Nutritional Vulnerability in Older Adults: A Continuum of Concerns

Starr, Kathryn; McDonald, Shelley; Bales, Connie W.

doi:10.1007/s13668-015-0118-6

Cited by 121 publications

(122 citation statements)

References 92 publications

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“…Despite being well documented as a preventable condition, hospital malnutrition is highly prevalent among older adults (20–60%) [7–9]. It remains unclear whether malnutrition occurs before or after admission since at hospital admission, nutrition screening is not mandatory and is conducted infrequently [10–12]. …”

Section: Introductionmentioning

confidence: 99%

Dysphagia risk, low muscle strength and poor cognition predict malnutrition risk in older adults at hospital admission

et al. 2018

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BackgroundMalnutrition in patients admitted to hospital may have detrimental effects on recovery and healing. Malnutrition is preceded by a state of malnutrition risk, yet malnutrition risk is often not detected during admission. The aim of the current study was to investigate the magnitude and potential predictors of malnutrition risk in older adults, at hospital admission.MethodsA cross-sectional was study conducted in 234 older adults (age ≥ 65 or ≥ 55 for Māori or Pacific ethnicity) at admission to hospital in Auckland, New Zealand. Assessment of malnutrition risk status was performed using the Mini Nutritional Assessment Short-Form (MNA®-SF), dysphagia risk by the Eating Assessment Tool (EAT-10), muscle strength by hand grip strength and cognitive status by the Montreal Cognitive Assessment (MoCA) tool.ResultsAmong 234 participants, mean age 83.6 ± 7.6 years, 46.6% were identified as at malnutrition risk and 26.9% malnourished. After adjusting for age, gender and ethnicity, the study identified [prevalence ratio (95% confidence interval)] high dysphagia risk [EAT-10 score: 0.98 (0.97–0.99)], low body mass index [kg/m2: 1.02 (1.02–1.03)], low muscle strength [hand grip strength, kg: 1.01 (1.00–1.02)] and decline in cognition [MoCA score: 1.01 (1.00–1.02)] as significant predictors of malnutrition risk in older adults at hospital admission.ConclusionAmong older adults recently admitted to the hospital, almost three-quarters were malnourished or at malnutrition risk. As the majority (88%) of participants were admitted from the community, this illustrates the need for routine nutrition screening both at hospital admission and in community-dwelling older adults. Factors such as dysphagia, unintentional weight loss, decline in muscle strength, and poor cognition may indicate increased risk of malnutrition.

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Section: Introductionmentioning

confidence: 99%

Dysphagia risk, low muscle strength and poor cognition predict malnutrition risk in older adults at hospital admission

et al. 2018

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“…[8][9][10] It is important to identify nutritional vulnerability among community-dwelling older adults, so that preventative or supportive strategies can be implemented when needed. 11 The Mini Nutritional Assessment Short Form (MNA®-SF) is the most frequently used tool for nutrition risk screening in older adults. 12 As body mass index (BMI) is incorporated into the MNA®-SF tool, the use of additional body composition assessments may help elucidate the association between individuals' nutrition risk and measures of body mass.…”

mentioning

confidence: 99%

Associations between nutrition risk status, body composition and physical performance among community‐dwelling older adults

Chatindiara

Williams

Sycamore

et al. 2019

Australian and New Zealand Journal of Public Health

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Objective: To investigate the associations between nutrition risk status, body composition and physical performance among community‐dwelling older New Zealanders. Methods: This cross‐sectional study enrolled 257 community‐dwelling older adults (median age 79 years). Assessments included the Mini Nutritional Assessment‐Short Form (MNA®‐SF) for nutrition risk; the Eating Assessment Tool‐10 for dysphagia risk; bioimpedance analysis for body composition (free fat mass (FFM) and percentage body fat) and gait speed for physical performance. A multiple logistics regression analysis was conducted, to determine factors associated with lower odds [OR (95% CI)] for nutrition risk. Results: Every yearly increase in age was associated with higher odds 1.09 (1.01–1.17) for nutrition risk. Additionally, nutrition risk was less likely to occur among participants of age <85 years 0.30 (0.11–0.79), with no dysphagia 0.29 (0.09–0.97) and those with a healthy gait speed 0.29 (0.09–0.97). Lower odds for nutrition risk were also found with increasing values of FFM index 0.51 (0.34–0.77), and percentage body fat 0.81 (0.72–0.90). Gait speed was positively correlated with FFM index (r=0.19 p<0.022), percentage body fat (r=0.23, p=0.006) and BMI (r=0.29, p<0.001). Conclusion: Among these participants, associations between nutrition risk, body composition and physical performance were found. Implications for public health: Routine screening of nutrition risk and/or physical performance among vulnerable older adults is key towards identifying those in need of assessment and dietary intervention. Alongside strategies to encourage physical activity, this may help to slow losses of FFM and protect physical performance.

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“…Porter Starr et al 22 suggest food vulnerability as evoking a classic image of a home-bound older person with limited resources and/or medical disabilities that impede their ability to consume an adequate diet. But such images evade the inherent complexities of eating in older age.…”

Section: Food Vulnerabilitymentioning

confidence: 99%

“…Underpinning the study presented here is an intention to understand and characterize food vulnerability in older, bereaved men. Porter Starr et al . suggest food vulnerability as evoking a classic image of a home‐bound older person with limited resources and/or medical disabilities that impede their ability to consume an adequate diet.…”

Section: Introductionmentioning

confidence: 99%

Understanding food vulnerability and health literacy in older bereaved men: A qualitative study

Thompson

Tod

Bissell

et al. 2017

Health Expectations

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BackgroundOlder people are sometimes challenged in maintaining a healthy diet but, because of age and disadvantage, are also more vulnerable to the adverse health consequences of poor nutrition. It has been claimed that older adults have low levels of health literacy regarding food and struggle to discern which foods are healthy from the vast range available in developed counties. However, nutrition and eating behaviour are modifiable risk factors for health in old age and health benefits can accrue from promoting healthy eating later in life. In order to achieve these health benefits, it is necessary to understand more about the capabilities and vulnerabilities of older people in terms of acquiring and maintaining a healthy diet.ObjectiveTo understand the potential for issues around food vulnerability to arise in that group and to characterize that vulnerability, if present.DesignNarrative interviews were conducted to collect the data. An interpretative thematic approach to analysis was utilized.ParticipantsTwenty older, bereaved men from two communities in the North of England.FindingsFive overarching themes were identified: financial security, social networks, cooking skills, food and routine and single servings.DiscussionOur findings suggest that some older men experience cumulative benefit from resources at their disposal, which contributes towards their capabilities to avoid food vulnerability.

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Nutritional Vulnerability in Older Adults: A Continuum of Concerns

Cited by 121 publications

References 92 publications

Dysphagia risk, low muscle strength and poor cognition predict malnutrition risk in older adults at hospital admission

Dysphagia risk, low muscle strength and poor cognition predict malnutrition risk in older adults at hospital admission

Associations between nutrition risk status, body composition and physical performance among community‐dwelling older adults

Understanding food vulnerability and health literacy in older bereaved men: A qualitative study

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