Body composition in Swedish old people aged 65-99 years, living in residential care facilities
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, SE-901 87 Umeå, Sweden. Archives of gerontology and geriatrics
(Impact Factor: 1.85).
09/2008; 49(1):98-107. DOI: 10.1016/j.archger.2008.05.012
It is important to evaluate body composition changes in subjects with an existing multi-system reduction in capacity, as a small decrease in fat-free mass (FFM) can cause serious impairments. The aim of the study was to describe body composition in old people living in institutions. Body composition data were collected within a study of 173 subjects with functional and cognitive impairment, aged 65-99 years, and living in residential care facilities. A bioelectrical impedance spectrometer (BIS) (Xitron Hydra 4200; 5-1000 kHz) was used to assess the amount of both FFM and fat mass (FM) which where adjusted for height. The Harpenden caliper and a tape measure were used to assess body fat, arm-muscle and arm-fat area (mm(2)). A large proportion of the old and functionally impaired population was at risk of malnutrition or already malnourished (63.4% vs. 17.4%) according to Mini-Nutritional Assessment (MNA). Women had significantly lower fat-free mass index (FFMI) and higher FMI, inversely related to age, than men. Bioelectrical impedance spectroscopy and anthropometrical measurements correlated but on different levels. In addition the FM% differed between the two methods (46.3% vs. 33.4%).
Available from: Ulf Jakobsson
- "Malnutrition is common among nursing home residents all over the world, with recent reports showing a prevalence of 15–40% (Carlsson, Gustafson, Eriksson, & Haglin, 2009; Chan, Lim, Ernest, & Tan, 2010; Diekmann et al., 2013; Verbrugghe et al., 2013). The reported prevalence of malnutrition varies greatly partly due to the different screening tools used to assess nutritional status (Diekmann et al., 2013; van Bokhorst-de van der Schueren, Guaitoli, Jansma, & de Vet, 2014). "
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ABSTRACT: Poor nutritional status is widespread among the elderly and is associated with increased morbidity and mortality. The aim of this study was to longitudinally describe the nutritional status in elderly people living in nursing homes. Nutritional status was recorded longitudinally in elderly people living in 11 different nursing homes in Sweden. Participants were examined at baseline by specially trained nurses who also assisted with questionnaires and collected data for current medical treatment from patient records. Nutritional status was evaluated at baseline and after 24 months with the mini nutritional assessment (MNA). The study included 318 subjects. The mean age of the participants was 85.0 years (range 65–101). At baseline, 41.6% were well nourished, 40.3% at risk of malnutrition, and 17.7% malnourished according to the MNA. Survival was significantly lower in the malnourished group. After 24 months, almost half of the population had died. The group of participants who survived at 24 months represents a population of better nutritional state, where 10.6% were malnourished at baseline increasing to 24.6% after 24 months. After 24 months, 38.7% of the participants showed a decline in nutritional state. The group with deteriorating MNA scores had higher weight, BMI values, and a higher hospitalization rate. The prevalence of malnutrition in nursing home residents increased over time and it is important to evaluate nutritional state regularly. Nutritional interventions should be considered in better nourished groups, as well as in malnourished individuals, to prevent a decline in nutritional state.
Available from: Olof Geirsdottir
- "It is important to evaluate body composition as it has a strong impact on health and disease (Carlsson et al., 2009). "
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ABSTRACT: The aims were (1) to compare fat free mass (FFM) estimates from regional hand-held bioelectrical impedance analysis (HHBIA) with conventional BIA (CBIA) and dual energy X-ray absorptiometry (DXA) and (2) to develop a population specific equation for FFM prediction in Icelandic elderly.
DXA, CBIA and HHBIA data were available for 98 free-living Icelandic elderly (age=73.0 ± 5.6 years, body mass index=28.8 ± 5.2 kg/m(2)). Participants were randomized into a development block (n=50) and validation block (n=48). A population specific equation for FFM prediction was calculated using CBIA-derived resistance and anthropometric data from the development block and then compared with other BIA equations (Deurenberg, Segal, company-specific equations) and DXA estimates using the validation block.
The correlations between BIA methods and DXA were very high, that is, >0.9; however, mean differences compared with DXA were quite variable, ranging from -5.0 (Deurenberg) to +2.5 (Segal, HHBIA) and +3.3 kg (CBIA). Mean difference of the population-specific equation was below 0.1 kg. The standard deviations of the differences ranged from 2.6 to 3.3 kg. The limits of agreement of the BIA methods were similar and between 9.9 and 12.9 kg.
In Icelandic elderly, HHBIA and CBIA produce similar FFM estimates when using company-specific prediction equations. CBIA provides the additional possibility to use a population-specific prediction equation, which yields best results. However, limits of agreement were wide and similar of all employed BIA methods, which indicates principal limitations of BIA analysis in the determination of FFM.
Available from: Sakinah Harith
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ABSTRACT: Malnutrition is a common, potentially serious and frequently undiagnosed condition among hospitalized elderly patients. It is important to determine the magnitude of malnutrition among hospitalized geriatric patients using anthropometric and biochemical indicators. This is a cross-sectional study involving the nutritional assessment of 181 subjects (98 women) aged 65 or older. These subjects were admitted to the Geriatric Ward, University Malaya Medical Centre within 72 hours of admission between April and August 2003. Subjects were assessed for anthropometric (body weight, height, mid upper arm circumference, and calf circumference), and biochemical (serum albumin, hemoglobin, total lymphocyte count and serum cholesterol) malnutrition. Although the majority of subjects had a normal Body Mass Index (BMI), 18.0% were underweight and 37.3% were overweight. 16.0% and 26.0% subjects had muscle wasting as assessed by low mid upper arm circumference (MUAC) and calf circumference (CC) respectively. Biochemical tests indicated that 41.4% subjects had hypoalbuminemia, 39.4% had anemia, and 23.4% had low total lymphocyte count. There were no subjects with low serum cholesterol values on admission. Since malnutrition is prevalent among hospitalized geriatric patients, there is a need to screen elderly patients during admission to ascertain who are at risk of malnutrition in order to improve their health, nutritional status and decrease the length of hospital stay.
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