Nutritional status in community-dwelling elderly in France in urban and rural areas.
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ABSTRACT:
SUBMITTER: Torres MJ
PROVIDER: S-EPMC4136808 | biostudies-other | 2014
REPOSITORIES: biostudies-other
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Project description:We aimed to evaluate the intake of minerals (calcium, phosphorous, sodium, and potassium) in the urban and rural elderly and explore the adequacy of intake and food sources for each mineral using nationwide big data. The study used data from the Korea National Health and Nutrition Examination Survey (KNHANES) between 2013 and 2016. We analyzed 5292 elderly individuals that were aged 65 years and older (2271 men, 3021 women). Daily calcium, phosphorous, sodium, and potassium intake, and they were analyzed using the 24-h dietary recall method. Additionally, the adequacy of intake and food sources for each mineral was analyzed. Blood triglyceride level was significantly higher in rural elderly than in urban elderly. The intake of calcium and potassium per 1000 kcal of energy intake was significantly lower in the rural elderly, and the proportion of participants with calcium intake below the Estimated Average Requirement was significantly higher in the rural elderly than in the urban elderly. The intake of calcium, phosphorous, and potassium in the rural elderly was lower than that in the urban elderly. These results can be used as basic data when making social and environmental policies for the health of the elderly and when providing targeted dietary education for the management of chronic diseases for the elderly.
| S-EPMC7277109 | biostudies-literature
Project description:The association between nutritional status and living environment among 703 community-dwelling participants (268 men and 435 women) aged 65 years and older was assessed. In this cross-sectional survey study, living environmental factors, health-related factors, and nutrition (the Nutrition Quotient for the Elderly scores; NQ-E) were assessed. NQ-E scores were significantly higher in men than women, as were diversity and behavior factor scores (diversity: men, 50.2 ± 16.1; women, 44.1 ± 17.5; behavior: men, 59.3 ± 16.9; women, 54.1 ± 16.6). Participants living with a spouse and engaging in frequent sports activities had significantly higher adjusted odds ratio (OR) for having a high NQ-E than those who lived alone and engaged in restful activities and hobbies (men: adjusted OR for high NQ-E = 8.99; 95% confidence interval (CI): 1.35-59.56; women: adjusted OR for high NQ-E = 5.62; 95%CI: 2.36-13.38). We confirmed that women's nutritional status, unlike men's, was better when proper nutrition education was provided and when food security was guaranteed. For all participants, social activities and networks were important for maintaining good nutritional status and a healthy life. We suggest that different nutritional management strategies are needed for elderly people depending on sex.
| S-EPMC7504555 | biostudies-literature
Project description:BackgroundDemographic transition in Nepal, like in many developing countries, has resulted in a burgeoning elderly population whose health status is not currently monitored. One pillar of health is adequate nutrition. Yet, little is known about the nutritional health status of the elderly in Nepal. The financial, material, and personnel limitations in Nepal's health delivery services necessitate health screening instruments that require minimal clinical staff and resources. To our knowledge, no such nutritional assessment tool has been validated in Nepal. Therefore, our aims are two-fold: To assess the nutritional status of the elderly population in one typical Nepali village, Okharpauwa, in Nuwakot District, Nepal; and concurrently, to validate the Mini Nutritional Assessment (MNA) tool.MethodsA cross-sectional field study was conducted with a sample of 242 elderly people in Okharpauwa, Nepal to obtain prevalence of malnutrition. Differences in demographic and lifestyle factors between these who were malnourished, those at risk of malnourishment, and those who had adequate nutritional status were analyzed. The MNA tool was evaluated using receiver operating characteristic (ROC) curve analysis; sensitivity, specificity, and diagnostic accuracy were calculated.Results111 males and 131 females, with a mean age of 69.8±7.4 years, participated in this study. The mean BMI of the participants was 21.4±3.9 kg/m2; the mean MNA score was 19.3±4.2. BMI was significantly correlated with the total MNA score (r = 0.58; p<0.001). The diagnostic accuracy, sensitivity and specificity of MNA were 81%, 86% and 67% respectively. Of the 242 elderly sampled, 24% were malnourished and 65% were at risk of malnutrition. Malnutrition was more prevalent among females (29%) than males (18%), and most prevalent among the marginalized Dalit ethnic group (40%). Elderly persons who were married and literate had better nutritional health than their counterparts.ConclusionsThe MNA appears to be a valid and sensitive tool for rapid nutritional screening of the elderly in Nepal. The prevalence of malnutrition was high among Nepalese elderly in the Okharpauwa VDC, which requires urgent health monitoring and management attention.
| S-EPMC5308814 | biostudies-literature
Project description:Alzheimer's patients living in rural communities may face significant barriers to effective outpatient medical care.We sought to examine rural-urban differences in risk for ambulatory care sensitive hospitalizations (ACSH), an indicator of access to outpatient care, in community-dwelling veterans with dementia.Medicare and Veteran Affairs inpatient claims for 1,186 US veterans with dementia were linked to survey data from the 1998 National Longitudinal Caregiver Survey. ACSH were identified in inpatient claims over a 1-year period following collection of independent variables. Urban Influence Codes were used to classify care recipients into 4 categories of increasing county-level rurality: large metropolitan; small metropolitan; micropolitan; and noncore rural counties. We used the Andersen Behavioral Model of Health Services to identify veteran, caregiver, and community factors that may explain urban-rural differences in ACSH.Thirteen percent of care recipients had at least 1 ACSH. The likelihood of an ACSH was greater for patients in noncore rural counties versus large metropolitan areas (22.6% vs 12.8%, unadjusted odds ratio [OR]= 1.99; P < .01). The addition of other Andersen behavioral model variables did not eliminate the disparity (adjusted OR = 1.97; P < .05).We found that dementia patients living in the most rural counties were more likely to have an ACSH; this disparity was not explained by differences in caregiver, care recipient, or community factors. Furthermore, the annual rate of ACSH was higher in community-dwelling dementia patients compared to previous reports on the general older adult population. Dementia patients in rural areas may face particular challenges in receiving timely, effective ambulatory care.
| S-EPMC3691102 | biostudies-literature
Project description:Tongue microbiota are a dominant source of oral microbial populations that are ingested with saliva, and therefore careful attention is required for the maintenance of health of elderly adults, who are susceptible to aspiration of oral contents. This study aimed to investigate the variation in tongue microbiota among community-dwelling elderly adults. Following a dental examination, tongue coating was collected from a 15-mm-diameter circular area at the center of the tongue dorsum of 506 elderly adults aged 70 to 80 years inhabiting the town of Hisayama, Japan. The microbial composition and density were determined by a 16S rRNA gene sequencing approach using a next-generation sequencer and quantitative PCR analysis, respectively. Co-occurrence network analysis identified two cohabiting groups of predominant commensals, one of which was primarily composed of Prevotella histicola, Veillonella atypica, Streptococcus salivarius, and Streptococcus parasanguinis; these organisms have been previously associated with an increased risk of mortality due to pneumonia in the frail elderly. This bacterial group was more predominant in the elderly with fewer teeth, a higher plaque index, and more dental caries experience, whereas the total bacterial density was independent of these traits. A higher density of fungi was also observed in the elderly with these traits, as well as in individuals who wore dentures. These results suggest that elderly adults with poorer oral health swallow a more dysbiotic microbiota formed on the tongue.IMPORTANCE Aspiration of oral contents can lead to pneumonia, which is a major cause of death among elderly adults susceptible to swallowing impairments. Tongue microbiota are a dominant source of oral microbial populations that are ingested with saliva. This large-scale population-based study revealed variations in the tongue microbiota among community-dwelling elderly adults. The total bacterial density was independent of the conditions of teeth surrounding the tongue, whereas the microbiota composition, especially the relative abundances of predominant commensals, showed an association with tooth conditions. Our results demonstrate that the elderly with fewer teeth, poorer dental hygiene, and more dental caries experience constantly ingest more dysbiotic microbiota, which could be harmful for their respiratory health.
| S-EPMC6094060 | biostudies-literature
Project description:Research on geographic differences in health focuses largely on children less than five years; little is known about adolescents-and even less regarding younger adolescents-a vulnerable group at a critical stage of the life course. Africa's rapid population growth and urbanization rates, coupled with stagnant rates of undernutrition, further indicate the need for country-specific data on rural-urban health disparities to inform development policies. This study examined rural-urban disparities in body mass index-for-age-and-sex (BAZ) and height-for-age-and-sex z-scores (HAZ) among younger adolescents in Tanzania. Participants were randomly selected adolescents aged 10-14 years (N = 1,125) residing in Kilosa (rural) and Moshi (urban) districts of Tanzania. Individual and household-level data were collected using surveys and anthropometric data was collected on all adolescents. Age, sex, household living conditions, and assets were self-reported. BAZ and HAZ were calculated using the WHO reference guide. The prevalence of undernutrition was 10.9% among rural and 5.1% among urban adolescents (p<0.001). Similarly, stunting prevalence was greater in rural (64.5%) than urban (3.1%) adolescents (p<0.001). After adjusting for covariates, rural residence was significantly and inversely associated with BAZ (B = -0.29, 95% CI: -0.52, -0.70, p = 0.01), as well as with HAZ (B = -1.79, 95% CI: -2.03, -1.54, p<0.001). Self-identified males had lower BAZ (B = -0.23, 95% CI: -0.34, -0.11, p<0.001) and HAZ (B = -0.22, 95% CI: -0.35, -0.09, p = 0.001) than self-identified female adolescents. Rural-urban disparities in nutritional status were significant and gendered. Findings confirm place of residence as a key determinant of BAZ and HAZ among younger adolescents in Tanzania. Targeted gender-sensitive interventions are needed to limit growth faltering and improve health outcomes in rural settings.
| S-EPMC8687541 | biostudies-literature
Project description:BackgroundIdentification of factors relevant to balance performance impairments in the elderly population was critical for developing effective interventions and preventions. However, there have been very limited data available based on large scale studies. The present study identified factors that independently contributed to performance impairments in overall balance, domains of static balance, postural stability, and dynamic balance, and individual items.MethodsA total of 1984 community-dwelling Chinese elderly from urban areas of Shanghai were recruited. Information on demographic characteristic, exercise, and health status were collected with a face-to-face interview. Balance performances were assessed on site by trained investigators based on the X16 balance testing scale. To identify the effectors, ordinal logistic regression analysis was applied for overall balance, static balance, postural stability, and dynamic balance. Binary logistic regression analysis was used for 16 items.ResultsThe community-dwelling elderly residents were aged from 60 to 97 years old. With increases of age, risks of impairments in overall balance increased gradually (ORs from 1.26 to 3.20, all P < 0.01). In the elderly with overweight and obesity, there was higher proportion of balance impairments compared to the elderly with normal BMI (OR = 1.26, P < 0.001). Regular exercise every week was associated with reduced risks of balance impairments (ORs from 0.63 to 0.73, all P < 0.001). Presences with vision lesion (ORs from 1.28 to 1.59, all P < 0.001), moderate hearing impairment (OR = 1.54, P < 0.001), somesthesis dysfunction (ORs from 1.59 to 13.26, all P < 0.001), and cerebrovascular disease (OR = 1.45, P = 0.001) were related to increased risks of balance impairments. Likewise, age, exercise, vision, hearing, somesthesis, and cerebrovascular disease were significantly associated with static balance, postural stability, and dynamic balance. Both overweight and obesity and underweight were associated with higher proportions of dynamic balance impairments. Regular exercise was significantly related to reduced risks of impairments in 15 out of the 16 items.ConclusionsIn the elderly, age, overweight and obesity, exercise, vision, hearing, somesthesia, and cerebrovascular disease were dominant factors associated with impairments in overall balance, domains of static balance, postural stability, and dynamic balance, and most individual items.Trial registrationNot applicable.
| S-EPMC10486131 | biostudies-literature
Project description:OBJECTIVE:Independent living ability is crucial for the elderly; however, its assessment performed in China employs various scales and lacks risk factors, especially behavioural and social-psychological factors, which could be improved through health education. This study aimed to assess the independent living ability of community-dwelling elderly in urban areas of China and to identify the association with behavioral and social-psychological factors. DESIGN:A population-based study using random cluster sampling method was performed in two core cities in Liaoning Province during March-November 2012. STUDY POPULATION:3686 individuals who were >=65 years old, had no dementia and cognitive impairment, had lived in the sampled communities for >=5 years and could take part in the study were enrolled. MAIN OUTCOME MEASURES:Interviews were conducted to collect information of independent living ability, indicated by the instrumental activity of daily living (IADL), behavioural factors, social-psychological factors and confounders (demographic characteristics and health status). The Mini-Mental State Examination was used to screen for cognitive impairment. RESULTS:The independence rate was 46.3% in men and 41.1% in women. Structural equation modelling analysis showed that physical activity, drawn from taking a walk and doing exercise, had the strongest association with the IADL in both men (-0.34, SE 0.10) and women (-0.33, SE 0.11). Falling in the last year and worrying about falling were also significantly associated with IADL. The effects of regular drinking, feeling lonely and participating in entertainment were significant in men. CONCLUSION:The independent living ability of the elderly in urban areas in Liaoning Province in China was at a low level. Physical activity was one of the important roles in both men and women; whereas the role of social-psychological factors only existed in men. Gender-specific healthcare and education to avoid sedentary life should be advocated for the elderly to maintain/improve their independent living ability.
| S-EPMC6797253 | biostudies-literature
Project description:BackgroundStudies have labelled chronic kidney disease (CKD) among the adult population in urban Bangladesh. To address knowledge gaps on CKD, we aimed to generate data on prevalence, health and nutrition of CKD individuals living in rural and peri-urban Bangladesh.MethodsParticipants were recruited from the Mirzapur Demographic Surveillance System by age-stratified random sampling. We screened participants by measuring serum creatinine and urine albumin to creatinine ratio, and collected socio-demographic, lifestyles and health information (phase I). After 3 months (phase II), we repeated the urine and blood tests as per the Kidney Disease Outcomes Quality Initiative guidelines. The glomerular filtration rate was calculated using the CKD Epidemiology Collaboration equation.ResultsAmong 928 participants, 872 completed the study. In phase I, probable CKD cases were 281 (32.2%); in phase II, confirmed cases were 192 (22.0%) (stage 1, 4.0%; stage 2, 11.8%; stage 3, 5.5%; stage 4, 0.6%; stage 5, 0.1%). In multivariable analysis, associated factors for prevalent CKD included aged ⩾60 years [adjusted odds ratio (aOR) 5.02; 95% confidence interval (CI) 1.85-13.65], hypertension (aOR 3.08; 95% CI 2.07-4.59), diabetes (aOR 2.52; 95% CI 1.60-3.96), presence of red blood cell in urine (aOR 3.20; 95% CI 1.71-5.98) and anemia (aOR 2.50; 95% CI 1.63-3.84).ConclusionsThis is the first ever research on CKD prevalence in rural and peri-urban Bangladesh and recorded about 22%, which is higher than urban settings. Monitoring systems are needed to evaluate the overall burden and to mitigate risk factors with an emphasis on the rural and peri-urban population.
| S-EPMC8326824 | biostudies-literature
Project description:BACKGROUND:A good nutritional status is key for maintaining health and quality of life in older adults. In the Netherlands, 11 to 35% of the community-dwelling elderly are undernourished. Undernutrition or the risk of it should be signalled as soon as possible to be able to intervene at an early stage. However, in the context of an ageing population health care resources are scarce, evoking interest in health enabling technologies such as telemonitoring. This article describes the design of an intervention study focussing at telemonitoring and improving nutritional status of community-dwelling elderly. METHODS:The PhysioDom Home Dietary Intake Monitoring intervention was evaluated using a parallel arm pre-test post-test design including 215 Dutch community-dwelling elderly aged >?65 years. The six-month intervention included nutritional telemonitoring, television messages, and dietary advice by a nurse or a dietician. The control group received usual care. Measurements were performed at baseline, after 4.5 months, and at the end of the study, and included the primary outcome nutritional status and secondary outcomes behavioural determinants, diet quality, appetite, body weight, physical activity, physical functioning, and quality of life. Furthermore, a process evaluation was conducted to provide insight into intervention delivery, feasibility, and acceptability. DISCUSSION:This study will improve insight into feasibility and effectiveness of telemonitoring of nutritional parameters in community-dwelling elderly. This will provide relevant insights for health care professionals, researchers, and policy makers. TRIAL REGISTRATION:The study was retrospectively registered at Clinical-Trials.gov (identifier NCT03240094 ) since August 3, 2017.
| S-EPMC6240290 | biostudies-literature