Journal of Nutrition in Gerontology and Geriatrics最新文献

Inadequate protein intake contributes to poor nutritional status, reduced muscle mass, strength and function, and increased mortality. Evaluating differences in protein intake and related health indicators among racial/ethnic groups enables the development of targeted interventions. This study's purpose was to determine differences in protein intake, nutritional status, and muscle strength/function among 273 older African, European, and Hispanic Americans. Protein intake, nutritional status, grip strength, timed-up-and-go (TUG), and chair stand assessments were conducted. Protein intake was significantly greater among Hispanic Americans (0.96 g/kg body weight) followed by European Americans (0.83 g/kg body weight), and African Americans (0.64 g/kg body weight). Intakes by all groups were below recommendations. Low nutritional status, grip strength, chair rise, and TUG scores were observed in African Americans and European American females and were consistent with lower protein intakes. Results show significant differences among the groups and the need for interventions to improve diet and physical health.

Objective: To evaluate dairy intake patterns in older adults across Europe. Methods: We conducted cross-sectional analysis using data from the fourth wave (2011/2012) of the Survey of Health, Aging and Retirement in Europe (SHARE) database. Prevalence rates regarding the number of weekly servings of dairy in individuals ≥50 years old were calculated for 16 European countries. Results: The overall prevalence rate of daily dairy product intake in Europe was 66.95% (CI95%: 66.28-67.63%). Global prevalence in men was 63.35% (CI95%:62.37-64.35%) and in women 69.80% (CI95%:68.86-70.71%). Among men, this type of intake was highest in Denmark (84.89% [CI95%: 79.11-90.66%]) and lowest in Poland (26.15% [CI95%: 22.71-29.58%]). Among women, the highest prevalence was found in Spain (89.51% [CI95%: 85.16-93.86%]) and the lowest in Poland (31.33% [CI95%: 27.05-35.61%]). The overall prevalence rate of dairy product intake less than once a week was 3.99% (CI95%: 3.83-4.16%). In terms of gender, men in Hungary (11.02% [CI95%: 9.16-12.89%]) and women in Slovenia (8.76% [CI95%: 7.26-10.25%]) had the lowest such intake. Conclusions: Dairy intake is very heterogeneous across Europe, with overall intake levels lower than recommended. Differences were also observed between genders, with a lower intake in men, and with age, with the intake lower in older individuals.

This study investigated barriers to fulfilling food preferences from nursing home (NH) residents' perspectives, and the reasons preferences changed (situational dependencies). Interviews were completed with 255 residents in 28 NHs across greater Philadelphia, PA using six food items from the Preferences for Everyday Living Inventory-NH (PELI-NH). Participants were predominantly white (77%), female (67.8%), and widowed (44%) with high school educations (48%). Content analysis was used to identify n = 386 barriers and n = 57 situational dependencies. Participants reported provider policies and staff proficiency as environmental barriers to preference fulfillment regarding what, when, and where to eat. Perceived health and personal resources were barriers to obtaining snacks, take-out, and dining out. Situational dependencies resulted from residents' perceived health and quality of family relationships. Results have implications for providers to centralize food preference fulfillment in care planning, and to use food preferences to address dining quality concerns.

In nursing homes (NHs), residents are at risk for malnutrition and weight loss. The purpose of this secondary data analysis was to examine the impact of resident cognitive status and level of feeding assistance provided by NH staff on resident's daily nutritional intake and body weight. As part of a large, multisite clinical trial (N = 786), residents with and without dementia were examined according to level of feeding assistance required during mealtimes (independent, set-up only, needs help eating) over a 21-day period. Outcomes analyzed were percent of meal intake by meal type (breakfast, lunch, dinner) and overall daily intake (meals + snacks/supplements). Residents with dementia who required meal set-up assistance had significantly lower meal intake for all three meals. Residents without dementia requiring meal set-up assistance experienced significantly lower intake for breakfast and dinner, but not lunch. When snacks and supplements were offered between meals, residents with dementia consumed approximately 163 additional calories/day, and residents without dementia consumed approximately 156 additional calories/day. This study adds new evidence that residents at greatest risk for low intake are those who are only provided set-up assistance for meals and/or have cognitive impairment.

Malnourishment leads to poor outcomes in the geriatric surgical population and national guidelines recommend preoperative nutrition screening. However, care practices do not reflect current recommendations. As a quality-improvement project, a validated nutritional screening tool, the Mini Nutritional Assessment-Short Form (MNA-SF), was implemented in the preoperative clinic of a large academic health center to identify patients at-risk for malnutrition prior to elective surgery. Patients were screened during the nursing intake process and categorized as no nutritional risk; at-risk for malnourishment; or severely malnourished. During the four-week screening period, 413 patients met inclusion criteria with 67.8% (n = 280) screened. No nutritional risk was identified in 77.5% (n = 215) of patients, 18.2% (n = 51) were at-risk, and 4.3% (n = 12) were malnourished. This project will inform and guide a prehabilitation plan for nutrition optimization to improve healthcare quality, outcomes, and costs in the geriatric surgical population.

The oldest old (aged ≥80 years) are often the population subgroup at high nutritional risk due to age-related metabolic changes. We performed a validation analysis of a dietary screening tool (DST) which was developed for older adults among the oldest old. We examined dietary intakes using three 24-hour dietary recalls and the DST among 122 participants (aged 82-97) of the Geisinger Rural Aging Study. DST scores were compared with the Health Eating Index (HEI)-2015 scores, which were calculated based on three-day dietary recalls. Pearson correlations were used to characterize concurrent validity and Bland-Altman plots were used to identify potential bias. DST scores were significantly correlated with HEI scores (adjusted r = 0.68; p < 0.001) in an age- and sex-adjusted model. Those within the not-at-risk DST group had significantly higher HEI scores (adjusted means = 79.6 ± 3.68) compared with those who were in the at-risk (adjusted means = 51.2 ± 1.56) and the possibly-at-risk (adjusted means = 66.3 ± 1.79) groups (p-trend < 0.001). The DST appears to be a valid measure of diet quality in the oldest old when compared with the HEI and may be a potential tool to assess overall diet quality in this population.

Objectives: Food insecurity, limited or uncertain access to adequate nutrition, is an increasingly recognized determinant of health outcomes and is often associated with having obesity. It is unclear, however, if this association persists in elderly populations.

Methods: We conducted a cross-sectional study of 2868 participants' aged 65+ years from the Health and Retirement Study. Multivariate logistic regression was used to assess associations between food insecurity and body mass index, demographic characteristics, psychiatric history, and medical history.

Results: Participants with overweight/obesity had a higher prevalence of food insecurity than leaner counterparts, however, weight status was not a significant predictor of food insecurity after multivariate adjustment. Instead, mental illness, current smoking status, and non-White race were all independently associated with food insecurity.

Discussion: Beyond financial status, health care providers are encouraged to use these characteristics to identify elderly patients that may be at risk of food insecurity.

The potential for B-vitamins to reduce plasma homocysteine (Hcy) and reduce the risk of Alzheimer's disease (AD) has been described previously. However, the role of Apolipoprotein E є4 (APOE4) in this relationship has not been adequately addressed. This case-control study explored APOE4 genotype in an Australian sample of 63 healthy individuals (female = 38; age = 76.9 ± 4.7 y) and 63 individuals with AD (female = 35, age = 77.1 ± 5.3 y). Findings revealed 55 of 126 participants expressed the APOE4 genotype with 37 of 126 having both AD and the APOE4 genotype. Analysis revealed an increased likelihood of AD when Hcy levels are >11.0 µmol/L (p = 0.012), cysteine levels were <255 µmol/L (p = 0.033) and serum folate was <22.0 nmol/L (p = 0.003; in males only). In females, dietary intake of total folate <336 µg/day (p=0.001), natural folate <270 µg/day (p = 0.011), and vitamin B2 < 1.12 mg/day (p = 0.028) was associated with an increased AD risk. These results support Hcy, Cys, and SF as useful biomarkers for AD, irrespective of APOE4 genotype and as such should be considered as part of screening and managing risk of AD.

Background: Mobile health (mHealth) technologies comprise a multidisciplinary treatment strategy providing potential solutions for overcoming challenges of successfully delivering health promotion interventions in rural areas. We evaluated the potential of using technology in a high-risk population.

Methods: We conducted a convergent, parallel mixed-methods study using semi-structured interviews, focus groups, and self-reported questionnaires, using purposive sampling of 29 older adults, 4 community leaders and 7 clinicians in a rural setting. We developed codes informed by thematic analysis and assessed the quantitative data using descriptive statistics.

Results: All groups expressed that mHealth could improve health behaviors. Older adults were optimistic that mHealth could track health. Participants believed they could improve patient insight into health, motivating change and assuring accountability. Barriers to using technology were described, including infrastructure.

Conclusions: Older rural adults with obesity expressed excitement about the use of mHealth technologies to improve their health, yet barriers to implementation exist.

Knowledge related to the relationship between obesity and frailty is limited. This study aimed to investigate associations between obesity, dietary inflammation, and frailty among older adults. Study data came from National Health and Nutrition Examination Survey (2007-2014) examinations of adults age ≥60 years (n = 7182). Dietary inflammatory potential was determined using the Dietary Inflammatory Index (DII^®) derived from 24-h dietary recall. We analyzed independent and joint associations of obesity and DII with frailty to evaluate interaction. Multivariable logistic regression revealed that both obesity (Odds Ratio [OR] = 2.24, 95% CI: 1.68, 2.99) and moderately pro-inflammatory DII (OR = 1.68, 95% CI: 1.10, 2.58) were independently associated with greater frailty prevalence. A negative multiplicative interaction between obesity and highest pro-inflammatory diet also was found (adjusted odds in non-obese and obese were 2.07 and 2.37, respectively; p = 0.046). Results indicate the importance of considering obesity and dietary inflammatory potential when screening for frailty or developing treatments.