Objective: This study aimed to investigate how informal primary caregivers of individuals with dementia living in the community cope with caring-related measures of anxiety, depression, burden and quality of life. Participants and Design: Participants included 60 informal caregivers (23 males and 37 females) of community-dwelling individuals with dementia who attended a state-run geriatric day hospital in Malta. Caregiver measures included the Hospital Anxiety and Depression Scale, the World Health Organization Quality of Life–BREF and Brief COPE questionnaires, and Zarit Burden Interview. The Mini Mental State Examination and Barthel Index of Activities of Daily Living scores were used to determine the degree of cognitive impairment and performance in activities of daily living of care-recipients. Results: Informal caregivers experienced anxiety and depression with both emotional distress states negatively affecting all quality of life domains. Depression and burden experienced by informal primary caregivers showed a strong association with individuals with dementia-related variables such as age, cognitive impairment and activities of daily living scores. The use of dysfunctional coping strategies was found to be related to caregivers’ emotional distress, low quality of life and burden. Conclusion: The findings indicate that informal primary caregivers experienced anxiety and depression, had a lower quality of life, and feel burdened during their caring role. However, caregivers making use of emotion-focused coping strategies were found to be protected against emotional distress. The results highlight the need of providing support services aimed at promoting the psychological wellbeing of informal carers of community-dwelling individuals with dementia.
{"title":"COPING WITH ANXIETY, DEPRESSION, BURDEN AND QUALITY OF LIFE IN INFORMAL PRIMARY CAREGIVERS OF COMMUNITY-DWELLING INDIVIDUALS WITH DEMENTIA","authors":"M. Muscat, C. Scerri","doi":"10.14283/jarcp.2018.22","DOIUrl":"https://doi.org/10.14283/jarcp.2018.22","url":null,"abstract":"Objective: This study aimed to investigate how informal primary caregivers of individuals with dementia living in the community cope with caring-related measures of anxiety, depression, burden and quality of life. Participants and Design: Participants included 60 informal caregivers (23 males and 37 females) of community-dwelling individuals with dementia who attended a state-run geriatric day hospital in Malta. Caregiver measures included the Hospital Anxiety and Depression Scale, the World Health Organization Quality of Life–BREF and Brief COPE questionnaires, and Zarit Burden Interview. The Mini Mental State Examination and Barthel Index of Activities of Daily Living scores were used to determine the degree of cognitive impairment and performance in activities of daily living of care-recipients. Results: Informal caregivers experienced anxiety and depression with both emotional distress states negatively affecting all quality of life domains. Depression and burden experienced by informal primary caregivers showed a strong association with individuals with dementia-related variables such as age, cognitive impairment and activities of daily living scores. The use of dysfunctional coping strategies was found to be related to caregivers’ emotional distress, low quality of life and burden. Conclusion: The findings indicate that informal primary caregivers experienced anxiety and depression, had a lower quality of life, and feel burdened during their caring role. However, caregivers making use of emotion-focused coping strategies were found to be protected against emotional distress. The results highlight the need of providing support services aimed at promoting the psychological wellbeing of informal carers of community-dwelling individuals with dementia.","PeriodicalId":73537,"journal":{"name":"JAR life","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66885004","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}
T. Abe, S. Dankel, S. Buckner, M. Jessee, K. Mattocks, J. Mouser, Z. Bell, J. Loenneke
There may be some individuals who do not adapt favorably to an exercise stimulus. This is most commonly determined by assessing the error of the measurement across two separate testing sessions separated by a short period of time. It has been recommended that this error be assessed over the same time frame as the intervention. We examined the 24-h test-retest reliability (n=18, aged 42 to 64 years) of forearm muscle thickness, handgrip strength, and “muscle quality” and compared that to the reliability observed when visits are separated by 1-year (n=80, aged 60 to 79 years). The measurement errors were greater in all measured variables following test-retest separated by 1-year than the test-retest separated by 24-hours. Our findings suggest that a time-matched control group is likely important to fully capture the error of the tester as well as the error associated with random biological variability within a timed intervention.
{"title":"SHORT TERM (24 HOURS) AND LONG TERM (1 YEAR) ASSESSMENTS OF RELIABILITY IN OLDER ADULTS: CAN ONE REPLACE THE OTHER?","authors":"T. Abe, S. Dankel, S. Buckner, M. Jessee, K. Mattocks, J. Mouser, Z. Bell, J. Loenneke","doi":"10.14283/jarcp.2018.15","DOIUrl":"https://doi.org/10.14283/jarcp.2018.15","url":null,"abstract":"There may be some individuals who do not adapt favorably to an exercise stimulus. This is most commonly determined by assessing the error of the measurement across two separate testing sessions separated by a short period of time. It has been recommended that this error be assessed over the same time frame as the intervention. We examined the 24-h test-retest reliability (n=18, aged 42 to 64 years) of forearm muscle thickness, handgrip strength, and “muscle quality” and compared that to the reliability observed when visits are separated by 1-year (n=80, aged 60 to 79 years). The measurement errors were greater in all measured variables following test-retest separated by 1-year than the test-retest separated by 24-hours. Our findings suggest that a time-matched control group is likely important to fully capture the error of the tester as well as the error associated with random biological variability within a timed intervention.","PeriodicalId":73537,"journal":{"name":"JAR life","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66884984","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}
E. Wernio, J. A. D. ska, Hanna Kujawska-Danecka, A. Hajduk, Z. Zdrojewski, S. M. gorzewicz
Introduction: To improve the quality of life and health of the elderly, attention is paid to the early detection of frailty syndrome. Unfortunately, one simple and practical screening tool has not been established yet. Recently came the proposal of the Novel Frailty Index (NFI) created by Yamada and Arai. Therefore, the purpose of this study was to assess the relationship between nutritional status and NFI of the elderly. Materials and methods: In a group of 67 elderly patients (27 hospitalised and 40 living in the home environment) we used the NFI and evaluated nutritional status with the use of full-MNA together with SNAQ (appetite questionnaire), manual dynamometry and bioimpedance analysis. Results: Based on the NFI results, frailty syndrome was diagnosed in more than half of hospitalised elderly. The syndrome was significantly less prevalent in free-living older people (15% vs 63%, p<0.001).We found the significant correlations of NFI values with age (r=0.031, p=0.03), co-morbidity(r=0.295, p=0.016), phase angle (r=-0.407, p<0.001), full-MNA score (r=-0.515, p<0.001). Conclusions: Our preliminary results suggest the relevant association between NFI results and age, phase angle as well comorbidity and nutritional status. So further evaluation of NFI as a screening tool for frailty syndrome diagnose is needed.
前言:为了提高老年人的生活质量和健康水平，人们重视虚弱综合征的早期发现。不幸的是，目前还没有一种简单实用的筛查工具。最近，山田和新井提出了新的脆弱指数(NFI)。因此，本研究的目的是评估老年人营养状况与NFI之间的关系。材料和方法:在67例老年患者(27例住院，40例生活在家庭环境中)中，我们使用NFI，并使用full-MNA结合SNAQ(食欲问卷)、手动动力测量和生物阻抗分析来评估营养状况。结果:基于NFI结果，半数以上的住院老年人被诊断为虚弱综合征。该综合征在自由生活的老年人中发病率明显较低(15% vs 63%， p<0.001)。我们发现NFI值与年龄(r=0.031, p=0.03)、共发病(r=0.295, p=0.016)、相位角(r=-0.407, p<0.001)、full-MNA评分(r=-0.515, p<0.001)有显著相关性。结论:我们的初步结果提示NFI结果与年龄、相位角、合并症和营养状况有关。因此，需要进一步评估NFI作为虚弱综合征诊断的筛查工具。
{"title":"THE NOVEL FRAILTY INDEX (NFI) CORRELATES WITH A VALUE OF PHASE ANGLE AND MNA IN HOSPITALISED AND FREELIVING ELDERLY - PRELIMINARY REPORT","authors":"E. Wernio, J. A. D. ska, Hanna Kujawska-Danecka, A. Hajduk, Z. Zdrojewski, S. M. gorzewicz","doi":"10.14283/jarcp.2018.21","DOIUrl":"https://doi.org/10.14283/jarcp.2018.21","url":null,"abstract":"Introduction: To improve the quality of life and health of the elderly, attention is paid to the early detection of frailty syndrome. Unfortunately, one simple and practical screening tool has not been established yet. Recently came the proposal of the Novel Frailty Index (NFI) created by Yamada and Arai. Therefore, the purpose of this study was to assess the relationship between nutritional status and NFI of the elderly. Materials and methods: In a group of 67 elderly patients (27 hospitalised and 40 living in the home environment) we used the NFI and evaluated nutritional status with the use of full-MNA together with SNAQ (appetite questionnaire), manual dynamometry and bioimpedance analysis. Results: Based on the NFI results, frailty syndrome was diagnosed in more than half of hospitalised elderly. The syndrome was significantly less prevalent in free-living older people (15% vs 63%, p<0.001).We found the significant correlations of NFI values with age (r=0.031, p=0.03), co-morbidity(r=0.295, p=0.016), phase angle (r=-0.407, p<0.001), full-MNA score (r=-0.515, p<0.001). Conclusions: Our preliminary results suggest the relevant association between NFI results and age, phase angle as well comorbidity and nutritional status. So further evaluation of NFI as a screening tool for frailty syndrome diagnose is needed.","PeriodicalId":73537,"journal":{"name":"JAR life","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66885424","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}
Objective and Method: A case presentation of a 73-year-old delirious patient diagnosed with hyperaldosteronism and Anorexia Nervosa. A possible pathophysiological relationship between a decades-long uncontrolled eating disorder (so called Senile Anorexia) and a resulting transformation of the adrenal gland is discussed. Results and Conclusion: Senile anorexia can remain undetected for decades only to then manifest itself through somatic complications, e.g. symptoms of hyperaldosteronism. In older, underweight patients with unclear neuropsychiatric symptoms, the diagnosis of Anorexia Nervosa should be considered.
{"title":"SENILE ANOREXIA AND HYPERALDOSTERONISM","authors":"D. Schwerthöffer, T. Grimmer, I. Bauer","doi":"10.14283/jarcp.2018.6","DOIUrl":"https://doi.org/10.14283/jarcp.2018.6","url":null,"abstract":"Objective and Method: A case presentation of a 73-year-old delirious patient diagnosed with hyperaldosteronism and Anorexia Nervosa. A possible pathophysiological relationship between a decades-long uncontrolled eating disorder (so called Senile Anorexia) and a resulting transformation of the adrenal gland is discussed. Results and Conclusion: Senile anorexia can remain undetected for decades only to then manifest itself through somatic complications, e.g. symptoms of hyperaldosteronism. In older, underweight patients with unclear neuropsychiatric symptoms, the diagnosis of Anorexia Nervosa should be considered.","PeriodicalId":73537,"journal":{"name":"JAR life","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66885442","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}
Benjamin Buaud, J. Tressou, P. Guesnet, Noémie Simon, S. Pasteau
Objectives: The aim of this study was to explore polyunsaturated fatty acid (PUFA) intakes in the French elderly population (65 to 79 years old). Design: The study used data on French food consumption issued from 348 elderly of the cross-sectional national French INCA 2 dietary survey performed in 2006 and 2007, combined with the nutritional content of food consumed updated in 2013 by the French Information Center on Food Quality. Results: It was observed for the French elderly population an adequate total fat daily intake and a linoleic acid (LA) daily intake close or superior to the recommended dietary intake (RDI) by the French authorities (from 4.1 to 4.4% of the total energy intake excluding alcohol (EIEA) vs 4% EIEA). By contrast, the French elderly have, regardless of age and gender, a low mean dietary alpha-linolenic acid (ALA) intake equal half of the RDI (0.5% EIEA vs 1% EIEA), and a mean dietary docosahexaenoic acid (DHA) intake close to two-thirds of the RDI (i.e. from 154 to 167 mg/d vs 250 mg/d). These translated into a LA/ALA ratio between 9.5 and 9.9, twice as high as the recommended threshold inferior to 5, and a mean dietary eicosapentaenoic acid (EPA) plus DHA intake (from 267 to 293 mg/d) slightly more than half of the RDI (500 mg/d). Conclusion: This study supports the need to promote higher intakes of n-3 PUFAs, as well as the setting of specific intake recommendations for these fatty acids for the French elderly population.
{"title":"INADEQUACY OF N-3 POLYUNSATURATED FATTY ACID DIETARY INTAKES IN THE GENERAL FRENCH POPULATION OF ELDERLY (65 TO 79 YEARS OLD): THE INCA 2 SURVEY","authors":"Benjamin Buaud, J. Tressou, P. Guesnet, Noémie Simon, S. Pasteau","doi":"10.14283/jarcp.2018.13","DOIUrl":"https://doi.org/10.14283/jarcp.2018.13","url":null,"abstract":"Objectives: The aim of this study was to explore polyunsaturated fatty acid (PUFA) intakes in the French elderly population (65 to 79 years old). Design: The study used data on French food consumption issued from 348 elderly of the cross-sectional national French INCA 2 dietary survey performed in 2006 and 2007, combined with the nutritional content of food consumed updated in 2013 by the French Information Center on Food Quality. Results: It was observed for the French elderly population an adequate total fat daily intake and a linoleic acid (LA) daily intake close or superior to the recommended dietary intake (RDI) by the French authorities (from 4.1 to 4.4% of the total energy intake excluding alcohol (EIEA) vs 4% EIEA). By contrast, the French elderly have, regardless of age and gender, a low mean dietary alpha-linolenic acid (ALA) intake equal half of the RDI (0.5% EIEA vs 1% EIEA), and a mean dietary docosahexaenoic acid (DHA) intake close to two-thirds of the RDI (i.e. from 154 to 167 mg/d vs 250 mg/d). These translated into a LA/ALA ratio between 9.5 and 9.9, twice as high as the recommended threshold inferior to 5, and a mean dietary eicosapentaenoic acid (EPA) plus DHA intake (from 267 to 293 mg/d) slightly more than half of the RDI (500 mg/d). Conclusion: This study supports the need to promote higher intakes of n-3 PUFAs, as well as the setting of specific intake recommendations for these fatty acids for the French elderly population.","PeriodicalId":73537,"journal":{"name":"JAR life","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66884875","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}
Background: Protein intake is a major risk factor of sarcopenia. To combat sarcopenia, strategies focused on providing sufficient high quality dietary protein are required. Objectives: We aimed to identify the pattern of dietary protein intake and its association with muscle and physical functions among community-dwelling sarcopenic Chinese older adults in Hong Kong. Design: Baseline data of a randomized controlled trial in sarcopenia were analyzed. Setting: Participants who were ambulant and could travel to the assessment centre at a regional hospital in Hong Kong were recruited in nearby community elderly centers, nursing homes and other institutional settings. Participants: A total of 113 Chinese older adults aged 65 or above who had sarcopenia defined using The Asia Working Group Criteria for Sarcopenia were recruited. Measurements: Dietary data and muscle function tests were measured. Results: Although the energy intake (mean + standard deviation: 1491.7±338.6 kcal/d in female, 1738.1±392.9 kcal/d in male) was lower than the recommended daily energy requirement, protein intake averaged 1.6±0.5 g/kg body weight/day, which was high compared to the current Recommended Daily Allowance (RDA, 0.8 g/kg body weight/day for older people). Animal and plant sources contributed to 62% and 38% respectively of the total protein intake. Dietary protein intake was not evenly distributed throughout the day. Physical Activity Scale for the Elderly (PASE) score was more predictive of muscle mass and functions compared to protein intake and sources. Conclusions: Our findings showed that PASE was more predictive of muscle mass and functions compared to protein intake and sources, and there was a minimal association between protein intake and muscle performance measures in our community-dwelling sacropenic older adults. The protein replete state of our study population may explain these findings. The observations that an uneven distribution of protein intake throughout a day may suggest the need to increase protein intake at breakfast among Chinese sarcopenic older adults.
{"title":"DIETARY PROTEIN INTAKE PATTERN AND SOURCES AND THEIR ASSOCIATIONS WITH MUSCLE AND PHYSICAL FUNCTION MEASURES IN OLDER CHINESE ADULTS WITH SARCOPENIA IN HONG KONG","authors":"Liu-Ying Zhu, R. Chan, L. Li, T. Kwok, J. Woo","doi":"10.14283/jarcp.2018.14","DOIUrl":"https://doi.org/10.14283/jarcp.2018.14","url":null,"abstract":"Background: Protein intake is a major risk factor of sarcopenia. To combat sarcopenia, strategies focused on providing sufficient high quality dietary protein are required. Objectives: We aimed to identify the pattern of dietary protein intake and its association with muscle and physical functions among community-dwelling sarcopenic Chinese older adults in Hong Kong. Design: Baseline data of a randomized controlled trial in sarcopenia were analyzed. Setting: Participants who were ambulant and could travel to the assessment centre at a regional hospital in Hong Kong were recruited in nearby community elderly centers, nursing homes and other institutional settings. Participants: A total of 113 Chinese older adults aged 65 or above who had sarcopenia defined using The Asia Working Group Criteria for Sarcopenia were recruited. Measurements: Dietary data and muscle function tests were measured. Results: Although the energy intake (mean + standard deviation: 1491.7±338.6 kcal/d in female, 1738.1±392.9 kcal/d in male) was lower than the recommended daily energy requirement, protein intake averaged 1.6±0.5 g/kg body weight/day, which was high compared to the current Recommended Daily Allowance (RDA, 0.8 g/kg body weight/day for older people). Animal and plant sources contributed to 62% and 38% respectively of the total protein intake. Dietary protein intake was not evenly distributed throughout the day. Physical Activity Scale for the Elderly (PASE) score was more predictive of muscle mass and functions compared to protein intake and sources. Conclusions: Our findings showed that PASE was more predictive of muscle mass and functions compared to protein intake and sources, and there was a minimal association between protein intake and muscle performance measures in our community-dwelling sacropenic older adults. The protein replete state of our study population may explain these findings. The observations that an uneven distribution of protein intake throughout a day may suggest the need to increase protein intake at breakfast among Chinese sarcopenic older adults.","PeriodicalId":73537,"journal":{"name":"JAR life","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66884965","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}
L. Håglin, L. Bâckman, J. Linder, L. Forsgren, M. Domellöf
Background: Cognitive decline and dementia are common non-motor problems in Parkinson’s disease (PD). The underlying aetiology is multifaceted and both chronic and reversible causes for cognitive decline are likely to be present. Malnutrition is frequent in the Parkinson population, both early and late in the disease, and nutritional deficiencies could play a role in some cognitive deficits. Objectives: The objective is to study the association between nutritional status with focus on iron intake and homeostasis, mild cognitive impairment (MCI), and PD dementia (PDD). Setting and Participants: This study included 73 out of 145 patients with PD participating in a population-based study in northern Sweden. Measurements: Registration of nutritional status by laboratory analyses of blood plasma and neuropsychological assessments at time of diagnosis were performed. MCI and PDD were assessed yearly up to ten years after diagnosis. Mini Nutritional Assessments (Full-MNA score) and plasma variables detecting iron homeostasis were compared between patients with MCI and patients with normal cognition (NC). Motor severity was measured using the Unified Parkinson´s disease rating scale III, (UPDRS III) and Hoehn and Yahr (H&Y) staging scale. Cox proportional Hazard model were performed to see if any variables that differed between MCI and NC could predict PDD at follow-up. Results: Patients with MCI at time of diagnosis had lower levels of plasma iron (P-Fe) and albumin (P-Albumin) as well as a lower score on Full-MNA score. Dietary intake of iron was higher in patients with MCI than in patients with NC (p = 0.012). In logistic regression models adjusted for age, sex, and UPDRS III, lower levels of P-Fe (p = 0.025) and P-Albumin (p = 0.011) and higher dietary iron intake (p = 0.019) were associated with MCI at baseline. A Cox regression model with dementia as endpoint revealed that lower levels of P-Fe increase the risk of dementia at follow-up with adjustments for age, sex, UPDRS III, and MCI at baseline (HR 95% CI = 0.87 (0.78-0.98), p = 0.021). Conclusions: Low P-Fe was associated with cognitive disturbance at baseline and predicted dementia up to ten years after diagnosis in patients with PD. Low P-Albumin and malnutrition assessed with Full-MNA score were associated with MCI at baseline but did not predict dementia at follow-up.
背景:认知能力下降和痴呆是帕金森病(PD)常见的非运动问题。潜在的病因是多方面的，认知能力下降的慢性和可逆原因都可能存在。营养不良在帕金森患者中很常见，无论是在疾病的早期还是晚期，营养缺乏可能在一些认知缺陷中起作用。目的:目的是研究营养状况(关注铁摄入和体内平衡)、轻度认知障碍(MCI)和PD痴呆(PDD)之间的关系。环境和参与者:本研究纳入了145名PD患者中的73名，这些患者参加了瑞典北部的一项基于人群的研究。测量方法:诊断时通过血浆实验室分析和神经心理学评估登记营养状况。MCI和PDD在诊断后10年内每年进行一次评估。比较MCI患者和认知正常患者(NC)的Mini营养评估(Full-MNA评分)和血浆铁稳态检测变量。运动严重程度采用统一帕金森病评定量表III (UPDRS III)和Hoehn and Yahr (H&Y)分期量表进行测量。采用Cox比例风险模型，观察MCI和NC之间是否存在差异的变量可以预测随访时的PDD。结果:诊断时MCI患者血浆铁(P-Fe)和白蛋白(P-Albumin)水平较低，Full-MNA评分较低。MCI患者的膳食铁摄入量高于NC患者(p = 0.012)。在调整了年龄、性别和UPDRS III的logistic回归模型中，较低水平的p - fe (p = 0.025)和p -白蛋白(p = 0.011)以及较高的膳食铁摄入量(p = 0.019)与基线时的MCI相关。以痴呆为终点的Cox回归模型显示，在调整年龄、性别、UPDRS III和基线时MCI后，较低水平的p - fe增加了痴呆的风险(HR 95% CI = 0.87 (0.78-0.98)， p = 0.021)。结论:低P-Fe与基线认知障碍有关，并预测PD患者诊断后10年内的痴呆。以Full-MNA评分评估的低p -白蛋白和营养不良与基线时的MCI相关，但不能预测随访时的痴呆。
{"title":"EARLY RECOGNITION OF COGNITIVE ABILITY AND NUTRITIONAL MARKERS FOR DEMENTIA IN PARKINSON’S DISEASE","authors":"L. Håglin, L. Bâckman, J. Linder, L. Forsgren, M. Domellöf","doi":"10.14283/jarcp.2018.26","DOIUrl":"https://doi.org/10.14283/jarcp.2018.26","url":null,"abstract":"Background: Cognitive decline and dementia are common non-motor problems in Parkinson’s disease (PD). The underlying aetiology is multifaceted and both chronic and reversible causes for cognitive decline are likely to be present. Malnutrition is frequent in the Parkinson population, both early and late in the disease, and nutritional deficiencies could play a role in some cognitive deficits. Objectives: The objective is to study the association between nutritional status with focus on iron intake and homeostasis, mild cognitive impairment (MCI), and PD dementia (PDD). Setting and Participants: This study included 73 out of 145 patients with PD participating in a population-based study in northern Sweden. Measurements: Registration of nutritional status by laboratory analyses of blood plasma and neuropsychological assessments at time of diagnosis were performed. MCI and PDD were assessed yearly up to ten years after diagnosis. Mini Nutritional Assessments (Full-MNA score) and plasma variables detecting iron homeostasis were compared between patients with MCI and patients with normal cognition (NC). Motor severity was measured using the Unified Parkinson´s disease rating scale III, (UPDRS III) and Hoehn and Yahr (H&Y) staging scale. Cox proportional Hazard model were performed to see if any variables that differed between MCI and NC could predict PDD at follow-up. Results: Patients with MCI at time of diagnosis had lower levels of plasma iron (P-Fe) and albumin (P-Albumin) as well as a lower score on Full-MNA score. Dietary intake of iron was higher in patients with MCI than in patients with NC (p = 0.012). In logistic regression models adjusted for age, sex, and UPDRS III, lower levels of P-Fe (p = 0.025) and P-Albumin (p = 0.011) and higher dietary iron intake (p = 0.019) were associated with MCI at baseline. A Cox regression model with dementia as endpoint revealed that lower levels of P-Fe increase the risk of dementia at follow-up with adjustments for age, sex, UPDRS III, and MCI at baseline (HR 95% CI = 0.87 (0.78-0.98), p = 0.021). Conclusions: Low P-Fe was associated with cognitive disturbance at baseline and predicted dementia up to ten years after diagnosis in patients with PD. Low P-Albumin and malnutrition assessed with Full-MNA score were associated with MCI at baseline but did not predict dementia at follow-up.","PeriodicalId":73537,"journal":{"name":"JAR life","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66885115","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}
A. T. Bakre, Yiqing Song, A. Clifford, Anthony Chen, Tina Smith, Yuhui Wan, Linda Devlin, J. J. Tang, Weiju Zhou, Isaac M Danat, Zhi Hu, R. Chen
Objectives: Habitual fish consumption and its determinants in older people have not been well investigated. We addressed these issues through a population-based cohort study. Methods: In 2001-2003 we interviewed a random sample of 3336 residents aged ≥60 years in China, documenting socioeconomic status (SES) and disease risk factors. In 2007-2009 we re-interviewed 1757 survivors, additionally surveying average self-reported intake of fish over the past two years. Results: Of 1757 participants, 1697 responded to the fish consumption questionnaire; 23.0% of whom had “never eat” fish, 43.4% “once a week”, 26.9% “more than twice a week”, and 6.7% “≥once a day”. There was an inverse association of fish consumption with older age (multivariate adjusted odds ratio 0.64 [95% CI 0.45-0.92] and 0.35 [0.24-0.52] at ages of 75-79, and ≥80 years), female gender (0.63, 0.47-0.84), smoking (0.65, 0.48-0.88), living in a rural area (0.10, 0.07-0.15), having educational level of ≤primary school (0.10, 0.05-0.19), occupation of peasant (0.08, 0.05-0.14), low income (0.11, 0.07-0.18), financial difficulties (0.25, 0.18-0.34), being never married/divorced (0.48, 0.28-0.81), having undetected hypertension (0.71, 0.55-0.91), depression (0.50, 0.29-0.84) and dementia (0.64, 0.41-0.98). However, participants with central obesity and heart disease at baseline had increased odds of fish consumption. Separate data analysis for different levels of fish consumption showed a dose-response trend for these associations. Conclusion: In older Chinese, there are large socioeconomic inequalities, and certain lifestyle, psychosocial factors and health-related conditions are strong determinants of fish consumption. Such information is important for future development or refinement of effective dietary interventions targeting older adults.
目的:老年人的习惯性鱼类消费及其决定因素尚未得到很好的调查。我们通过一项基于人群的队列研究来解决这些问题。方法:2001-2003年，我们随机采访了3336名年龄≥60岁的中国居民，记录了社会经济地位(SES)和疾病危险因素。在2007-2009年，我们重新采访了1757名幸存者，另外调查了过去两年中自我报告的平均鱼摄入量。结果:在1757名参与者中，1697人回答了鱼类消费问卷;23.0%的人“从不吃”鱼，43.4%的人“一周吃一次”，26.9%的人“一周吃两次以上”，6.7%的人“每天≥一次”。鱼类消费与年龄(多因素调整比值比分别为0.64 [95% CI 0.45-0.92]和0.35[0.24-0.52])、女性(0.63,0.47-0.84)、吸烟(0.65,0.48-0.88)、生活在农村(0.10,0.07-0.15)、受教育程度≤小学(0.10,0.05-0.19)、农民职业(0.08,0.05-0.14)、低收入(0.11,0.07-0.18)、经济困难(0.25,0.18-0.34)、未婚/离异(0.48,0.48,0.48)呈负相关。高血压(0.71,0.55-0.91)，抑郁症(0.50,0.29-0.84)，痴呆(0.64,0.41-0.98)。然而，中枢性肥胖和心脏病的参与者在基线时吃鱼的几率增加了。对不同鱼类消费水平的单独数据分析显示了这些关联的剂量-反应趋势。结论:在中国老年人中，存在较大的社会经济不平等，某些生活方式、社会心理因素和健康相关条件是鱼类消费的重要决定因素。这些信息对于未来开发或改进针对老年人的有效饮食干预措施非常重要。
{"title":"DETERMINANTS OF FISH CONSUMPTION IN OLDER PEOPLE: A COMMUNITY-BASED COHORT STUDY","authors":"A. T. Bakre, Yiqing Song, A. Clifford, Anthony Chen, Tina Smith, Yuhui Wan, Linda Devlin, J. J. Tang, Weiju Zhou, Isaac M Danat, Zhi Hu, R. Chen","doi":"10.14283/jarcp.2018.27","DOIUrl":"https://doi.org/10.14283/jarcp.2018.27","url":null,"abstract":"Objectives: Habitual fish consumption and its determinants in older people have not been well investigated. We addressed these issues through a population-based cohort study. Methods: In 2001-2003 we interviewed a random sample of 3336 residents aged ≥60 years in China, documenting socioeconomic status (SES) and disease risk factors. In 2007-2009 we re-interviewed 1757 survivors, additionally surveying average self-reported intake of fish over the past two years. Results: Of 1757 participants, 1697 responded to the fish consumption questionnaire; 23.0% of whom had “never eat” fish, 43.4% “once a week”, 26.9% “more than twice a week”, and 6.7% “≥once a day”. There was an inverse association of fish consumption with older age (multivariate adjusted odds ratio 0.64 [95% CI 0.45-0.92] and 0.35 [0.24-0.52] at ages of 75-79, and ≥80 years), female gender (0.63, 0.47-0.84), smoking (0.65, 0.48-0.88), living in a rural area (0.10, 0.07-0.15), having educational level of ≤primary school (0.10, 0.05-0.19), occupation of peasant (0.08, 0.05-0.14), low income (0.11, 0.07-0.18), financial difficulties (0.25, 0.18-0.34), being never married/divorced (0.48, 0.28-0.81), having undetected hypertension (0.71, 0.55-0.91), depression (0.50, 0.29-0.84) and dementia (0.64, 0.41-0.98). However, participants with central obesity and heart disease at baseline had increased odds of fish consumption. Separate data analysis for different levels of fish consumption showed a dose-response trend for these associations. Conclusion: In older Chinese, there are large socioeconomic inequalities, and certain lifestyle, psychosocial factors and health-related conditions are strong determinants of fish consumption. Such information is important for future development or refinement of effective dietary interventions targeting older adults.","PeriodicalId":73537,"journal":{"name":"JAR life","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66885183","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}
Objective: This study investigates whether the loss of natural teeth associate with elderly frailty, as well as their connection with quality of life. Design: This study collected data from January 2012 to April 2013, and the subjects were the elderly over the age of 65 living in community. Setting: Loss of natural teeth and frailty are common issues in elderly and it is noteworthy to address these issues while the investigation of healthy ageing. Participants: The research included 543 elderly people over the age of 65. Measurements: The face-to-face interviews with a structured questionnaire were performed. Results: Elderly people with no natural teeth are more likely to become frail (OR=1.87); the relationship between frailty and quality of life is more significant. After adjusting for all the independent variables, results showed that frailty in elderly leads to poorer quality of life, and oral health status is not correlated with quality of life (P>0.05). The remain of natural teeth is correlated with occurrence of frailty in the elderly. Conclusions: Frailty has a significant and strong influence on oral health-related quality of life. For the elderly, frailty shall be early diagnosed to ensure provision of proper preventive health care.
{"title":"FRAILTY, LOSS OF NATURAL TEETH AND QUALITY OF LIFE","authors":"I-C. Lee, Stephanie Weng, P. Ho","doi":"10.14283/jarcp.2018.16","DOIUrl":"https://doi.org/10.14283/jarcp.2018.16","url":null,"abstract":"Objective: This study investigates whether the loss of natural teeth associate with elderly frailty, as well as their connection with quality of life. Design: This study collected data from January 2012 to April 2013, and the subjects were the elderly over the age of 65 living in community. Setting: Loss of natural teeth and frailty are common issues in elderly and it is noteworthy to address these issues while the investigation of healthy ageing. Participants: The research included 543 elderly people over the age of 65. Measurements: The face-to-face interviews with a structured questionnaire were performed. Results: Elderly people with no natural teeth are more likely to become frail (OR=1.87); the relationship between frailty and quality of life is more significant. After adjusting for all the independent variables, results showed that frailty in elderly leads to poorer quality of life, and oral health status is not correlated with quality of life (P>0.05). The remain of natural teeth is correlated with occurrence of frailty in the elderly. Conclusions: Frailty has a significant and strong influence on oral health-related quality of life. For the elderly, frailty shall be early diagnosed to ensure provision of proper preventive health care.","PeriodicalId":73537,"journal":{"name":"JAR life","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66884535","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}
An increasing number of researches on gerontology has emphasized an aging process without impairments of physical and/or cognitive function, alongside with an increase of life expectancy. However, studies to date on a healthy aging have suggested limited information on normal and usual aging in an inconsistent manner. Here, we review characteristics to define a healthy aging and, moreover, suggest effective elements to achieve the healthy aging through systematic review. Based on two databases including RISS and PUPMED, we collected original articles showing links between health-related traits and associated factors in Korean population aged 65 years or older. After screening the titles and abstracts, full texts of 186 articles were reviewed, and the remaining 109 papers meeting the inclusion criteria were analyzed to extract aging characteristics and factors of healthy aging. Here, we focus on two themes: 1) definition of a healthy aging and 2) effective determinants influencing the healthy aging. Our results suggest that a healthy aging is a multidisciplinary concept involving objective, subjective and comprehensive definitions. We classify the healthy aging-associated factors into physical, emotional, mental, social and economic domains, and identify that dietary patterns and nutrients among the multi-layer elements become good modifiable factor to achieve the healthy aging.
{"title":"A SYSTEMATIC REVIEW ON FACTORS INFLUENCING THE HEALTHY AGING: A KOREAN PERSPECTIVE","authors":"J. H. Park, Y. J. Park","doi":"10.14283/jarcp.2018.2","DOIUrl":"https://doi.org/10.14283/jarcp.2018.2","url":null,"abstract":"An increasing number of researches on gerontology has emphasized an aging process without impairments of physical and/or cognitive function, alongside with an increase of life expectancy. However, studies to date on a healthy aging have suggested limited information on normal and usual aging in an inconsistent manner. Here, we review characteristics to define a healthy aging and, moreover, suggest effective elements to achieve the healthy aging through systematic review. Based on two databases including RISS and PUPMED, we collected original articles showing links between health-related traits and associated factors in Korean population aged 65 years or older. After screening the titles and abstracts, full texts of 186 articles were reviewed, and the remaining 109 papers meeting the inclusion criteria were analyzed to extract aging characteristics and factors of healthy aging. Here, we focus on two themes: 1) definition of a healthy aging and 2) effective determinants influencing the healthy aging. Our results suggest that a healthy aging is a multidisciplinary concept involving objective, subjective and comprehensive definitions. We classify the healthy aging-associated factors into physical, emotional, mental, social and economic domains, and identify that dietary patterns and nutrients among the multi-layer elements become good modifiable factor to achieve the healthy aging.","PeriodicalId":73537,"journal":{"name":"JAR life","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66884676","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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