Factors Associated With Weight Loss, Low BMI, and Malnutrition Among Nursing Home Patients: A Systematic Review of the Literature

Tamura, Bruce K.; Bell, Christina; Masaki, Kamal; Amella, Elaine

doi:10.1016/j.jamda.2013.02.022

Cited by 219 publications

(155 citation statements)

References 19 publications

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“…Estos resultados no difieren de los hallazgos obtenidos en otros grupos de pacientes hospitalizados (22) y de pacientes en unidades de media y larga estancia (23). Además, nuestros resultados ponen de manifiesto que la población anciana institucionalizada en centros sociosanitarios presenta una mayor prevalencia de malnutrición y riesgo de malnutrición, tal y como se recoge en otras series (24,25).…”

Section: Discussionunclassified

Valoración Nutricional Con La Situación Funcional Tras Sufrir Un Ictus.

Espuela¹,

Portilla-Cuenca²,

Mohedas³

et al. 2017

Nutr Hosp

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Palabras clave:Ictus. Mini Nutritional Assessment. Malnutrición. Dependencia. ResumenObjetivo: valorar el estado nutricional (EN) del paciente a los tres meses de sufrir un ictus y establecer la relación del EN con la recuperación funcional y las complicaciones en este periodo. Material y métodos: estudio observacional y transversal que evaluó el EN de pacientes mayores de 65 años a los tres meses de presentar un ictus. El EN se valoró mediante el Mini Nutritional Assessment (MNA). Se recogieron datos sociodemográficos, antropométricos, factores de riesgo cardiovascular, así como el estado funcional (mediante el índice de Barthel y la escala de Rankin modificada) y las complicaciones presentadas. Resultados: incluimos 103 pacientes, con edad media de 75,81 (± 6,73) años. La puntuación en el MNA fue de 23,13 puntos (± 4,47); el 8,2% presentaba malnutrición y el 38,1%, riesgo de malnutrición. No se observaron diferencias en el EN entre mujeres y hombres (p = 0,076) ni relación del EN con la edad. El estado nutricional deficitario se asoció a peor situación funcional (r = 0,608; p < 0,001), al desarrollo de complicaciones (infección urinaria y fiebre) (p = 0,044) y a la disfagia (p = 0,014). Además, aquellos pacientes con mejor EN presentaban mejor calidad de vida (r = 0,506; p < 0,001). También se relacionó con peor nivel socioeconómico (p = 0,020) y mayor institucionalización en centros sociosanitarios (p = 0,004). Conclusiones: el riesgo de desnutrición a corto plazo es frecuente en los supervivientes a un ictus. Este EN se asocia con una peor situación funcional y calidad de vida autopercibida y mayor tasa de complicaciones. Es fundamental detectar precozmente el riesgo de desnutrición en pacientes que han sufrido un ictus. Key words:Stroke. Mini Nutritional Assessment. Malnutrition. Disability. AbstractObjective: To assess the nutritional status (NS) of patients at three months of suffering a stroke, and to establish the relationship between functional recovery and complications in this period. Material and methods: A cross-sectional observational study evaluating the NS of patients older than 65 years at three months of having a stroke. The NS was assessed using the Mini Nutritional Assessment (MNA). Sociodemographic and anthropometric data, cardiovascular risk factors, as well as functional status (through the Barthel index and the modified Rankin scale) and the presented complications were collected. Results: One hundred and three patients were included, with a medium age of 75.81 (± 6.73). The MNA score was 23.13 points (± 4.47); 8.2% had malnutrition and 38.1% had risk of malnutrition. There were no differences in the NS between women and men (p = 0.076) neither relation of the NS with age. NS deficiency was associated with poorer function (r = 0.608; p < 0.001), the development of complications (urinary tract infection and fever) (p = 0.044) and dysphagia (p = 0.014). In addition, those patients with better nutritional status had a better quality of life (r = 0.506; p < 0.001). It was also associated wit...

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Section: Discussionunclassified

Valoración Nutricional Con La Situación Funcional Tras Sufrir Un Ictus.

Espuela¹,

Portilla-Cuenca²,

Mohedas³

et al. 2017

Nutr Hosp

View full text Add to dashboard Cite

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“…Efficient chewing also means that meals do not have to be pureed, so that the dishes look more appetizing. Furthermore, institutionalised patients tend to withdraw from common meals when chewing difficulties preclude 'decent' table manners; however, company and social interaction seem to positively influence the caloric intake in geriatric patients 31 . How many teeth are needed for maintaining satisfactory oral function?…”

Section: The Benefits Of Retaining Natural Teeth Dietmentioning

confidence: 99%

Oral health for an ageing population: the importance of a natural dentition in older adults

Müller

Shimazaki

Kahabuka

et al. 2017

International Dental Journal

119

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Despite progress in dentistry, tooth loss in old age is still a reality, even more so in long-term-care residents. However, recent trends indicate that natural teeth are lost later in life. Functional decline and age-related pathologies have to be considered in oral health care for this vulnerable population. Retaining and restoring teeth and oral function in elders is important. Tooth loss significantly impairs masticatory performance, which cannot be fully restored by prosthodontic means. Hence an unconscious change in food intake occurs, often involving malnutrition and withdrawal from common meals. Poor oral appearance and bad breath may further impede social activities. Although a chewing activity may be beneficial for cognitive function, natural teeth can present a considerable risk for fragile elders, in whom aspiration of biofilm can lead to pneumonia and death. The presence of natural teeth is also correlated with higher life expectancy, but socio-economic confounding factors have to be considered. When evaluating oral health in the elderly population, standards and priorities for reporting oral health outcome measures have to be defined. Anatomical indicators such as the number of natural teeth or the presence of prostheses might be one option for reporting. However, functional indicators such as masticatory performance and patient-centred outcome measures may be more relevant. In conclusion, there is an overwhelming body of evidence that maintaining a healthy natural dentition in old age is beneficial from a structural, functional and psycho-social point of view.

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“…A physiological reduction in appetite and energy intake, referred to as the "anorexia of ageing", occurs naturally with progressive aging and usually exceeds the reduction in energy expenditure, resulting in unintentional weight loss mainly in the form of lean body mass (52). Additionally, a multitude of factors often referred to as the "nine D's" (Figure 1) are commonly observed in older adults and are associated with difficulty with self-feeding; social and financial problems; impaired digestion, absorption, and excretion of nutrients; and gastrointestinal symptoms (such as nausea, constipation, vomiting, diarrhoea, loss of appetite, and early satiety); resulting in decreased food consumption and exacerbation of malnutrition (12,15,(53)(54)(55)(56)(57)(58)(59)(60)(61). The use of plastic dishware has been associated with malnutrition due to its potential influence on taste of food items and residents' perception of being in hospital (62).…”

Section: Aetiology Of Malnutrition In Racmentioning

confidence: 99%