Pub Date : 2019-11-23DOI: 10.1080/21551197.2019.1695037
B. Bustillos, J. Sharkey
Abstract Objectives: To study the experiences and challenges of type 2 diabetes (T2D) self-management among homebound older adults who regularly receive home-delivered meals and services. Methods: Participants (n = 31) were recruited by telephone screening and were selected by purposive sampling. Semi-structured interviews were subsequently conducted within participants’ homes. The interpretive methodology utilized in this study was developed to systematically assess T2D self-management. Results: Thematic analysis shows that participants felt mostly responsible for their health status, but attributed any noncompliance to lack of social and economic assistance. Most of the seniors in this study felt competent, but often did not have the opportunity to engage in protective measures due to a number of economic, physical, and social barriers. Conclusions: These results contribute to a better understanding of how to approach, support, and motivate homebound older adults with T2D while addressing challenges. Findings offer insight into the development of diabetes self-management education (DSME) and interventions for this population.
{"title":"“I Try to Keep That Sugar Down.” Experiences of Homebound Older Adults With Type 2 Diabetes: Barriers to Self-Management","authors":"B. Bustillos, J. Sharkey","doi":"10.1080/21551197.2019.1695037","DOIUrl":"https://doi.org/10.1080/21551197.2019.1695037","url":null,"abstract":"Abstract Objectives: To study the experiences and challenges of type 2 diabetes (T2D) self-management among homebound older adults who regularly receive home-delivered meals and services. Methods: Participants (n = 31) were recruited by telephone screening and were selected by purposive sampling. Semi-structured interviews were subsequently conducted within participants’ homes. The interpretive methodology utilized in this study was developed to systematically assess T2D self-management. Results: Thematic analysis shows that participants felt mostly responsible for their health status, but attributed any noncompliance to lack of social and economic assistance. Most of the seniors in this study felt competent, but often did not have the opportunity to engage in protective measures due to a number of economic, physical, and social barriers. Conclusions: These results contribute to a better understanding of how to approach, support, and motivate homebound older adults with T2D while addressing challenges. Findings offer insight into the development of diabetes self-management education (DSME) and interventions for this population.","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"15 1","pages":"69 - 87"},"PeriodicalIF":0.0,"publicationDate":"2019-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74844670","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}
Pub Date : 2019-11-13DOI: 10.1080/21551197.2019.1689882
K. Lambert, E. Taylor, S. Bowden, K. Charlton
Abstract This retrospective observational study evaluated the association between nutritional status, functional ability and discharge outcomes. Data from 1430 older rehabilitation patients (43% male, median age 79 years, interquartile range: 74–84) were analyzed. One fifth (20.6%, n = 294) of patients were malnourished on admission to rehabilitation. Three important findings were evident. Firstly, nutritional status on admission to rehabilitation was associated with reduced functional, motor, cognitive and feeding scores on admission and discharge (all P < 0.05). Secondly, malnutrition at admission was associated with significantly slower gains in rehabilitation. Finally, malnutrition at admission was associated with significantly higher odds of a decline in functional ability during admission (OR 3.95; 95% CI: 2.14–7.27), and almost three times greater odds of additional care requirements on discharge (OR: 2.9 ((95% CI: 1.02–8.3). The nutritional status of patients on admission to inpatient rehabilitation is a predictor of both the speed and degree of rehabilitation gains and discharge outcomes.
{"title":"Nutritional Status According to the Mini Nutritional Assessment Predicts Speed and Degree of Functional Improvement and Discharge Outcomes in Rehabilitation Patients","authors":"K. Lambert, E. Taylor, S. Bowden, K. Charlton","doi":"10.1080/21551197.2019.1689882","DOIUrl":"https://doi.org/10.1080/21551197.2019.1689882","url":null,"abstract":"Abstract This retrospective observational study evaluated the association between nutritional status, functional ability and discharge outcomes. Data from 1430 older rehabilitation patients (43% male, median age 79 years, interquartile range: 74–84) were analyzed. One fifth (20.6%, n = 294) of patients were malnourished on admission to rehabilitation. Three important findings were evident. Firstly, nutritional status on admission to rehabilitation was associated with reduced functional, motor, cognitive and feeding scores on admission and discharge (all P < 0.05). Secondly, malnutrition at admission was associated with significantly slower gains in rehabilitation. Finally, malnutrition at admission was associated with significantly higher odds of a decline in functional ability during admission (OR 3.95; 95% CI: 2.14–7.27), and almost three times greater odds of additional care requirements on discharge (OR: 2.9 ((95% CI: 1.02–8.3). The nutritional status of patients on admission to inpatient rehabilitation is a predictor of both the speed and degree of rehabilitation gains and discharge outcomes.","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"10 1","pages":"16 - 29"},"PeriodicalIF":0.0,"publicationDate":"2019-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74286174","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}
Pub Date : 2019-11-04DOI: 10.1080/21551197.2019.1684417
M. O'Leary, M. Barreto, J. Bowtell
Abstract We evaluated the effectiveness of a 3-week, daily meal provision service by a non-profit provider on the physical and psychological wellbeing of an older adult population. We further examined the feasibility of carrying out such measures in participant’s homes. 19 older adult participants (8M, 11F; 78.3 ± 8.7 years) received 3 meals per day for 21 days and supplemented these meals ad libitum. Risk of malnutrition (Mini Nutritional Assessment; MNA) body composition, blood pressure, handgrip strength, balance, mobility, loneliness, social capital, satisfaction with life and mood were evaluated in participant’s homes before and after the intervention. Following the intervention, MNA score increased significantly and participants rated themselves as significantly less depressed. We describe a methodology that was largely feasible and outline ways in which it could be improved. We have demonstrated that even short-term, home meal deliveries improve MNA scores and can positively alter some measures of mood.
{"title":"Evaluating the Effect of a Home-Delivered Meals Service on the Physical and Psychological Wellbeing of a UK Population of Older Adults – A Pilot and Feasibility Study","authors":"M. O'Leary, M. Barreto, J. Bowtell","doi":"10.1080/21551197.2019.1684417","DOIUrl":"https://doi.org/10.1080/21551197.2019.1684417","url":null,"abstract":"Abstract We evaluated the effectiveness of a 3-week, daily meal provision service by a non-profit provider on the physical and psychological wellbeing of an older adult population. We further examined the feasibility of carrying out such measures in participant’s homes. 19 older adult participants (8M, 11F; 78.3 ± 8.7 years) received 3 meals per day for 21 days and supplemented these meals ad libitum. Risk of malnutrition (Mini Nutritional Assessment; MNA) body composition, blood pressure, handgrip strength, balance, mobility, loneliness, social capital, satisfaction with life and mood were evaluated in participant’s homes before and after the intervention. Following the intervention, MNA score increased significantly and participants rated themselves as significantly less depressed. We describe a methodology that was largely feasible and outline ways in which it could be improved. We have demonstrated that even short-term, home meal deliveries improve MNA scores and can positively alter some measures of mood.","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"88 1","pages":"1 - 15"},"PeriodicalIF":0.0,"publicationDate":"2019-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77626533","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}
Pub Date : 2019-10-01Epub Date: 2019-06-21DOI: 10.1080/21551197.2019.1628158
Angela Ott, Melanie Senger, Thomas Lötzbeyer, Olaf Gefeller, Cornel C Sieber, Dorothee Volkert
This proof-of-concept study investigated the effects of an innovative nutrition concept, comprising texture modification, enrichment, and reshaping, on dietary intake and nutritional status of 16 nursing home residents with chewing and/or swallowing problems (mean age 86.5 ± 7.4 years) in a pre-test post-test design. During 6 weeks with usual texture-modified diet (P1) energy and protein intake were constant. After the implementation of the innovative diet, daily energy intake increased by 204.2 (median) [interquartile range 95.8-444.4] kcal (P = 0.011), and protein intake by 18.3 [9.9-26.3] g (P < 0.001) and remained constant during the following 6 weeks (P2). Body weight decreased during P1 (-0.5 [-1.4 to 0.2] kg), and increased during P2 (+1.1 [0.0 to 1.7] kg, P = 0.004). The present nutrition concept turned out to be a promising strategy for nutritional management of chewing and/or swallowing problems, however, the effects need to be confirmed in larger studies.
{"title":"Effects of a Texture-Modified, Enriched, and Reshaped Diet on Dietary Intake and Body Weight of Nursing Home Residents with Chewing and/or Swallowing Problems: An <i>Enable</i> Study.","authors":"Angela Ott, Melanie Senger, Thomas Lötzbeyer, Olaf Gefeller, Cornel C Sieber, Dorothee Volkert","doi":"10.1080/21551197.2019.1628158","DOIUrl":"https://doi.org/10.1080/21551197.2019.1628158","url":null,"abstract":"<p><p>This proof-of-concept study investigated the effects of an innovative nutrition concept, comprising texture modification, enrichment, and reshaping, on dietary intake and nutritional status of 16 nursing home residents with chewing and/or swallowing problems (mean age 86.5 ± 7.4 years) in a pre-test post-test design. During 6 weeks with usual texture-modified diet (P1) energy and protein intake were constant. After the implementation of the innovative diet, daily energy intake increased by 204.2 (median) [interquartile range 95.8-444.4] kcal (<i>P</i> = 0.011), and protein intake by 18.3 [9.9-26.3] g (<i>P</i> < 0.001) and remained constant during the following 6 weeks (P2). Body weight decreased during P1 (-0.5 [-1.4 to 0.2] kg), and increased during P2 (+1.1 [0.0 to 1.7] kg, <i>P</i> = 0.004). The present nutrition concept turned out to be a promising strategy for nutritional management of chewing and/or swallowing problems, however, the effects need to be confirmed in larger studies.</p>","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"38 4","pages":"361-376"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21551197.2019.1628158","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37352131","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}
Pub Date : 2019-09-12DOI: 10.1080/21551197.2019.1662356
Mai Takase, H. Murayama, Sayaka Hirukawa, M. Sugimoto, S. Ono, Tomoki Tanaka, M. Kimata
Abstract Previous research indicated that dining style is associated with depressive mood in community-dwelling older adults; however, the nature of this relationship in care facilities is unclear. The association between dining style and depressive mood was examined in Japanese assisted living facility. A questionnaire survey was conducted among residents older than 65 years. Dining style was assessed by objective (the number of people with whom one eats) and subjective (feelings of enjoyment during mealtimes) factors. The odds ratio of participants who ate alone but enjoyed meals having depressive mood were not statistically different from the reference group (eating with others and enjoying). In contrast, participants who ate with others and did not enjoy meals, and participants who ate alone and did not enjoy meals were more likely to have depressive mood compared to the reference group. Although a cross-sectional study, findings suggested that caregivers should consider residents’ subjective dining styles to provide optimal support at mealtimes.
{"title":"Which Aspects of Dining Style are Associated with Depressive Mood? A Study at an Assisted Living Facility in Japan","authors":"Mai Takase, H. Murayama, Sayaka Hirukawa, M. Sugimoto, S. Ono, Tomoki Tanaka, M. Kimata","doi":"10.1080/21551197.2019.1662356","DOIUrl":"https://doi.org/10.1080/21551197.2019.1662356","url":null,"abstract":"Abstract Previous research indicated that dining style is associated with depressive mood in community-dwelling older adults; however, the nature of this relationship in care facilities is unclear. The association between dining style and depressive mood was examined in Japanese assisted living facility. A questionnaire survey was conducted among residents older than 65 years. Dining style was assessed by objective (the number of people with whom one eats) and subjective (feelings of enjoyment during mealtimes) factors. The odds ratio of participants who ate alone but enjoyed meals having depressive mood were not statistically different from the reference group (eating with others and enjoying). In contrast, participants who ate with others and did not enjoy meals, and participants who ate alone and did not enjoy meals were more likely to have depressive mood compared to the reference group. Although a cross-sectional study, findings suggested that caregivers should consider residents’ subjective dining styles to provide optimal support at mealtimes.","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"37 1","pages":"377 - 386"},"PeriodicalIF":0.0,"publicationDate":"2019-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86901860","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}
Pub Date : 2019-09-10DOI: 10.1080/21551197.2019.1656135
T. Wallace, C. Frankenfeld, B. Frei, Alpa Shah, Ching-Ray Yu, J. Klinken, Maryann Adeleke
Abstract Micronutrient inadequacies are common in older adults and using a multivitamin/multimineral supplement (MVM) may improve their nutritional status. National Health and Nutrition Examination Survey data were analyzed to determine micronutrient intakes based on diet and MVM use in adults aged ≥51 years. Deficiencies were evaluated using nutrient biomarkers. The National Cancer Institute Method was used to estimate usual intakes of 18 micronutrients stratified by age and frequency of MVM use. Compared with food alone, MVM use was associated with higher nutrient intake and lower prevalence of inadequacies of almost all micronutrients examined and improved nutrient biomarker status of folate, iodine, selenium, and vitamins B6, B12, and D. Regular MVM use (≥16 days/month) decreased the odds of clinical deficiency (defined by biomarker status) of vitamins B6 and D but increased the proportion exceeding the tolerable upper intake level of folic acid. Vitamin B6 deficiency in MVM non-users was common and increased with age.
{"title":"Multivitamin/Multimineral Supplement Use is Associated with Increased Micronutrient Intakes and Biomarkers and Decreased Prevalence of Inadequacies and Deficiencies in Middle-Aged and Older Adults in the United States","authors":"T. Wallace, C. Frankenfeld, B. Frei, Alpa Shah, Ching-Ray Yu, J. Klinken, Maryann Adeleke","doi":"10.1080/21551197.2019.1656135","DOIUrl":"https://doi.org/10.1080/21551197.2019.1656135","url":null,"abstract":"Abstract Micronutrient inadequacies are common in older adults and using a multivitamin/multimineral supplement (MVM) may improve their nutritional status. National Health and Nutrition Examination Survey data were analyzed to determine micronutrient intakes based on diet and MVM use in adults aged ≥51 years. Deficiencies were evaluated using nutrient biomarkers. The National Cancer Institute Method was used to estimate usual intakes of 18 micronutrients stratified by age and frequency of MVM use. Compared with food alone, MVM use was associated with higher nutrient intake and lower prevalence of inadequacies of almost all micronutrients examined and improved nutrient biomarker status of folate, iodine, selenium, and vitamins B6, B12, and D. Regular MVM use (≥16 days/month) decreased the odds of clinical deficiency (defined by biomarker status) of vitamins B6 and D but increased the proportion exceeding the tolerable upper intake level of folic acid. Vitamin B6 deficiency in MVM non-users was common and increased with age.","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"1 1","pages":"307 - 328"},"PeriodicalIF":0.0,"publicationDate":"2019-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90729850","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}
Pub Date : 2019-08-19DOI: 10.1080/21551197.2019.1651237
A. Yoxall, Alison F Bell, Kate Gee, Caroline Lecko
Abstract In 2015, the UK National Health Service (NHS) established a taskforce to review single portion food and beverage packaging, which has been identified as a potential challenge to users in hospitals. Hence, a study was undertaken to determine the suitability and accessibility of the current single portion packs. The packaging was assessed using ISO 17480 (Guidelines for Accessible Packaging), Annex D. The standard determines a pass or fail of packaging opening asking a panel 20 older adults to open a pack. A pack is recorded as a failure if within the 20 people cohort, there is an example of pack being unable to be opened within the time limit (defined as 1 minute) or the overall satisfaction score ranks below 3 on a 5-point Likert scale. Ten standard single portion packaging items were randomly selected for testing. The packs were chosen to reflect a broad range of food and beverage and packaging types. The results showed that the standard provided useful assessment data, identifying that 70% of the packs were so poorly designed that they failed to pass the standard, with 50% of the packs having examples that were unopenable by the participants, whilst a further 20% rated poorly for satisfaction.
{"title":"Single Portion Packaging and the Use of User Test Protocols to Determine Patient Accessibility","authors":"A. Yoxall, Alison F Bell, Kate Gee, Caroline Lecko","doi":"10.1080/21551197.2019.1651237","DOIUrl":"https://doi.org/10.1080/21551197.2019.1651237","url":null,"abstract":"Abstract In 2015, the UK National Health Service (NHS) established a taskforce to review single portion food and beverage packaging, which has been identified as a potential challenge to users in hospitals. Hence, a study was undertaken to determine the suitability and accessibility of the current single portion packs. The packaging was assessed using ISO 17480 (Guidelines for Accessible Packaging), Annex D. The standard determines a pass or fail of packaging opening asking a panel 20 older adults to open a pack. A pack is recorded as a failure if within the 20 people cohort, there is an example of pack being unable to be opened within the time limit (defined as 1 minute) or the overall satisfaction score ranks below 3 on a 5-point Likert scale. Ten standard single portion packaging items were randomly selected for testing. The packs were chosen to reflect a broad range of food and beverage and packaging types. The results showed that the standard provided useful assessment data, identifying that 70% of the packs were so poorly designed that they failed to pass the standard, with 50% of the packs having examples that were unopenable by the participants, whilst a further 20% rated poorly for satisfaction.","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"20 1","pages":"387 - 396"},"PeriodicalIF":0.0,"publicationDate":"2019-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82762746","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}
Pub Date : 2019-07-30DOI: 10.1080/21551197.2019.1646690
Katarina M. Doma, Emily L. Farrell, Erin R. Leith-Bailey, Victoria D. Soucier, A. Duncan
Abstract Beans are nutrient-dense and can reduce risk of chronic diseases. This is relevant to older adults who can benefit from consuming beans to reduce their elevated chronic disease risk. This study explored bean consumption in older adults (≥65 years) using mixed-methods including a researcher-administered questionnaire (n = 250) and focus groups (n = 49). Prevalence of bean consumption (daily or weekly) was 51.2%. Motivators to bean consumption were significantly more likely among bean consumers with the top three including nutritional value, taste/texture and versatility, which were also predictors of consuming beans (OR = 3.54, 2.72, and 4.24, respectively). Conversely, barriers to bean consumption were significantly more likely among bean non-consumers with the top three including not part of traditional diet/do not think to include beans in meals, flatulence/abdominal discomfort and lack of knowledge about preparation/cooking, which were also predictors of not consuming beans (OR = 3.85, 2.26, and 5.08, respectively). This research will inform dietary strategies to increase bean consumption.
{"title":"Motivators, Barriers and Other Factors Related to Bean Consumption in Older Adults","authors":"Katarina M. Doma, Emily L. Farrell, Erin R. Leith-Bailey, Victoria D. Soucier, A. Duncan","doi":"10.1080/21551197.2019.1646690","DOIUrl":"https://doi.org/10.1080/21551197.2019.1646690","url":null,"abstract":"Abstract Beans are nutrient-dense and can reduce risk of chronic diseases. This is relevant to older adults who can benefit from consuming beans to reduce their elevated chronic disease risk. This study explored bean consumption in older adults (≥65 years) using mixed-methods including a researcher-administered questionnaire (n = 250) and focus groups (n = 49). Prevalence of bean consumption (daily or weekly) was 51.2%. Motivators to bean consumption were significantly more likely among bean consumers with the top three including nutritional value, taste/texture and versatility, which were also predictors of consuming beans (OR = 3.54, 2.72, and 4.24, respectively). Conversely, barriers to bean consumption were significantly more likely among bean non-consumers with the top three including not part of traditional diet/do not think to include beans in meals, flatulence/abdominal discomfort and lack of knowledge about preparation/cooking, which were also predictors of not consuming beans (OR = 3.85, 2.26, and 5.08, respectively). This research will inform dietary strategies to increase bean consumption.","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"16 1","pages":"397 - 413"},"PeriodicalIF":0.0,"publicationDate":"2019-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87472662","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}
Pub Date : 2019-07-30DOI: 10.1080/21551197.2019.1647327
T. Sadarangani, L. Missaelides, Gary Yu, Chau Trinh-Shevrin, A. Brody
Abstract Information regarding nutritional risk among users of American adult day health centers (ADHCs), 60% of whom are racial minorities, is scant. This study examined nutritional risk and associated factors in a diverse sample ADHC users aged 50+ using secondary cross-sectional analysis of data collected between 2013 and 2017. Risk was assessed using the DETERMINE checklist, and results were stratified by race. The majority of the sample (N = 188) was at moderate (45.2%) or high (38.5%) nutritional risk, with statistically significant racial differences. Blacks were at greater risk than any other group: 65% had high nutritional risk; 76.5% ate <5 servings of fruits, vegetables, or milk daily; 21% ate <2 meals daily, 48.5% reported involuntary weight loss/gain, and 41.2% had tooth loss/mouth pain. Older adults in ADHCs are at elevated risk of malnutrition, disproportionately so amongst blacks. Both routine nutrition screening and population-specific approaches are needed to attenuate risk.
{"title":"Racial Disparities in Nutritional Risk among Community-Dwelling Older Adults in Adult Day Health Care","authors":"T. Sadarangani, L. Missaelides, Gary Yu, Chau Trinh-Shevrin, A. Brody","doi":"10.1080/21551197.2019.1647327","DOIUrl":"https://doi.org/10.1080/21551197.2019.1647327","url":null,"abstract":"Abstract Information regarding nutritional risk among users of American adult day health centers (ADHCs), 60% of whom are racial minorities, is scant. This study examined nutritional risk and associated factors in a diverse sample ADHC users aged 50+ using secondary cross-sectional analysis of data collected between 2013 and 2017. Risk was assessed using the DETERMINE checklist, and results were stratified by race. The majority of the sample (N = 188) was at moderate (45.2%) or high (38.5%) nutritional risk, with statistically significant racial differences. Blacks were at greater risk than any other group: 65% had high nutritional risk; 76.5% ate <5 servings of fruits, vegetables, or milk daily; 21% ate <2 meals daily, 48.5% reported involuntary weight loss/gain, and 41.2% had tooth loss/mouth pain. Older adults in ADHCs are at elevated risk of malnutrition, disproportionately so amongst blacks. Both routine nutrition screening and population-specific approaches are needed to attenuate risk.","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"1 1","pages":"345 - 360"},"PeriodicalIF":0.0,"publicationDate":"2019-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81701744","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}
Pub Date : 2019-07-23DOI: 10.1080/21551197.2019.1640165
H. Keller, V. Vucea, S. Slaughter, H. Jager-Wittenaar, C. Lengyel, F. Ottery, N. Carrier
Abstract The ideal tool for determination of malnutrition risk or malnutrition in long term care (LTC) is elusive. This study compares prevalence, association with resident risk factors and sensitivity (SE) and specificity (SP) of malnutrition or risk categorization in 638 residents from 32 LTC homes in Canada using four tools: the Mini-Nutritional Assessment Short Form (MNA-SF); Patient-Generated Subjective Global Assessment (PG-SGA) Global Category Rating and the Pt-Global webtool; and the interRAI Long Term Care Facility undernutrition trigger. Prevalence was most common with MNA-SF (53.7%) and lowest with InterRAI (28.9%), while the PG-SGA Global Category Rating (44%) was higher than the Pt-Global webtool (33.4%). Tools were consistently associated with resident covariates with few exceptions. The PG-SGA Global Category Rating demonstrated the best sensitivity and specificity when compared to all other tools. Further work to determine the predictive validity of this tool in LTC residents is required.
确定营养不良风险或营养不良长期护理(LTC)的理想工具是难以捉摸的。本研究使用四种工具比较了来自加拿大32个LTC家庭的638名居民营养不良或风险分类的患病率、与居民风险因素的关联以及敏感性(SE)和特异性(SP):迷你营养评估简短表格(MNA-SF);患者主观全局评估(PG-SGA)全局分类评定与Pt-Global webtool以及interRAI长期护理机构的营养不良诱因。MNA-SF患病率最高(53.7%)，InterRAI患病率最低(28.9%)，而PG-SGA Global Category Rating(44%)高于Pt-Global webtool(33.4%)。除少数例外，工具始终与常驻协变量相关。与所有其他工具相比，PG-SGA Global Category Rating显示出最佳的敏感性和特异性。需要进一步的工作来确定该工具在LTC居民中的预测有效性。
{"title":"Prevalence of Malnutrition or Risk in Residents in Long Term Care: Comparison of Four Tools","authors":"H. Keller, V. Vucea, S. Slaughter, H. Jager-Wittenaar, C. Lengyel, F. Ottery, N. Carrier","doi":"10.1080/21551197.2019.1640165","DOIUrl":"https://doi.org/10.1080/21551197.2019.1640165","url":null,"abstract":"Abstract The ideal tool for determination of malnutrition risk or malnutrition in long term care (LTC) is elusive. This study compares prevalence, association with resident risk factors and sensitivity (SE) and specificity (SP) of malnutrition or risk categorization in 638 residents from 32 LTC homes in Canada using four tools: the Mini-Nutritional Assessment Short Form (MNA-SF); Patient-Generated Subjective Global Assessment (PG-SGA) Global Category Rating and the Pt-Global webtool; and the interRAI Long Term Care Facility undernutrition trigger. Prevalence was most common with MNA-SF (53.7%) and lowest with InterRAI (28.9%), while the PG-SGA Global Category Rating (44%) was higher than the Pt-Global webtool (33.4%). Tools were consistently associated with resident covariates with few exceptions. The PG-SGA Global Category Rating demonstrated the best sensitivity and specificity when compared to all other tools. Further work to determine the predictive validity of this tool in LTC residents is required.","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"83 1","pages":"329 - 344"},"PeriodicalIF":0.0,"publicationDate":"2019-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80904950","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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