Vanhuksen vajaaravitsemuksen arviointi, ehkäisy ja hoito

Vanhuksilla vajaaravitsemus on yleisintä sairaalassa ja ympärivuorokautisessa hoidossa. Vanhusten vajaaravitsemuksen ja sen riskin seulonnan ja arvioinnin validoitu mittari on Mini Nutritional Assessment (MNA). Syiden ja taustatekijöiden arvioinnin tulisi olla kokonaisvaltaista. Vajaaravitsemusta ehkäistään ja hoidetaan ravitsemusneuvonnalla sekä tehostetulla ravitsemushoidolla.</div

Koronarajoitusten yhteys omaishoitajien kokemaan terveyteen ja elämänlaatuun

Koronapandemian aikaiset rajoitustoimet muuttivat merkittävästi omaishoitajien saamia tukipalveluita. Pandemia vaikeutti omaishoitajien arkielämän sujumista sekä aiheutti epävarmuutta omasta ja hoidettavan terveydestä. Tämän tutkimuksen tarkoituksena oli kuvata omaishoitajien kokemaa terveydentilaa ja elämänlaatua sekä itsearvioitua fyysistä ja psyykkistä terveyttä koronapandemian aikana. Aineistona olivat Suomessa täysi-ikäistä henkilöä hoitavien omaishoitajien (n=234) vastaukset Eurocarersin ja Italian National Institute of Health and Science on Ageing (INRCA) -tutkimuslaitoksen kyselyaineistosta. Aineisto kerättiin verkkokyselyllä marraskuun 2020 ja maaliskuun 2021 välisenä aikana. Aineisto analysoitiin kuvailevilla tilastollisilla menetelmillä ja binäärisellä logistisella regressioanalyysilla. Omaishoitajan päivittäinen kanssakäyminen vain hoitamansa henkilön kanssa oli yhteydessä omaishoitajan heikentyneeseen fyysiseen kuntoon, psyykkiseen hyvinvointiin, yleiseen terveydentilaan ja elämänlaatuun. Omaishoitajan kokema vapauden puute oli yhteydessä heikentyneeseen psyykkiseen hyvinvointiin ja elämänlaatuun. Lisäksi hoidettavan sosiaali- ja terveyspalvelujen keskeytyminen oli yhteydessä omaishoitajan heikentyneeseen psyykkiseen hyvinvointiin. Koronapandemian vaikutukset ovat olleet omaishoitajille monitahoisia, ja nämä vaikutukset tulee ottaa huomioon tukitoimien suunnittelussa. The effects of COVID-19 restrictions on family caregivers’ self-reported health and quality of life The COVID-19 pandemic has caused uncertainty for family caregivers and practical difficulties in everyday life. Therefore, this research assesses the experiences of family caregivers on their health and quality of life during the pandemic in Finland. The study included family caregivers caring for an adult (n=234). Data were collected from November 2020 to March 2021 through a web-based survey created by Eurocarers in collaboration with the Italian National Institute of Health and Science on Ageing. The data were analyzed with binary logistic regression analysis. Family caregivers’ daily contact only with their care recipient predicted caregivers’ impaired physical condition, psychological well-being, general health, and quality of life. In addition, the lack of freedom experienced by the family caregiver was associated with impaired psychological well-being and quality of life. Consequently, the effects of the pandemic have been multi-layered for family caregivers, which must be considered when planning support measures

Is Loneliness Associated with Malnutrition in Older People?

The aim of this study was to assess the possible relationship between loneliness and malnutrition among older people. The data were collected as part of the Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) study. A randomly selected sample (n = 573) of persons 75 years and older was included in the study. Nutritional status was screened with the Mini Nutritional Assessment (MNA). The individuals were classified into two groups, based on their MNA score: (1) well-nourished (i.e., MNA score ≥ 24) or (2) risk of malnutrition/malnutrition (i.e., MNA score < 24). Frequent feelings of loneliness (odds ratio = 1.63; 95% confidence interval, 1.09–2.45] and low Mini-Mental State Examination scores (odds ratio, 1.18; 95% confidence interval, 1.14–1.23) were associated with the risk of malnutrition/malnutrition. We concluded that subjective feelings of loneliness and cognitive impairment were associated with the risk of malnutrition/malnutrition

Lack of freedom predicted poor self‐reported health among family caregivers of children with disabilities during the COVID‐19 pandemic in Europe

Abstract Aim We aim to assess the effects of the COVID‐19 pandemic on self‐reported health and quality of life among family caregivers of children with disabilities across Europe. Design Cross‐sectional study. Methods Data from the survey by the Eurocarers and IRCCS‐INRCA were used. The data were collected between November 2020 and March 2021 from 16 European countries. Data analysis was done using regression analysis to identify family caregivers' self‐reported health and well‐being predictors. Results This study included 289 caregivers. The mean age of children was 12 years. Their family caregiver's mean age was 44, and they were mainly women. Experience of lack of freedom predicted family caregivers' poor self‐reported health and quality of life. Children's interrupted health and social services also predicted family caregivers' poor self‐reported mental well‐being. Longitudinal evidence on the pandemic's effects and a diverse view of family caregivers of children with disabilities are needed to plan effective post‐pandemic health services and nursing practice. No Patient or Public Contribution

Prevalence and risk factors of frailty among home care clients

Abstract Background Frailty is a common problem among older people and it is associated with an increased risk of death and long-term institutional care. Early identification of frailty is necessary to prevent a further decline in the health status of home care clients. The aims of the present study were to determine the prevalence of frailty and associated factors among 75-year-old or older home care clients. Methods The study participants were 75-year-old or older home care clients living in three cities in Eastern and Central Finland. Home care clients who had completed the abbreviated Comprehensive Geriatric Assessment (aCGA) for frailty (n = 257) were included in the present study. Baseline data were obtained on functional status, cognitive status, depressive symptoms, self-rated health, ability to walk 400 m, nutritional status, drug use and comorbidities. Results Most of the home care clients (90%) were screened for frailty using the aCGA. Multivariate analysis showed that the risk of malnutrition or malnutrition (OR = 4.27, 95% CI = 1.56, 11.68) and a low level of education (OR = 1.14, 95% CI = 1.07, 1.23) were associated with frailty. Conclusion Frailty is a prevalent problem among home care clients. The risk of malnutrition or malnourishment and a lower level of education increase the risk of frailty. Screening for frailty should be done to detect the most vulnerable older people for further intervention to prevent adverse health problems. Trial registration ClinicalTrials.gov: NCT02214758

Prevalence and risk factors of frailty among home care clients

Abstract Background Frailty is a common problem among older people and it is associated with an increased risk of death and long-term institutional care. Early identification of frailty is necessary to prevent a further decline in the health status of home care clients. The aims of the present study were to determine the prevalence of frailty and associated factors among 75-year-old or older home care clients. Methods The study participants were 75-year-old or older home care clients living in three cities in Eastern and Central Finland. Home care clients who had completed the abbreviated Comprehensive Geriatric Assessment (aCGA) for frailty (n = 257) were included in the present study. Baseline data were obtained on functional status, cognitive status, depressive symptoms, self-rated health, ability to walk 400 m, nutritional status, drug use and comorbidities. Results Most of the home care clients (90%) were screened for frailty using the aCGA. Multivariate analysis showed that the risk of malnutrition or malnutrition (OR = 4.27, 95% CI = 1.56, 11.68) and a low level of education (OR = 1.14, 95% CI = 1.07, 1.23) were associated with frailty. Conclusion Frailty is a prevalent problem among home care clients. The risk of malnutrition or malnourishment and a lower level of education increase the risk of frailty. Screening for frailty should be done to detect the most vulnerable older people for further intervention to prevent adverse health problems. Trial registration ClinicalTrials.gov: NCT02214758

Far from easy and accurate - detection of metabolic syndrome by general practitioners

Abstract Background Metabolic syndrome (MetS) is a major public health challenge. General practitioners (GPs) could play a key role in its recognition. However, it often remains undiagnosed in primary care. This study assesses how well GPs and patients recognise MetS among patients with coronary heart disease or at least one of its risk factors. Methods Twenty-six health centres around Finland were randomly selected for the purpose of identifying, over a two-week period in April 2005, patients meeting the inclusion criteria of coronary heart disease or one of its risk factors. GPs and identified patients (n = 1880) were asked to complete surveys that included a question about the patient's MetS status. A trained nurse conducted health checks (n = 1180) of the identified patients, utilising criteria of MetS modified from the National Cholesterol Program. Data from the GPs' survey were compared with those from the health check to establish the extent of congruence of identification of MetS. Results Almost half (49.4%) of the patients met the criteria of MetS as established by objective measures. However, in the GPs' survey responses, only 28.5% of the patients were identified as having MetS. Additionally, these groups of MetS patients were not congruent. The sensitivity of the GPs' diagnosis of MetS was 0.31 with a specificity of 0.73. Only 7.1% of the study patients stated that they were suffering from MetS. Conclusion Detection of MetS is inaccurate among GPs in Finland. Most patients were not aware of having MetS. The practical relevance of MetS in primary care should be reconsidered.</p

Effects of individual dietary counseling as part of a comprehensive geriatric assessment (CGA) on frailty status: A population-based intervention study

AbstractBackground/PurposeIn this study, our aim was to evaluate the effects of individual dietary counseling as part of a comprehensive geriatric assessment (CGA) on frailty status among community-dwelling people aged 75 years or older.MethodsData were obtained from a subpopulation of participants in the population-based Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) intervention study in 2004 to 2007. In the present study, the population consisted of 159 persons at risk of malnutrition in the year 2005 in an intervention and a control group. Nutritional status was assessed with the Mini Nutritional Assessment (MNA). Frailty was defined according to the five frailty criteria used in the Cardiovascular Health Study (CHS). Assessment of nutritional status and frailty status was performed at the beginning of the study and at 1-year follow-up.ResultsAt baseline the mean age of the 159 community-dwelling participants with risk of malnutrition was 83 years and 126 (79%) of them were female. The proportions of frail and pre-frail persons were 25% (n = 19) and 61% (n = 47) in the intervention group, and 26% (n = 21) and 61% (n = 50) in the control group. After the 1-year nutritional intervention, compared to the control group, the intervention group tended to have a better outcome of frailty and MNA (OR = 1.89, 95% CI: 1.08–3.54, OR = 2.61, 95% CI: 1.67–5.56, respectively) and was less likely to deteriorate as assessed with MNA (OR = 0.23, 95% CI: 0.14–0.87). In multivariate analysis, change in MNA (OR = 1.12, 95% CI: 1.03–1.31) was associated independently with improved frailty status.ConclusionIt appears that multidisciplinary geriatric assessment including individual dietary counseling has a positive effect on frailty status. More emphasis on good nutrition in the older population might have a preventive effect on the incidence of frailty