Malnutrition and its association with functional, cognitive and psychological status among Palestinian older adults in long-term care houses

Older adults often suffer from psychological, functional and health-related diseases. Literature has documented the relationship between, malnutrition with adverse health outcomes. This study aims to examine the relationship between malnutrition with the cognitive, functional and psychological status of older adults living in long-term care houses. The study employed a cross-sectional approach in which 99 participants were included from seven nursing homes in six different cities across the West Bank, Palestine. The nutritional status of older adults was assessed using anthropometric measurements and meal patterns. Malnutrition risk was assessed using Mini Nutritional Assessment; the cognitive function using Mini Mental Status Examination; the functional status using the Activity of Daily Living. Results: A total of 99 participants (45.5%) men and (54.5%) women were included in the final data analysis. The results revealed 47% of the participants were at risk of malnutrition, while 23% were malnourished. Variables that were significantly associated with malnutrition; male gender, higher score of depressive symptoms, and impaired cognitive function, p < .05 using chi square test. However, number of meals and hours of overnight fasting were not associated with being malnourished. Greater dependency level was associated with high risk of malnutrition, p < .05 using One Way ANOVA test. Conclusion: Risk of malnutrition was common among the study sample, and it was associated with impaired cognitive, psychological and functional status. Hence, there is a need to provide older adults living in long-term care houses with health programs to enhance their overall health and decrease the level of dependency. These findings are important to design educational programs targeting the stakeholders in the long-term care facilities to improve the residents' nutritional and functional status

Determinants and indicators of successful aging as a multidimensional outcome: a systematic review of longitudinal studies

Background: Successful aging (SA) has been coined as a term to describe the multidimensional aspects associated with achieving optimal combination of physical and mental health along with social well-being health, mental and social well-being at older age. In recent years there has been an increased interest in understanding the role of determinants of SA, such as demographic, biological, behavioral, psychological and social factors. To synthesize the recent evidence, we conducted a systematic review of longitudinal studies on a range of determinants and indicators of SA defined as a multidimensional outcome. Methods: A systematic search of PubMed, MEDLINE and Web of Science for finding eligible papers published between August 2016 and June 2023 was conducted following the Preferred Reporting Items for a Systematic Review and Meta-Analysis (PRISMA) guidelines. The review protocol was registered in PROSPERO International Prospective Register of Systematic Reviews (Registration number: CRD42021250200). The web-based automated screening tool–Rayyan–was used for title and abstract screening. The study quality was assessed using the Quality in Prognosis Studies (QUIPS) tool. Results: A total of 3,191 records were initially identified using the predefined search strategy. Out of 289 articles selected for full text screening, 22 were found eligible and included in the review. A variety of factors have been explored in relation to SA, ranging from socio-demographic factors, nutrition, lifestyle, biological pathways, psychological health, and well-being. Overall, the results of recent studies have confirmed the role of metabolic health, adherence to healthy dietary patterns, such as the Mediterranean diet, physical activity, non-smoking, and higher socio-economic status as main factors associated with higher odds for SA. Emerging research highlights the role of psycho-social factors and early life health as determinants of SA. Conclusion: In summary, this review highlights the importance of healthy living and monitoring metabolic risk along with sustaining psychological well-being in adult life as major determinants of SA. Further methodological and research work on SA would pave the way toward development of adequate health promotion policies in aging societies

Blood inflammatory markers, anabolic hormone, vitamin D and L-carnitine status according to frailty status among older adults

Frailty is associated with functional decline and reduced ability to cope with physiological challenges. The pathophysiological changes in frailty include inflammation, endocrine disturbances, neuromuscular and immune dysfunction. However, comprehensive information on the relationship between biological markers and frailty is scarce. We aimed to determine the relationship between selected biomarkers and frailty among Malaysian older adults. In this cross sectional study, 600 community dwelling older adults were randomly selected from ten different areas in Klang Valley. A total of 382 participants met the inclusion criteria and consented to the study. Out of these, a subsamples of 91 participants were selected for biomarkers analysis. Frailty was defined using Fried’s criteria. Fasting blood glucose, lipid profile, albumin, selected frailty biomarkers including IL-6, TNF- alpha and IGF-1 and vitamin D together with free L-carnitine and acetyl L-carnitine were analysed. The results showed a significantly higher level of serum IL-6 and TNF-α among participants classified as frail as compared to pre-frail and robust (p<0.05). With respect to nutritional biomarkers, binary logistic regression showed that vitamin D deficiency is associated with three times higher risk of frailty (p<0.05). There was no significant relationship between blood L-carnitines and frailty. Further research is required to explore the relationship between L-carnitine and frailty using different parameters involved in L-carnitine homeostasis such as CPTII enzyme and OCTN2 mutation. In conclusion, frailty was associated with increased level of inflammatory markers and vitamin D deficiency. It is empirical to promote healthy lifestyle or disease management to reduce inflammation and increase vitamin D status as one of the frailty prevention action plan among older adults

Risk Factors of Subjective Cognitive Decline among Older People with Low Socioeconomic Status

The aim of the study is to investigate the predictors associated with Subjective Cognitive Decline (SCD)especially among older people with low socioeconomic status. This was a cross- sectional study involving older people with low socioeconomic status in Kelantan, which is one of the poorest states in Malaysia. Data of anthropometry, body composition, cognitive function, sarcopenia, depressive symptoms, medical history, blood pressure and polypharmacy were obtained via face-to-face interview. SCD was determined by a single item in the Geriatric Depression Scale (GDS). Variables were analysed using the binary logistic regression model for identification of risk factors. A total of 293 older people with mean age of 69.1 years old was recruited. The SCD proportion in this study was 24.6%. One unit increase in Geriatric Depression Scale (GDS) score increases risk of subjective cognitive decline by odds of 1.814 (OR=0.595: 95% CI:1.441–2.283; p<0.001). Meanwhile, those with diabetes have a tendency of 2.972 to have SCD as compared to non-diabetics (OR=1.089: 95% CI:1.062–8.315; p<0.038). The prevalence of SCD in this study is high and may contribute to cognitive impairment. The predictors of SCD were larger waist circumference, having diabetes, and increasing score in GDS. SCD must be screened earlier and healthy lifestyle must be emphasized. Routine screening and monitoring of non-communicable disease risk factors are important for the prevention of SCD

Effectiveness of exercise and protein supplementation intervention on body composition, functional fitness, and oxidative stress among elderly Malays with sarcopenia

Sarcopenia, characterized as muscle loss that occurs with aging, is a major health problem in an aging population, due to its implications on mobility, quality of life, and fall risk. Protein supplementation could improve the physical fitness by increasing protein anabolism, and exercise has a documented evidence of positive effect on functional status among the elderly. However, the combined effect of both protein supplementation and exercise has not been investigated among sarcopenic elderly in the Asian population. Thus, this study aimed to determine the effectiveness of exercise intervention and protein supplementation either alone or in combination for 12 weeks, on body composition, functional fitness, and oxidative stress among elderly Malays with sarcopenia. Sixty five sarcopenic elderly Malays aged 60-74 years were assigned to the control group, exercise group (ExG), protein supplementation group (PrG), or the combination of exercise and protein supplementation group. A significant interaction effect between body weight and body mass index (BMI) was observed, with the PrG (-2.1% body weight, -1.8% BMI) showing the highest reductions. Further, there was a decrease in % body fat (-4.5%) and an increase in fat-free mass (kg) (+5.7%) in the ExG after 12 weeks (P < 0.05). The highest increments in lower and upper body strength were observed in the PrG (73.2%) and ExG (47.6%), respectively. In addition, the ExG showed a reduction in superoxide dismutase (SOD) levels, and both interventions did not alter either lipid or protein oxidation. In conclusion, the exercise program was found to improve muscle strength and body composition, while protein supplementation reduced body weight and increased upper body strength, among sarcopenic elderly in Malaysia

Determinants and indicators of successful aging as a multidimensional outcome: a systematic review of longitudinal studies

BackgroundSuccessful aging (SA) has been coined as a term to describe the multidimensional aspects associated with achieving optimal combination of physical and mental health along with social well-being health, mental and social well-being at older age. In recent years there has been an increased interest in understanding the role of determinants of SA, such as demographic, biological, behavioral, psychological and social factors. To synthesize the recent evidence, we conducted a systematic review of longitudinal studies on a range of determinants and indicators of SA defined as a multidimensional outcome.MethodsA systematic search of PubMed, MEDLINE and Web of Science for finding eligible papers published between August 2016 and June 2023 was conducted following the Preferred Reporting Items for a Systematic Review and Meta-Analysis (PRISMA) guidelines. The review protocol was registered in PROSPERO International Prospective Register of Systematic Reviews (Registration number: CRD42021250200). The web-based automated screening tool–Rayyan–was used for title and abstract screening. The study quality was assessed using the Quality in Prognosis Studies (QUIPS) tool.ResultsA total of 3,191 records were initially identified using the predefined search strategy. Out of 289 articles selected for full text screening, 22 were found eligible and included in the review. A variety of factors have been explored in relation to SA, ranging from socio-demographic factors, nutrition, lifestyle, biological pathways, psychological health, and well-being. Overall, the results of recent studies have confirmed the role of metabolic health, adherence to healthy dietary patterns, such as the Mediterranean diet, physical activity, non-smoking, and higher socio-economic status as main factors associated with higher odds for SA. Emerging research highlights the role of psycho-social factors and early life health as determinants of SA.ConclusionIn summary, this review highlights the importance of healthy living and monitoring metabolic risk along with sustaining psychological well-being in adult life as major determinants of SA. Further methodological and research work on SA would pave the way toward development of adequate health promotion policies in aging societies.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021250200, CRD42021250200

Mental illness stigma as a moderator in the relationship between religiosity and help-seeking attitudes among Muslims from 16 Arab countries

Background: Determining the potential barriers responsible for delaying access to care, and elucidating pathways to early intervention should be a priority, especially in Arab countries where mental health resources are limited. To the best of our knowledge, no previous studies have examined the relationship between religiosity, stigma and help-seeking in an Arab Muslim cultural background. Hence, we propose in the present study to test the moderating role of stigma toward mental illness in the relationship between religiosity and help-seeking attitudes among Muslim community people living in different Arab countries. Method: The current survey is part of a large-scale multinational collaborative project (StIgma of Mental Problems in Arab CounTries [The IMPACT Project]). We carried-out a web-based cross-sectional, and multi-country study between June and November 2021. The final sample comprised 9782 Arab Muslim participants (mean age 29.67 ± 10.80 years, 77.1% females). Results: Bivariate analyses showed that less stigmatizing attitudes toward mental illness and higher religiosity levels were significantly associated with more favorable help-seeking attitudes. Moderation analyses revealed that the interaction religiosity by mental illness stigma was significantly associated with help-seeking attitudes (Beta =.005; p \u3c.001); at low and moderate levels of stigma, higher religiosity was significantly associated with more favorable help-seeking attitudes. Conclusion: Our findings preliminarily suggest that mental illness stigma is a modifiable individual factor that seems to strengthen the direct positive effect of religiosity on help-seeking attitudes. This provides potential insights on possible anti-stigma interventions that might help overcome reluctance to counseling in highly religious Arab Muslim communities

Cross-cultural comparison of mental illness stigma and help-seeking attitudes: a multinational population-based study from 16 Arab countries and 10,036 individuals

BackgroundThere is evidence that culture deeply affects beliefs about mental illnesses\u27 causes, treatment, and help-seeking. We aimed to explore and compare knowledge, attitudes toward mental illness and help-seeking, causal attributions, and help-seeking recommendations for mental illnesses across various Arab countries and investigate factors related to attitudes toward help-seeking.MethodsWe carried out a multinational cross-sectional study using online self-administered surveys in the Arabic language from June to November 2021 across 16 Arab countries among participants from the general public.ResultsMore than one in four individuals exhibited stigmatizing attitudes towards mental illness (26.5%), had poor knowledge (31.7%), and hold negative attitudes toward help-seeking (28.0%). ANOVA tests revealed a significant difference between countries regarding attitudes (F = 194.8, p \u3c .001), knowledge (F = 88.7, p \u3c .001), and help-seeking attitudes (F = 32.4, p \u3c .001). Three multivariate regression analysis models were performed for overall sample, as well as Palestinian and Sudanese samples that displayed the lowest and highest ATSPPH-SF scores, respectively. In the overall sample, being female, older, having higher knowledge and more positive attitudes toward mental illness, and endorsing biomedical and psychosocial causations were associated with more favorable help-seeking attitudes; whereas having a family psychiatric history and endorsing religious/supernatural causations were associated with more negative help-seeking attitudes. The same results have been found in the Palestinian sample, while only stigma dimensions helped predict help-seeking attitudes in Sudanese participants.ConclusionInterventions aiming at improving help-seeking attitudes and behaviors and promoting early access to care need to be culturally tailored, and congruent with public beliefs about mental illnesses and their causations

Mental illness stigma as a moderator in the relationship between religiosity and help-seeking attitudes among Muslims from 16 Arab countries

Background: Determining the potential barriers responsible for delaying access to care, and elucidating pathways to early intervention should be a priority, especially in Arab countries where mental health resources are limited. To the best of our knowledge, no previous studies have examined the relationship between religiosity, stigma and help-seeking in an Arab Muslim cultural background. Hence, we propose in the present study to test the moderating role of stigma toward mental illness in the relationship between religiosity and help-seeking attitudes among Muslim community people living in different Arab countries. Method: The current survey is part of a large-scale multinational collaborative project (StIgma of Mental Problems in Arab CounTries [The IMPACT Project]). We carried-out a web-based cross-sectional, and multi-country study between June and November 2021. The final sample comprised 9782 Arab Muslim participants (mean age 29.67 ± 10.80 years, 77.1% females). Results: Bivariate analyses showed that less stigmatizing attitudes toward mental illness and higher religiosity levels were significantly associated with more favorable help-seeking attitudes. Moderation analyses revealed that the interaction religiosity by mental illness stigma was significantly associated with help-seeking attitudes (Beta = .005; p < .001); at low and moderate levels of stigma, higher religiosity was significantly associated with more favorable help-seeking attitudes. Conclusion: Our findings preliminarily suggest that mental illness stigma is a modifiable individual factor that seems to strengthen the direct positive effect of religiosity on help-seeking attitudes. This provides potential insights on possible anti-stigma interventions that might help overcome reluctance to counseling in highly religious Arab Muslim communities

Prevalence, risk factors and psychosocial status of obese and overweight adolescents in Hebron city, Palestine

Background and aims: Obesity and overweight among children and adolescents have caused a prime public health apprehension because they are significantly associated with medical and psychosocial comorbidity. Children with high body mass index often become obese adults, who are at risk of many chronic conditions such as diabetes and cardiovascular disease. It is vital to further examine obesity and overweight in school children and identify their modifiable risk factors. Therefore, this cross-sectional study aims to explore the prevalence of obesity and overweight among Palestinian adolescents in secondary schools, and their relationship with sociodemographic factors, dietary habits, lifestyle, and healthy nutrition awareness. Methods: The participants were randomly selected from four different areas in Hebron city, Palestine. A total sample comprising 392 students, females (51.3%) and males (48.7%), was included in the final analysis. The nutritional status was assessed using anthropometric measurements and dietary habits. Obesity and overweight were defined using World Health Organization–Centers for Disease Control and Prevention sex-specific growth chart for children, aged 2 to 18 years. Anxiety, stress, and depression were assessed using Arabic version of the Depression Anxiety Stress Scales. Results: The results revealed that obesity prevalence was 3.3% and overweight was 13.8% among the students, with no significant association with gender, age, or area of living. Obesity and overweight were significantly associated with lower self-satisfaction (P<0.01). Conclusion: Considerable prevalence levels of obesity and overweight were reported among the study sample. There is a need to promote intervention educational programs to increase students’ awareness on obesity and overweight, and promote healthy diet intake and lifestyle among them