High degree of BMI misclassification of malnutrition among Swedish elderly population: Age-adjusted height estimation using knee height and demispan.

Background/Objectives:The degree of misclassification of obesity and undernutrition among elders owing to inaccurate height measurements is investigated using height predicted by knee height (KH) and demispan equations.Subjects/Methods:Cross-sectional investigation was done among a random heterogeneous sample from five municipalities in Southern Sweden from a general population study 'Good Aging in Skåne' (GÅS). The sample comprised two groups: group 1 (KH) including 2839 GÅS baseline participants aged 60-93 years with a valid KH measurement and group 2 (demispan) including 2871 GÅS follow-up examination participants (1573 baseline; 1298 new), aged 60-99 years, with a valid demispan measurement. Participation rate was 80%. Height, weight, KH and demispan were measured. KH and demispan equations were formulated using linear regression analysis among participants aged 60-64 years as reference. Body mass index (BMI) was calculated in kg/m(2).Results:Undernutrition prevalences in men and women were 3.9 and 8.6% by KH, compared with 2.4 and 5.4% by standard BMI, and more pronounced for all women aged 85+ years (21% vs 11.3%). The corresponding value in women aged 85+ years by demispan was 16.5% vs 10% by standard BMI. Obesity prevalences in men and women were 17.5 and 14.6% by KH, compared with 19.0 and 20.03% by standard BMI. Values among women aged 85+ years were 3.7% vs 10.4% by KH and 6.5% vs 12.7% by demispan compared with the standard.Conclusions:There is an age-related misclassification of undernutrition and obesity attributed to inaccurate height estimation among the elderly. This could affect the management of patients at true risk. We therefore propose using KH- and demispan-based formulae to address this issue.European Journal of Clinical Nutrition advance online publication, 10 September 2014; doi:10.1038/ejcn.2014.183

Coming-Out to Family Members and Internalized Sexual Stigma in Bisexual, Lesbian and Gay People

Coming out has been described as an essential component in the lesbian, gay, and bisexual identity development process and in the mental health of sexual minority people. This study investigated the coming out to family members in lesbian, gay, and bisexual people and analyzed the potential predictors associated to the choice to come out. For this purpose, disclosure of sexual orientation to family members, internalized sexual stigma (evaluated through an adapted short version of the internalized sexual stigma for lesbians, gay men, and bisexual people, measure of the internalized sexual stigma for lesbians, gay, and bisexual), gender, age, sexual orientation, background information, current romantic relationship and the wealth of social network with sexual minority people were assessed on an Italian sample of 291 adolescents and young adults (206 lesbian/gay men and 85 bisexual people). Hierarchical multiple regression showed that higher scores of coming out to family were associated with gay/lesbian identity, liberal political orientation, higher education level, presence of a stable romantic relationship, higher number of lesbian, gay, and bisexual contacts, and lower levels of internalized sexual stigma. Results suggest that bisexual people encounter major difficulties regarding the coming out to family members, respect to lesbian/gay people and indicate that internalized sexual stigma is strongly associated with concealing one’s sexual orientation. Clinical implications for the present findings are discussed