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      Factores asociados al riesgo nutricional en adultos mayores autónomos no institucionalizados Translated title: Nutrition-related risk factors in autonomous non-institutionalized adult elderly people

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          Abstract

          Objetivos: Determinar factores asociados al riesgo nutricional en adultos mayores autónomos no institucionalizados. Métodos: Estudio transversal realizado en 660 adultos mayores autónomos, no institucionalizados. Los participantes fueron evaluados en 12 centros sociales (provincia de Valencia) seleccionados mediante un muestreo estratificado por bloques. Criterios de inclusión: tener 65 años o más, vivir en el domicilio, poseer autonomía funcional, residir más de un año en la provincia de Valencia, acudir periódicamente a los centros sociales y colaborar voluntariamente en el estudio. Se usa el MNA para la valoración nutricional y se recogen factores asociados al estado nutricional en una encuesta ad-hoc. Resultados: De los 660 sujetos estudiados, el 48,33% son hombres y el 51,67% mujeres, la edad media es de 74,3±6,57 años. El 23,33% presentan riesgo de malnutrición. Los factores independientes asociados al riesgo de malnutrición, con el odds de prevalencia ajustada, son: no poseer estudios (OR=2,29), sentir soledad (OR=2,34), mantener dietas controladas (OR=0,55), un apetito escaso (OR=2,56), número de fracciones en la ingesta diaria (OR=0,66), sufrir xerostomía (OR=1,72), tener dificultades para deglutir (OR=2,30), el número de enfermedades crónicas (OR=1,38) y haber sufrido enfermedades agudas en el último año (OR=2,03). Un incremento en el IMC se asocia a un buen estado nutricional (OR=0,85). Estos factores nos han permitido clasificar correctamente a un 80% de los pacientes encuestados. Conclusiones: Tener numerosas enfermedades crónicas, haber sufrido enfermedades agudas recientes, mantener dietas sin control, sufrir xerostomía y dificultad para deglutir, comer pocas veces al día y con escaso apetito, sentirse solo y no tener estudios son factores que, permiten predecir el riesgo de malnutrición en los adultos mayores.

          Translated abstract

          Objectives: To determine factors related to nutritional riskin autonomous non-institutionalized adult elder people. Methods: Cross-sectional study including 660 autonomous non-institutionalized adult elder people. Participants were assessed in 12 social centres (province of Valencia) and selected using stratified sampling by blocks. Inclusion criteria: age 65 or over, living at home, functionally autonomous, having lived for more than 1 year in the province of Valencia, regularly visiting social centres and voluntary participation in the study. MNA is used for nutritional assessment and factors associated to nutritional status are collected by means of an ad-hoc survey. Results: Out of the 660 study subjects, 48.33% are male and 51.67% are female, mean age is 74.3±6,57. 23.33% show malnutrition risk. Independent factors associated to malnutrition risk with adjusted prevalence odds ratioare: absence of academic education (OR=2.29), feeling lonely (OR=2.34), following controlled diets (OR=0.55), reduced appetite (OR=2.56), number of fractions in daily intake (OR=0.66), suffering from xerostomia (OR=1.72), swallowing difficulties (OR=2.30), number of chronic diseases (OR=1.38) and having suffered from acute diseases during the last year (OR=2.03). An increase in BMI is associated with a good nutritional status (OR=0.85). These factors have allowed an accurate classification of 80% of the surveyed patients. Conclusions: Numerous chronic diseases, recent acute diseases, non-controlled diets, xerostomia and swallowing difficulties, eating few times a day and little appetite, feelling lonely and lacking from academic education are factors allowing the prediction of malnutrition risk in adult elder people.

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          The Rapid Assessment of Physical Activity (RAPA) Among Older Adults

          Introduction The Rapid Assessment of Physical Activity (RAPA) was developed to provide an easily administered and interpreted means of assessing levels of physical activity among adults older than 50 years. Methods A systematic review of the literature, a survey of geriatricians, focus groups, and cognitive debriefings with older adults were conducted, and an expert panel was convened. From these procedures, a nine-item questionnaire assessing strength, flexibility, and level and intensity of physical activity was developed. Among a cohort of 115 older adults (mean age, 73.3 years; age range, 51–92 years), half of whom were regular exercisers (55%), the screening performance of three short self-report physical activity questionnaires — the RAPA, the Behavioral Risk Factor Surveillance System (BRFSS) physical activity questions, and the Patient-centered Assessment and Counseling for Exercise (PACE) — was compared with the Community Healthy Activities Model Program for Seniors (CHAMPS) as the criterion. Results Compared with the BRFSS and the PACE, the RAPA was more positively correlated with the CHAMPS moderate caloric expenditure (r = 0.54 for RAPA, r = 0.40 for BRFSS, and r = 0.44 for PACE) and showed as good or better sensitivity (81%), positive predictive value (77%), and negative predictive value (75%) as the other tools. Specificity, sensitivity, and positive predictive value of the questions on flexibility and strength training were in the 80% range, except for specificity of flexibility questions (62%). Mean caloric expenditure per week calculated from the CHAMPS was compared between those who did and those who did not meet minimum recommendations for moderate or vigorous physical activity based on these self-report questionnaires. The RAPA outperformed the PACE and the BRFSS. Conclusion The RAPA is an easy-to-use, valid measure of physical activity for use in clinical practice with older adults.
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            Nutritional assessment interpretation on 22,007 Spanish community-dwelling elders through the Mini Nutritional Assessment test.

            To evaluate the prevalence of undernutrition among community-dwelling elderly people in Spain using the Mini Nutritional Assessment (MNA) and to analyse its distribution according to age, gender and residence region. Cross-sectional study assessing the nutritional status of elderly persons through both the short form and the full version of the MNA test. Pharmacy offices across the whole country (Spain) were enrolled to recruit participants. A total of 22 007 participants (8014 men and 13 993 women), aged >or=65 years, assessed during the last two months of 2005. According to MNA screening, 4.3 % subjects were classified as undernourished (MNA score or=17 to
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              Malnutrition and depression among community-dwelling elderly people.

              This study had the objective of analyzing the association between nutritional deficit and the presence of depression among community-dwelling elderly people. Cross-sectional study. Population of elderly people living in one district of a city in southern Brazil. The subjects were 267 individuals aged 60 to 74 years who did not present any significant functional incapacity. Nutritional deficit was considered to be present if the individuals were classified as malnourished or at nutritional risk by means of the Mini Nutritional Assessment (MNA). Depression was identified as regular use of antidepressives or scores higher than 5 points on the Geriatric Depression Scale. A majority of the elderly individuals were female (59.9%). Nutritional deficit was identified in 58 elderly people (21.7%) and depression in 65 (24.3%). Nutritional deficit presented a significant association with depression, even after adjusting for control variables such as low schooling, low socioeconomic level, and smoking (OR = 4.38; 95% CI: 2.23-8.64; P < .001). The results showed that there was an independent association between nutritional deficit and depression in this population of elderly people, which emphasizes the importance of early identification of depression among individuals with nutritional disorders.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                nh
                Nutrición Hospitalaria
                Nutr. Hosp.
                Grupo Arán (Madrid, Madrid, Spain )
                0212-1611
                1699-5198
                October 2014
                : 30
                : 4
                : 858-869
                Affiliations
                [02] Alicante orgnameUniversidad de Alicante orgdiv1Facultad de Ciencia de la Salud orgdiv2Departamento de Enfermería España
                [01] Valencia orgnameUniversidad de Valencia orgdiv1Escuela de Enfermería La Fe España
                [03] Valencia orgnameUniversidad Politécnica de Valencia orgdiv1Departamento de Estadiística e Investigación Operativa Apliicadas y Calidad España
                Article
                S0212-16112014001100021
                10.3305/nh.2014.30.4.7829
                0f75010e-e768-48a2-b66c-a7ef092d1df2

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 06 August 2014
                : 21 July 2014
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 45, Pages: 12
                Product

                SciELO Spain


                Factores asociados,Riesgo nutricional,Adultos mayores,Autónomos no institucionalizados,Related factors,Nutrition risk,Adult elder people,Autonomous non-institutionalized

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