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JARCP Vol 8, 2019
EVALUATION OF INPATIENTS NUTRITIONAL STATUS AND PROGNOSTIC INVOLVEMENT
J. Ares Blanco, L. Moreno Díaz, E. Fernández-Fernández, A.J. López-Alba
J Aging Res Clin Practice 2019;8:15-19Show summaryHide summary
Background: There is an association between malnutrition and mortality. However, it is unclear if this association is truly independent of confounding factors. Objectives: The objective of this study is to evaluate nutritional status, defined according to the three categories defined in the Nutritional Screening Tool “Mini Nutritional Assessment”, and to investigate its prognostic involvement. Design, Setting and Participants: Single cohort retrospective observational study in hospitalized patients between December 2013 and January 2014, who were placed under observation until September 2015 (21 months) (n=144). Nutritional status was determined by MNA short form at the beginning of the study, as well as clinical and epidemiological data. Results: Based on categories defined by MNA SF, 59 (40.97%) were well nourished, 55 (38.19%) were at risk of malnutrition, and 30 (20.83%) patients showed malnutrition. 45 patients died during follow up (31.25%). Of them, 40% (18) were malnourished, 38% (17), at risk of malnutrition, and 22% (9), well nourished. After adjusting for confounding factors, hazard ratio (95% CI) for all-cause mortality was significantly greater in the malnourished group (3.44 (1,27-9,31: p 0,015)), comparing to the reference group (well-nourished patients). Conclusions: Nutritional status defined according to the 3 categories defined in MNA short form predicts the probability of mid-term death in hospitalized patients, after adjusting for confounding factors as age and comorbidities. These data show the importance of knowing nutritional status during hospitalization for avoiding potential complications and helping the patient to overcome them.
J. Ares Blanco ; L. Moreno Díaz ; E. Fernández-Fernández ; A.J. López-Alba (2019): EVALUATION OF INPATIENTS' NUTRITIONAL STATUS. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2019.3
NUTRITIONAL ADEQUACY AND ORAL NUTRITIONAL SUPPLEMENTATION IN OLDER COMMUNITY-DWELLING ADULTS
L. McKeever, I.C. Farrar, S. Sulo, J. Partridge, P. Sheean, M. Fitzgibbon
J Aging Res Clin Practice 2019;8:7-14Show summaryHide summary
Background: Older adults (65 years and older) comprise a high-risk group that are susceptible to the development of malnutrition. Dietary intake and diet quality represent key modifiable risk factors to help prevent and to treat declines in nutrition status, with oral nutritional supplements (ONS) often being a cost-effective therapy for many to increase protein and caloric intake. The DETERMINE Checklist offers a series of questions capable of mapping the initial landscape of contextual factors that influence the dietary patterns of the at-risk populations. Objectives: To examine independent predictors of inadequate dietary intake and poor diet quality amongst a multi-ethnic sample of urban community-dwelling older adults in an effort to identify target groups of participants that could benefit most from an ONS intervention. Design: Cross-sectional. Participants: Chicago, Illinois, United States urban residents greater than 55 years of age who self-reported to be non-Hispanic White, non-Hispanic Black, or Hispanic. Methods: Telephone surveys were conducted to obtain basic demographic information. The DETERMINE Checklist was administered to (1) characterize participants’ nutritional risk, and (2) identify participants with inadequate intake and/or poor diet quality. Predictors of inadequate intake, defined as any participant who reported either to eat less than two meals per day and/or poor diet quality, defined as any participant who reported to eat few fruits, vegetables or dairy were used to identify groups of participants who could benefit most from ONS consumption. Mantel-Hanzel chi square, Breslow-day tests, and logistic regressions were conducted. Results: 1001 ethnically diverse participants were interviewed (37% non-Hispanic White, 37% non-Hispanic Black, and 26% Hispanic). Respondents were predominantly female (69%) with a mean age of 66.9 (± 6.4) years. The majority were found to be at either moderate or high nutrition risk (78.7%). Domains of the DETERMINE Checklist that predicted either inadequate dietary intake or poor diet quality included social isolation, lower levels of educational attainment, food insecurity, limitations in activities of daily living (ADL), polypharmacy, or three or more alcoholic drinks per day. Of the participants who met the criteria as those who would benefit from ONS, less than 50% had reported consuming ONS in the past six months. Conclusion: Older community-dwelling adults living in an urban setting, especially those with social isolation, lower levels of education, food insecurity, limitations with ADLs, polypharmacy, and those reporting heavy alcohol intake represent a population who could benefit from consuming ONS. Efforts should be made towards further understanding these contextual factors and providing nutrition education along with an ONS intervention that could be beneficial to supplement dietary inadequacies in this population.
L. McKeever ; I.C. Farrar ; S. Sulo ; J. Partridge ; P. Sheean ; M. Fitzgibbon (2019): Nutritional Adequacy and Oral Nutritional Supplementation in Older Community-Dwelling Adults. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2019.2
EFFECT OF ß-HYDROXY-ß-METHYLBUTYRATE (HMB) ON MUSCLE STRENGTH IN OLDER ADULTS WITH LOW PHYSICAL FUNCTION
K. Kinoshita, S. Satake, Y. Matsui, S. Kawashima, H. Arai
J Aging Res Clin Practice 2019;8:1-6Show summaryHide summary
Objectives: To evaluate the effects of β-hydroxy-β-methylbutyrate (HMB) on muscle strength, physical performance, and muscle mass without additional exercise training in older adults with low physical function. Design: Randomized, controlled trial (Open-label study). Setting: Outpatients. Participants: 34 senior outpatients with low physical function who do not exercise regularly. Intervention: 2.4 g of HMB (3.0 g of calcium β-hydroxy-β-methylbutyrate [CaHMB]) per day was given for 60 days, and subjects in the control group were asked to engage in daily activities as normal. Measurements: Weakness or low function was defined by the Asian Working Group for Sarcopenia criteria, then the participants were assigned to the HMB group or the control group. All participants underwent several evaluations such as grip strength, the timed up and go test, the 5-times chair stand test (5CS), and skeletal muscle mass index by the bioimpedance method at baseline and at the end of intervention or control period. Results: An intragroup comparison of pre- to post-treatment values showed significant improvement in grip strength and the 5CS in the HMB group (grip strength: HMB, 16.6±6.1 kg to 18.2±6.4 kg, P=.001; control, 16.5±4.3 kg to 16.7±4.7 kg, P=.729; 5CS: HMB, 11.0 [8.8-13.0] s to 10.1 [8.5-12.6] s, P=.011; control, 11.1 [8.6-13.8] s to 10.0 [8.8-11.3] s, P=.246). Two-way repeated measures analysis of variance (ANOVA) used to compare the HMB and control groups showed a significant improvement in grip strength in the HMB group compared with the control group (P=.029). Conclusion: A supplementation of HMB without additional exercise may improve muscle strength in older patients with low muscle strength.
K. Kinoshita ; S. Satake ; Y. Matsui ; S. Kawashima ; H. Arai (2019): Effect of β-Hydroxy-β-methylbutyrate (HMB) on muscle strength in older adults with low physical function . The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2019.1