Energy Intake and Severity of Dementia Are Both Associated with Health-Related Quality of Life among Older Long-Term Care Residents

Abstract

Our aim was to investigate how energy intake modifies the association of the stage of dementia with health related quality of life (HRQoL) among institutionalized older people. A cross-sectional sample of 538 older long-term care residents with dementia in Helsinki, Finland were assessed with HRQoL (15D), energy intake (from one to two days), and the stage of dementia by the clinical dementia rating (CDR) scale. The energy intakes were standardized by z-scores to include both men and women in the same analyses. Severity of dementia was associated with HRQoL (15D index in CDR 0.5–1: 0.65 (0.11), CDR 2: 0.60 (0.10), CDR 3: 0.52 (0.10)). When the three groups of dementia severity were divided according to their energy intake quartiles, there was an association between the HRQoL and the stage of dementia (p < 0.001) and energy intake (p = 0.013); however, no interaction was observed (p = 0.30). While partial correlation analysis showed that energy intake correlated with HRQoL among residents with very mild/mild or moderate dementia, this was not observed among those with severe dementia. In moderate dementia, the dimensions of mobility and usual activities correlated significantly with higher energy intake. Both energy intake and severity of dementia are associated with HRQoL.

Role of NAFLD on the Health Related QoL Response to Lifestyle in Patients With Metabolic Syndrome: The PREDIMED Plus Cohort

“…Yet, the present results are valuable from the clinical point of view, providing remarkably similar assessment of the influence of adherence to healthy lifestyle patterns in patients' health as that of the consultation room. The longitudinal multivariate analysis and adjustments, using features related to HRQoL such as waist circumference obesity, MetS features (39), alcohol consumption (40) and total caloric intake (41,42) provide plausibility to the present results.…”

Predictors of incident malnutrition—a nutritionDay analysis in 11,923 nursing home residents

“…Lannering et al also showed that cognitive impairment at baseline is associated with malnutrition at FU [13]. It is well known and confirmed by recent studies, that a poor cognitive status is associated with low meal/energy intake [43,44]. The occurrence of nutrition/mealtime-related problems such as olfactory and taste dysfunction, attention deficit, behavioral problems, or refusal to eat have repeatedly been described with declining cognitive abilities [45].…”

Nutritional Care for Institutionalized Persons with Dementia: An Integrative Review

“…It is recommended to propitiate positive food experiences that foster residual autonomy to improve well-being [ 4 , 9 , 25 , 26 , 27 , 29 , 34 , 37 , 38 , 42 , 45 , 48 , 50 , 51 , 54 , 56 , 57 , 59 , 62 , 66 ]. In this sense, interventions should make the most of subjects’ remaining abilities by providing verbal support, which is the key to motivating people to eat; visual support, i.e., role modeling; and partial physical support, such as putting food in utensils so that people can put the utensils in their mouths.…”

“…A central aspect of this category is to guarantee an adequate diet, rich in protein and low in carbohydrates and sugars, to preserve cognitive capacity as much as possible [ 39 ]. Balanced diets that provide protein-based energy improve body weight and muscle strength [ 55 ], which leads to an improved mobility, functionality, and quality of life for people with dementia [ 54 ]. Diets can be supplemented with oral supplements and protein-based formulas [ 50 , 62 ] to reduce the risk of malnutrition, although there is a need for more robust studies to validate this statement.…”