The Journal of Nutrition, Health & Aging最新文献

{"title":"Prognostic Impact of Delirium in Older People With/Without Dementia: A Retrospective Cohort Study in Taiwan.","authors":"C-K Liang, H-Y Chuang, F-Y Hsiao, M-Y Chou, T-Y Liu, C-C Yang, L-K Chen","doi":"10.1007/s12603-020-1459-4","DOIUrl":"10.1007/s12603-020-1459-4","url":null,"abstract":"<p><strong>Objectives: </strong>To elucidate the hypothetically different interactions between delirium and post-discharge prognostic indicators in elderly hospital inpatients with versus without dementia.</p><p><strong>Design: </strong>Retrospective cohort study of claims data by Taiwan National Health Insurance beneficiaries between 2002-2013.</p><p><strong>Setting: </strong>Records of public hospital admissions in the Taiwan National Health Insurance Research database.</p><p><strong>Participants: </strong>Propensity-score matched subgroups of patients with delirium superimposed on dementia (n = 922) versus dementia alone (n = 922), delirium alone (n = 680) versus neither delirium nor dementia (n = 680).</p><p><strong>Measurements: </strong>Mortality, emergency department visits, readmissions, and psychotropic drug use, within 30, 180, and 365 days of discharge, were analyzed using multivariate proportional hazards or logistic regression analyses.</p><p><strong>Results: </strong>Delirium superimposed on dementia was not associated with increased post-discharge mortality, or emergency department visits, but significantly increased the risk of readmissions at 365-day follow-up (adjusted HR, 95% CI: 1.26, 1.01-1.56). However, delirium without dementia was significantly associated with increased post-discharge mortality, emergency department visits and readmissions at 180 days and 365 days (respective adjusted HRs: mortality, 1.63 and 1.79; adjusted ORs: emergency department visits, 1.89 and 1.81; readmissions, 1.47 and 1.53). Delirium in patients both with dementia and without, was associated with six-fold higher likelihood of in-hospital psychotropic drug use, and doubled post-discharge psychotropic drug usage.</p><p><strong>Conclusions: </strong>The obvious association between in-hospital delirium and worsened long-term prognosis, irrespective of dementia, raises awareness to warrants proactive and multimodal prevention and intervention strategies. Furthermore, the mechanisms about different influence of delirium for patients with/without dementia need to be further explored.</p>","PeriodicalId":501202,"journal":{"name":"The Journal of Nutrition, Health & Aging","volume":" ","pages":"951-958"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12280676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38677422","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":"Nutritional Risk and Mortality at One Year for Elderly Patients Hospitalized with Nonvalvular Atrial Fibrillation. Nonavasc Registry.","authors":"A Arenas Miquélez, M A Requena Calleja, A Gullón, A Pose Reino, F Formiga, M Camafort, J M O Cepeda Rodrigo, J M Mostaza, C Suárez Fernández, J Díez-Manglan","doi":"10.1007/s12603-020-1418-0","DOIUrl":"10.1007/s12603-020-1418-0","url":null,"abstract":"<p><strong>Objectives: </strong>To determine whether nutritional risk is associated with the mortality of elderly patients hospitalized with nonvalvular atrial fibrillation (NVAF).</p><p><strong>Design: </strong>Prospective, multicenter cohort study.</p><p><strong>Setting: </strong>Internal medicine departments in Spain.</p><p><strong>Participants: </strong>Inpatients >75 years with NVAF.</p><p><strong>Measurements: </strong>We measured the thrombotic and hemorrhagic risk at admission using the CHA2DS2-VASc and HAS-BLED scales, respectively, and the nutritional risk with the controlling nutritional status (CONUT) index. We established 4 degrees of nutritional risk: null (CONUT score 0-1 point), low (2-4 points), moderate (5-8 points) and high (9-12 points). We also conducted a 1-year follow-up.</p><p><strong>Results: </strong>We included 449 patients, with a mean age of 85.2(5.2) years. The nutritional risk was null for 70(15.6%) patients, low for 206 45.9%), moderate for 152(33.8%) and high for 21(4.7%). At the end of one year, 177(39.4%) patients had died. The score on the CONUT index was higher for the deceased patients (4.6 vs. 3.6, p<0.001). The CONUT score (HR, 1.076; 95%CI 1.009-1.148; p=0.025), the Charlson index (HR, 1.080; 95%CI 1.017-1.148; p=0.013) and the presence of pressure ulcers (HR, 1.700; 95%CI 1.028-2.810; p=0.039) were independently associated with increased mortality at one year of follow-up. The prescription of oral anticoagulants at discharge was associated with lower mortality (HR, 0.440; 95%CI 0.304-0.638; p<0.001).</p><p><strong>Conclusions: </strong>More than a third of elderly patients hospitalized with NVAF have a moderate to high nutritional risk. These patients have greater mortality at the end of one year.</p>","PeriodicalId":501202,"journal":{"name":"The Journal of Nutrition, Health & Aging","volume":" ","pages":"981-986"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12280566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38677427","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":"Peak Expiratory Flow as an Index of Frailty Syndrome in Older Adults: A Cross-Sectional Study.","authors":"J A Magave, S J S Bezerra, A P Matos, A C P N Pinto, M S Pegorari, D G Ohara","doi":"10.1007/s12603-020-1423-3","DOIUrl":"10.1007/s12603-020-1423-3","url":null,"abstract":"<p><strong>Objectives: </strong>to compare the obtained and predicted peak expiratory flow (PEF) values between frail, pre-frail, and non-frail older adults; verify the association between PEF and FS; and establish cut-off points for PEF as determinants of frailty syndrome (FS).</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Location: </strong>Macapá, Amapá, Brazil.</p><p><strong>Participants: </strong>Community-based study community-dwelling older people.</p><p><strong>Methods: </strong>PEF was evaluated using a peak-flow meter and FS was evaluated using Fried's frailty phenotype. The statistical analyses performed included a multinomial logistic regression model and Receiver Operating Characteristic (ROC) curves to establish cut-off points for discriminating FS.</p><p><strong>Results: </strong>409 older adults with a mean age of 70.09±7.22 years were evaluated; of these, 58.7% were pre-frail, and 12.7% were frail. PEF was lower in frail than in pre-frail participants, and lower in pre-frail than in non-frail. Frail and pre-frail older adults obtained lower PEF values than predicted. PEF (% Predicted) was inversely associated with frailty and pre-frailty even after adjustment. Cut-off points were established to discriminate the presence of frailty in older men (PEF≤350L/min; AUC=0.669; sensitivity=76.92%; specificity=52%) and women (PEF≤220L/min; AUC=0.597; sensitivity=71.79%; specificity=46.98%).</p><p><strong>Conclusions: </strong>Frail and pre-frail older adults presented significantly lower PEF than non-frail participants, and these values were lower than predicted. PEF was inversely associated with frailty and pre-frailty. PEF cut-off points can be used as a complementary method to indicate frailty in community-dwelling older adults.</p>","PeriodicalId":501202,"journal":{"name":"The Journal of Nutrition, Health & Aging","volume":" ","pages":"993-998"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12280685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38576025","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":"Abstracts from the 4th European Congress on Nutrition and Health in the Elderly. November 4-5, 2004. Toulouse, France.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":501202,"journal":{"name":"The Journal of Nutrition, Health & Aging","volume":" ","pages":"435-84"},"PeriodicalIF":5.8,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25033815","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}