Journal of Nutrition in Gerontology and Geriatrics最新文献

{"title":"Identifying Geriatric Patients at Risk for Malnutrition: A Quality Improvement Project.","authors":"Lauren C Mays,&nbsp;Jennifer W Drummonds,&nbsp;Summer Powers,&nbsp;David R Buys,&nbsp;Penni I Watts","doi":"10.1080/21551197.2019.1604464","DOIUrl":"https://doi.org/10.1080/21551197.2019.1604464","url":null,"abstract":"<p><p>Malnourishment leads to poor outcomes in the geriatric surgical population and national guidelines recommend preoperative nutrition screening. However, care practices do not reflect current recommendations. As a quality-improvement project, a validated nutritional screening tool, the Mini Nutritional Assessment-Short Form (MNA-SF), was implemented in the preoperative clinic of a large academic health center to identify patients at-risk for malnutrition prior to elective surgery. Patients were screened during the nursing intake process and categorized as no nutritional risk; at-risk for malnourishment; or severely malnourished. During the four-week screening period, 413 patients met inclusion criteria with 67.8% (n = 280) screened. No nutritional risk was identified in 77.5% (n = 215) of patients, 18.2% (n = 51) were at-risk, and 4.3% (n = 12) were malnourished. This project will inform and guide a prehabilitation plan for nutrition optimization to improve healthcare quality, outcomes, and costs in the geriatric surgical population.</p>","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"38 2","pages":"115-129"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21551197.2019.1604464","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37181769","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}

{"title":"Validation of a Diet Quality Screening Tool for Use in the Oldest Old^.","authors":"Yi-Hsuan Liu,&nbsp;Xiang Gao,&nbsp;Diane C Mitchell,&nbsp;G Craig Wood,&nbsp;Regan K Bailey,&nbsp;Christopher D Still,&nbsp;Gordon L Jensen","doi":"10.1080/21551197.2019.1601604","DOIUrl":"https://doi.org/10.1080/21551197.2019.1601604","url":null,"abstract":"<p><p>The oldest old (aged ≥80 years) are often the population subgroup at high nutritional risk due to age-related metabolic changes. We performed a validation analysis of a dietary screening tool (DST) which was developed for older adults among the oldest old. We examined dietary intakes using three 24-hour dietary recalls and the DST among 122 participants (aged 82-97) of the Geisinger Rural Aging Study. DST scores were compared with the Health Eating Index (HEI)-2015 scores, which were calculated based on three-day dietary recalls. Pearson correlations were used to characterize concurrent validity and Bland-Altman plots were used to identify potential bias. DST scores were significantly correlated with HEI scores (adjusted r = 0.68; p < 0.001) in an age- and sex-adjusted model. Those within the not-at-risk DST group had significantly higher HEI scores (adjusted means = 79.6 ± 3.68) compared with those who were in the at-risk (adjusted means = 51.2 ± 1.56) and the possibly-at-risk (adjusted means = 66.3 ± 1.79) groups (p-trend < 0.001). The DST appears to be a valid measure of diet quality in the oldest old when compared with the HEI and may be a potential tool to assess overall diet quality in this population.</p>","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"38 2","pages":"196-204"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21551197.2019.1601604","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37381097","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}

{"title":"Mental Illness, Not Obesity Status, is Associated with Food Insecurity Among the Elderly in the Health and Retirement Study.","authors":"Diana P Brostow,&nbsp;Elise Gunzburger,&nbsp;Lauren M Abbate,&nbsp;Lisa A Brenner,&nbsp;Kali S Thomas","doi":"10.1080/21551197.2019.1565901","DOIUrl":"https://doi.org/10.1080/21551197.2019.1565901","url":null,"abstract":"<p><strong>Objectives: </strong>Food insecurity, limited or uncertain access to adequate nutrition, is an increasingly recognized determinant of health outcomes and is often associated with having obesity. It is unclear, however, if this association persists in elderly populations.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of 2868 participants' aged 65+ years from the Health and Retirement Study. Multivariate logistic regression was used to assess associations between food insecurity and body mass index, demographic characteristics, psychiatric history, and medical history.</p><p><strong>Results: </strong>Participants with overweight/obesity had a higher prevalence of food insecurity than leaner counterparts, however, weight status was not a significant predictor of food insecurity after multivariate adjustment. Instead, mental illness, current smoking status, and non-White race were all independently associated with food insecurity.</p><p><strong>Discussion: </strong>Beyond financial status, health care providers are encouraged to use these characteristics to identify elderly patients that may be at risk of food insecurity.</p>","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"38 2","pages":"149-172"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21551197.2019.1565901","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36989775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between B-Vitamin Biomarkers and Dietary Intake with Apolipoprotein E є4 in Alzheimer's Disease.","authors":"Nathan M D'Cunha,&nbsp;Ekavi N Georgousopoulou,&nbsp;Lyndell Boyd,&nbsp;Martin Veysey,&nbsp;Jonathan Sturm,&nbsp;Bill O'Brien,&nbsp;Mark Lucock,&nbsp;Andrew J McKune,&nbsp;Duane D Mellor,&nbsp;Paul D Roach,&nbsp;Nenad Naumovski","doi":"10.1080/21551197.2019.1590287","DOIUrl":"https://doi.org/10.1080/21551197.2019.1590287","url":null,"abstract":"<p><p>The potential for B-vitamins to reduce plasma homocysteine (Hcy) and reduce the risk of Alzheimer's disease (AD) has been described previously. However, the role of Apolipoprotein E є4 (APOE4) in this relationship has not been adequately addressed. This case-control study explored APOE4 genotype in an Australian sample of 63 healthy individuals (female = 38; age = 76.9 ± 4.7 y) and 63 individuals with AD (female = 35, age = 77.1 ± 5.3 y). Findings revealed 55 of 126 participants expressed the APOE4 genotype with 37 of 126 having both AD and the APOE4 genotype. Analysis revealed an increased likelihood of AD when Hcy levels are >11.0 µmol/L (p = 0.012), cysteine levels were <255 µmol/L (p = 0.033) and serum folate was <22.0 nmol/L (p = 0.003; in males only). In females, dietary intake of total folate <336 µg/day (p=0.001), natural folate <270 µg/day (p = 0.011), and vitamin B2 < 1.12 mg/day (p = 0.028) was associated with an increased AD risk. These results support Hcy, Cys, and SF as useful biomarkers for AD, irrespective of APOE4 genotype and as such should be considered as part of screening and managing risk of AD.</p>","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"38 2","pages":"173-195"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21551197.2019.1590287","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37100384","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}

{"title":"Technology for Behavioral Change in Rural Older Adults with Obesity.","authors":"John A Batsis, John A Naslund, Alexandra B Zagaria, David Kotz, Rachel Dokko, Stephen J Bartels, Elizabeth Carpenter-Song","doi":"10.1080/21551197.2019.1600097","DOIUrl":"10.1080/21551197.2019.1600097","url":null,"abstract":"<p><strong>Background: </strong>Mobile health (mHealth) technologies comprise a multidisciplinary treatment strategy providing potential solutions for overcoming challenges of successfully delivering health promotion interventions in rural areas. We evaluated the potential of using technology in a high-risk population.</p><p><strong>Methods: </strong>We conducted a convergent, parallel mixed-methods study using semi-structured interviews, focus groups, and self-reported questionnaires, using purposive sampling of 29 older adults, 4 community leaders and 7 clinicians in a rural setting. We developed codes informed by thematic analysis and assessed the quantitative data using descriptive statistics.</p><p><strong>Results: </strong>All groups expressed that mHealth could improve health behaviors. Older adults were optimistic that mHealth could track health. Participants believed they could improve patient insight into health, motivating change and assuring accountability. Barriers to using technology were described, including infrastructure.</p><p><strong>Conclusions: </strong>Older rural adults with obesity expressed excitement about the use of mHealth technologies to improve their health, yet barriers to implementation exist.</p>","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"38 2","pages":"130-148"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6999857/pdf/nihms-1067074.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37139632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity, Dietary inflammation, and Frailty among Older Adults: Evidence from the National Health and Nutrition Examination Survey.","authors":"Matthew C Lohman,&nbsp;Nicholas V Resciniti,&nbsp;Michael D Wirth,&nbsp;Nitin Shivappa,&nbsp;James R Hébert","doi":"10.1080/21551197.2018.1552226","DOIUrl":"https://doi.org/10.1080/21551197.2018.1552226","url":null,"abstract":"<p><p>Knowledge related to the relationship between obesity and frailty is limited. This study aimed to investigate associations between obesity, dietary inflammation, and frailty among older adults. Study data came from National Health and Nutrition Examination Survey (2007-2014) examinations of adults age ≥60 years (n = 7182). Dietary inflammatory potential was determined using the Dietary Inflammatory Index (DII^®) derived from 24-h dietary recall. We analyzed independent and joint associations of obesity and DII with frailty to evaluate interaction. Multivariable logistic regression revealed that both obesity (Odds Ratio [OR] = 2.24, 95% CI: 1.68, 2.99) and moderately pro-inflammatory DII (OR = 1.68, 95% CI: 1.10, 2.58) were independently associated with greater frailty prevalence. A negative multiplicative interaction between obesity and highest pro-inflammatory diet also was found (adjusted odds in non-obese and obese were 2.07 and 2.37, respectively; p = 0.046). Results indicate the importance of considering obesity and dietary inflammatory potential when screening for frailty or developing treatments.</p>","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"38 1","pages":"18-32"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21551197.2018.1552226","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37037132","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}

{"title":"Long-Term Effects of Randomization to a Weight Loss Intervention in Older Adults: A Pilot Study.","authors":"Denise K Houston,&nbsp;Michael E Miller,&nbsp;Dalane W Kitzman,&nbsp;W Jack Rejeski,&nbsp;Stephen P Messier,&nbsp;Mary F Lyles,&nbsp;Stephen B Kritchevsky,&nbsp;Barbara J Nicklas","doi":"10.1080/21551197.2019.1572570","DOIUrl":"https://doi.org/10.1080/21551197.2019.1572570","url":null,"abstract":"<p><p>Randomized, controlled trials (RCTs) show intentional weight loss improves body composition and physical function in older adults; however, the long-term benefits (and risks) are unknown. We conducted a pilot study to assess the feasibility of recalling prior RCT participants to examine the long-term effects of intentional weight loss on body composition and physical function. A weighted, random sample of 60 older adults who were randomized to caloric restriction plus exercise (CR + EX) or exercise (EX) only in 5 prior RCTs (mean age at randomization, 67.3 years; 69% women, 80% white) were invited to participate. Follow-up was obtained on 89% (42 clinic visits, 10 phone interviews, 1 death) an average of 3.5 years (range, 2.2-5.8 years) after RCT completion. Despite greater weight, fat and lean mass loss during the RCT (mean difference in change (95% CI): -4.19 (-7.52, -0.86), -2.75 (-5.10, -0.40), and -2.32 (-3.69, -0.95) kg, respectively) in those randomized to CR + EX, long-term changes in weight (2.05 (-2.35, 6.45) kg) and body composition (1.80 (-1.56, 5.17) and 0.03 (-2.20, 2.26) kg for fat and lean mass, respectively) from baseline and physical function at long-term follow-up (mean difference in 400-m walk and SPPB (95% CI): 23.2 (-19.3, 65.6) sec and -0.03 (-1.02, 0.96) points, respectively) were similar in CR + EX and EX only. Although improvements in weight and body composition following intentional weight loss may not be sustained long-term, physical function does not appear to be negatively impacted. A larger study is needed to confirm these results.</p>","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"38 1","pages":"83-99"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21551197.2019.1572570","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37037560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropsychological Functioning in Older Adults with Obesity: Implications for Bariatric Surgery.","authors":"Robert M Roth,&nbsp;Sivan Rotenberg,&nbsp;Jeremy Carmasin,&nbsp;Sarah Billmeier,&nbsp;John A Batsis","doi":"10.1080/21551197.2018.1564722","DOIUrl":"https://doi.org/10.1080/21551197.2018.1564722","url":null,"abstract":"<p><p>Bariatric surgery is the most effective approach to treating morbid obesity, resulting in decreased morbidity, mortality, and improved quality of life. Research on outcomes has generally been restricted to young and middle-aged adults, despite a growing epidemic of obesity in older adults. The use of bariatric surgery has been limited in older individuals, in part due to concerns that preexisting cognitive dysfunction increases the risk of poor post-surgical outcomes, including cognitive decline. The literature on the relationship between obesity and cognition in older adults is emerging, but fraught by several methodological limitations. While there is insufficient research to determine the nature of cognitive outcomes following bariatric surgery in older adults, the aim of this paper is to review the existing evidence and make the case for further study.</p>","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"38 1","pages":"69-82"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21551197.2018.1564722","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36989892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Weight Reduction and Enhanced Protein Intake on Biomarkers of Inflammation in Older Adults with Obesity.","authors":"Kathryn N Porter Starr,&nbsp;Melissa Orenduff,&nbsp;Shelley R McDonald,&nbsp;Hillary Mulder,&nbsp;Richard Sloane,&nbsp;Carl F Pieper,&nbsp;Connie W Bales","doi":"10.1080/21551197.2018.1564200","DOIUrl":"https://doi.org/10.1080/21551197.2018.1564200","url":null,"abstract":"<p><p>Both aging and obesity are associated with increased levels of pro-inflammatory metabolites, while weight reduction is associated with improvements in inflammatory status. However, few studies have explored the response of key inflammatory markers to the combined settings of weight reduction in an aging population. There are also few studies that have investigated the potential impact of diet composition on inflammatory marker responses. In the MEASUR-UP trial, we evaluated changes in baseline levels of inflammatory markers with post-study levels for a traditional weight loss control group versus a group with generous, balanced protein intake. In this 6-month randomized controlled trial (RCT), older (≥60 years) adults with obesity (BMI ≥30 kg/m²) and Short Physical Performance Battery (SPPB) score of 4-10 were randomly assigned to either a traditional weight loss regimen, (Control, n = 14) or one with higher protein intake (≥30 g) at each meal (Protein, n = 25). All participants were prescribed a hypo-caloric diet and attended weekly support and education groups and weigh-ins. Protein participants consumed ≥30 g of high-quality protein/meal, including lean and extra lean beef provided to them for two of the three meals per day. Protein intakes were 0.8 and 1.2 g/kg/day for Control and Protein, respectively. Adiponectin, leptin, C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), IL-6, IL-8, serum amyloid A (SAA), vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), and glycated serum protein (GSP) levels were measured at 0 and 6-month time points. At the 6-month endpoint, there was significant weight loss and decrease in BMI in both the Control (-4.8 ± 8.2 kg; -2.3 ± 2.4 kg/m²; p = 0.05) and Protein (-8.7 ± 7.4 kg; -2.9 ± 2.3 kg/m²; p < 0.0001) groups. SPPB scores improved in both arms, with a superior functional response in Protein (p < 0.05). Body fat (%) at baseline was positively correlated with leptin, hs-CRP, VCAM-1, ICAM-1, and GSP. Several markers of inflammation responded to the Protein group: leptin (p < 0.001), hs-CRP (p < 0.01), and ICAM-1 (p < 0.01) were decreased and adiponectin increased (p < 0.01). There were no significant changes in any inflammatory markers in the Control arm. In the between group comparison, only adiponectin trended towards a group difference (more improvement in Protein; p < 0.07). Our findings in the MEASUR-UP trial show that a weight loss diet with enhanced protein intake is comparable to an adequate protein diet in terms of weight loss success and that it can lead to improvements in inflammatory status, specifically for adiponectin, leptin, hs-CRP, and ICAM-1. These findings are important given current recommendations for higher protein intakes in older adults and justify the additional study of the inflammatory impact of an enhanced protein diet. (ClinicalTrials.gov identifier: NCT01715753).</p>","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"38 1","pages":"33-49"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21551197.2018.1564200","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37178633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight Loss-Induced Reduction of Bone Mineral Density in Older Adults with Obesity.","authors":"Bryan C Jiang,&nbsp;Dennis T Villareal","doi":"10.1080/21551197.2018.1564721","DOIUrl":"https://doi.org/10.1080/21551197.2018.1564721","url":null,"abstract":"<p><p>Obesity in older adults is a growing public health problem, yet the appropriate treatment remains controversial partly due to evidence that weight loss reduces bone mass and may increase fracture risk. The purpose of this review is to summarize the research to date on the effects of diet-induced weight loss on bone health in obese (body mass index 30 kg/m² and above) older (aged 65 years or older) adults. Observational studies have shown that weight loss in this population decreases total hip bone mineral density and increases the risk of frailty fractures (composite of proximal femur, pelvis, and proximal humerus fractures). Randomized controlled trials have largely confirmed these earlier observations but have also shown that exercise, particularly progressive resistance training, can attenuate or even alleviate this bone loss. Further research incorporating outcomes concerning bone quality and mass are needed to identify the optimal exercise and nutritional regimens to counteract the bone loss.</p>","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"38 1","pages":"100-114"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21551197.2018.1564721","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36989778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}