference decreased, respectively, from 35.4 ± 3.4 to 33.6 ± 3.7 (p < 0.001), and 116.3 ± 7.5 to 108.7 ± 9.2 cm (p = 0.002). Grip strength, gait speed, and 5-times sit-to-stand time all improved from 29.2 ± 7.5 to 35.2 ± 6.7 kg (p = 0.006), 1.16 ± 0.21 to 1.35 ± 0.23 m/s (p = 0.004), and 12.5 ± 4.0 to 9.6 ± 1.7s (p = 0.02). The intervention was feasible and acceptable, and holds promise in promoting weight loss with a concomitant improvement in physical function in older adults.

Objective: The purpose of this study was to explore dietetic students' facilitators, barriers, and perceptions of working with older adults.Method: A purposive sampling method was used to conduct individual, face-to-face-interviews with students majoring in human nutrition (n = 17). All interviews were audio recorded, transcribed verbatim, and coded using NVivo 11 software. A directed content analysis revealed the following themes under categories of (1) perception, (2) barriers, (3) facilitators, and (4) impact of experience.Results: For perception, students discussed older adults' positive and negative personality traits and their physical and cognitive deterioration. Such perception contributed to their view of barriers in interactions with older adults, which were both external and internal in nature. Students mentioned previous experience and knowledge about older adults as well as their own personalities served as major facilitators in interacting with older adults. Gaining experience working with older adults deepened students' understanding of and empathy for this population.Discussion: Findings offer insight into how to develop dietetic curricula to address students' perceptions and resulting barriers for training well-prepared registered dietitians motivated to serve the rapidly growing older adult population.

New Zealand blackcurrant (NZBC) can increase exercise performance in young adults, potentially by anthocyanin-induced cardiovascular function alterations and increased blood flow, however, effects upon blood pressure, functional exercise performance and cognitive function in older adults is unknown. In a randomized, double-blind, placebo-controlled, cross-over design, 14 older adults (age: 69 ± 4 years, height: 172 ± 9 cm, body mass: 85 ± 12) ingested NZBC extract (600 mg·day^-1 CurraNZ™) or placebo (PL, 600 mg microcrystalline cellulose) for 7-days (7-day washout between conditions). On day-7, 2-hours following consumption of the capsules, resting blood pressure, cognitive function (Cambridge neuropsychological test automated battery) and 6-minute walk test performance and were measured. Intake of NZBC caused a decrease (p < 0.05) in systolic (PL: 136 ± 14; NZBC: 130 ± 12 mmHg) and diastolic (PL: 84 ± 11; NZBC 78 ± 6 mmHg) blood pressure. There was no effect on 6-minute walk performance or cognitive function variables. Future research should address optimization of intake and examine cardiovascular responses during exercise.

Objective: To investigate how change in nutritional status is associated with physical function and disability among community-dwelling older adults. Methods: Baseline and 1-year follow-up data of 593 community-dwelling older adults were obtained from the Population Health Index survey in Singapore. The Mini Nutritional Assessment was used to assess nutritional status; the Late-Life Function and Disability Instrument was used to measure physical function and disability. Multivariate linear regression was applied to examine the association of change in nutritional status with physical function and disability. Results: Compared to older adults with normal nutritional status at both baseline and 1-year follow-up, those who became undernourished or remained undernourished reported poorer physical function (B = -6.36 and -5.96, respectively; both P < 0.01), and had less frequent involvement (B = -3.95 and -2.84, respectively; both P < 0.01) and more limitation in performing life tasks (B = -13.24 and -16.02, respectively; both P < 0.01) at 1-year follow-up. However, older adults with improved nutritional status did not differ in physical function and frequency of involvement in life tasks compared to those with normal nutrition. Conclusion: Undernutrition is associated with poorer physical function and disability in community-dwelling older adults regardless of whether it developed or was persistent over one year. Improving nutritional status could be an effective strategy to improve physical function in older adults.

Community service providers, such as Meals on Wheels (MOW) programs, help older adults remain in their homes despite advanced care needs. The purpose of this study was to determine if a frailty index (FI) could be calculated from self-reported health, function, and nutrition information already collected by MOW providers to provide additional information for care planning and risk stratification. Data from 258 MOW clients at one provider were used to calculate the FI from 40 possible health and age-related variables collected during routine health assessments. The average FI was 0.29 ± 0.13(SD), range 0.05-0.68. Frailty was categorized as non-frail, vulnerable, frail, and most frail; nutrition risk increased incrementally with these categories; however, they appear to assess risk from differing angles and etiologies. The addition of the FI can provide a more holistic picture of MOW client health than nutrition risk alone and the FI can be calculated from routinely-collected data.