Search Results (46)

(1) Background: The accelerated aging of the population raises concerns about the diet of older adults due to its relationship with health and quality of life. This study aimed to investigate the prevalence of poor diet quality and its association with sociodemographic factors and health status among older adults residing in the city of Bagé, located in southern Brazil; (2) Methods: A cross-sectional analysis was conducted using data from the 2016/2017 follow-up of the Bagé Aging Cohort Study (SIGa-Bagé). Diet quality was assessed using the Elderly Diet Quality Index. Descriptive analysis and Poisson regression with robust variance adjustment, based on hierarchical levels, were used to calculate crude and adjusted prevalence ratios with their respective 95% confidence intervals; (3) Results: The sample included 728 older adults (65.7% female; mean age: 77.2 years). Poor diet quality was observed in 41.5% of participants. After adjustment, male sex, black or brown skin color, absence of multimorbidity, and presence of depressive symptoms were significantly associated with poor diet quality; (4) Conclusions: The findings highlight the most vulnerable groups and the need for investments in strategies to promote mental health and healthy eating habits among the older adults, particularly among men and racial minority groups. Full article

Purpose: Heart failure (HF) impairs physical performance and increases the incidence of orthostatic hypotension (OH). Individuals with OH have a higher risk of falls, which are a major source of morbidity and mortality in older adults. Dietary protein supplementation can improve physical performance in healthy older adult individuals; however, its effect on OH in older adult patients with HF is unknown. Methods: Twenty-one older adult patients with mild-to-moderate HF were randomized to placebo or protein supplementation. Dietary protein was supplemented with whey protein so the total protein intake for each participant was 1.2 g/kg bodyweight/day, plus 1 g/day of the amino acid l-carnitine for 16 weeks. Susceptibility to OH was assessed using a head-up tilt test, blood markers, and a functional test (6 min walk) at baseline and 16 weeks. Results: There were no differences in tilt test responses or 6 min walk test (6MWT) distances. The protein-supplement group had a significant increase in 6MWT pulse pressures post-walk after 16 weeks of treatment as compared to placebo. However, the tachycardia observed at baseline after 6MWT in the protein group was not seen at the end of the study. There was also a trend towards lower levels of brain naturetic peptide (proBNP) in the protein group vs. placebo at 16 weeks. Conclusions: The improved pulse-pressure response to exertion and positive trends in proBNP in this pilot study suggest that dietary supplementation may improve cardiovascular function and general health in individuals with HF and that larger future studies are justifiable. Full article

Introduction: Diverticular disease, once considered a rare geriatric gastrointestinal condition, has now become a prevalent disorder associated with increased morbidity and healthcare costs. The spectrum of complications from diverticular disease ranges from incidental findings to more serious issues such as bleeding and diverticulitis. Symptomatic diverticular disease represents a significant economic burden in the western world. Diabetes mellitus is a major global health issue. As global aging accelerates, geriatric syndromes such as diabetes mellitus (DM) and diverticular disease (DD) are becoming increasingly prevalent. Understanding their interplay is critical, particularly within the geriatric population. Both conditions are linked to lifestyle, dietary habits, and changes in gut physiology. Additionally, age-related alterations in the gut microbiome and immune system make this association more complex, contributing to morbidity and healthcare burdens in older adults. The primary aim of this review is to provide an update on the association between diabetes mellitus and diverticular disease. Methods: This narrative review explores the association between diabetes mellitus and diverticular disease. Relevant articles were identified by searching major databases. Results: Risk factors for diverticular disease include insulin resistance, diabetes mellitus, smoking, non-alcoholic fatty liver disease, lack of physical activity, a low-fibre diet, and a high-carbohydrate diet. These risk factors are also associated with the development of diabetes mellitus. Major population studies indicate that diabetes can either increase the risk of diverticular disease or have a neutral impact. A complication of diabetes mellitus includes impaired intestinal peristalsis and enteric nervous system dysfunction, which can ultimately lead to the formation of intestinal diverticula. High-calorie foods low in fibre are a staple in the diets of many type 2 diabetes mellitus patients, contributing to gut dysbiosis. A detrimental consequence of dysbiosis is a breach in the protective intestinal barrier, which promotes the development of diverticulosis. Conclusions: Diabetes mellitus may be associated with diverticular disease, and the risk factors that contribute to diabetes mellitus can also be linked to diverticular disease. Further studies are needed to explore the complex relationship between diabetes mellitus and diverticular disease. Full article

Background: Malnutrition is a widespread issue among older people, significantly impacting health outcomes. Nutritional interventions can improve health, but their success often depends on the attitudes and knowledge of healthcare workers. Aim: This study assesses healthcare workers’ attitudes toward older people’s nutrition using the validated Italian version of the Staff Attitudes to Nutritional Nursing Geriatric care scale (SANN-G), focusing on staff in nursing homes in Northern Italy. Methods: A cross-sectional study was conducted with 1789 healthcare workers from 41 facilities. The SANN-G questionnaire measured attitudes across five dimensions: nutritional norms, habits, assessment, intervention, and individualization. Data were collected online and on paper, with descriptive and inferential statistical analyses (chi-square and ANOVA) performed using R software (R-4.4.2 for Windows). Results: Most healthcare workers were female (68.59%) and aged 41–50 (33.31%), with nursing assistants comprising 35.83%. Only 23.48% scored positively on the SANN-G scale, with most exhibiting neutral or negative attitudes. Healthcare workers who attended a malnutrition course were more likely to exhibit positive attitudes toward nutrition, particularly in the dimension of norms, assessment, intervention, and individualization. Younger healthcare workers, with the role of nurses and who attended a course on malnutrition, were more likely to have positive attitudes, while older healthcare workers and with the role of physicians tended to show neutral or negative attitudes. Conclusions: Education on malnutrition improves healthcare workers’ attitudes toward older adults’ nutrition, especially among younger nurses. The low percentage of positive attitudes (23.48%) underscores the need for broader education programs to enhance nutritional care quality. Full article

(1) Background: Mental health issues in older adults, particularly cognitive impairment and depression, can affect nutritional status. This study investigates the prevalence of malnutrition among community-dwelling older adults at risk of social exclusion and dependency in Lebanon and its association with cognitive impairment and depression. (2) Methods: This cross-sectional study used secondary data from the TEC-MED project, involving 1410 older adults aged 60 and above in Beirut. Nutritional status was assessed with the Mini Nutritional Assessment _Short Form (MNA_SF), cognitive impairment with the AD8 Dementia Screening Interview, and depression with the Geriatric Depression Scale (GDS-15). (3) Results: 87.2% of participants were at risk of malnutrition, and 2.5% were malnourished. Cognitive impairment was present in 82.2% of the sample and 45% experienced moderate to severe depression. Malnourished individuals had significantly higher rates of cognitive impairment (96.7% vs. 57.8%) and depression (85.7% vs. 23.2%). Significant associations were found between the risk of malnutrition, decreased food intake, cognitive impairment, and depression; however, no significant association was found with BMI. Logistic regression analysis indicated that older age, cognitive impairment, and depression were significant predictors of malnutrition, while having a caregiver was protective. (4) Conclusions: The high prevalence of risk of malnutrition among vulnerable older adults with cognitive impairment and depression underscores the need for policies integrating nutritional screening into routine health check-ups for older adults. Full article

Aging is a natural, complex, and individual process that focuses on the progressive decay of the body and a decrease in cell function that begins in approximately the sixth decade of life and ends with death. Current scientific evidence shows that the aging process is mostly related to genetic load and varies because of the environment. Therefore, aging can be adjusted through the intervention of factors that control homeostasis in genetic, biochemical, and immunological processes, including those involving the gut microbiota. Indeed, the diversity of the gut microbiota decreases during aging, based on the presence of modifications in the hormonal, immunological, and operational processes of the gastrointestinal tract. These modifications lead to a state of dysbiosis. However, altering bacterial communities remains complicated due to the great diversity of factors that influence their modification. Alterations caused by the aging process are known to foster dysbiosis and correspond to conditions that determine the degree of frailty in senior citizens. Consequently, the microbial structure can be used as a biomarker for geriatric care in the promotion of healthy aging. Full article

Sarcopenia and frailty are important conditions that become increasingly prevalent with age. There is partial overlap between the two conditions, especially in terms of the physical aspects of the frailty phenotype: low grip strength, gait speed, and muscle mass. This study examined whether administration of the essential branched-chain amino acid leucine, besides improving sarcopenia, may reduce frailty assessed by frailty index (FI) in older institutionalized people living in nursing homes. We conducted a secondary analysis of a placebo-controlled, randomized, double-blind design study (ClinicalTrials.gov NCT03831399). The study included fifty males and females aged 65 and over who were living in nursing homes and did not have dementia. The participants were randomized to a parallel group intervention of 13 weeks’ duration, with a daily intake of leucine (6 g/day) or placebo (lactose, 6 g/day). The outcome of this study was to evaluate whether there was a change in the level of a 95 item FI compared to the baseline and to compare the effect of the leucine group versus the placebo group. A significant inverse correlation was found between FI and performance of the activities of daily life, cognitive function, gait and balance, muscle function parameters, and nutritional status (p < 0.001 in all cases). There were no statistically significant differences in FI levels at baseline (placebo group FI 0.27 ± 0.08 and leucine group FI 0.27 ± 0.10) and at the 13 week follow-up (placebo group FI 0.28 ± 0.10 and leucine group FI 0.28 ± 0.09). There were also no significant differences between the leucine and placebo groups in the mean FI difference between baseline and follow-up (p = 0.316, Cohen’s d: 0.04). This pilot study showed that a nutritional supplementation with leucine did not significantly modify the frailty index in older nursing home residents. Full article

Background and Objectives: HIV infection is a global public health problem that can lead to the progression of AIDS. Nutritional status and biochemical markers can significantly contribute to the progression of AIDS in HIV/AIDS patients. The main objective of this study is to examine the association between nutritional and biochemical markers as well as BMI in HIV/AIDS patients in the kingdom of Bahrain. Methods: A retrospective cohort study, including 300 patients (248 males and 52 females) with HIV/AIDS in Bahrain, was carried out. Various biochemical markers were collected from patients’ medical records, including CD$4^{+}$ T cell count, albumin, Hb, HCT, MCV, WBCs, and creatinine. A semi-structured questionnaire using a standardized food frequency questionnaire (FFQ) was used, from which total energy and total macronutrients were calculated. Results: The mean BMI of the participants was 27.20 kg/m², and none of the participants had a BMI lower than 18.5 kg/m² (underweight). The majority of patients’ dietary intake of macronutrients and total calorie intake were either within or above the recommended RDA levels. The results also showed that all of the mean values of the nutritional and biochemical markers (CD$4^{+}$ T cell count, albumin, Hb, HCT, MCV, WBCs, and creatinine) were within the normal reference ranges. A significant positive correlation between CD$4^{+}$ T cell count, Hb, HCT, and albumin at the <0.05 level was found. There was no significant correlation between CD$4^{+}$ T cell count and MCV, WBCs, and creatinine. A positive significant correlation was found between BMI, CD$4^{+}$ T cell count, and WBCs at the <0.01 level. Conclusion: The BMI values were significantly correlated with the biochemical markers of AIDS progression. The dietary patterns of the participants were undiversified, with a high prevalence of obesity and overweight. Malnutrition among this study population was not present. Full article

Nutrition knowledge is a primary factor influencing food choices and the ability to identify nutritional risk for carers of people with dementia. Acquiring nutrition knowledge helps carers monitor changes in food intake and micronutrient intake, and whether a healthy and balanced diet is being consumed. This study aimed to assess the nutrition knowledge of carers in the Australian community and their experiences with nutrition education. Using a mixed-methods approach, the nutrition knowledge of informal carers was assessed using the revised General Nutrition Knowledge Questionnaire (AUS-R-NKQ), and interviews of informal carers were used to explore the perspectives in a sub-sample. A total of 57 carers (44 females; mean age of 63.0 ± 13.1) completed the survey, and 11 carers participated in follow-up interviews. The total sample scored 22.9 (±4.57) out of 38 on the AUS-R-NKQ, suggesting basic nutrition knowledge. The interviewed carers acknowledged the importance of healthy nutrition but viewed the provision of a healthy diet for a person with dementia as challenging. In both the survey and interviews, carers reported limited use and availability of dementia-specific nutrition resources. Carers were unsatisfied with the advice and number of referrals provided to improve the nutrition of the person with dementia and desired less confusing nutrition education materials adapted to their level of knowledge. The present study highlights the need for informal carers to be supported to acquire adequate nutrition knowledge. Full article

Low-cost educational interventions to improve dietary pattern is a pragmatic solution to prevent undernutrition in low- and middle-income countries. A prospective nutritional education intervention was conducted among older adults aged 60 years or above with undernutrition with 60 people in each intervention and control group. The objective was to develop and evaluate the efficacy of a community-based nutrition education intervention to improve the dietary pattern of older adults with undernutrition in Sri Lanka. The intervention consisted of two modules to improve the diversity, the variety of diet, and the serving sizes of food consumed. The primary outcome was the improvement of the Dietary Diversity Score (DDS) and the secondary outcomes were the Food Variety Score and Dietary Serving Score, which was assessed using the 24 h dietary recall. The mean difference in scores between the two groups was compared using the independent sample t-test at baseline, two weeks and three months post-intervention. Baseline characteristics were comparable. After two weeks, only the difference in DDS between the two groups was statistically significant (p = 0.002). However, this was not sustained at three months (p = 0.08). This study concludes that nutrition education interventions have the potential for short-term improvement in dietary patterns in older adults in a Sri Lanka setting. Full article

Japan is experiencing a super-ageing society faster than anywhere else in the world. Consequently, extending healthy life expectancy is an urgent social issue. To realize a diet that can support the extension of healthy life expectancy, we studied the quantitative relationships among physical activities (number of steps and activity calculated using an accelerometer), physical functions (muscle strength, movement function, agility, static balance, dynamic balance, and walking function), and dietary intake among 469 older adults living in the Tokyo metropolitan area (65–75 years old; 303 women and 166 men) from 23 February 2017 to 31 March 2018. Physical activities and functions were instrumentally measured, and the dietary survey adopted the photographic record method. There was a significant positive association (p < 0.05) between physical activities (steps, medium-intensity activity, and high-intensity activity) and physical functions (movement function, static balance, and walking function), but no association with muscle strength. These three physical functions were significantly positively correlated with intake of vegetables, seeds, fruits, and milk; with magnesium, potassium, and vitamin B6; and with the dietary fibre/carbohydrate composition ratio (p < 0.05). Future intervention trials must verify if balancing diet and nutrition can improve physical activities in older adults through increased physical functions. Full article

Japan has the world’s highest life longevity, and centenarian patients are no longer rare. However, sufficient information related to centenarians is not available. Herein, we report the case of a 101-year-old centenarian woman who recovered from extreme inactivity and general weakness, mainly through nutritional management at home, to understand instances of nutritional management in centenarians. The patient developed lethargy, with a rapid decline in activity levels and food intake. She was diagnosed with senility by a primary doctor. We concluded that she had no problems with feeding and swallowing and predicted that her motivation to eat had decreased. We planned an intervention that lasted three months. To reduce the risk of aspiration, we paid attention to her posture while eating. To stimulate her appetite, we increased the variety and color of food items. To consider both the texture of food and safety, we changed the form of foods from paste (IDDSI Level 4)-like to solid food of regular size as much as possible. We recommended that the patient consume her favorite sweet between meals to enjoy eating. Two and half months after the initial intervention, the patient’s inactivity and general weakness improved dramatically, which was recognized by her willingness to eat, laugh loudly, and hum, although she could not speak clearly. The patient finally was able to have dinner with her family. Full article

It is important to assess the physical and nutritional status of the body using a bioelectrical impedance analyzer (BIA) in patients with cachexia; however, the correlation between cachexia and nutritional evaluations remains unclear. The objective of this study is to follow the effects of diet therapy in patients with cachexia/sarcopenia, using parameters measured by BIA, clinical parameters, and other nutrition-related assessments in patients with osteoporosis. This study aims to clarify the correlation between BIA-measured parameters, clinical parameters, and other nutrition-related assessments. Methods: Measurements of body composition, a clinical assessment of the sarcopenia/cachexia, and nutritional goal setting/a nutrition care process were performed. Results: The number of subjects was 200, of which 15 people (7.5%) were diagnosed with sarcopenia/cachexia. Univariate analyses showed that participants with a high body-fat mass tend to develop sarcopenic obesity (p = 0.029), those who lost a significant and progressive amount of muscle mass tend to develop sarcopenia (p = 0.001), as well as those with malnutrition (p < 0.001). The regression study shows not only the correlation but also the cause of the correlation, as is the case with obesity. As obesity increases, so does the sarcopenic index (this can explain sarcopenic obesity), and as fat mass decreases it leads to muscle mass loss, increasing the risk of cachexia with age. Conclusions: There was an improvement, but statistically insignificant, in cachexia and the nutritional objectives (p > 0.05); at the same time, correlations were established between the independent parameters (sex, age) and malnutrition parameters (hemoglobin and amylase) with the parameters of the research. Full article

Background: The interaction of quality of life (QoL) with functionality, nutrition and depression has been studied, but few studies have compared different realities. Our objective was to compare the associations of QoL with impaired functionality, nutritional status and depressive symptoms among older people patients treated in primary health care (PHC) in Brazil and Portugal. Methods: Cross-sectional, comparative study was conducted with primary data from PHC services in Brazil and Portugal with users over 65 years old. Participants’ scores were classified as “impaired” and “preserved” for QoL, functional decline, nutrition and depression. We used Pearson’s chi-square test, Fisher’s exact test and the Mann–Whitney U test. Results: Our sample had a total of 150 PHC users. We found lower QoL scores in Brazil, which were associated with the risk of functional decline for the domains Physical Functioning, General Health Perceptions, Mental Health dimensions and Physical Health. Nutritional impairment in the group from Portugal included the domains of Vitality and Social Role Functioning. For depressive impairment, Portugal showed an association with the domains Mental Health, Vitality and Social Role Functioning. Conclusions: QoL was associated with functional and nutritional impairment and depressive symptoms, highlighting physical, mental and social characteristics related to the perception of well-being. Full article