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02/2013 journal articles

PORTION SIZES OF FOOD ITEMS AMONG ELDER SUBJECTS IN THE GENERAL POPULATION. A METHODOLOGICAL DIETARY STUDY FROM MALMÖ, SWEDEN

J. Ekblad, S. Elmståhl

J Aging Res Clin Practice 2013;2(2):158-167

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Objectives: To describe portion size for different food items included in food frequency questionnaire in the Good Aging in Skåne study (GÅS), in an elderly population in Malmö, Sweden in relation to an increased age. Design: Self-reported intake of portion size among older volunteers. Setting: General population from the city of Malmö, Sweden. Participants: 106 men and women in three age groups (60-69, 70-79 and 80-91 years) from the general population participated in the study. Measurements: The participants were interviewed regarding their consumption of regular food items in meals and snack meals and beverages. They estimated their portion sizes of 71 different food items. Results: Portion sizes for the eight food items; red and white wine, soft drinks, crisp bread, chocolate, salted nuts, stewed fruit and low fat hard cheese differed between the three male age groups with the oldest men reporting the lowest intake. Among women, only three food items differed namely; oil-based dressing, soup and medium strong beer. Generally the oldest women reported the lowest intake. Conclusion: There were few differences in portion sizes regarding an increased age, from 60 to 90 years of age, for both genders. There is in reality no need to considerate portion size for more than a few food items when using dietary assessment methods such as FFQ in nutritional epidemiology, and reduction factors are presented for these food items.

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BREAKFAST AND READY-TO-EAT CEREAL CONSUMPTION ARE ASSOCIATED WITH IMPROVED MARKERS OF CARDIOMETABOLIC HEALTH IN ADULTS: RESULTS FROM THE NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY 2001 - 2008

C.R. McGill, L.M. Sanders, K.B. Miller, V.L. Fulgoni III

J Aging Res Clin Practice 2013;2(2):168-173

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Background: Breakfast and cereal consumption has been associated with higher diet quality, lower body weight and improved measures of cardiometabolic health. Objectives: To investigate the relationship between breakfast consumption, particularly ready-to-eat cereal, and anthropometric measures, likelihood of overweight/obesity, prevalence of metabolic syndrome (MetS), and other cardiometabolic risk factors in US adults. Design: Cross-sectional. Setting: The 2001-2008 National Health and Nutrition Examination Survey (NHANES), USA. Participants: Adults aged 19-70 years (n=14,316) divided into 2 groups: 19-50 years (n=9,292) and 51-70 years (n=5,024). Measurements: Three breakfast types were defined, ready-to-eat cereal (RTEC), Other Breakfast (OB) and No Breakfast (NB) using a 24 hour dietary recall. Sample weighted data were used to determine least square means ± SE by regression analysis with adjustment for covariates. Odds ratios for risk factors were determined by logistic regression with adjustment for covariates. Results: RTEC and OB consumption were associated with more favorable anthropometry, cardiometabolic measures, and lower prevalence of risk factors for MetS compared to NB in 19 to 50 year old adults. RTEC consumption, compared to OB, was associated with lower body weight, lower BMI, reduced abdominal adiposity and lower prevalence of risk factors for MetS in adults aged 19 to 50 years. There were no differences in likelihood of being overweight or obese or the presence of risk factors for MetS in the 51 to 70 year old adults based on breakfast type. Conclusion: Consumption of breakfast, particularly RTEC, may contribute to healthy aging through reduced risk of chronic disease.

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ACUTE GENOPROTECTIVE EFFECTS ON LYMPHOCYTIC DNA WITH GINSENG EXTRACT SUPPLEMENTATION

Y.T. Szeto, A.W. Ko

J Aging Res Clin Practice 2013;2(2):174-177

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Ginseng is regarded as the ‘miracle’ herb or supplement in the traditional Chinese medicine. Minimizing DNA damage is thought to contribute to longevity. Previous study on ginseng aqueous extract showed in vitro DNA protection on human lymphocytes against oxidative stress. In the current study, the potential DNA protective effect on lymphocytes after supplementation of commercial ginseng extract was measured by comet assay. Seven volunteers were requested to ingest 200 mL water with five capsules of ginseng extract. On the other occasions, seven volunteers took 200 mL of water only as the control trial. Venous blood samples before ingestion were taken. Subjects were requested to keep fasting and the second blood sample was taken at 2.5 hours. Lymphocyte was isolated and subjected to comet assay. DNA damage of isolated lymphocytes was induced by 50 μM H2O2 and the level of damage of was graded under fluorescence microscope. Results showed that there was significant decrease (77% lower) in comet score in ginseng treatment group. No significant change of DNA damage in water treatment group was observed. In conclude, a normal dose of commercial ginseng extract was able to lower DNA damage of peripheral lymphocyte within 2.5 hours of ingestion.

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EFFECT OF THE DIETARY SUPPLEMENT ELEVATP ON BLOOD ATP LEVEL: AN ACUTE PILOT CLINICAL STUDY

T. Reyes-Izquierdo, B. Nemzer, R. Argumedo, C. Shu, L. Huynh, Z. Pietrzkowski

J Aging Res Clin Practice 2013;2(2):178-184

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Objectives: Adenosine triphosphate (ATP) participates in a number of biological processes and its levels diminish during aging. We studied the effects of a proprietary combination of a plant-mineral-rich ancient peat material and a polyphenol-rich apple extract, marketed under the trade name elevATP™, on blood ATP levels. Design: Acute, placebo-controlled, prospective clinical trial. Participants: 18 generally healthy, adult human subjects. Intervention: A single, 150 mg dose of elevATP™ or 50 mg of encapsulated silica oxide (placebo). Measurements: Blood was collected prior to, and at 60, 90 and 120 minutes after treatment. We measured whole blood ATP, total mammalian target for rapamycin (mTOR), lactate, reactive oxygen species (ROS), and glucose. We also identified and quantified the mineral and bioactive components of elevATP™. Results: When compared to the placebo group, elevATP™ caused an acute increase in blood levels of ATP by 64% (P=0.02). ROS and lactate levels were unchanged by elevATP. Total mTOR levels in blood were modestly, but significantly, lower after treatment. Conclusion: Results show that treatment with a single dose of elevATP™ increased blood ATP levels without increasing ROS. Confirmation of these results in a larger study sample is needed. Trials in older individuals may be particularly informative.

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THE EFFECTS OF WEIGHT LOSS ON BODY COMPOSITION, MUSCLE STRENGTH AND PHYSICAL PERFORMANCE IN ELDERLY WOMEN WITH MORBID OBESITY

F. De Stefano, G.Pintore, F. Bolzetta, M. Marangon, G. Sergi, E. Manzato, L. Busetto

J Aging Res Clin Practice 2013;2(2):185-190

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Objectives: The risk/benefits ratio of weight loss in morbid obese elderly is still debated. Our aim was to analyse the effects of an important weight loss on body composition, muscle strength and physical performance in a group of elderly morbid obese women as compared to younger female patients. Design: Intervention study. Setting: Bariatric Unit of the Padua University Hospital. Participants: 6 morbid obese women with age range 61-75 years were recruited for a 6 months weight loss treatment with the use of an intra-gastric balloon. Control group: 6 female morbid obese women with age range 20-60 years. Intervention: Elderly patients were treated with intra-gastric balloon and younger ones with laparoscopic adjustable gastric banding (LAGB). Measurements: Patients were evaluated before and after weight loss. The baseline evaluation was performed immediately before the procedure. The after weight loss evaluation was performed shortly after the removal of the intra-gastric balloon in the elderly group and after obtaining a similar level of weight loss in the control group. Body composition by densitometry (DEXA), muscle composition by peripheral quantitative computed tomography (CT), muscle strength by dynamometer and physical performance by the Short Physical Performance Battery (SPPB) test were determined. Results: No significant differences between the two groups were found before treatment. A 14% weight loss was obtained in both groups and weight loss was associated with a loss of both fat mass and fat free mass. Peripheral quantitative CT showed no significant changes in muscle area or muscle density. A reduction in muscle strength, but a mild improvement in functional tests was found in both groups. Conclusion: Weight loss in morbid obese elderly women was associated with a significant reduction in fat free mass and muscle strength, but with a mild improvement in physical performance. These modifications were similar to those obtained in younger subjects.

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CALCIUM AND VITAMIN D STATUS OF KELANTANESE MALAY WOMEN FROM LOW INCOME FAMILY: A POPULATION-BASED STUDY

M. Hawa, H. Sakinah, H. Hermizi

J Aging Res Clin Practice 2013;2(2):191-196

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Objectives: The objective of this study is to determine the calcium and vitamin D status of Malay women from low income family in Kelantan. Design: The study design is a cross-sectional study. Setting: Kelantan, Malaysia. Participants: Calcium and vitamin D status were determined in 150 (51 pre and 99 postmenopausal) healthy Kelantanese Malay women. Measurements: Calcium intake was determined by diet recall and food frequency questionnaire, while vitamin D based on serum levels of 25-hydroxyvitamin D (25 (OH) D). Results: The data showed that the mean calcium intake was 492.9±316.51 mg/day where 86.3% of the pre- and 91.9% of the postmenopausal subjects have calcium intakes lower than the recommended daily intake for Malaysian women (800 mg/day and 1000mg/day respectively). The intake of calcium was affected by calorie intake and education level (P<0.05). Whilst for vitamin D, 16.4% of the subjects were classified under Hypovitaminosis D, 82.9% insufficient vitamin D level and another 0.7% is under deficiency category. None of the subjects have sufficient circulating level of 25 (OH) vitamin D. Vitamin D intake showed significant correlation with BMI (P<0.05). Conclusion: These findings, which showed that majority of the subjects, have low calcium and vitamin D status is a concern as it will lead to public health problems, especially osteoporosis. Strategy needs to be developed in combating this problem in the lower income populations. Educating the public to raise consciousness towards healthy eating and maintaining a healthy body mass index, and calcium with vitamin D supplementation in the selected high risk groups might be a cost-effective preventative measure.

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VITAMIN C STATUS IN AN ELDERLY POPULATION HOSPITALIZED IN A GERIATRIC REHABILITATION UNIT

C. Chen, O. Chermak, V. Has, H. Belhadj-Tahar, N. Sadeg

J Aging Res Clin Practice 2013;2(2):197-199

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Background: Malnutrition and vitamin deficiencies are frequent in the elderly, especially after occurrence of deterioration in their health status. The aim of this study is to determine the vitamin C status as well and it relation with biological markers of inflammatory and nutritional status in patients hospitalized in a geriatric rehabilitation unit of a general hospital. Methods: This prospective study covers a population of 36 elderly admitted in the rehabilitation unit during one month. At admission, the blood concentrations of Vitamin C, CRP, Albumin and prealbumin were measured. Statistic studies were performed to assess the vitamin C status in this population and to determine the relation of vitamin C with the biological markers. Results: Most patients (94%) have biological criteria for malnutrition (serum albumin concentration <35g/L). Only four patients (11%) have levels of vitamin C over 5mg/L and these patients have also biological criteria for mild malnutrition. The AA levels observed in this study (the mean serum AA concentration in this study was 2.7 mg/L and the median is 1.95 mg/L) were compatible with vitamin C deficiency. Vitamin C deficiency was slightly correlated with biological criteria of inflammatory and malnutrition syndromes; with correlation index R2 of (vitamin C vs CRP) 0.20; R2 of (vitamin C vs albumin) = 0.38 and R2 of (vitamin C vs prealbumin) 0.32. Therefore CRP, albumin and prealbumin are not reliable predictive biological criteria for vitamin C deficiency. These results suggest that a systematic higher intake of vitamin C in the elderly may be particularly interesting after acute health status deterioration. Finally, screening for vitamin C status should be included in the assessment of the general health status of the elderly population.

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REPETITIVE BIOELECTRICAL IMPEDANCE ANALYSIS TO PREDICT OUTCOME IN EARLY GERIATRIC REHABILITATION

H. Burkhardt, M. Schaarschmidt, F. Schneider, H. Leweling

J Aging Res Clin Practice 2013;2(1):200-204

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Objectives: To evaluate prognostic value of bioelectrical impedance analysis in a geriatric acute care setting providing early rehabilitation. Design: Observational study. Setting: Geriatric acute care ward. Participants: A case series of 33 elderly patients admitted to early geriatric rehabilitation course after severe deconditioning in the context of acute disease. Measurements: Comprehensive geriatric assessment, Mini-Nutritional-Assessment (MNA), bioelectrical impedance analysis (BIA). Telephone based assessment 6 months after discharge. Results: 11 patients showed a favorable rehabilitation course (gain of at least 10 ADL points) and 22 patients did not. A positive increment of reactance in the repetitive analysis was significantly associated with an unfavorable outcome, whereas baseline values of functionality markers and BIA were not. 11 patients died within a 6-month interval after discharge. Lower ADL-score, reactance and phase angle were found to be significantly associated with 6-month-mortality. A phase angle below 4° comprised a 3.7 fold mortality-risk. Conclusion: Assessment of phase angle that could be easily obtained even in bedridden subjects may represent a comprehensive additional marker to estimate 6-month prognosis of an individual patient undergoing early geriatric rehabilitation treatment in an acute care setting. For short-term improvement of functionality during rehabilitation course the assessment of increments in BIA-markers reveals more promising.

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KRAEPELINIAN SYSTEMATIC PARAPHRENIA AS A RECOGNIZABLE DISORDER

N. Borja-Santos, B. Trancas, B.Ferreira, J. Parente, A. Gamito, S. Almeida, C. Vieira, A. Luengo, S. Xavier, C. Klut, J. Graça, J. Ramos, M. Martins, J. Ribeiro, A. Neto, M. Palma, A. Luis, G. Cardoso

J Aging Res Clin Practice 2013;2(2):205-210

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Objectives: To demonstrate that systematic paraphrenia as defined by Kraepelin (the most consistent prototypic paraphrenia subtype) can be recognized and diagnosed. Subjects and methods: All patients admitted to a Portuguese psychiatric inpatient unit between September 2006 and October 2011, meeting the criteria for systematic paraphrenia based on Kraepelin’s definition, Munro’s operational criteria and the authors’ criteria, were evaluated by two senior psychiatrists. Results: Out of 27 evaluated patients, 16 (10 women and 6 men) were confirmed as having systematic paraphrenia, accounting for 0.83% of the total number of inpatients (1921). The mean age of onset was 34.3 years (SD = 8.9) and the mean duration of illness at observation was 19.5 years (SD = 12.3). Most (n = 13) had no family psychiatric history, were married (n = 11) before the onset of the disorder and none had previous sensorial deficit. Six were born outside of Portugal. Their academic achievements were only slightly inferior to the general population. Conclusions: Systematic paraphrenia can be recognized and diagnosed. Contrary to Kraepelin, the disorder seems to be more frequent in women. It does not seem to be associated with old age or heredity. This syndrome is internally consistent and its only similarity with schizophrenia is the positive symptoms’ dimension. It should also be distinguished from late paraphrenia.

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NUTRITIONAL STATUS AND ITS ASSOCIATION WITH BODY COMPOSITION COMPARTMENTS IN PHYSICALLY INDEPENDENT, ELDERLY MEXICAN SUBJECTS

H. Alemán-Mateo, L. Tavano Colaizzi, A.B. Pérez-Lizaur

J Aging Res Clin Practice 2013;2(2):211-215

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Objective: The aim of this study was to assess nutritional status by combining the mini nutritional assessment (MNA) and body mass index (BMI) and to explore the association between nutritional status categories and body composition compartments. Design: This is a cross-sectional study based on a non-randomized sample. Settings: Free-living, elderly people residing in community and in shelter homes. Participants: 245 physically independent adults over 60 years of age were evaluated. Measurements: Nutritional status was assessed by combining the MNA survey and BMI. Body composition was determined by a validated predictive equation. The relation between the categories of nutritional status and body composition, specifically fat mass, was tested by an ANOVA. Results: The prevalence of undernutrition on the MNA was 4.9%, and 31% of subjects had risk of undernutrition; while 40% and 32% by BMI were overweight and obese, respectively. The elderly with risk of undernutrition had significantly lower values for body weight, BMI, waist circumference, total body fat, FFM and arm circumference. Fat mass increased or decreased according to the associated nutritional status categories. Subjects with undernutrition according to the MNA had the lowest mean values for fat mass, which were significantly different from those found in elderly subjects classified as well-nourished, and in obese participants. Conclusions: This combination of methods allows a better understanding of alterations of nutritional status. The risks of undernutrition, overweight, and obesity were the most frequent problems. Due to its association, the fat mass compartment proved to be an effective means of identifying subjects at risk of undernutrition. Finally, intervention studies designed to improve the nutritional status of the elderly Mexican population are warranted.

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NUTRITIONAL STATUS BUT NOT VITAMIN DEFICIENCIES ARE ASSOCIATED WITH LOW FUNCTIONAL SCORES

F. O’Leary, M. Allman-Farinelli, P. Petocz, S. Samman

J Aging Res Clin Practice 2013;2(2):216-220

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Objectives: To investigate relationships between selected vitamins, nutritional status and functional outcomes. Design: Cross-sectional study. Setting: Sub-acute geriatric rehabilitation hospital. Participants: 146 newly admitted rehabilitation patients. Measurements: Nutritional assessment using the Mini Nutritional Assessment (MNA) tool, vitamins B12, D and folate concentrations. Length of stay and Functional Independence Measure data were collected from discharge medical records. Results: Age was 83 ± 7 (mean ± sd) years and BMI 25 ± 6 kg/m2. The majority (80%) of subjects were malnourished or at risk of malnutrition and 20% of them had 2 or more vitamin concentrations below the reference range. Vitamin D < 50 nmol/L was found in 55%, vitamin B12 < 221 pmol/L in 34% and serum folate < 6.8 nmol/L in 6% of subjects. Function was related to nutritional status determined by the MNA tool but not related to vitamin concentrations. The assessment component of the MNA score predicted 10% of admission function (β = 0.36, p<0.0005), and subjects with poorer functional scores (< 95) had lower mean MNA scores (19 versus 21, p=0.028). Conclusion: Nutritional status was associated with low functional scores. Low concentrations of vitamins D and B12 were common but were not related to function. More research is needed to investigate the relationship between nutritional status and function.

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APPROPRIATENESS OF FIVE MEASURES PROPOSED BY EWGSOP FOR DIAGNOSING SARCOPENIA IN CLINICAL PRACTICE AMONG THE ELDERLY LIVING AT THE SENIOR CENTRE IN BLANSKO, CZECH REPUBLIC - A CASE STUDY

M. Steffl, M. Masek, M. Petr, V. Bunc, J. Heller, H. Vankova, M. Musalek, E. Kohlikova, I. Holmerova

J Aging Res Clin Practice 2013;2(2):221-225

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Objectives: To evaluate the possibilities of some recommended diagnostic tools on selected groups of the elderly. Design and Methods: 79 elderly people (average age 81.8) participated in a study aimed at verifying the possibilities of using diagnostic methods of sarcopenia proposed by the European Working Group on Sarcopenia in Older People (EWGSOP). We measured body composition by bioimpedence analysis (BIA), physical performance with hand-grip dynamometry and the standing balance, sit-to-stand and walking speed items of the Short Physical Performance Battery (SPPB). For data analysis, we used the IRT statistical method. Results: We demonstrated that these selected tests have a unidimensional character but they do not measure the level of fitness in the elderly. In addition, we found that the item "Chair Stand" is, according to our experience, too difficult in its current version and thus it underestimates the overall performance of the population in this age category. Conclusions: Although the diagnostic tools suggested by EWGSOP are important tools for the senior population in general, we found some difficulties in their use in the sample of seniors who lived at the institution under study. Nevertheless, one possible limitation of our research was the sample size.

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DELIRIUM OUTCOMES AND ITS RELATION TO NUTRITIONAL STATUS IN ELDERLY PATIENTS ADMITTED TO ACUTE GERIATRIC MEDICAL WARD

W.M. Abd-El-Gawad, R.M. Abou-Hashem, M.O. El Maraghy, G.E. Amin

J Aging Res Clin Practice 2013;2(2):226-230

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Background and Objectives: Malnutrition is a prevalent and under diagnosed problem among elderly and it is considered as a major risk for delirium. So, the primary aim was to clarify the effect of nutritional status on delirium and its outcomes: length of stay (LOS), and three month mortality, in recently hospitalized elderly patients. Method: A prospective cohort study was conducted on 190 patients aged 60 and over admitted to acute geriatric medical wards. Patients were subjected to screening for delirium using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria and nutritional assessment using Mini Nutritional Assessment-Short Form-Arabic version (MNA-SF-A) score, serum prealbumin, total protein (TP), and albumin. Results: Mean age was 68.72±7.60 years. Delirium prevalence was 17.6% (n=21). Three month mortality and median LOS were significantly higher in delirious than non-delirious patients (p= 0.003, 0.002 respectively). Delirious patients had statically significant lower MNA-SF-A scores, prealbumin, TP, albumin levels (p=0.028, <0.001, 0.037, 0.033 respectively) than non–delirious patients. By regression, delirium was predictor of the three month mortality (Odds Ratio=1.314, p value=0.022) and delirium and TP were predictors of increased LOS (β= 4.059, 1.655, p value=0.020, 0.019). MNA-SF-A scores, TP, albumin, and prealbumin levels were predictors of delirium (β=0.251, 0.592, 1.012, 0.448, p value=0.025, 0.034, 0.016, <0.001). Conclusion: Delirium is an independent predictor of increased length of stay and three month mortality. MNA-SF scores, total protein, albumin and prealbumin levels are independent predictors for the occurrence of delirium in hospitalized elderly patients.

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MID-UPPER ARM CIRCUMFERENCE (MUAC) FOR DETECTING MALNUTRITION IN HOSPITALIZED ELDERLY

V.A. Leandro-Merhi, M. Nicastro, J.L. Braga de Aquino

J Aging Res Clin Practice 2013;2(2):231-235

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Objective: This study investigated the relationship between mid-upper arm circumference and other nutritional assessment indicators to be used as a tool for the nutritional diagnosis of the elderly. Methods: Anthropometry was used for the nutritional assessment of 123 hospitalized elderly patients with subsequent investigation of the relationship between mid-upper arm circumference (MUAC) and the other indicators. The Mann-Whitney test was used for comparing the data and the Spearman’s linear correlation coefficient was used for assessing the association between the variables. The receiver operator characteristic (ROC) curve was constructed for determining the cut-off. Results: A positive and significant correlation was found between MUAC and other indicators in the whole group and by gender, except between MUAC and waist-to-hip ratio. MUAC differed significantly from the other indicators, suggesting that MUAC can also be used as an indicator of malnutrition in this casuistic. For the construction of the ROC curve, the gold standard was risk estimated by body mass index since correlated best with MUAC. The ROC curve identified a cut-off point of 28.25 cm, with high sensitivity (87.10%) and high specificity (76.09%). Conclusion: The use of MUAC has practical implications for the nutritional assessment of hospitalized elderly, especially if a greater cut-off point is used for the population.

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NUTRITIONAL INTERVENTION OF PATIENTS WITH ALZHEIMER’S DISEASE LIVING AT HOME WITH THEIR SPOUSE: A RANDOMIZED CONTROLLED TRIAL. BASELINE FINDINGS AND FEASIBILITY

T.M. Puranen, S.K. Jyvakorpi, K.H. Pitkala, U. Eloniemi-Sulkava, M.M. Raivio, M.H. Suominen

J Aging Res Clin Practice 2013;2(2):236-241

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Background: Alzheimer patients (AD) and their caregivers are a good target group for nutritional care. AD patients are known to be at risk of malnutrition, and their older caregivers often have multiple diseases and may also have nutritional problems. Purpose: To present the baseline findings of a randomized controlled trial exploring the effectiveness of tailored nutritional treatment among home-dwelling AD patients and their caregivers and the feedback given by spouses regarding the trial. Subjects and methods: Central AD registers in Finland were used to recruit AD patients (n= 99) living at home with their spouses for a randomized controlled trial lasting one year. The intervention group received tailored nutritional advice and care in their homes 4-8 times during the intervention, and the control group received a written guide on nutrition for older people. The participants were asked to give anonymous feedback about the study at the end of the study. Nutrition was assessed with the Mini-Nutritional Assessment (MNA) and three-day food diaries. Results: The mean age of AD patients was 77.4 years (SD 5.6) and the mean age of their spousal caregivers was 75.2 (SD 7.0). The patients’ mean MMSE score was 19.3 (SD 5.6). 44 % of patients and 16 % of caregivers were at risk of malnutrition according to the MNA. At the baseline the mean energy intake was 1714 (SD 477) kcal, protein 73 g (SD 24) and calcium 964 mg (Md 913) per day in AD patients and 1557 kcal (SD 417), 68 g (SD 19) and 886 mg (Md 839) for caregivers. However, the intake levels of nutrients varied widely. Of spousal caregivers, 88 % were satisfied with how the study home visits were organized. Conclusions: We randomized 99 patients with Alzheimer’s disease and 99 aged spouses in a tailored nutrition trial. There was a great heterogeneity in the intake of protein and other nutrients among participants. The feedback from spousal caregivers was positive.

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FUNCTIONAL AND MUSCULAR GAINS IN OLDER ADULTS: MULTICOMPONENT VS. RESISTANCE EXERCISE

R. Forte, C.A.G. Boreham, J. Costaleite, M. Ditroilo, J. Rodrigues-Krause, L. Brennan, E. Gibney, G. De Vito

J Aging Res Clin Practice 2013;2(2):242-248

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Background: Progressive resistance training (PRT) and multicomponent training, the latter incorporating neuromotor exercises such as balance, agility and coordination, are currently recommended to maintain functional ability in older individuals. While PRT has proved effective, the efficacy of multicomponent training for healthy individuals is less certain. Objective: This study investigated the efficacy of group-based multicomponent training exercise compared to PRT for improving functional ability, muscular strength and power in healthy, older individuals. Design and Participants: Thirty-nine males and females aged 65 to 75 were allocated to either multicomponent or PRT training twice weekly for three months. They were tested at baseline (T1), following a four-week control period (T2), and post-intervention (T3). Measurements: functional ability by habitual and maximal walking speeds and chair rise time; muscular strength by isometric hand grip and isokinetic knee extension and flexion, and lower limb peak power by countermovement jump. Results: Two-way repeated ANOVA showed effects irrespective of training type for maximal walking speed (+7%; F=11.4 p<0.000), chair rise time (-18%; F= 29.4 p<0.000) and peak power (+8%; F = 24.7; p<0.000). Knee extension (+26%; F = 7.6; p<0.001) and flexion (+35%; F = 11.1; p<0.000) torques increased only with PRT. Conclusions: Both forms of training improved functional ability in healthy older individuals. PRT was confirmed to be effective for the enhancement of both muscular strength and power. Multicomponent training did not enhance strength, although peak power was improved which may be relevant for the maintenance of independence in older people. The present findings add to the limited evidence on the efficacy of multicomponent training in healthy older adults and may help to define exercise recommendations for this population. This may represent an important element in the strategy for the postponement of functional decline and compression of morbidity in this population.

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