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Nutrition and Rehabilitation in Older Patients with Disability

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (31 March 2021) | Viewed by 39272

Special Issue Editor


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Guest Editor
Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Mie 514-8507, Japan
Interests: rehabilitation medicine; dysphagia; clinical nutrition; aspiration pneumonia; health service research
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The prevalence of malnutrition in older patients who undergo rehabilitation is high. Malnutrition is associated with impairment, disability, and handicap. The major causes of disability in rehabilitation facility inpatients are often complicated by malnutrition.

A combination of both rehabilitation and nutritional management is important in older patients with disabilities. Rehabilitation and nutritional care improve physical function, activities of daily living, and quality of life. There has been growing interest in associations between nutrition and rehabilitation.

The aim of this Special Issue is to update knowledge on nutritional management and rehabilitation in older patients with disabilities. We invite the submission of clinical research, epidemiological research, and up-to-date reviews (scoping and systematic reviews, as well as meta-analyses).

Dr. Ryo Momosaki
Guest Editor

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Keywords

  • Undernutrition
  • Rehabilitation
  • Older
  • Disability
  • Frailty
  • Cachexia
  • Dysphagia
  • Sarcopenia

Published Papers (7 papers)

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Editorial

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2 pages, 178 KiB  
Editorial
Nutritional Care for Older Patients Undergoing Rehabilitation
by Kae Morita, Yuka Shirai, Momoko Tohyama and Ryo Momosaki
Nutrients 2023, 15(13), 2893; https://doi.org/10.3390/nu15132893 - 26 Jun 2023
Viewed by 808
Abstract
Malnutrition is a common complication in patients undergoing rehabilitation [...] Full article
(This article belongs to the Special Issue Nutrition and Rehabilitation in Older Patients with Disability)

Research

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13 pages, 292 KiB  
Article
Nutrition Screening, Reported Dietary Intake, Hospital Foods, and Malnutrition in Critical Care Patients in Malawi
by Grace C. Barcus, Peggy C. Papathakis, Andrew Schaffner and Bernadette Chimera
Nutrients 2021, 13(4), 1170; https://doi.org/10.3390/nu13041170 - 1 Apr 2021
Cited by 7 | Viewed by 4160
Abstract
In low-income countries there are few data on hospital malnutrition. Reduced food intake combined with nutrient-poor foods served in hospitals contribute to nutritional risk. This study investigated whether reported dietary intake and disease state of hospitalized adults in critical care units was related [...] Read more.
In low-income countries there are few data on hospital malnutrition. Reduced food intake combined with nutrient-poor foods served in hospitals contribute to nutritional risk. This study investigated whether reported dietary intake and disease state of hospitalized adults in critical care units was related to malnutrition determined by mid-upper arm circumference (MUAC). Adult in-patients (n = 126) in tuberculosis, burn, oncology, and intensive care units in two public tertiary hospitals in Malawi were screened for nutritional status using MUAC and a question on current dietary intake. The hospital menu was reviewed; portion sizes were weighed. The prevalence of moderate and severe malnutrition was 62%. Patients with organ-related diseases and infectious diseases had the highest rates of reduced reported dietary intake, 71.4% and 57.9%, respectively; however, there was no association between reported dietary intake and MUAC. In those unable to eat, however, the rate of severe malnutrition was 50%. The menu consisted of porridge and thickened corn-based starch with fried cabbage; protein foods were provided twice weekly. There was a nutrient gap of 250 calories and 13 gm protein daily. The findings support the need for increasing dietetic/nutrition services to prevent and treat malnutrition in hospitals using simple screening tools. Full article
(This article belongs to the Special Issue Nutrition and Rehabilitation in Older Patients with Disability)
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8 pages, 244 KiB  
Article
The Influence of Dysphagia on Nutritional and Frailty Status among Community-Dwelling Older Adults
by Takahiro Nishida, Kazumi Yamabe and Sumihisa Honda
Nutrients 2021, 13(2), 512; https://doi.org/10.3390/nu13020512 - 4 Feb 2021
Cited by 26 | Viewed by 3769
Abstract
Malnutrition is a core symptom of the frailty cycle in older adults. The purpose of this study was to investigate whether dysphagia influences nutrition or frailty status in community-dwelling older adults. The study participants were 320 Japanese community-dwelling older adults aged ≥65 years. [...] Read more.
Malnutrition is a core symptom of the frailty cycle in older adults. The purpose of this study was to investigate whether dysphagia influences nutrition or frailty status in community-dwelling older adults. The study participants were 320 Japanese community-dwelling older adults aged ≥65 years. All participants completed a questionnaire survey that included items on age, sex, family structure, self-rated health, nutritional and frailty status, and swallowing function. Nutritional status was categorized as malnourished, at risk of malnutrition, and well-nourished based on the Mini Nutrition Assessment-Short Form. The participants were then classified into a malnutrition (malnourished/at risk) or a well-nourished group (well-nourished). Frailty was assessed using the Cardiovascular Health Study criteria. The participants were then divided into a frailty (frail/pre-frail) or a non-frailty group (robust). Dysphagia was screened using the 10-item Eating Assessment Tool. Multiple logistic regression analysis was conducted to determine whether dysphagia was associated with nutritional or frailty status. The results revealed that dysphagia influenced both nutrition (odds ratio [OR]: 4.0; 95% confidence interval [CI]: 1.9–8.2) and frailty status (OR: 2.3; 95% CI: 1.0–5.2); therefore, the swallowing function would be an important factor for community-dwelling older adults on frailty prevention programs. Full article
(This article belongs to the Special Issue Nutrition and Rehabilitation in Older Patients with Disability)
11 pages, 266 KiB  
Article
Fruit and Vegetable Consumption and Incident Prefrailty and Frailty in Community-Dwelling Older People: The English Longitudinal Study of Ageing
by Gotaro Kojima, Steve Iliffe, Stephen Jivraj and Kate Walters
Nutrients 2020, 12(12), 3882; https://doi.org/10.3390/nu12123882 - 18 Dec 2020
Cited by 14 | Viewed by 3744
Abstract
Background: There is limited evidence in the literature regarding associations between fruit and vegetable consumption and risk of frailty. Objective: To examine associations between fruit and vegetable consumption and risk of incident frailty and incident prefrailty/frailty. Design: A prospective panel study. Setting and [...] Read more.
Background: There is limited evidence in the literature regarding associations between fruit and vegetable consumption and risk of frailty. Objective: To examine associations between fruit and vegetable consumption and risk of incident frailty and incident prefrailty/frailty. Design: A prospective panel study. Setting and Subjects: 2634 non-frail community-dwelling men and women aged 60 years or older from the English Longitudinal Study of Ageing (ELSA). Methods: Fruit and vegetable consumption/day was measured using a self-completion questionnaire at baseline. Frailty status was measured at baseline and follow-up was based on modified frailty phenotype criteria. Four-year incident frailty was examined among 2634 robust or prefrail participants, and incident prefrailty/frailty was measured among 1577 robust participants. Results: Multivariable logistic regression models adjusted for age, gender, and other confounders showed that fruit and vegetable consumption was not associated with incident frailty risks among robust or prefrail participants. However, robust participants consuming 5–7.5 portions of 80 g per day (odds ratio (OR) = 0.56, 95% confidence interval (CI) = 0.37–0.85, p < 0.01) and 7.5–10 portions per day (OR = 0.46, 95%CI = 0.27–0.77, p < 0.01) had significantly lower risk of incident prefrailty/frailty compared with those consuming 0–2.5 portions/day, whereas those consuming 10 or more portions/day did not (OR = 1.10, 95%CI = 0.54–2.26, p = 0.79). Analysis repeated with fruit and vegetable separately showed overall similar results. Conclusions: Robust older adults without frailty who eat current U.K. government recommendations for fruit and vegetable consumption (5–10 portions/day) had significantly reduced risks of incident prefrailty/frailty compared with those who only eat small amount (0–2.5 portions/day). Older people can be advised that eating sufficient amounts of fruit and vegetable may be beneficial for frailty prevention. Full article
(This article belongs to the Special Issue Nutrition and Rehabilitation in Older Patients with Disability)
18 pages, 495 KiB  
Article
Effects of High Intensity Dynamic Resistance Exercise and Whey Protein Supplements on Osteosarcopenia in Older Men with Low Bone and Muscle Mass. Final Results of the Randomized Controlled FrOST Study
by Wolfgang Kemmler, Matthias Kohl, Franz Jakob, Klaus Engelke and Simon von Stengel
Nutrients 2020, 12(8), 2341; https://doi.org/10.3390/nu12082341 - 5 Aug 2020
Cited by 45 | Viewed by 8226
Abstract
The present study aimed to evaluate the effect of high intensity dynamic resistance exercise (HIT-DRT) and whey protein supplementation (WPS) on bone mineral density (BMD) and sarcopenia parameters in osteosarcopenic men. Men ≥ 72 years with osteosarcopenia (n = 43) were randomly [...] Read more.
The present study aimed to evaluate the effect of high intensity dynamic resistance exercise (HIT-DRT) and whey protein supplementation (WPS) on bone mineral density (BMD) and sarcopenia parameters in osteosarcopenic men. Men ≥ 72 years with osteosarcopenia (n = 43) were randomly assigned to a HIT-RT (HIT-RT: n = 21) or a non-training control group (n = 22). Supervised HIT-RT twice/week was applied for 18 months, while the control group maintained their habitual lifestyle. Supplying WPS, total protein intake amounted to 1.5–1.6 (HIT-RT) and 1.2 g/kg/body mass/d (control). Both groups were supplied with calcium and vitamin D. Primary study outcomes were BMD and the sarcopenia Z-score. After adjusting for multiplicity, we observed significant positive effects for sarcopenia Z-score (standardized mean difference (SMD): 1.40), BMD at lumbar spine (SMD: 0.72) and total hip (SMD: 0.72). In detail, effect sizes for skeletal muscle mass changes were very pronounced (1.97, p < 0.001), while effects for functional sarcopenia parameters were moderate (0.87, p = 0.008; handgrip strength) or low (0.39, p = 0.209; gait velocity). Apart from one man who reported short periods of temporary worsening of existing joint pain, no HIT-RT/WPS-related adverse effects or injuries were reported. We consider HIT-RT supported by whey protein supplementation as a feasible, attractive, safe and highly effective option to fight osteosarcopenia in older men. Full article
(This article belongs to the Special Issue Nutrition and Rehabilitation in Older Patients with Disability)
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Review

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24 pages, 495 KiB  
Review
Analysis of the Impact of Selected Vitamins Deficiencies on the Risk of Disability in Older People
by Wassim Gana, Arnaud De Luca, Camille Debacq, Fanny Poitau, Pierre Poupin, Amal Aidoud and Bertrand Fougère
Nutrients 2021, 13(9), 3163; https://doi.org/10.3390/nu13093163 - 10 Sep 2021
Cited by 7 | Viewed by 7310
Abstract
Vitamin deficiencies have a serious impact on healthy aging in older people. Many age-related disorders have a direct or indirect impact on nutrition, both in terms of nutrient assimilation and food access, which may result in vitamin deficiencies and may lead to or [...] Read more.
Vitamin deficiencies have a serious impact on healthy aging in older people. Many age-related disorders have a direct or indirect impact on nutrition, both in terms of nutrient assimilation and food access, which may result in vitamin deficiencies and may lead to or worsen disabilities. Frailty is characterized by reduced functional abilities, with a key role of malnutrition in its pathogenesis. Aging is associated with various changes in body composition that lead to sarcopenia. Frailty, aging, and sarcopenia all favor malnutrition, and poor nutritional status is a major cause of geriatric morbidity and mortality. In the present narrative review, we focused on vitamins with a significant risk of deficiency in high-income countries: D, C, and B (B6/B9/B12). We also focused on vitamin E as the main lipophilic antioxidant, synergistic to vitamin C. We first discuss the role and needs of these vitamins, the prevalence of deficiencies, and their causes and consequences. We then look at how these vitamins are involved in the biological pathways associated with sarcopenia and frailty. Lastly, we discuss the critical early diagnosis and management of these deficiencies and summarize potential ways of screening malnutrition. A focused nutritional approach might improve the diagnosis of nutritional deficiencies and the initiation of appropriate clinical interventions for reducing the risk of frailty. Further comprehensive research programs on nutritional interventions are needed, with a view to lowering deficiencies in older people and thus decreasing the risk of frailty and sarcopenia. Full article
(This article belongs to the Special Issue Nutrition and Rehabilitation in Older Patients with Disability)
15 pages, 762 KiB  
Review
Nutritional Assessment in Adult Patients with Dysphagia: A Scoping Review
by Junko Ueshima, Ryo Momosaki, Akio Shimizu, Keiko Motokawa, Mika Sonoi, Yuka Shirai, Chiharu Uno, Yoji Kokura, Midori Shimizu, Ai Nishiyama, Daisuke Moriyama, Kaori Yamamoto and Kotomi Sakai
Nutrients 2021, 13(3), 778; https://doi.org/10.3390/nu13030778 - 27 Feb 2021
Cited by 29 | Viewed by 9851
Abstract
Malnutrition negatively affects the quality of life of patients with dysphagia. Despite the need for nutritional status assessment in patients with dysphagia, standard, effective nutritional assessments are not yet available, and the identification of optimal nutritional assessment items for patients with dysphagia is [...] Read more.
Malnutrition negatively affects the quality of life of patients with dysphagia. Despite the need for nutritional status assessment in patients with dysphagia, standard, effective nutritional assessments are not yet available, and the identification of optimal nutritional assessment items for patients with dysphagia is inadequate. We conducted a scoping review of the use of nutritional assessment items in adult patients with oropharyngeal and esophageal dysphagia. The MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases were searched to identify articles published in English within the last 30 years. Twenty-two studies met the inclusion criteria. Seven nutritional assessment categories were identified: body mass index (BMI), nutritional screening tool, anthropometric measurements, body composition, dietary assessment, blood biomarkers, and other. BMI and albumin were more commonly assessed in adults. The Global Leadership Initiative on Malnutrition (GLIM), defining new diagnostic criteria for malnutrition, includes the categories of BMI, nutritional screening tool, anthropometric measurements, body composition, and dietary assessment as its required components, but not the blood biomarkers and the “other” categories. We recommend assessing nutritional status, including GLIM criteria, in adult patients with dysphagia. This would standardize nutritional assessments in patients with dysphagia and allow future global comparisons of the prevalence and outcomes of malnutrition, as well as of appropriate interventions. Full article
(This article belongs to the Special Issue Nutrition and Rehabilitation in Older Patients with Disability)
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