Search Results (172)

Background/Objectives: Malnutrition in older adults is both preventable and treatable, yet its detection and etiology remain complex. Therefore, the aim of this study was to evaluate the prevalence of malnutrition and various factors involved in the etiology of malnutrition in community-dwelling individuals aged 65 years and older. Methods: This cross-sectional study was conducted with community-dwelling individuals aged 65 years and older in a health center in Ağrı, Türkiye. The nutritional status of older adults was measured using the Mini Nutritional Assessment (MNA). Data were collected through face-to-face interviews and a series of validated instruments, including the Standardized Mini Mental Examination (MMSE), body composition measurements (BIA), dietary intake records, and physical performance tests such as hand grip strength, chair stand, and Timed ‘Up & Go’ (TUG) Test. Statistical analyses included chi-square and Mann-Whitney U tests for group comparisons and logistic regression to investigate independent factors associated with risk of malnutrition. Results: A total of 182 participants were included in the study. The mean age of the participants was 72.1 ± 6.0 years. Of the participants, 59.3% were male. 1.6% of the participants were malnourished, and 25.3% were at risk of malnutrition. Perceived health status compared to peers (OR: 1.734, 95% CI: 1.256–2.392, p = 0.001), lower appetite status (OR: 1.942, 95% CI: 1.459–2.585, p < 0.001) and lower waist circumference (OR: 1.089, 95% CI: 1.040–1.140, p < 0.001) were independent predictors of malnutrition risk. Conclusions: The risk of malnutrition was higher among individuals with lower appetite, poorer self-perceived health status compared to peers, and smaller waist circumference. Reduced physical function and strength were also associated with an increased risk of malnutrition. Full article

Background and Objectives: Adverse clinical outcomes are associated with malnutrition and frailty, which are highly prevalent among hospitalized older patients. This study aimed to evaluate their predictive value for the duration of hospitalization, short-term survival, and rehospitalization of patients admitted to internal medicine wards. Materials and Methods: This prospective cohort study included 134 acutely ill patients aged ≥50 years who were hospitalized in an internal medicine department and evaluated within the first 48 h of admission. Nutritional status was evaluated using the Mini nutritional assessment–short form (MNA-SF), Nutritional Risk Screening 2002 (NRS-2002), and Global Leadership Initiative on Malnutrition (GLIM) criteria. Frailty was evaluated using the FRAIL scale and Clinical Frailty Scale (CFS). The primary outcomes were prolonged hospitalization (>10 days), mortality, and rehospitalization at 3 and 6 months post-discharge. Results: According to MNA-SF, 33.6% of patients were malnourished; 44% had nutritional risk per NRS-2002, and 44.8% were malnourished per GLIM. Frailty prevalence was 53.7% (FRAIL) and 59% (CFS). Malnutrition defined by all three scales (MNA-SF, NRS-2002, GLIM) was significantly associated with prolonged hospitalization (p = 0.043, 0.014, and 0.023, respectively), increased rehospitalization at both 3 months (p < 0.001) and 6 months (p < 0.001). Mortality was also significantly higher among malnourished patients. Higher CFS scores and low handgrip strength were additional predictors of adverse outcomes (p < 0.05). In multivariable analysis, GLIM-defined malnutrition and CFS remained independent predictors of rehospitalization and mortality. Conclusions: Frailty and malnutrition are highly prevalent and independently associated with prolonged hospital stay, short-term rehospitalization and mortality. Routine screening at admission may facilitate early identification and guide timely interventions to improve patient outcomes. These findings might guide hospital protocols in aging health systems and support the development of standardized geriatric care pathways. Full article

Hip fractures in elderly patients pose significant clinical challenges, confronting us with high morbidity and mortality rates. A comprehensive geriatric assessment plays an important role in determining prognosis as well as the indication for surgery. Aim: In this study, we aim to (1) assess frailty-based functional status in seniors with hip fractures, (2) evaluate geriatric assessment’s predictive value for postoperative recovery, and (3) analyze 1-year postoperative survival. Material and Methods: This prospective study included 60 senior patients admitted for hip fracture in the Orthopedics Department. Patients were examined using geriatric assessment instruments Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Mini Nutritional Assessment (MNA), and Frailty Groningen Indicator (GFI). We recorded the sex, marital status, number of comorbidities, and number of recommended drugs. Results: In total, 65% of patients were frail pre-surgery; the proportion increased post-surgery to 86.7%; (p = 0.005). Age greater than 80 years and unmarried marital status were associated with higher frailty risk (p = 0.04; p = 0.03). Preoperatively, important predictors of frailty were mild–moderate cognitive impairment (p = 0.017), mild–moderate depression (p = 0.01), and malnutrition (p = 0.04). Postoperatively, only mild–moderate cognitive impairment (p = 0.04) and mild–moderate depression (p = 0.01) proved to be important predictors of frailty. According to the ROC curve, good predictors of postoperative frailty were shown to be preoperative frailty and the degree of polypharmacy and comorbidity. Of all parameters predictive of postoperative frailty, only the number of medications reached statistical significance (p < 0.038). The study identified a 1-year all-cause mortality rate of 42.6% in elderly patients who underwent hip fracture surgery, with a significant association between mortality and preoperative MMSE, GDS, and MNA scores. Conclusions: Complex geriatric assessment of senior patients with hip fracture can stratify postoperative risk and predict 1-year mortality and postoperative functional recovery. Key predictors include cognitive status, depression, malnutrition, and comorbidities. Multidisciplinary care and standardized evaluation are essential for improving outcomes. Full article

Objectives: This study aimed to evaluate the association between nutritional status and oral health-related quality of life (OHRQoL) in older adults from population-based studies of two cities in southern Brazil. Methods: A total of 569 community-dwelling individuals aged 60 years and older were included. Sociodemographic, dental, and behavioral data were collected. Nutritional status was evaluated using the Mini Nutritional Assessment (MNA). OHRQoL, the primary outcome, was measured using the Oral Health Impact Profile-14 (OHIP-14) questionnaire. Poisson regression with robust variance was applied in crude and adjusted analyses to evaluate the impact of nutritional status on OHIP-14 outcomes. Results: The prevalence of risk of malnutrition was 31.6%, while the mean OHIP-14 was 4.86 ± 7.55. Individuals with malnutrition risk (7.44 ± 9.95) showed overall OHIP-14 scores significantly higher than those with normal nutrition (3.65 ± 5.76) (p < 0.001). A similar trend in results was detected in all domains of OHIP-14 (p < 0.05). In the adjusted analysis, individuals at risk of malnutrition had a 66% higher prevalence ratio (PR) (95% confidence interval [95% CI]: 1.23–2.23) of having poorer OHRQoL. Associations were also observed for the severity (PR: 1.69; 95% CI: 1.31–2.19) and extent (PR: 2.33; 95% CI: 1.55–3.49) of OHIP-14. Conclusions: In conclusion, poorer nutritional status is significantly associated with a higher impact on OHRQoL in older adults. Full article

Background: Frailty is common in colorectal cancer (CRC) patients and is associated with poor prognosis and increased mortality. Anti-inflammatory dietary education is a promising and cost-effective strategy for frailty improvement. Methods: A prospective, assessor-blinded, two-arm randomized controlled trial was conducted to assess the effects of a 12-week dietary inflammatory index (DII)-based anti-inflammatory dietary education program on frailty in frail CRC patients. Participants in the intervention group received a DII-based anti-inflammatory dietary education, while the control group received a routine health education. Outcome measurements included the Fried frailty phenotype (FP), DII, plasma inflammatory biomarkers, body mass index (BMI), nutritional status, and quality of life (QoL), which were all assessed at baseline and post-intervention. Results: A total of 86.4% (57/66) of participants completed the follow-up. No statistically significant baseline differences were observed between groups. After the intervention, the intervention group showed significant improvements in DII (p = 0.029), BMI (p = 0.012), mini nutritional assessment (MNA) scores (p = 0.027), and QoL (p = 0.014) compared with the control group. Within-group comparisons revealed significant decreases in frailty status (p = 0.031), DII (p = 0.008), and interleukin (IL)-6 (p = 0.003), and significant increases in IL-10 (p = 0.021), MNA scores (p = 0.010), and QoL (p < 0.001) in the intervention group, with no significant changes in the control group. Conclusions: DII-based anti-inflammatory dietary education can improve the frailty, nutritional status, and QoL of frail CRC patients by modulating systemic inflammation. Given its acceptability and utility, this strategy may be incorporated into routine cancer health education. Full article

Background/Objectives: Loop diuretics are among the most commonly used drugs in patients with heart failure with reduced ejection fraction (HFrEF). Higher doses of these diuretics are associated with poorer clinical status and may contribute to malnutrition. The study aims to assess the relationship between the use of high-dose loop diuretics and nutritional status in patients with HFrEF. Methods: The study included 353 hospitalized patients with HFrEF. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), the Geriatric Nutritional Index (GNRI), and the CONtrolling NUTritional status (CONUT). Patients were divided into three groups according to the daily dose of loop diuretics (defined as furosemide equivalent = 1 × furosemide dose and 2 × torsemide dose): low dose (LD), 40 mg/day or no treatment; medium dose (MD), 41–160 mg/day; or high dose (HD), >160 mg/day. Results: Of the evaluated patients, the mean MNA score was 23.31 ± 2.93 points, and 49.8% were at risk of malnutrition or malnourished. According to the MNA, patients in HD and MD groups had worse nutritional status than the LD group, similarly according to the GNRI. For CONUT, the differences were significant between all groups: nutritional status was the worst in the HD group, intermediate in the MD group, and the best in the LD group. Conclusions: The intake of loop diuretics, especially in high doses, correlates with an elevated risk of malnutrition in patients with HFrEF independently of sex, age, NYHA class, and left ventricular ejection fraction. Full article

Background: There is limited knowledge about nutritional intake and energy needs during the post-intensive care unit (ICU) period and their relationship with clinical outcomes and physical recovery. Aims and Methods: Thus, this observational multicenter study (Azienda Ospedaliero-Universitaria “Santa Maria”, Terni and “Madonna del Soccorso” General hospital, San Benedetto del Tronto, Italy) aimed, firstly, to measure energy expenditure via indirect calorimetry (IC) (Q-NRG+^® Metabolic Monitor, Cosmed, Rome, Italy), derived respiratory quotient (R/Q1) and, malnutrition risk via Mini Nutritional Assessment (MNA) test and body composition through bioimpedance vector analysis (BIVA-Akern, Pontassieve, Italy); secondly, to assess their effect on energy needs, body composition and physical rehabilitation steps in critically ill adults after ICU discharge. The provision of nutrients (PIS test) was also recorded. Oral nutritional supplementation was used to reach the optimal nutritional intake. All patients followed a standardized rehabilitation program. Results: A total of 43 patients were enrolled from January 2024 until February 2025 at the beginning of their post-ICU period. The mean age was 65.7 ± 1.0 years, the mean BMI was 20.73 ± 0.8 kg/m² at the recovery ward, and 60.4% (n = 26) were male. The mean admission period was 19.5 ± 1.7 days. The resting energy expenditure (mREE) was 1591 ± 71.2 at the admission and 1.856 ± 62.7 kcal/kg/d at the discharge (p < 0.05). The median phase angle value was 4.33 ± 0.15 at the admission and 5.05 ± 0.17° at the discharge (p < 0.05); R/Q1 at the admission was 0.7 ± 0.1 and 1.086± 0.11 at the discharge (p < 0.05). Improved energy expenditure significantly correlated with R/Q1 and phase angle (r = 0.81 and r = 0.72, respectively). Interestingly, there was no significant correlation between improved metabolism and improved PIS test scores (r = 0.18). Improved metabolism and nutritional status showed a tendency to correlate with shorter post-ICU courses and earlier physical recovery, without reaching statistical significance. Conclusions: Measurement of energy expenditure and caloric intake, along with the assessment of body composition is feasible and provides an objective tool to guide and possibly enhance the functional recovery in patients during the post-ICU period. Full article

Background: Oral frailty is a state between normal oral function and oral hypofunction. Oral frailty progresses to oral hypofunction and dysphagia, which leads to malnutrition, and then to physical frailty and sarcopenia. Oral frailty is reported to be associated with physical frailty and malnutrition in hemodialysis patients, but there have been no reports on peritoneal dialysis (PD) patients. Methods: This prospective cohort study investigated the associations of oral frailty with physical frailty, sarcopenia, and malnutrition in patients on PD. Patients were divided into an oral frailty group and a non-oral frailty group according to the Oral Frailty Index-8. Patients were assessed for physical frailty, sarcopenia, and malnutrition at baseline and 1 year later, and changes in each measure were compared between the two groups. Physical frailty was assessed using the Revised Japanese version of the Cardiovascular Health Study Criteria (Revised J-CHS) and the FRAIL scale. Sarcopenia was assessed using the diagnostic criteria reported by the Asian Working Group for Sarcopenia in 2019 (AWGS2019 criteria) and the Screening Tool for Sarcopenia Combined with Calf Circumference (SARC-CalF), skeletal muscle index (SMI), calf circumference (CC), grip strength, and gait speed. Nutritional status was assessed with the Short-Form Mini-Nutritional Assessment (MNA-SF), the Malnutrition Universal Screening Tool (MUST), the Global Leadership Initiative on Malnutrition (GLIM) criteria, weight, and body mass index (BMI). Results: Of the 58 eligible patients, 51 completed the study. The oral frailty group was significantly older and had slower gait speed, fewer teeth, higher intact parathyroid hormone, higher C-reactive protein, higher frequency of cardiovascular disease, and lower employment at baseline. The oral frailty group had significantly worse physical frailty (Revised J-CHS, p = 0.047; FRAIL scale, p = 0.012), sarcopenia (SMI, p = 0.018; CC, p = 0.002), and nutritional status (MNA-SF, p = 0.029; MUST, p = 0.005; GLIM criteria, p = 0.022; weight, p < 0.001; BMI, p < 0.001). However, there were no significant differences in the worsening of sarcopenia (AWGS2019 criteria, SARC-CalF, grip strength, and gait speed). Conclusions: Oral frailty in patients on PD was associated with the development and progression of physical frailty and malnutrition, and may be associated with the development and progression of sarcopenia. Full article

Background: The global population is rapidly aging, and an epidemic increase in chronic kidney disease (CKD) has been reported. As the presence of malnutrition in elderly CKD patients can pose serious health problems, the aim of our study was to identify, using different assessment tools, the relationship between nutrition with kidney function and albuminuria in elderly patients. Methods: The study included 793 hospitalized patients aged 65 years and older. A comprehensive assessment of nutritional status and renal involvement was performed, and the relationship between malnutrition and kidney issues was tested. Results: CKD was highly prevalent in our geriatric population, with 39.84% having CKD G3a–5. Malnutrition, determined according to the Mini Nutritional Assessment (MNA) score, was identified in 34.6% of patients. With an increase in albuminuria, we observed worse nutrition indicators: low serum albumin; lower body fat (p = 0.002) and visceral fat (p = 0.001), assessed via bioimpedance; and lower MNA (p = 0.04) and geriatric nutritional risk index (GNRI) (p = 0.002) scores. Elderly patients with CKD G3a–5 had lower HDL-cholesterol (p < 0.001), higher triglycerides (p < 0.001), lower albumin (p = 0.011), and a lower MNA score (p = 0.001). Conclusions: Malnutrition was found to be common and more severe with increased albuminuria and decreased eGFR. Our study sheds light on a novel relationship between malnutrition, albuminuria, and renal function in a geriatric population. Full article

Background: Assessing nutrition-related health risks in older individuals is often overlooked in clinical practice due to the lack of appropriate methods of evaluation. While anthropometric measurements and body composition analyses are mainly used, these tools are not standardized for the oldest old and fail to account for age-related changes. This underscores the need for improved assessment techniques that accurately capture the progressive and non-linear shifts in nutritional status throughout the aging process. Accordingly, the primary aim of our paper is to identify the most effective tools to use for evaluating nutritional status in the oldest population. Methods: To address this gap, we conducted a cross-sectional study, investigating the nutritional status of a cohort of Sicilian individuals aged between 65 and 111, using methods commonly applied to adult and older adult populations. These included the BIoimpedance Analysis (BIA), the Mini Nutritional Assessment (MNA) evaluation, and nutritional risk indices such as the COntrolling NUTritional Status (CONUT) score and Geriatric Nutritional Risk Index (GNRI). Results: Despite the oldest population being classified as “at risk” of malnutrition by the MNA or “cachetic” by BIA, our results indicated a “normal” or “low risk” of malnutrition when assessments were performed using tools (GNRI and CONUT) that were not reliant on body composition parameters. These findings align with clinical history assessments conducted during their recruitment. Conclusions: This pilot study highlights the need for future research aimed at developing standardized, multidimensional assessment models tailored to the heterogeneity of each age group, to improve risk stratification, clinical outcomes, and personalized nutritional care. Full article

Background/Objectives: Sarcopenia, characterized by the loss of muscle mass and strength, is prevalent in older persons and affects their quality of life. Nutritional intervention and physical activity play a key role in its prevention and treatment. This study aims to investigate the relationship between food consumption frequency as assessed through the Mini Nutritional Assessment (MNA) and probable sarcopenia, evaluated by grip strength, in Chilean older persons aged 65 or older. Methods: A correlational, cross-sectional study with a non-probabilistic sample of 155 older persons aged 65 or older was undertaken. Food consumption frequency was assessed using the MNA, and muscle strength was measured using a handgrip dynamometer. The authors analyzed the relationship between food consumption frequency, as assessed by the MNA, and the protein intake index with muscle strength. Results: Participants who consumed less than two servings of fruits and vegetables per day were 4.28 times more likely to have low muscle strength compared to those who consumed two or more servings per day (OR = 4.28; 95% CI: 1.59–11.45). No significant associations were found with the consumption of dairy products, legumes, meat, fish, poultry, or fluids. The protein intake index did not show a significant relationship with muscle strength. Conclusions: The results suggest that a diet rich in fruits and vegetables may have a protective effect on muscle strength in older persons. Promoting adequate intake of these foods could be critical in the prevention of sarcopenia in this population. Full article

Background/Objectives: Possible sarcopenia and malnutrition are critical public health concerns among older adults, particularly in vulnerable populations such as those with a history of homelessness. However, limited evidence exists on the nutritional status and muscle health of this group in Thailand. Methods: This study aimed to assess the nutritional status of formerly homeless older adults residing in supportive housing in Thailand and examine its association with possible sarcopenia. A cross-sectional study was conducted among 116 participants aged 50 years and older. Sociodemographic information was collected using a structured questionnaire. Nutritional status was then assessed using the Mini Nutritional Assessment short form (MNA-SF) and body mass index (BMI). Possible sarcopenia was determined based on the Asian Working Group for Sarcopenia (AWGS) 2019 criteria, including low calf circumference, reduced handgrip strength, and/or low gait speed. Data were analyzed using descriptive statistics and logistic regression. Results: Of all participants, 66.4% were male, with a mean age of 59.14 years (SD = 7.791). A total of 78.4% were identified as having possible sarcopenia. Univariate analysis revealed significant associations between possible sarcopenia and malnutrition (OR = 6.111, 95% CI = 2.104–17.750), low BMI (OR = 16.784, 95% CI = 3.729–75.535), and waist circumference (OR = 0.129, 95% CI = 0.049–0.342). Multivariate logistic regression indicated that malnutrition (OR = 3.429, 95% CI = 1.093–10.763) and low BMI (OR = 11.732, 95% CI = 2.523–54.567) were significant predictors of possible sarcopenia, collectively explaining 33.8% of the variance. Conclusions: The findings underscore a high prevalence of possible sarcopenia among formerly homeless older adults in supportive housing in Thailand and highlight poor nutritional status, particularly low BMI and malnutrition, as a key contributing factor. These results emphasize the importance of early nutritional screening and interventions to prevent or delay sarcopenia in this vulnerable population. Full article

Background/Objectives: In primary care, tailored physical activity and nutritional counselling are scarce for older adults. Several challenges contribute to this issue, the primary obstacle being limited access to expert healthcare providers. The purpose of this study was to propose a quick, easy-to-implement case-finding tool offering straightforward nutritional and physical activity counselling to overcome these barriers. Methods: Cross-sectional, baseline analysis was performed on 277 participants of the Cognitive Function and Amyloid Marker in Frail Older Adults (COGFRAIL) study, aged 70 years and older with mild cognitive impairment (mini-mental state examination score ≥ 20) and autonomy in daily living activities (ADL ≥ 4). Body composition was assessed using dual-energy X-ray absorptiometry, physical function was assessed using the short physical performance battery (SPPB), and nutrition was assessed using the mini nutritional assessment (MNA). A structured dietary interview was conducted to collect data on a typical daily intake pattern. A second database of 725 autonomous frail older adults from the Frailty clinic was used to test the robustness of the findings. Results: Participants with MNA scores < 24/30 and SPPB scores < 6/12 presented a high percentage of protein (74.1%) and caloric (66.7%) deficiency compared to the other categories. Based on standard daily protein and caloric recommendations, age, and weight, this category had a daily protein-caloric deficit of −19.4 ± 22.7 g and −225.5 ± 430.1 Kcal. Conclusions: Based on the data, an easy-to-use algorithm using MNA and SPPB scores is suggested. This algorithm could serve as an effective tool for guiding nutritional and physical activity counselling for community-dwelling older adults. Full article

Background: Patients undergoing cardiovascular surgery often experience postoperative complications and Activities of Daily Living (ADL) decline, even in the absence of preoperative malnutrition. Since postoperative ADL decline is particularly serious in elderly patients, this study aimed to identify a nutritional assessment tool that is effective in predicting postoperative ADL decline. Methods: Patients undergoing open-heart surgery with cardiopulmonary bypass were assessed using eight nutritional assessment tools, including the Malnutrition Universal Screening Tool (MUST), the Global Leadership Initiative on Malnutrition (GLIM) criteria, the Nutritional Risk Screening 2002 (NRS-2002), the Subjective Global Assessment (SGA), the Controlling Nutritional Status (CONUT) score, the Prognostic Nutritional Index (PNI), the Geriatric Nutritional Risk Index (GNRI), and the Mini Nutritional Assessment-Short Form (MNA-SF). Results: A total of 197 patients were enrolled in this study, with a mean age of 70.4 ± 11.6 years old; 31.0% were female. Depending on the nutritional assessment tool, 17.8% to 78.2% of patients were identified as at risk of malnutrition. Among the various assessment tools, the MUST was the most effective in predicting postoperative ADL decline (OR 4.75, 95% CI 1.37–16.5, p = 0.014) and was also associated with severe complications and length of hospital stay (OR 3.08, 95% CI 0.20–0.76, p = 0.009). On the other hand, nutritional risk detected by assessment tools other than MUST, including MNA-SF and GLIM, could predict postoperative complications but showed no relationship to ADL decline. Conclusions: We concluded that MUST was the most useful preoperative nutritional assessment tool for predicting outcomes, particularly for assessing the risk of postoperative ADL decline in patients undergoing cardiovascular surgery. Full article

Background/Objectives: Malnutrition in senile patients leads to functional disability while reducing quality of life. Medical professionals should routinely assess their nutritional status during hospitalization. However, diagnosing malnutrition may be difficult, especially since obesity may mask malnourishment. Thus, it is essential to search for biomarkers that improve the identification of malnourished inpatients. Methods: In the present cross-sectional study, selected venous blood parameters were analyzed in 137 older inpatients at the age of 80.5 ± 7.78 admitted to the Geriatrics Clinic of the Antoni Jurasz University Hospital No. 1 in Bydgoszcz, Poland between 2017 and 2018, for a comprehensive geriatric assessment. The participants were grouped according to their nutritional risks based on the Mini Nutritional Assessment (MNA) and the Geriatric Nutrition Risk Index (GNRI). The Kruskal–Wallis test was utilized to evaluate the equality of variances for a variable calculated for two or more groups. The level of significance was set at p < 0.05. Results: For total protein, albumin, homocysteine, hemoglobin, hematocrit, total magnesium, total calcium, C-reactive protein (CRP), interleukin 6 (IL-6), and interferon γ-induced protein 10 (IP-10), statistically significant differences were found between groups of patients classified by the MNA. However, additional significant differences were also observed for creatinine, folic acid, and triglycerides, according to the GNRI compartmentalization. The results indicate that decreased levels of albumin (<3 g/dL) and hemoglobin (<11 g/dL), along with elevated homocysteine, CRP, IL-6 (>7.5 pg/mL), and IP-10 (>250 pg/mL), should alert medical professionals to potential malnutrition in hospitalized patients. Conclusions: Routine analysis of venous blood parameters can help rapidly identify malnutrition and the immediate implementation of a specialized diet. Full article