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03/2015 journal articles

CLINICAL CHARACTERISTICS ASSOCIATED WITH DYSPHAGIA IN THE HOSPITALIZED ELDERLY

Y. Kuroda

J Aging Res Clin Practice 2015;4(3):133-136

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The aim of this study was to determine the factors associated with dysphagia in the hospitalized older adults. The dysphagia group consisted of 46 patients (23 men and 23 women) while the non-dysphagia group consisted of 40 patients (10 men and 30 women). The measurements included Mini Nutritional Assessment Short-Form (MNA-SF) scores, serum albumin levels, anthropometrics, and a mobility index. The dysphagia group was older and had significantly higher rates of male sex, respiratory disease on admission, dementia, other neurological disease, and impaired mobility than the non-dysphagia group. The dysphagia group also showed significantly lower values in nutritional measurements including MNA-SF scores, serum albumin levels. Logistic regression analysis showed that the factors significantly and independently associated with dysphagia were impaired mobility, dementia, and male gender. The results of present study showed that hospitalized elderly with dysphagia are likely to present with problems including physical and mental disabilities and malnutrition.

CITATION:
Y. Kuroda (2015): Clinical characteristics associated with dysphagia in the hospitalized elderly. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.64

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INVESTIGATION INTO WATER CONSUMPTION AND ITS INFLUENCE ON DEPRESSION, MEMORY PROBLEMS AND CONSTIPATION IN OLDER PERSONS

P.S. Tsindos, C. Itsiopoulos, A. Kouris-Blazos

J Aging Res Clin Practice 2015;4(3):137-143

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Objective: This study examines a possible relationship between plain water consumption, mild cognitive impairment, depression and constipation in a cohort of Greek-born Australians aged 65 and over. Design: A cross-sectional study using a semi-quantitative food frequency and lifestyle questionnaire. Participants: We recruited 150 elderly Greek migrant volunteers who were born on Greek Mediterranean islands and collected detailed diet and lifestyle data using an established protocol used in the Mediterranean Islands Study (MEDIS) in Greece. Measurements: Water intake from plain water, beverages and foods was assessed using a validated food frequency questionnaire. Depression and memory were assessed using the validated Geriatric Depression Scale – Short version. Results: Mean water intake from all sources for all participants was 2871 mL (p = 0.010), water derived from foods was 1048mL (p = 0.014), beverage intake other than plain water was 876mL (p < 0.001) and plain water consumption was low with a mean of 947mL (p = 0.001) per day. Those who reported as not depressed (GDS < 6) consumed 100 mL less total water from food and beverages than those who scored 6 or above and those who self-reported no constipation consumed nearly 300mL more water in foods than those who self-reported being constipated. Conclusion: Results suggest that habitual low consumption of plain water (< 1000mL/day) was not associated with constipation or self-reported mental-emotional disorders in this group. Water consumption from food was significantly higher in those with no constipation suggesting that consumption of water in food may be a significant factor in ensuring adequate water needs. Clinicians should consider water intake in food when assessing patient water intake.

CITATION:
P.S. Tsindos ; C. Itsiopoulos ; A. Kouris-Blazos (2015): Investigation into water consumption and its influence on depression, memory problems and constipation in older persons. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.65

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HIGHER APPENDICULAR AND TRUNK FAT MASS USING BIOELECTRICAL IMPEDANCE ANALYSIS ARE RELATED TO HIGHER RESTING BLOOD PRESSURE IN OLDER ADULTS

D. Takagi, M. Kageyama, S. Kojima, Y. Nishida

J Aging Res Clin Practice 2015;4(3):144-148

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Background: Little is known about how fat mass and muscle mass in different parts of the body (e.g., appendages, trunk) using bioelectrical impedance analysis influences resting blood pressure in older adults. Objective: The purpose of the study was to clarify the association between resting blood pressure and muscle mass and fat mass in older adults using bioelectrical impedance analysis. Design: A cross-sectional study. Settings: A sample living independently in the community. Participants: The subjects were older adults between the ages of 65 and 85 years (n = 100). Measurements: Systolic, diastolic and mean arterial pressure was measured using an automatic hemodynamometer, and bioelectrical impedance analysis was used to estimate muscle mass and fat mass. Results: A positive correlation was observed between total fat mass, left and right arm fat mass, trunk fat mass, and left and right leg fat mass and resting systolic, diastolic and mean arterial pressure (p < 0.05), but this was not observed with any muscle mass (p > 0.05). In a multiple regression analysis adjusted for sex, systolic, diastolic and mean arterial pressure were independently predicted by total fat mass, left and right arm fat mass, trunk fat mass, and left and right leg fat mass (p < 0.05). Conclusions: These findings suggest that total, appendicular, and trunk fat mass, measured using bioelectrical impedance analysis, could aid in detecting the factors that increase blood pressure in clinical settings and even in daily life, thereby helping in controlling blood pressure.

CITATION:
D. Takagi ; M. Kageyama ; S. Kojima ; Y. Nishida (2015): Higher Appendicular and Trunk Fat Mass Using Bioelectrical Impedance Analysis are Related to Higher Resting Blood Pressure in Older Adults. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.66

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EVALUATE HEALTH-RELATED QUALITY OF LIFE AMONG URBAN ELDERS IN DIFFERENT LIVING ENVIRONMENTS

H. Xing, W. Yu, S. Chen, Y. Sun, X. He

J Aging Res Clin Practice 2015;4(3):149-153

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Background: This study aimed to assess and compare the health-related quality of life (HRQOL) in older people who lived with different living mode, including staying at home with spouse or child, staying at home alone and staying in nursing home. Methods: Data were collected by cross-sectional survey in 2013. The sample included 95 elderly people who were staying at home with spouse or child, 43 elderly people at home alone and 93 elderly people in nursing home. Results: The three groups were similar according to gender, education and existence of chronic disease. The univariate analysis showed that physical component summary (PCS) and mental component summary (MCS) scores of HRQOL were lower in those living in nursing home than those living in their own homes. The scores of PCS and MCS for the old elderly people (over 75 years old) were lower compared to the young elderly people (60-74 years old). The scores of PCS and MCS for elderly people who had part or incapacity of self-care ability were lower compared to complete self-care ability. There was a positive correlation between the number of weekly physical exercise and PCS and MCS. The main influential factors for PCS were physical exercise, age and self-care ability, physical exercise also affected MCS based on multiple linear regression analysis. Conclusion: These data suggest that PCS and MCS are not lower in elderly assisted living in nursing home compared to staying at home by multiple statistical analyses. HRQOL may be affected by physical exercise.

CITATION:
H. Xing ; W. Yu ; S. Chen ; Y. Sun ; X. He (2015): Evaluate health-related quality of life among urban elders in different living environments. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.61

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PROFILES OF ICF DISABILITY IN ALZHEIMER AND VASCULAR DEMENTIA

A. Malara, G. Sgrò, F. Ceravolo, G. Curinga, G.F. Renda, F. Spadea, V. Rispoli

J Aging Res Clin Practice 2015;4(3):154-158

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Backgrounds: The International Classification of Functioning, Disability and Health (ICF) is a suitable tool to standardize the status of health and disability. A previous study, carried out on 546 subjects included in the database ANASTE (National Association of Nursing Home for Third Age) Calabria, showed that 78.43% of the patients suffered from cognitive impairment whereas 52% had a severe degree of dementia. 65% of them was suffering from Alzheimer’s Disease (AD), whereas 23% from vascular dementia (VD). Objectives: Aim of this study was to analyse the prevalence of functional impairments, activity limitations and participation restrictions of patients affected by AD and VD. Design: Observational descriptive study. Setting: Nursing Homes ANASTE Calabria. Partecipants: 10 patients with probable AD (ADPr) and 10 patients affected by probable VD (VDPr). Measurements: All patients were underwent multidimensional geriatric assessment. The profiles of disability ICF, were expressed in terms of Capacity and Performance, and coded according to mild, medium, severe and complete disability. Environmental factors were skilled in facilitator or no facilitator. Results: The patients with ADPr displayed a severe impairment of functional status, and advanced clinical stage requiring higher care burden compared with VDPr patients. The ICF assessment showed that the global and specific Mental Functions, Communication and Interpersonal Relationships were more reduced in patients with ADPr respect those with VDPr. Conclusions: The identification of a ICF checklist of various forms of dementia, might provides a more detailed description of the profiles of disability and improving therapeutic, rehabilitative interventions and psico-social care.

CITATION:
A. Malara ; G. Sgrò ; F. Ceravolo ; G. Curinga ; G.F. Renda ; F. Spadea ; V. Rispoli (2015): PROFILES OF ICF DISABILITY IN ALZHEIMER AND VASCULAR DEMENTIA . The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.62

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ADVANCING RESEARCH BY CLEARLY LABELING MEASURES OF PHYSICAL FUNCTION: EXTRACTING AMBULATION AND STAIR-CLIMBING FROM “MOBILITY DISABILITY”

C. Siordia, A.N. Lewis

J Aging Res Clin Practice 2015;4(3):159-163

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The term “mobility disability” is used in different academic disciplines to discuss conceptualizations of physical movement. Inadequate attention has been paid to how this umbrella term refers to various forms of measurements on both hypothetical and enacted function. Refining what is meant by mobility disability may impact clinical practice by providing more specific information to clinicians. Less ambiguous labeling may have the potential to advance research by lowering measurement imprecision. We complement discussion by presenting empirical analysis on 5,995 participants (aged > 65) from National Health and Aging Trends Study (NHATS-2011). Ambiguous labeling of mobility may unintentionally obscure what is known about perceived capacity for ambulation and stair-climbing. Because creating low-cost and readily-available measures of health in the population has the potential to advance public health knowledge, efforts should continue to standardize and clarify measures of mobility.

CITATION:
C. Siordia ; A.N. Lewis (2015): Advancing Research by Clearly Labeling Measures of Physical Function: Extracting Ambulation and Stair-Climbing from “Mobility Disability”. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.63

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DIETARY INTAKE OF MINERALS AND PROSTATE CANCER: INSIGHTS INTO PROBLEM BASED ON THE CHEMICAL ELEMENT CONTENTS IN THE PROSTATE GLAND

V. Zaichick, S. Zaichick

J Aging Res Clin Practice 2015;4(3):164-171

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Objective: As men age total dietary mineral bioavailability falls which may increase the risk of prostate cancer. The aims of this study were to investigate the changes in main mineral contents in prostate gland that occurred with aging. Design: Population based study on changes in mineral contents in prostate gland with ageing. Participants and setting: 65 free-living healthy men aged 21-87 years who had died suddenly. Prostates were removed at necropsy and the samples of morphologic normal prostate tissue were investigated. Measurements: Contents of ten main minerals (B, Ca, Co, Cr, Cu, Fe, Mg, Mn, Se, and Zn) were determined by four instrumental analytical methods. Results: No any age-related deficiencies in minerals such as B, Ca, Co, Cr, Cu, Fe, Mg, Mn, Se, and Zn in the prostate tissue were found. Moreover, the mean mass fractions of Co, Fe, and Zn in prostate tissue for the age group adult men aged 41 years and older were statistically significant higher than for those younger than 40 years. Conclusions: Ageing is not associated with reduced mineral contents in prostate gland resulting in inadequate intakes in nutrients. Nutrition policy for men aged 41 years and older should include advice to decrease intakes of red meat for the purpose to reduce Fe and Zn intake.

CITATION:
V. Zaichick ; S. Zaichick ; (2015): Dietary intake of minerals and prostate cancer: insights into problem based on the chemical element contents in the prostate gland. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.67

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CUMULATIVE ENERGY DEFICIT IN THE FIRST SEVEN DAYS AFTER ADMISSION IS ASSOCIATED WITH POOR OUTCOMES AT THREE MONTHS IN NON-ACUTE HOSPITALIZED OLDER ADULTS

Y. Hokotachi, S. Ichimaru, M. Hayashida, T. Amagai

J Aging Res Clin Practice 2015;4(3):172-179

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Aim: To examine the hypothesis that larger cumulative energy deficit and late initiation of enteral nutrition for older adult patients in non-acute setting is associated with poor outcome at 3 and 6 months later. Methods: This is retrospective study with chart review in a single institute. The consecutive older adult patients (>= 65 years-old) admitted to the institute were included. Dividing all subjects by two categories: take nutrients by mouth (PO) during hospital stay vs. non-PO group, and enteral nutrition (EN) during the first 7 and 14 days after admission vs. non-EN (NEN) group. Between these two groups, demographics, nutritional, and outcomes were compared. Results: 1, PO group showed significantly longer length of hospital stay (p=0.049). 2, NEN group showed significantly larger cumulative energy deficit, longer length of hospital stay, and higher mortality at 3 and 6 months later (p=0.000, p=0.000, p=0.044, and p=0.008, respectively). Conclusion: The larger cumulative energy more than 10, 000 kcal is considered to be associated with poor clinical outcomes, including longer LOS and higher mortality at 3 and 6 months later in the hospitalized older adults (>= 80 years-old). The cumulative energy deficit might be considered in nutritional support even for older adults admitted to non-acute setting to prevent poor outcomes.

CITATION:
Y. Hokotachi ; S. Ichimaru ; M. Hayashida ; T. Amagai (2015): Cumulative Energy Deficit in the First Seven Days after Admission Is Associated with Poor Outcomes at Three Months in Non-acute Hospitalized Older Adults. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.68

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WHICH PATIENTS SURGICALLY TREATED FOR UROLITHIASIS NEED NUTRITIONAL CARE?

V. Aparecida Leandro-Merhi, J.L. Braga de Aquino, R. Marmiroli, L. Oliveira Reis

J Aging Res Clin Practice 2015;4(3):180-184

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Introduction: The present study is justified by the interest of investigating the impact of nutritional status on urology patients. Objective: To investigate the nutritional status of urology patients and identify the risk factors associated with type of kidney stone. Method: This cross-sectional study assessed the nutritional status and energy and nutrient intakes of 175 hospitalized adult urology patients stratified as follows: patients submitted to percutaneous nephrolithotripsy (PN), patients submitted to endoscopic ureterolithotripsy (EU), and patients without kidney stones. All study variables were investigated as possible predictors of urologic diseases. Multinomial logistic regression analysis and the proportional odds model identified the factors associated with kidney stones. The significance level was set at 5%. Results: Kidney stones were more common in females (p<0.0001), EU patients without nutritional risk according to the Nutritional Risk Screening (NRS) (p=0.0061), patients with normal triceps skinfold thickness (p=0.015), and younger patients (p=0.0001). Patients hospitalized for longer periods (p=0.0038) and older patients (p=0.0001) did not have kidney stones. In EU patients kidney stones were associated with being female (p<0.0001; OR: 3.699; CI: 2.001; 6.838), having mid-upper arm muscle circumference between the 10th and 90th percentiles (p=0.0477; OR: 3.164; CI: 1.012; 9.895), not being at nutritional risk according to the NRS (p=0.0308; OR: 3.265; IC: 1.116; 9.557), and being younger (p=0.0008; OR: 0.966; CI: 2.001; 6.838). Conclusion: PN patients seem to need nutritional assessment and follow-up, while patients with kidney stones smaller than one centimeter do not seem to need routine nutritional assessment.

CITATION:
V. Aparecida Leandro-Merhi ; J.L. Braga de Aquino ; R. Marmiroli ; L. Oliveira Reis (2015): Which patients surgically treated for urolithiasis need nutritional care?. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.69

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TWO METHODS OF ORAL DELIVERY OF RESVERATROL: A CASE STUDY

K. Bojanowski, R. Bojanowski

J Aging Res Clin Practice 2015;4(3):185-189

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Background: Resveratrol is one of the most popular nutrition supplements, especially in the older population segment, yet its safety and health benefits are not fully established. This study aimed at determining bioavailability and the physiological effects of resveratrol delivered by 2 methods in a one senior patient case study. Methods: Bioavailability of resveratrol and blood chemistry parameters following the gastrointestinal and transbuccal intake were measured, respectively, by HPLC in blood and urine, and by blood chemistry analyzer. Results: The fraction of the initially administered resveratrol detected in the blood was over 15 times higher following transbuccal intake than through the gastrointestinal tract. About 36% of the ingested resveratrol was excreted in urine as 3 major metabolites, while only 11% were secreted as major metabolites following the transbuccal intake. The major metabolite in urine peaked at the same time regardless of the method of delivery. Three long-term (31 day) cycles of resveratrol supplementation by transbuccal mucoadhesive film or by ingestion did not result in any noticeable (over 5%) variation of blood chemistry, blood pressure or the overall physical condition of the patient. Conclusion: Bioavailability of resveratrol delivered through oral mucosa may be over one log higher than by swallowing, as determined by the fraction of the initial resveratrol intake in the blood and, under metabolized form, in urine. Lack of resveratrol-associated changes in blood pressure and chemistry following long term supplementation demonstrates good tolerance to high doses of resveratrol in this senior patient case study.

CITATION:
K. Bojanowski ; R. Bojanowski (2015): Two Methods of Oral Delivery of Resveratrol: a case study. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2015.70

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