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Letter to the Editor regarding “Comfort Feeding in Hospitalised People with Dementia: A Retrospective Study of Survival Following Comfort Feeding Recommendations” 致编辑的信,内容涉及 "住院痴呆症患者的舒适喂养:舒适喂养建议实施后存活率的回顾性研究
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-15 DOI: 10.1016/j.jnha.2024.100383
Rui He, Lingjia Xu
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引用次数: 0
Limited predictive value of bioelectrical phase angle for the development of sarcopenia in older Europeans 生物电相位角对欧洲老年人患肌少症的预测价值有限
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-15 DOI: 10.1016/j.jnha.2024.100386
Małgorzata Pigłowska , Andrea Corsonello , Tomasz Kostka , Regina Roller-Wirnsberger , Gerhard Wirnsberger , Johan Ärnlöv , Axel C. Carlsson , Lisanne Tap , Francesco Mattace-Raso , Francesc Formiga , Rafael Moreno-González , Robert Kob , Cornel Sieber , Pedro Gil , Sara Lainez Martinez , Ronit Ben-Romano , Itshak Melzer , Paolo Fabbietti , Fabrizia Lattanzio , Agnieszka Guligowska

Background

Despite the emerging interest in phase angle (PhA), a non-invasive marker of cell hydration and nutritional status, no previous study has reported the prospective association between PhA and incident sarcopenia. Therefore, the aim of our study was to evaluate the association of baseline PhA in older subjects without sarcopenia with the development of new sarcopenia as outcome.

Methods

Six-hundred ninety-six subjects without sarcopenia aged ≥75 years enrolled in an international multicenter observational study were included. Sarcopenia was assessed according to the revised EWGSOP2 criteria at baseline and in follow-up visits at 12 and 24 months. Muscle strength was assessed through the handgrip strength test using a hydraulic grip strength dynamometer, muscle mass was assessed by bioimpedance analysis (BIA) and appendicular skeletal muscle mass (ASMM) was estimated. Physical performance was assessed by Short Physical Performance Battery (SPPB).

Results

Participants who developed sarcopenia were older, less educated, had higher prevalence of osteoporosis, and lower baseline cognitive function, SPPB, handgrip strength and ASMM than those without sarcopenia. Baseline PhA was significantly lower in subjects developing sarcopenia. Nevertheless, after adjusting for all potential covariates including baseline components of sarcopenia in multiple logistic regression, neither PhA as continuous variable nor different levels of PhA were any more significant predictors of sarcopenia.

Conclusions

As an indicator of cells function, PhA could be a potential useful early marker in identifying older people at risk of developing sarcopenia but its practical applicability remains uncertain with the present data.
背景尽管相位角(PhA)这一细胞水合与营养状况的非侵入性标志物正受到越来越多的关注,但此前还没有任何研究报道过相位角与肌肉疏松症之间的前瞻性关联。因此,我们的研究旨在评估无肌肉疏松症的老年受试者的基线 PhA 与新发肌肉疏松症之间的关系。根据修订后的 EWGSOP2 标准,在基线以及 12 个月和 24 个月的随访中对肌肉疏松症进行评估。肌肉力量通过使用液压握力计进行的手握力测试进行评估,肌肉质量通过生物阻抗分析(BIA)进行评估,并估算出附着骨骼肌质量(ASMM)。结果与未患肌肉疏松症的参与者相比,患肌肉疏松症的参与者年龄较大、受教育程度较低、骨质疏松症发病率较高,基线认知功能、SPPB、握力和ASMM均较低。出现肌肉疏松症的受试者的基线 PhA 明显较低。结论 作为细胞功能的一个指标,PhA 可能是识别有患肌肉疏松症风险的老年人的一个有用的早期标记,但目前的数据仍无法确定其实际应用性。
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引用次数: 0
Corrigendum to “The association between anemia and all-cause mortality among Chinese older people: The evidence from CHARLS” [The Journal of nutrition, health and aging 28 (2024) 100281] 中国老年人贫血与全因死亡率的关系:来自 CHARLS 的证据》[《营养、健康与老龄化杂志》28 (2024) 100281]。
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.jnha.2024.100380
Xiao-Ming Zhang , Lie-E Li , Cong-Hua Wang , Qing-Li Dou , Yun-Zhi Yang
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引用次数: 0
Diet quality in U.S. adults eating in senior and community centers: NHANES 2009-2018 在老年中心和社区中心就餐的美国成年人的饮食质量:Nhanes 2009-2018。
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.jnha.2024.100379
Maximilian Andreas Storz , Alvaro Luis Ronco

Background

With advancing age, the worsening of cognitive and physical disabilities may lead older adults to seek help in their daily living activities. Community/senior centers support older adults during aging, offering a wide variety of services, including meal programs. Using data from the National Health and Nutrition Examination Surveys (2009–2018), we aimed to examine whether community/senior center meal programs were associated with an improved nutritional exposure in U.S. adults aged 60 years or older.

Methods

Nutrient exposure and nutrient-based dietary indexes, including the Diet Quality Score (DQS) and the Food Nutrient Index (FNI) were compared between those eating meals at community/senior centers and the general population. Nutrient intakes were contrasted to the daily nutritional goals from the Dietary Guidelines for Americans.

Results

This study included 6261 participants aged ≥60 years, thereof n = 421 reporting community/senior center meals. The latter were predominantly female and almost 45% were widowed or divorced. Eating at community/senior centers did not result in a better diet quality in crude analyses. After adjustment for potential sociodemographic confounders as well as alcohol, smoking and energy intake, however, sex-specific differences emerged, revealing significantly higher FNI scores in males eating at community/senior centers (adjusted FNI predictions: 61.71 [CI:58.55–64.88] vs 57.64 [CI:56.86−58.41] points).

Conclusions

Eating at community/senior centers was associated with an improved nutrient exposure in older men, whereas no better diet quality was found in women. Community/senior centers may play a pivotal role when it comes to the diet quality of a particularly vulnerable group of the population.
背景:随着年龄的增长,认知和身体残疾的恶化可能会导致老年人在日常生活活动中寻求帮助。社区/老年中心为老年人的老龄化提供支持,提供包括膳食计划在内的各种服务。我们利用全国健康与营养调查(2009-2018 年)的数据,旨在研究社区/老年中心膳食计划是否与美国 60 岁或以上老年人营养暴露的改善有关:方法:比较了在社区/养老中心就餐者和普通人群的营养暴露和基于营养素的膳食指数,包括膳食质量评分(DQS)和食物营养素指数(FNI)。营养素摄入量与《美国人膳食指南》规定的每日营养目标进行了对比:这项研究包括 6261 名年龄≥60 岁的参与者,其中 n = 421 人报告在社区/养老中心就餐。后者主要为女性,近 45% 为丧偶或离异。根据粗略分析,在社区/养老中心就餐并不会提高饮食质量。然而,在对潜在的社会人口混杂因素以及酒精、吸烟和能量摄入进行调整后,出现了性别差异,显示在社区/老年活动中心就餐的男性的 FNI 得分明显更高(调整后的 FNI 预测值为 61.71 [CI:58.0] :61.71 [CI:58.55-64.88] vs 57.64 [CI:56.86-58.41] 分):结论:在社区/老年活动中心就餐与老年男性营养素摄入量的提高有关,而在女性中却没有发现更好的饮食质量。社区/老年活动中心可能会在提高弱势群体的饮食质量方面发挥关键作用。
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引用次数: 0
Cost-effectiveness of protein-rich meals and snacks for increasing protein intake in older adults 增加老年人蛋白质摄入量的富含蛋白质的正餐和点心的成本效益
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-27 DOI: 10.1016/j.jnha.2024.100381
P. Rautakallio-Järvinen , S. Kunvik , M. Laaksonen , L. Fogelholm , I. Nykänen , U. Schwab

Objectives

To investigate the cost-effectiveness of protein-rich meals and snacks for increasing protein intake in home-dwelling older adults.

Design

Cost effectiveness analysis from a randomized controlled trial, the Power Meals study.

Setting

Participants were randomized into one of three groups for eight weeks: a protein-rich meal, snack and bread (Protein), a regular meal (Normal) and a control group without meal service (Control).

Participants

Home-dwelling home care clients, caregivers and care recipients aged ≥65 years (n = 65).

Measurements

Protein intake was assessed by a three-day food diary at the end of the study. Cost for the daily diet was estimated by using Finnish grocery store databases and the prices of the food service. The cost-effectiveness was assessed by an incremental cost-effectiveness ratio (ICER).

Results

Costs for the daily diet in the Protein (8.35 €/d) and the Normal (7.94 €/d) groups were significantly higher than in the control group (5.65 €/d) (p < 0.001). Incremental cost-effectiveness analysis showed that increasing protein intake was cost-effective in the Protein group as incremental cost-effectiveness ratio was 8.11 in the Protein, 8.72 in the Normal and 6.45 in the Control group.

Conclusions

Including protein rich meals and snacks in a diet increases protein intake in home-dwelling older adults cost-effectively.
目的研究富含蛋白质的正餐和点心在增加居家老年人蛋白质摄入量方面的成本效益。设置参与者被随机分为三组,每组八周:富含蛋白质的正餐、点心和面包组(蛋白质组)、普通正餐组(普通组)和不提供膳食服务的对照组(对照组)。日常饮食成本通过芬兰杂货店数据库和餐饮服务价格进行估算。结果蛋白质组(8.35 欧元/天)和正常组(7.94 欧元/天)的日常饮食成本明显高于对照组(5.65 欧元/天)(p < 0.001)。增量成本效益分析表明,蛋白质组增加蛋白质摄入量具有成本效益,因为蛋白质组的增量成本效益比为 8.11,正常组为 8.72,对照组为 6.45。
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引用次数: 0
Association of ultra-processed food intake with severe non-alcoholic fatty liver disease: a prospective study of 143073 UK Biobank participants 超加工食品摄入量与严重非酒精性脂肪肝的关系:对 143073 名英国生物数据库参与者的前瞻性研究
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-27 DOI: 10.1016/j.jnha.2024.100352
Yi-Feng Zhang , Wanning Qiao , Jinhong Zhuang , Hanxiao Feng , Zhilan Zhang , Yang Zhang

Background

Previous studies indicate a link between non-alcoholic fatty liver disease (NAFLD) and unhealthy dietary patterns or nutrient intake. However, it remains unclear whether ultra-processed foods (UPF) contribute to an increased risk of NAFLD. This study aimed to explore how ultra-processed food consumption correlates with severe NAFLD using the UK Biobank data.

Methods

This prospective cohort study included 143,073 participants from the UK Biobank. UPF consumption levels were determined using the NOVA classification and quantified from 24-h dietary recall data. The association between UPF consumption and severe NAFLD (hospitalization or death) was initially examined using Cox proportional hazards models with intake quartiles. Nonlinear associations were investigated using penalized cubic splines fitted in the Cox proportional hazards models. Adjustments were made for general characteristics, sociodemographic factors, body mass index (BMI), and lifestyle.

Results

Throughout the median follow-up period of 10.5 years, 1,445 participants developed severe NAFLD. The adjusted models indicated a significant increase in severe NAFLD risk in higher UPF intake groups compared to the lowest quartile (HR: 1.26 [95% CI: 1.11–1.43]). Subgroup analysis revealed that individuals with a BMI of 25 or higher were at greater risk in the highest quartile of UPF consumption. Sensitivity analyses yielded results consistent with these findings.

Conclusion

Higher consumption of UPF is associated with an increased risk of severe NAFLD. Reducing the intake of UPF can be a potential approach to lower the risk of NAFLD.
背景以往的研究表明,非酒精性脂肪肝(NAFLD)与不健康的饮食模式或营养摄入之间存在联系。然而,超加工食品(UPF)是否会导致非酒精性脂肪肝风险增加,目前仍不清楚。这项研究旨在利用英国生物库的数据,探讨超加工食品的摄入量与严重非酒精性脂肪肝的相关性。这项前瞻性队列研究纳入了英国生物库中的143,073名参与者,采用NOVA分类法确定UPF消费水平,并根据24小时饮食回忆数据进行量化。采用摄入量四分位数的考克斯比例危险模型初步检验了UPF摄入量与严重非酒精性脂肪肝(住院或死亡)之间的关系。在Cox比例危险模型中使用惩罚性立方样条来研究非线性关联。结果在中位 10.5 年的随访期间,有 1,445 名参与者患上了严重的非酒精性脂肪肝。调整后的模型显示,与最低四分位数相比,UPF摄入量较高的人群患严重非酒精性脂肪肝的风险明显增加(HR:1.26 [95% CI:1.11-1.43])。亚组分析显示,体重指数为25或更高的人在UPF摄入量最高的四分位组中风险更大。结论较高的 UPF 摄入量与严重非酒精性脂肪肝的风险增加有关。减少UPF的摄入量是降低非酒精性脂肪肝风险的一种潜在方法。
{"title":"Association of ultra-processed food intake with severe non-alcoholic fatty liver disease: a prospective study of 143073 UK Biobank participants","authors":"Yi-Feng Zhang ,&nbsp;Wanning Qiao ,&nbsp;Jinhong Zhuang ,&nbsp;Hanxiao Feng ,&nbsp;Zhilan Zhang ,&nbsp;Yang Zhang","doi":"10.1016/j.jnha.2024.100352","DOIUrl":"10.1016/j.jnha.2024.100352","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies indicate a link between non-alcoholic fatty liver disease (NAFLD) and unhealthy dietary patterns or nutrient intake. However, it remains unclear whether ultra-processed foods (UPF) contribute to an increased risk of NAFLD. This study aimed to explore how ultra-processed food consumption correlates with severe NAFLD using the UK Biobank data.</div></div><div><h3>Methods</h3><div>This prospective cohort study included 143,073 participants from the UK Biobank. UPF consumption levels were determined using the NOVA classification and quantified from 24-h dietary recall data. The association between UPF consumption and severe NAFLD (hospitalization or death) was initially examined using Cox proportional hazards models with intake quartiles. Nonlinear associations were investigated using penalized cubic splines fitted in the Cox proportional hazards models. Adjustments were made for general characteristics, sociodemographic factors, body mass index (BMI), and lifestyle.</div></div><div><h3>Results</h3><div>Throughout the median follow-up period of 10.5 years, 1,445 participants developed severe NAFLD. The adjusted models indicated a significant increase in severe NAFLD risk in higher UPF intake groups compared to the lowest quartile (HR: 1.26 [95% CI: 1.11–1.43]). Subgroup analysis revealed that individuals with a BMI of 25 or higher were at greater risk in the highest quartile of UPF consumption. Sensitivity analyses yielded results consistent with these findings.</div></div><div><h3>Conclusion</h3><div>Higher consumption of UPF is associated with an increased risk of severe NAFLD. Reducing the intake of UPF can be a potential approach to lower the risk of NAFLD.</div></div>","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"28 10","pages":"Article 100352"},"PeriodicalIF":4.3,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of allostatic load with functional disability in the China Health and Retirement Longitudinal Study 中国健康与退休纵向研究中异位负荷与功能障碍的关系
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-27 DOI: 10.1016/j.jnha.2024.100367
Wanyu Zhao , Yanjun Si , Xueqin Li , Yunli Zhao , Shuli Jia , Birong Dong

Objectives

Allostatic load (AL) is an index that manifests as cumulative wear and tear on multiple physiological systems resulting from repeated adaptation to stressors throughout the life course. Higher AL was found to be associated with increased risk of adverse health outcomes, but studies on functional disability among large Chinese older population were limited. We aimed to investigate the associations of AL with functional disability among Chinese older adults.

Research design and methods

This prospective cohort study included 5880 older adults who were at least 50 years old and participated in the CHARLS at baseline (2011 wave), with 3 follow-ups (2013, 2015 and 2018 waves). We selected 11 biomarkers from 4 physiological systems to construct AL. AL score was classified into three categories based on tertiles: 0–1 (low burden), 2–3 (medium burden) and 4–11 (high burden). Functional disability was assessed by activities of daily living (ADL) and instrumental activities of daily living (IADL). Multivariable logistic regression models examined the association between baseline AL, transitions of AL burden and incidence of functional disability.

Results

In cross-sectional analyses, medium and high AL burden were associated with an increased prevalence of ADL disability, while association was only significant between high AL burden and IADL disability. During the 7-year follow-up, 1102 and 1777 participants incident ADL disability and IADL disability, respectively. Those with medium and high AL burden had an increased risk of new-onset ADL disability than those with low AL burden (“medium”: OR = 1.25, 95%CI = 1.01, 1.55; “high”: OR = 1.69, 95%CI = 1.32, 2.18). As for IADL disability, association was only significant in “high” group (OR = 1.50, 95% CI = 1.24, 1.83). We also found keep medium/high AL burden in 2011 and 2015 was associated with new-onset ADL (OR = 2.27, 95%CI = 1.50, 3.44) and IADL disability (OR = 1.51, 95%CI = 1.11, 2.05) in 2018.

Conclusion

These results show that higher AL predicts functional disability among Chinese older adults. Monitoring AL and paying close attention to those with medium/high AL burden may aid prevention of adverse health outcomes, thus giving a healthier ageing experience to a large proportion of the population.
目的 静力负荷(Allostatic load,AL)是一个指数,表现为在整个生命过程中因反复适应压力因素而对多个生理系统造成的累积磨损。研究发现,较高的静力负荷与不良健康后果风险的增加有关,但有关中国老年人群功能障碍的研究却很有限。研究设计和方法这项前瞻性队列研究纳入了5880名年龄至少50岁、基线(2011年波)时参加了CHARLS的老年人,并进行了3次随访(2013年、2015年和2018年波)。我们从 4 个生理系统中选取了 11 个生物标志物来构建 AL。AL得分根据梯度分为三类:0-1(低负担)、2-3(中等负担)和 4-11(高负担)。功能障碍通过日常生活活动(ADL)和工具性日常生活活动(IADL)进行评估。多变量逻辑回归模型检验了基线AL、AL负担的转变与功能性残疾发生率之间的关联。结果在横断面分析中,中度和高度AL负担与ADL残疾发生率的增加有关,而高度AL负担与IADL残疾之间的关联仅有显著性。在7年的随访中,分别有1102名和1777名参与者出现了ADL残疾和IADL残疾。与低AL负担者相比,中度和高度AL负担者新发ADL残疾的风险更高("中度":OR=1.25,95%IR=1.25,95%IR=1.25):OR=1.25,95%CI=1.01,1.55;"高":OR=1.69,95%CI=1.32,2.18)。至于 IADL 残疾,只有 "高 "组的相关性显著(OR = 1.50,95% CI = 1.24,1.83)。我们还发现,2011 年和 2015 年的中/高 AL 负担与 2018 年新发的 ADL(OR = 2.27,95%CI = 1.50,3.44)和 IADL 残疾(OR = 1.51,95%CI = 1.11,2.05)相关。监测AL并密切关注中/高AL负担人群可能有助于预防不良健康后果,从而为大部分人群带来更健康的老年生活。
{"title":"Association of allostatic load with functional disability in the China Health and Retirement Longitudinal Study","authors":"Wanyu Zhao ,&nbsp;Yanjun Si ,&nbsp;Xueqin Li ,&nbsp;Yunli Zhao ,&nbsp;Shuli Jia ,&nbsp;Birong Dong","doi":"10.1016/j.jnha.2024.100367","DOIUrl":"10.1016/j.jnha.2024.100367","url":null,"abstract":"<div><h3>Objectives</h3><div>Allostatic load (AL) is an index that manifests as cumulative wear and tear on multiple physiological systems resulting from repeated adaptation to stressors throughout the life course. Higher AL was found to be associated with increased risk of adverse health outcomes, but studies on functional disability among large Chinese older population were limited. We aimed to investigate the associations of AL with functional disability among Chinese older adults.</div></div><div><h3>Research design and methods</h3><div>This prospective cohort study included 5880 older adults who were at least 50 years old and participated in the CHARLS at baseline (2011 wave), with 3 follow-ups (2013, 2015 and 2018 waves). We selected 11 biomarkers from 4 physiological systems to construct AL. AL score was classified into three categories based on tertiles: 0–1 (low burden), 2–3 (medium burden) and 4–11 (high burden). Functional disability was assessed by activities of daily living (ADL) and instrumental activities of daily living (IADL). Multivariable logistic regression models examined the association between baseline AL, transitions of AL burden and incidence of functional disability.</div></div><div><h3>Results</h3><div>In cross-sectional analyses, medium and high AL burden were associated with an increased prevalence of ADL disability, while association was only significant between high AL burden and IADL disability. During the 7-year follow-up, 1102 and 1777 participants incident ADL disability and IADL disability, respectively. Those with medium and high AL burden had an increased risk of new-onset ADL disability than those with low AL burden (“medium”: OR = 1.25, 95%CI = 1.01, 1.55; “high”: OR = 1.69, 95%CI = 1.32, 2.18). As for IADL disability, association was only significant in “high” group (OR = 1.50, 95% CI = 1.24, 1.83). We also found keep medium/high AL burden in 2011 and 2015 was associated with new-onset ADL (OR = 2.27, 95%CI = 1.50, 3.44) and IADL disability (OR = 1.51, 95%CI = 1.11, 2.05) in 2018.</div></div><div><h3>Conclusion</h3><div>These results show that higher AL predicts functional disability among Chinese older adults. Monitoring AL and paying close attention to those with medium/high AL burden may aid prevention of adverse health outcomes, thus giving a healthier ageing experience to a large proportion of the population.</div></div>","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"28 11","pages":"Article 100367"},"PeriodicalIF":4.3,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Biological sex as a tailoring variable for exercise prescription in hospitalized older adults 将生理性别作为住院老年人运动处方的定制变量
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-27 DOI: 10.1016/j.jnha.2024.100377
Mikel L. Sáez de Asteasu , Nicolás Martínez-Velilla , Robinson Ramírez-Vélez , Fabricio Zambom-Ferraresi , Arkaitz Galbete , Eduardo L. Cadore , Mikel Izquierdo

Background

Sex-based differences in the clinical presentation and outcomes are well-established in patients hospitalized for geriatric syndromes. We aimed to investigate sex differences in response to in-hospital exercise on function, strength, cognition, and quality of life in acute care admissions.

Methods

570 patients (mean age 87 years, 298 females [52.3%]) admitted to acute care for elderly units were randomized to multicomponent exercise emphasizing progressive resistance training or usual care. Functional assessments included Short Physical Performance Battery (SPPB), grip strength, Mini-Mental State Examination (MMSE), and health-related quality of life (EQ-VAS).

Results

Exercising females showed more significant SPPB improvements than males (between-group difference 1.48 points, p = 0.027), exceeding the minimal clinically significant difference. While female participants significantly increased handgrip strength and male patients improved cognition after in-hospital exercise compared to the control group (all p < 0.001), no sex differences occurred.

Conclusions

Females demonstrate more excellent physical function improvements compared to male older patients. Findings highlight the importance of tailored exercise incorporating patient factors like biological sex in geriatric medicine.

Trial registration

NCT04600453.
背景因老年综合症住院的患者在临床表现和预后方面的性别差异已得到证实。我们的目的是研究急诊入院患者对院内运动在功能、力量、认知和生活质量方面的反应的性别差异。方法:570 名老年急诊入院患者(平均年龄 87 岁,298 名女性 [52.3%])被随机分配到强调渐进阻力训练的多组分运动或常规护理中。功能评估包括短期体能测试(SPPB)、握力、迷你精神状态检查(MMSE)和与健康相关的生活质量(EQ-VAS)。结果与男性相比,锻炼女性的SPPB改善更为显著(组间差异为1.48分,P = 0.027),超过了最小临床显著性差异。与对照组相比,女性参与者的手握力明显增强,男性患者在院内锻炼后认知能力有所提高(均为 p <0.001),但无性别差异。结论与男性老年患者相比,女性患者的身体功能改善更为显著。研究结果凸显了在老年医学中结合患者生理性别等因素进行量身定制运动的重要性。
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引用次数: 0
Development of an older adult Nutrition Equity Index (NEI) and association with the Healthy Eating Index (HEI) in older Black and White U.S. adults 美国黑人和白人老年人营养公平指数(NEI)的制定及其与健康饮食指数(HEI)的联系
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-25 DOI: 10.1016/j.jnha.2024.100343
Aarohee P. Fulay , Samaneh Farsijani , Kerri Freeland , Jimmie Roberts , Andrea L. Rosso , Denise K. Houston , Elsa S. Strotmeyer

Objectives

We developed a novel measure for older U.S. adults called the Nutrition Equity Index (NEI), which includes functional ability. We compared both the NEI and food insufficiency with Healthy Eating Index (HEI) scores.

Design

The Health, Aging, and Body Composition Study is a prospective, longitudinal cohort of Medicare-eligible, community-dwelling Black and White men and women.

Setting

Pittsburgh, PA and Memphis, TN.

Participants

Participants (N = 2468, aged 74.7 ± 2.9 years) had baseline (1997−98) and 1-year follow-up NEI data; and 1 year follow-up for food insufficiency, key covariates, and the HEI (diet quality measure) from a 108-item interviewer-administered food frequency questionnaire.

Measurements

Food insufficiency was defined from a modified validated question on ample food amount/variety from the U.S. Department of Agriculture. NEI was constructed from 8 questions in three subdomains: food insecurity (food insufficiency, hunger, anxiety about limited food, limited money for food), food access (groceries), and food acquisition (difficulty shopping, preparing meals, carrying groceries). Final NEI categories were low nutrition equity (0), moderate nutrition equity (1), and high nutrition equity (2). Multivariable linear regression compared both NEI and food insufficiency with HEI, adjusted for sociodemographic, lifestyle and comorbidity factors.

Results

Of participants, 13.5% had food insufficiency, 12.1% had low NEI, and 32.5% had moderate NEI. Participants with food insufficiency (vs. food sufficiency) or low NEI (vs. high NEI) were more likely to be Black and have < high school education (both p < 0.0001). In minimally adjusted models, food insufficiency was associated with 2.2 point lower HEI score (p = 0.001), low NEI with 2.6 point lower HEI score (p = 0.001), and moderate NEI with 1.0 point lower HEI score (p < 0.05). Adjusting for race attenuated NEI associations with HEI to non-significance. After multivariable adjustment, food insufficiency was associated with 1.5 point lower HEI score (p = 0.03).

Conclusion

Food insufficiency was associated with lower dietary quality in this sample of older Black and White U.S. adults. NEI performed similarly to food insufficiency for HEI associations prior to multivariable adjustment and identified more older adults with nutrition inequity, who may be at risk for poor health outcomes.
目标我们为美国老年人开发了一种名为营养公平指数(NEI)的新测量方法,其中包括功能能力。我们将营养公平指数和食物不足指数与健康饮食指数 (HEI) 的得分进行了比较。参与者(N = 2468,年龄为 74.7 ± 2.9 岁)拥有基线(1997-1998 年)和 1 年随访的 NEI 数据;以及 1 年随访的食物不足、主要协变量和 HEI(饮食质量测量)数据,这些数据来自由访问者管理的 108 项食物频率问卷。NEI由三个子域中的8个问题构成:食物不安全(食物不足、饥饿、对食物有限的焦虑、购买食物的钱有限)、食物获取(杂货)和食物获取(购物、准备膳食、携带杂货的困难)。最终的营养公平指数类别为低营养公平指数(0)、中营养公平指数(1)和高营养公平指数(2)。多变量线性回归比较了NEI和食物不足与HEI,并对社会人口学、生活方式和合并症等因素进行了调整。结果 在参与者中,13.5%的人存在食物不足,12.1%的人存在低NEI,32.5%的人存在中度NEI。食物不足(vs.食物充足)或低NEI(vs.高NEI)的参与者更有可能是黑人且具有<高中学历(均为p<0.0001)。在最小调整模型中,食物不足与 HEI 分数降低 2.2 分相关(p = 0.001),低 NEI 与 HEI 分数降低 2.6 分相关(p = 0.001),中度 NEI 与 HEI 分数降低 1.0 分相关(p <0.05)。调整种族因素后,NEI 与 HEI 的相关性减弱至不显著。结论在美国老年黑人和白人样本中,食物不足与较低的膳食质量有关。在进行多变量调整之前,NEI 与食物不足在 HEI 关联性方面的表现类似,并且发现了更多存在营养不均的老年人,他们可能面临不良健康后果的风险。
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引用次数: 0
Intake of vegetables and fruits at midlife and the risk of physical frailty in later life 中年时蔬菜和水果的摄入量与晚年身体虚弱的风险
IF 4.3 3区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-23 DOI: 10.1016/j.jnha.2024.100374
Kevin Yiqiang Chua , Huiqi Li , Li-Ting Sheng , Wee-Shiong Lim , Woon-Puay Koh

Objectives

Our study evaluated the independent and overall associations of vegetable and fruit consumption at midlife with the likelihood of physical frailty in later life. We also investigated whether specific nutrients in these foods could have accounted for these associations, if present.

Design

Prospective cohort study.

Setting

A population-based cohort of Chinese adults followed over a period of 20 years in Singapore.

Participants

We used data from 11,959 subjects who participated in the baseline (1993–1998) and follow-up 3 (2014–2017) interviews of the Singapore Chinese Health Study.

Measurements

At baseline, dietary intake was evaluated using a validated food frequency questionnaire. During the follow-up 3 visits, physical frailty was assessed using a modified Cardiovascular Health Study phenotype that included weakness, slowness, exhaustion and weight loss. Multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the associations with physical frailty.

Results

Participants had mean ages of 52 years at baseline, and 72 years at follow-up 3. Baseline intake of vegetables, but not of fruits, showed a dose-dependent inverse relationship with physical frailty at follow-up 3 (Ptrend = 0.001). Compared to participants in the lowest quintile of vegetable intake, those in the highest quintile had reduced odds of frailty [OR (95% CI): 0.73 (0.60−0.89)]. Among the components of physical frailty, vegetable intake had the strongest inverse association with weakness defined by handgrip strength [OR (95% CI) between extreme quintiles: 0.62 (0.52−0.73); Ptrend < 0.001]. In models that were individually adjusted for nutrients, the vegetable-frailty association was attenuated and no longer statistically significant after adjusting for the intake of β-carotene, lutein, folate, α-carotene, and isothiocyanates.

Conclusion

: Increased midlife intake of vegetables was associated with reduced odds of physical frailty in later life, and the intake of β-carotene, lutein, folate, α-carotene, and isothiocyanates could have accounted for this association.
我们的研究评估了中年时蔬菜和水果消费量与晚年身体虚弱可能性之间的独立和整体关联。我们使用了 11959 名受试者的数据,这些受试者参加了新加坡华人健康研究的基线(1993-1998 年)和后续 3 次(2014-2017 年)访谈。测量基线时,我们使用经过验证的食物频率问卷评估了饮食摄入量。在后续 3 次访谈中,使用修改后的心血管健康研究表型评估身体虚弱情况,包括虚弱、迟钝、疲惫和体重减轻。采用多变量逻辑回归模型估算了与身体虚弱相关的几率比(OR)和 95% 的置信区间(CI)。与蔬菜摄入量最低五分位数的参与者相比,蔬菜摄入量最高五分位数的参与者身体虚弱的几率较低[OR (95% CI):0.73 (0.60-0.89)]。在体质虚弱的各组成部分中,蔬菜摄入量与以手握强度定义的体质虚弱的反向关系最为密切[极端五分位数之间的OR(95% CI):0.62(0.52-0.73);Ptrend < 0.001]。在对营养素进行单独调整的模型中,在调整了β-胡萝卜素、叶黄素、叶酸、α-胡萝卜素和异硫氰酸盐的摄入量后,蔬菜与肥胖的关系有所减弱,不再具有显著的统计学意义:结论:中年时期蔬菜摄入量的增加与晚年身体虚弱几率的降低有关,β-胡萝卜素、叶黄素、叶酸、α-胡萝卜素和异硫氰酸盐的摄入量可能是造成这种关联的原因。
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Journal of Nutrition Health & Aging
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