Nutrition and aging: nutritional status of “apparently healthy” elderly (Dutch nutrition surveillance system).

In a nationwide survey the nutritional status was assessed of 539 apparently healthy, independently living elderly aged 65-79 years. Anthropometric data showed no energy deficits. The prevalence of anemia was 4 and 1% among men and women, respectively. Many elderly showed a low level of 25-hydroxyvitamin D in plasma (less than 31 nmol/L: men 35%; women 43%), indicating a marginal status. Although the prevalence of low blood levels of folate, pyridoxal-5′-phosphate, and total carotenoids was higher among the elderly than among younger adults, clear (clinical) signs of nutritional deficiencies were not observed. Prevalence of obesity (13%), hypercholesterolemia (38%), and hypertension (63%) was found to be high, the percentages being higher for women than for men. Several indicators of the nutritional status appeared to differ among age groups. It is concluded that few differences can be considered as being due to physiological aging, which finding should be reflected in reference values for elderly people.     

Nutrition and aging: dietary intake of "apparently healthy" elderly (Dutch Nutrition Surveillance System)

The dietary intake (assessed through dietary history) of 539 apparently healthy, independently living elderly aged 65-79 years, was evaluated in a nationwide random sample. Except for pyridoxine, the intake of vitamins, minerals, and water was adequate according to the Dutch recommended dietary allowances. Fat intake (40 energy%) as well as P/S ratio (0.41) was assessed as being unfavorable, whereas the intake of vitamin B6 was marginal. The prevalence of obesity was higher among the women, while food selection was healthier as reflected in the higher nutrient density than among the men. Food consumption of elderly men (26%) and women (33%) on a dietary regimen was more prudent and nutrient density higher than among the elderly not on a diet. Our results are in accordance with previous food consumption studies among elderly in The Netherlands, but differ substantially from dietary intake figures for American elderly. Although the intake of energy and nutrients was lower among elderly men than among younger men, we conclude that age per se is not an important determinant of dietary intake among Dutch apparently healthy elderly aged 65-79 years.     

Nutritional vulnerability of older persons living in urban areas of Lake Victoria Basin in East Africa: a cross sectional survey

The aim of this study was to (1) determine the prevalence of malnutrition and (2) investigate factors affecting nutritional status of older persons living in urban areas of Lake Victoria Basin. The prevalence of underweight was 16.5%, with men (24.1%) being significantly more likely to be underweight (P < 0.05) than women (12.3%). Overall, 61.2% had normal body mass indices, 13.2% were overweight, and 9.1% were obese. Energy intake was low (1596.3-1630.5 Kcal), with only 22% and 38% of men and women, respectively, meeting their daily requirements. Protein intake was adequate in more than half of men and women. Vitamin A, iron, and zinc intakes were moderate, while calcium intake was low (P < 0.05). Inadequate food access, poor health, living arrangements, and poor eating patterns were the main nutritional risk factors. There is a need to plan nutrition programs that can improve living conditions, health, and nutritional status of older adults in these urban areas of the Lake Victoria Basin.     

Health status, lifestyle and nutrient intake of home resident elderly in Bahrain

The elderly are more susceptible to chronic diseases which reduce functional capacity. Researches on health and nutritional status, therefore, are needed to prevent and control these chronic diseases. The objective of this study was to find out the health, lifestyle, ability to carry out daily living tasks, and intake of nutrients among home-resident Bahraini elderly. Data were based on a cross-sectional community study of 201 Bahraini elderly aged 65 years, which were selected proportionally from all geographical regions of Bahrain (88 men and 113 women). They were visited and interviewed at home by trained female workers, using a pre-tested questionnaire. There was no statistically significant difference between men and women in the history of chronic diseases. However, the proportion of chronic diseases was higher among women, except for peptic ulcer. Men were more likely to smoke (38.6%) than women (24.8%) (p = 0.0353). Dietary supplements were more common among men (19.3%) than women (12.4%). Mean nutrient intakes for energy, iron and calcium were below the USA Recommended Daily Allowances. Men had more capability to do daily activities without help than women. In conclusion, there is a need to establish a national plan of action to promote health and nutritional status among the elderly of Bahrain. This study can provide some baseline data for further in depth study of health status of Bahraini elderly.     

Effect of household size on nutritional patterns among the Dutch elderly

Elderly persons are vulnerable to nutritional risks. Factors such as living alone make the elderly prone to poor nutritional status as a result of inadequate diets. The results of a Dutch national nutrition survey of food consumption and nutritional status among 539 independently living, apparently healthy elderly persons, aged 65 to 79 years, show that in general the intake of macronutrients deviates from the Dutch recommendations. In particular, saturated fat intake and P:S ratio were unfavorable, especially for the solitary elderly persons (saturated fat intake 19.0 +/- 3.2% and 17.7 +/- 3.3% total energy for men and women, respectively). Except for vitamin B-6 (about 92% of the recommendation on a group level for men and 78% for women), the intake of micronutrients studied is considered to be adequate. Elderly women living alone had a higher calcium:phosphorus ratio (0.76 +/- 0.12), lower meat consumption (90 +/- 31 gm), and a lower mean HDL-cholesterol concentration (1.22 +/- 0.28 mmol/L) in serum than non-solitary elderly women (Ca:P ratio 0.73 +/- 0.12, meat consumption 100 +/- 36 gm, HDL-cholesterol concentration 1.45 +/- 0.38 mmol/L). Potatoes, vegetables, and meat were more often prepared for more than one day at a time by elderly persons living alone than by the non-solitary elderly.     

Indicators of nutritional risk in a rural elderly Hispanic and non-Hispanic white population: San Luis Valley Health and Aging Study

OBJECTIVE: To describe the prevalence of nutritional risk factors among elderly residents in a rural Hispanic and non-Hispanic white population. DESIGN: A geographically based survey of community-dwelling elderly adults. SUBJECTS/SETTING: From July 1993 to July 1995, all Hispanic persons older than 65 years and an age-stratified, random sample of 69% of non-Hispanic white persons, from 2 Colorado counties, were invited to participate in a study of functional impairment and disability (81% responded). After exclusion of 184 respondents who required a surrogate respondent and 8 with missing diet data, the study consisted of 1,006 subjects. Interviews included questions similar to the Nutrition screening Initiative checklist, a 21-item food frequency questionnaire, and anthropometric measures. STATISTICAL ANALYSES PERFORMED: Gender- and ethnicity-specific, age-adjusted prevalence for each risk factor was estimated by use of logistic regression. RESULTS: Hispanic participants were more likely than non-Hispanic whites to report inadequate intake of vegetables, problems with teeth or dentures that limited the kinds and amounts of food eaten, difficulty preparing meals, and lack of money needed to buy food. Hispanic women reported nutritional risk factors more often than Hispanic men, although anthropometric markers indicated that Hispanic men may be at higher risk of nutritional deficiency. APPLICATIONS/CONCLUSIONS: Hispanic men and women had a higher prevalence of nutritional risk factors than non-Hispanic whites. Intervention programs targeting rural, elderly Hispanics should aim to ensure that basic nutrition needs (access to food, help preparing meals, and adequate dental care) are being met. Community programs to increase activity levels and consumption of nutrient-dense foods are recommended.     

我国农村老年人抑郁症状性别差异及影响因素研究

目的 了解我国农村老年人抑郁的性别差异及影响因素,为缩小农村老年人抑郁性别差异、促进两性健康公平提供参考依据。方法 利用2015年中国健康与养老追踪调查（China health and retirement longitudinal study,CHARLS）数据库中抑郁相关数据进行Fairlie分解,分析农村老年人抑郁现状及性别差异。结果 农村老年人抑郁患病率为39.09%,女性高于男性（47.82% vs 32.43%）,差异有统计学意义（χ²=97.05,P<0.001）。多因素回归分析表明,地域、睡眠时长、日常生活能力（activity of daily living,ADL）、自评健康、疼痛是男女两性抑郁的共同影响因素,婚姻状况、社会活动是男性抑郁的影响因素。Fairlie分解结果显示,农村老年人抑郁性别差异中的72.06%是可观测因素造成的,另外27.94%是性别属性造成的。结论 农村老年男性抑郁患病率低于老年女性。生活方式、生理健康、疼痛是造成农村老年人抑郁性别差异的主要因素。     

Anthropometric measurements in the elderly: age and gender differences

In clinical practice and epidemiological surveys, anthropometric measurements represent an important component of nutritional assessment in the elderly. The anthropometric standards derived from adult populations may not be appropriate for the elderly because of body composition changes occurring during ageing. Specific anthropometric reference data for the elderly are necessary. In the present study we investigated anthropometric characteristics and their relationship to gender and age in a cross-sectional sample of 3,356 subjects, randomly selected from an elderly Italian population. In both sexes, weight and height significantly decreased with age while knee height did not. The BMI was significantly higher in women than in men (27.6 SD 5.7 v. 26.4 SD 3.7; P<0.001) and it was lower in the oldest than in the youngest subjects (P<0.05) of both genders. The 75th year of age was a turning point for BMI as for other anthropometric measurements. According to BMI values, the prevalence of malnutrition was lower than 5 % in both genders, whereas obesity was shown to have a higher prevalence in women than in men (28% v. 16%; P<0.001). Waist circumference and waist: hip ratio values were higher for the youngest men than for the oldest men (P<0.05), whereas in women the waist: hip ratio values were higher in the oldest women, suggesting that visceral redistribution in old age predominantly affects females. In conclusion, in the elderly the oldest subjects showed a thinner body frame than the youngest of both genders, and there was a more marked fat redistribution in women.     

The nutritional status of frail elderly with care needs according to the mini-nutritional assessment

BACKGROUND AND AIMS: Although malnutrition is common in the geriatric population, the relationship between frail elderly with various care needs and nutritional status remains unknown. The purpose of this study was to analyze the association between subjects with higher care needs and poorer nutritional status in the Japanese community-dwelling frail elderly. METHODS: A total of 281 community-dwelling elderly subjects from day-care centers (81.9+/-7.2yr of age mean+/-SD; 72 men and 209 women) who were eligible for Long-Term Care Insurance were enrolled in this study to evaluate their nutritional status using the mini-nutritional assessment. The levels of care needs of participants were classified into six levels according to the Long-Term Care Insurance program. RESULTS: According to the mini-nutritional assessment classification, 39.9%, 51.2%, and 8.9% of the participants were assessed as well-nourished, at-risk of malnutrition, and malnourished, respectively. There were significant differences among the six groups with regard to the nutritional status; subjects with higher care needs were associated with poorer nutritional status. In the higher care needs group, more than half of the subjects did not know their weight change during 3-month intervals. CONCLUSIONS: The population of elderly with higher care needs in the community is associated with a higher prevalence of malnutrition.     

Iron status of the Taiwanese elderly: the prevalence of iron deficiency and elevated iron stores

Iron status, prevalence of iron deficiency and elevated iron stores, and the effect of gastrointestinal ulceration on iron status in free-living Taiwanese elderly persons were all assessed in a nationally representative, cross-sectional nutrition survey--the Elderly NAHSIT. The survey included blood measurements of iron indices. Data were collected from 1202 elderly men and 1152 elderly women aged 65 years and older. Multiple iron measures, including serum ferritin (SF), transferrin saturation (Tsat), and hemoglobin were used to evaluate the prevalence of iron deficient erythropoiesis (ID) and iron deficiency anemia (IDA). Despite no routine practice of iron fortification in Taiwan, elderly subjects had a low prevalence of ID and IDA. The prevalence of ID was 2.3% in men and 1.4% in women. The prevalence of IDA was 2.5% in men and 2.0% in women. In contrast, 15.7% of men and 9.8% of women had elevated iron stores as diagnosed by SF>300 microg/L. Subjects with a history of gastrointestinal ulceration had significantly lower serum ferritin than those without ulcers, but the prevalence of anemia, ID and IDA was unaffected. In conclusion, elderly people in Taiwan are an iron-replete population with a high prevalence of elevated iron stores and a low prevalence of iron deficiency.     

Nutritional status of the elderly in Naples

Nutritional status (anthropometry, food habits, thiamin and riboflavin status) has been evaluated in 136 (70 males and 66 females) free living healthy elderly individuals (age range 65-69 yrs) from the district of San Carlo Arena that can be considered representative of the sociocultural and economic level of the city of Naples. By assuming as reference values those of middle aged individuals, 50 percent of elderly men and 85 percent of elderly women showed different degree of excess body fat. As far as food habits are concerned legumes, vegetables and fruit daily intake was quite high whilst alcohol consumption was low. Furthermore milk and eggs intake was low and infrequent. Although prevalence of excess body weight was high, total daily energy intake was found to be equal or slightly above dietary recommendations for the elderly. Diet composition showed a high protein intake whilst CHO and fat intake was slightly below recommendations. Micronutrients' intake was insufficient for calcium in 10 percent of both males and females and for iron in 20 percent of men and 40 percent of women. Niacin intake was low in about 50 percent of both men and women. Thiamin nutritional status was found low in 20 percent of men and women and riboflavin status in 40 percent of men and 20 percent of women. In conclusion obesity and overweight are very frequent in an urbanized sample of free living healthy elderly individuals of Naples. On the other hand serum calcium and iron and some vitamin deficiency is not uncommon. The composition of the diet seems to be also poor in some micronutrients.     

Relationship between Appetite, Food Intake and Body Composition among Elderly Malays from an Urban Residential Area in Kuala Lumpur, Malaysia

Loss of appetite, decrease in food intake and changes in body composition appear to be inter-related factors that can influence the well-being of older individuals. Therefore, a study was conducted to determine the level of appetite, food intake and its relation to body composition and functional status among noninstitutionalised elderly Malays in Cheras, Kuala Lumpur. The Council on Nutrition Appetite Questionnaire (CNAQ), Diet History Questionnaire (DHQ), Bio-impedance Analysis (BIA) and Instrumental Activity of Daily Living (IADL) questionnaire and handgrip dynamometer were used to measure appetite, food intake, body composition and functional status respectively. A total of 112 subjects (41.1% men and 58.9% women) participated with mean age being 66.0 ± 5.0 years for men and 66.3 ± 6.2 years for women. Prevalence of poor appetite was higher in elderly women (72.3%) than in men (52.3%) (p<0.05). Pearson's correlation test showed that CNAQ score correlated significantly with age (r=-0.255, p<0.01), energy intake (r=0.272, p<0.01), IADL score (r=0.408, p<0.01) and handgrip strength (r=0.263, p<0.05). Energy intake correlated significantly with fat free mass (r=0.424, p<0.05), muscle mass (r=0.456, p<0.05) and total body water (r=0.403, p<0.05). Multiple regression analysis showed that 27.0% of poor appetite could be explained by advanced age, low energy intake and decreased functional status. In conclusion, the study showed that poor appetite was prevalent among the subjects, especially women and this was influenced by aging, inadequate energy intake and decreased functional status.     

Correlation of anthropometric parameters and blood-pressure in elderly people

INTRODUCTION: The elderly represent a growing segment of populations in developed and also in developing countries. Anthropological measurements offer a cheap and easy way method for assessment of health and nutritional status and in prediction for mortality. Anthropological parameters and their relation to blood pressure were studied in elderlies. METHODS: Two hundred-thirteen elderly people (83 men over 65 y and 110 women over 60 y) were involved. The weight, height, waist- and hip circumferences were measured and waist: hip ratio, and body mass index (BMI) were calculated. Blood pressure was measured by the use of sphygmomanometer. Hypertension was diagnosed when systolic blood pressure was >/= 140 and/or diastolic >/= 90 mmHg. The SPSS 10 version for Windows was used for statistical analysis. RESULTS: According to the BMI, 72% of men and 65% women were considered overweight or obese. According to waist circumference 51% of men and 83% of women belonged to the high risk group. Under 80 y the mean blood pressure was in the pathological range both in the case of men and women. That could be considered as a sign of the insufficient efficiency of treatment or bad compliance. By 60% of this elderly population hypertension was registered. 75% of people, considered overweight or obese according to BMI, showed hypertension. According to the waist circumference, in 73% of people in the high risk group hypertension was detected versus 6% of persons in the non-risk group. This relation could not be observed in women. CONCLUSION: The prevalence of obesity and overweight is higher in the elderly group than in the younger adult population. Decrease in body mass may be suggested only by cautious nutritional intervention, control of systolic blood pressure should be more regular and prudent.     

Nutritional status of the adult population in Niterói, Rio de Janeiro, Brazil: the nutrition, physical activity, and health survey

A household survey was conducted to assess the nutritional status of the adult population in Niterói, Rio de Janeiro, Brazil. In the selected households, all adults (>or= 20 years) had their body mass and stature measured. Body mass index (BMI) was used to determine the nutritional status according to the World Health Organization classification. The population estimates showed low prevalence of underweight (BMI < 18.5kg/m(2)), while 45.8% of women and 49.6% of men were overweight/obese (BMI >or= 25kg/m(2)). Obesity prevalence varied from 5.6% to 19.3% in men and from 9.6% to 21.3% in women, according to age. The prevalence of overweight/obesity was not associated with income (in either men and women) or schooling (in men), but there was an inverse relationship between schooling and overweight/obesity in women. The prevalence of underweight decreased with increasing mean income in the census enumeration area. The authors conclude that overweight/obesity is the most prevalent nutritional disorder in both men and women in Niterói. This pattern resembles recent results for the adult population in Southeast Brazil as a whole, where Niterói is located.     

Nutritional status of social groups in greater metropolitan São Paulo, Brazil

This paper focuses on prevalence of nutritional status (Body Mass Index, BMI) in social groups in greater metropolitan S?o Paulo, in Southeastern Brazil. The population was stratified in four socioeconomic groups. Prevalence of malnutrition (BMI<18.5kg/m2), low body mass (BMI<20.0kg/m2), and overweight (BMI>25.0kg/m2) and obesity (BMI(30.0kg/m2) were calculated. Prevalence of malnutrition was 3.9% in men and 6.2% in women. Prevalence of overweight ranged from 27.5% to 34.1% in men and from 25.8% to 43.6% in women. Obesity ranged from 2.5% to 11.1% in men and from 7.1% to 20.5 in women. Prevalence of overweight and obesity was greater among women than men (p<0.01). In relation to excess weight (BMI>25.0kgm/2), the study showed that prevalence in men was 43, 51, 35, and 30% for strata I, II, III, and IV, respectively. Among women, prevalence was 12, 61, 55 and 46% for strata I, II, III, and IV, respectively. In women there were an abrupt increase in excess weight just before 40 years of age. A high percentage of overweight and obesity was observed in all population groups.     

Nutrition and aging: dietary intake of “apparently healthy” elderly (Dutch Nutrition Surveillance System).

The dietary intake (assessed through dietary history) of 539 apparently healthy, independently living elderly aged 65-79 years, was evaluated in a nationwide random sample. Except for pyridoxine, the intake of vitamins, minerals, and water was adequate according to the Dutch recommended dietary allowances. Fat intake (40 energy%) as well as P/S ratio (0.41) was assessed as being unfavorable, whereas the intake of vitamin B6 was marginal. The prevalence of obesity was higher among the women, while food selection was healthier as reflected in the higher nutrient density than among the men. Food consumption of elderly men (26%) and women (33%) on a dietary regimen was more prudent and nutrient density higher than among the elderly not on a diet. Our results are in accordance with previous food consumption studies among elderly in The Netherlands, but differ substantially from dietary intake figures for American elderly. Although the intake of energy and nutrients was lower among elderly men than among younger men, we conclude that age per se is not an important determinant of dietary intake among Dutch apparently healthy elderly aged 65-79 years.     

Prevalence of thiamin and riboflavin deficiency among the elderly in Taiwan

The purpose of this study was to perform biochemical assessments of the nutritional status of thiamin and riboflavin in the 2379 elderly persons (1213 males, 1166 females) participating in the Elderly Nutrition and Health Survey in Taiwan (1999-2000) (Elderly NAHSIT). Through analysis of the data we aimed to investigate possible factors related to the prevalence of vitamin deficiency. Activity coefficients of erythrocyte transketolase and glutathione reductase (ETKAC and EGRAC) were the chosen biochemical indicators for thiamin and riboflavin status. The results showed that 14.7% of men and 11.9% of women were marginally thiamin deficient, and 16.5% of men and 14% of women were thiamin deficient. The prevalence rates of marginal riboflavin deficiency were 25.7% for males and 20.1% for females, and the deficiency rates were 6.6% for elderly males and 4.1% for elderly females. Although the average dietary thiamin and riboflavin intakes reached 146%-164% of Taiwan RDAs, the percentage of senior citizens whose thiamin or riboflavin dietary intakes were less than EARs (equivalent to 83.3% of RDAs) was around 30% for males and 40% for females. Some contributing factors to the significant prevalence of thiamin and riboflavin deficiencies are discussed in this article.     

Population-specific anthropometric cut-points improve the functionality of the Mini Nutritional Assessment (MNA) in elderly Taiwanese

The objective of this study was to determine the population-specific cut-points of body mass index (BMI), mid-arm circumference (MAC) and calf circumference (CC) for identifying subnormal nutritional status in elderly Taiwanese, and to evaluate the possibility of improving the functionality of the Mini Nutritional Assessment (MNA) by adopting these cut-points. This study analyzed data from 1583 men and 1307 women, 65 years or older, of a national survey. The survey involved in-home, face-to-face, interviews and anthropometric measurements. Results showed that based on the cumulative percentile curves, the fifth percentile values were: BMI, 17 kg/m2 for both men and women; MAC, 22.5 cm for men and 21 cm for women; and CC, 28 cm for men and 25 cm for women. Substitution of these population-specific cut-points for respective values in the MNA screen resulted in lowered proportions of elderly classified malnourished or at risk of malnutrition. The prevalence of malnutrition was reduced from 1.7% to 1.4% in men and from 2.4% to 1.5% in women. The proportions classified at risk of malnutrition were reduced from 10.1% to 8.9% for men and 16.8% to 12.8% for women. In conclusion, results suggest that the MNA is a valuable tool for geriatric nutritional risk assessment. However, in populations where significant differences exist in anthropometric measurements from the Caucasian populations, population-specific cut-points should be used.     

Anthropometric profile of the elderly Brazilian population: results of the National Health and Nutrition Survey, 1989

This paper presents the nutritional status of the elderly Brazilian population (60 years and older) based on a probabilistic sample survey in 1989. Nutritional assessment used the BMI (kg/m2), with cut-off points recommended by the WHO (1995). Socio-demographic variables included age, gender, region and place of residence in the country (urban/rural area), income, education, and housing conditions. Prevalence rates for thinness (BMI < 18.5) and overweight (BMI ( 25) were 7.8% and 30.4% in men and 8.4% and 50.2% in women, higher than in the young adult population. Thinness was more frequent in older women, in rural areas from the Midwest/Northeast regions (women) and Southeast/Midwest (men), in groups with lower income, less schooling, and worse housing conditions. Overweight was more frequent in women from urban areas in the South and Southeast and groups with higher income, more schooling, and better housing conditions. The results indicate problematic nutritional status in the Brazilian elderly, particularly women.     

Effect of indoor air pollution from biomass combustion on prevalence of asthma in the elderly

In this study I examined the effect of cooking smoke on the reported prevalence of asthma among elderly men and women greater than or equal to 60 years old). The analysis is based on 38,595 elderly persons included in India's second National Family Health Survey conducted in 1998-1999. Effects of exposure to cooking smoke, ascertained by type of fuel used for cooking (biomass fuels, cleaner fuels, or a mix of biomass and cleaner fuels), on the reported prevalence of asthma were estimated using logistic regression. Because the effects of cooking smoke are likely to be confounded with effects of age, tobacco smoking, education, living standard, and other such factors, the analysis was carried out after statistically controlling for such factors. Results indicate that elderly men and women living in households using biomass fuels have a significantly higher prevalence of asthma than do those living in households using cleaner fuels [odds ratio (OR) = 1.59; 95% confidence interval (95% CI), 1.30-1.94], even after controlling for the effects of a number of potentially confounding factors. Active tobacco smoking was also associated with higher asthma prevalence in the elderly, but not environmental tobacco smoke. Availability of a separate kitchen in the house and a higher living standard of the household were associated with lower asthma prevalence. The adjusted effect of cooking smoke on asthma was greater among women (OR = 1.83; 95% CI, 1.32-2.53) than among men (OR = 1.46; 95% CI, 1.14-1.88). The findings have important program and policy implications for countries such as India, where large proportions of the population rely on polluting biomass fuels for cooking and space heating. More epidemiologic research with better measures of smoke exposure and clinical measures of asthma is needed to validate the findings.