Nutrition, Nutritional State and Related Conditions in Older Adults with Intellectual Disabilities

__Abstract__ Het onderzoek naar voeding en voedingstoestand van oudere mensen met een verstandelijke beperking maakt deel uit van een grote epidemiologische studie naar de gezondheid van ouderen met een verstandelijke beperking: de GOUD studie. In de GOUD-studie is onderzoek gedaan naar het voorkomen van aandoeningen gerelateerd aan een drietal thema's: voeding en voedingstoestand, angst en depressie, en lichamelijke activiteit en fitheid. De belangrijkste conclusies uit het deelonderzoek voeding en voedingstoestand zijn: (1) voor het vaststellen van de voedingstoestand van ouderen met een verstandelijke beperking is op dit moment geen geschikt instrument beschikbaar. De Mini Nutritional Assessment is toepasbaar en betrouwbaar, maar niet valide voor gebruik bij deze populatie. (2) De kwaliteit van voedingsinname van ouderen met een verstandelijke beperking is slecht. 30% van de ouderen met een verstandelijke beperking eet te weinig eiwit en slechts 2% eet voldoende vezels. (3) Aandoeningen die in de algehele populatie gerelateerd zijn aan ondervoeding (slikstoornissen, osteoporose en sarcopenie), komen in de populatie ouderen met een verstandelijke beperking vaker voor in vergelijking met ouderen zonder verstandelijke beperking. Met name mensen met een laag BMI en mensen die rolstoelafhankelijk zijn, hebben een verhoogd risico op deze aandoeningen. Dit onderzoek heeft duidelijk gemaakt dat er meer aandacht moet komen voor gezonde voeding binnen zorginstellingen voor mensen met een verstandelijke beperking. Ook moet er meer gedaan worden aan screening en preventie van aandoeningen gerelateerd aan een slechte voedingstoestand. Tot slot moet er nader onderzoek gedaan worden naar de ontwikkeling van een geschikt instrument om de voedingstoestand van ouderen met een verstandelijke beperking te kunnen meten

Survey of fungal diversity in silages supplied to dairy cattle in Belgium over a two-year period

The fungal diversity in silages for dairy cattle feeding has been assessed by purification and identification of 966 isolates collected in silages during the two 2006 and 2007 winter storage/feed-out periods from farms localized in various geographic regions in Belgium. The relevant fungal species in silos were P. paneum and P. roqueforti (18.2 % and 14.5 % of total isolates, respectively). The proportion between the two species varied significantly from 2006 to 2007 (P<0.05) depending on the type of forage crop. The prevalence of P. paneum in Belgium compared to results in other countries is of major importance due to the mycotoxigenic capacity of this species. Information on numerous aspects of silage making process and silo management showed that neither the crop rotation, the date and weather at harvest, the use of additives, the feeding rate, the type and dimension of silo, the covering used nor the forage chopping length at ensiling could be significantly correlated to the fungal species composition isolated in farm silages. There were also no significant relationships between the chemico-fermentative parameters tested (dry matter, pH, NH3 content, concentration of lactic, acetic and butyric acids) and the fungal species composition in silages. The prevalent fungi were tolerant of the wide ranges of conditions found in the farm silages with year-to-year variations. Survey of Fungal Diversity in Silages Supplied to Dairy Cattle in Belgium Over a Two-Year Period. Available from: https://www.researchgate.net/publication/313255127_Survey_of_Fungal_Diversity_in_Silages_Supplied_to_Dairy_Cattle_in_Belgium_Over_a_Two-Year_Period [accessed Jul 24, 2017]

Eicosapentaenoic acid incorporation in membrane phospholipids modulates receptor-mediated phospholipase C and membrane fluidity in rat ventricular myocytes in culture

The influence of increased incorporation of linoleic acid (18:2n-6) and eicosapentaenoic acid (20:5n-3) in membrane phospholipids on receptor-mediated phospholipase Cβ (PLC-β) activity in cultured rat ventricular myocytes was investigated. For this purpose, cells were grown for 4 days in control, stearic acid (18:0)/oleic acid (18:1n-9), 18:2n-6 and 20:5n-3 enriched media, and subsequently assayed for the basal- and phenylephrine- or endothelin-1-induced total inositol phosphate formation. The various fatty acid treatments resulted in the expected alterations of fatty acid composition of membrane phospholipids. In 18:2n-6-treated cells, the incorporation of this 18:2n-6 in the phospholipids increased from 17.1 mol % in control cells to 38.9 mol %. In 20:5n-3-treated cells, incorporation of 20: 5n-3 and docosapentaenoic acid (22:5n-3) in the phospholipids increased from 0.5 and 2.7 mol % in control cells to 23.2 and 9.7 mol %, respectively. When 20:5n-3-treated cells were stimulated with phenylephrine or endothelin-1, the inositolphosphate production decreased by 33.2% and increased by 43.4%, respectively, as compared to cells grown in control medium. No efffects were seen in 18:2n-6-treated cells. When 18:0/18:1n-9-treated cells were stimulated with endothelin-1, inositolphosphate formation increased by 26.4%, whereas phenylephrine-stimulated inositolphosphate formation was not affected. In saponin-permeabilized cells, that were pre-treated with 20:5n-3, the formation of total inositolphosphates after stimulation with GTPγS, in the presence of Ca2+, was inhibited 19.3%. This suggests that the 20:5n-3 effect on intact cardiomyocytes could be exerted either on the level of agonist-receptor, receptor-GTP-binding-protein coupling or GTP-binding-protein-PLC-β interaction. Investigation of the time course of saponin-induced permeabilization of the cardiomyocytes, measured by the release of lactate dehydrogenase, unmasked a slight decrease in the rate of permeabilization by 20:5n-3 pretreatment, indicating a protective effect. This led the authors to measure the cholesterol/phospholipid molar ratio, the double bond index of membrane phospholipids, and the membrane fluidity; the latter by using a diphenylhexatriene probe. In 20: 5n-3-pretreated cells, a strong increase in the cholesterol/phospholipid molar ratio (from 0.23 to 0.39), a marked increase in the double bond index (from 1.76 to 2.33), and a slight decrease in fluidity (steady-state anisotropy r(ss) of the diphenylhexatriene probe increased from 0.196 to 0.217) were observed. Thus, treatment of cardiomyocytes for 4 days with 20:5n-3, but not with 18:2n-6, causes alterations of receptor-mediated phospholipase Cβ activity. A causal relationship may exist between the 20:5 n-3-induced alterations of the physicochemical properties in the bilayer and of the agonist-stimulated phosphatidylinositol cycle activity

The post-harvest quality of bananas is determined by pre-harvest factors

Anthracnose of bananas, caused by Colletotrichum musae and crown rot of bananas, caused by a broad unspecific parasitic complex; are the most important post-harvest diseases affecting the quality of exported bananas. These diseases develop during fruit transportation, conservation, ripening and marketing. Like for most post-harvest diseases, the control of these diseases relies mainly on post-harvest practices like fungicide applications, cooling, etc... Nevertheless, seasonal and spatial variations in the performance of these practices highly depend on the elaboration of a potential of fruit quality at field level. This potential of fruit quality is constituted by a physiological component (the fruit susceptibility) and a parasitic component (the level of fruit contamination). Recent work has shown the importance of these pre-harvest factors as important determinants of post-harvest quality of bananas. Referring to the parasitic component, it has been shown, in the case of anthracnose, that floral remnants are the main inoculum sources for fruit contamination by Colletotrichum musae, and that most contaminations occur very early in the field, during the first month of bunch emergence. Referring to the physiological component, fruit grown in highland areas are less susceptible to anthracnose and also to crown rot diseases than fruit grown in lowland areas. By another hand, it has been shown that the physiological age of fruit at harvest has also a strong influence on fruit susceptibility to both diseases: the youngest the fruits, the less susceptible. Lastly, the modification of source-sink ratio (leaf or fruit trimming), influences fruit susceptibility to crown rot but has no influence on fruit susceptibility to anthracnose. These results suggest that alternative methods to control these post-harvest diseases of bananas should take into account these pre-harvest factors. (Résumé d'auteur

The application of rules in morphology, syntax and number processing: a case of selective deficit of procedural or executive mechanisms?: Deficit of procedural or executive mechanisms

International audienceDeclarative memory is a long-term store for facts, concepts and words. Procedural memory subserves the learning and control of sensorimotor and cognitive skills, including the mental grammar. In this study, we report a single-case study of a mild aphasic patient who showed procedural deficits in the presence of preserved declarative memory abilities. We administered several experiments to explore rule application in morphology, syntax and number processing. Results partly support the differentiation between declarative and procedural memory. Moreover, the patient's performance varied according to the domain in which rules were to be applied, which underlines the need for more fine-grained distinctions in cognition between procedural rules

Prevalence and associated factors of sarcopenia in older adults with intellectual disabilities

Sarcopenia is defined as a syndrome characterised by progressive and generalised loss of skeletal muscle mass and strength. It has hardly been studied in older people with intellectual disabilities (ID). In this study 884 persons with borderline to profound ID aged 50 years and over, were investigated to determine the prevalence of sarcopenia in this group. To identify the associations of sarcopenia, logistic regression analyses were performed with patient characteristics, mobility, physical activity, intake of energy and proteins, body mass index (BMI) and levels of CRP, albumin and vitamin D in serum. The prevalence of sarcopenia was 14.3% in the total group. In the age group 50-64 years prevalence was 12.7%. Sarcopenia was positively associated with mobility impairment and inflammation and negatively with BMI. The next thing to do is collecting longitudinal data to study the relation between sarcopenia and negative outcomes in older people with ID. (c) 2012 Elsevier Ltd. All rights reserved

FEASIBILITY AND RELIABILITY OF THE MINI NUTRITIONAL ASSESSMENT (MNA) IN OLDER ADULTS WITH INTELLECTUAL DISABILITIES

Objective: Feasibility and reliability of the Mini nutritional assessment (MNA) in older adults with intellectual disabilities (id). Design: instrument development. Setting: three care providers for people with id. Participants: 48 persons aged 50 years and over with borderline to profound id and their professional caregivers. Measurements: the MNA was performed by means of interviews with participants (N=12) and caregivers (N=48) and physical assessments of participants (N=47). aspects of feasibility: completion of interview, difficulty of answering interview items, duration of interview and completion of physical assessment. aspects of reliability: inter-observer reliability between caregivers and between participants and caregivers, test-retest reliability and internal consistency. For inter-observer and test-retest reliability, intraclass correlation coefficients (ICC) were calculated, and for internal consistency Chronbach's alpha. Results: all participants and caregivers completed the interview part. For 7 out of 12 personally interviewed participants and none of the caregivers, at least 3 out of 15 questions were difficult to answer. Mean duration of the interview was 7 minutes in participants and 4 minutes in caregivers. Physical assessment was successfully performed in 40 participants (85.1%). in the remaining 7 participants (14.9%) missing values were retrieved from the medical records. ICCs (95% confidence interval) for test-retest and inter-observer reliability between caregivers were good, 0.85 (0.72-0.92) and 0.86 (0.74-0.92) respectively, but ICC for inter-observer reliability between caregivers and persons with id was low, 0.03 (-0.51-0.59). internal consistency was 0.61. Conclusion: the MNA is feasible and reliable for older people with id. interview data can be reliably obtained through caregivers, but not through people with ID

The use of a frailty index to predict adverse health outcomes (falls, fractures, hospitalization, medication use, comorbid conditions) in people with intellectual disabilities

Frailty in older people can be seen as the increased likelihood of future negative health outcomes. Lifelong disabilities in people with intellectual disabilities (ID) may not only influence their frailty status but also the consequences. Here, we report the relation between frailty and adverse health outcomes in older people with ID (50 years and over). In a prospective population based study, frailty was measured at baseline with a frailty index in 982 older adults with ID (>= 50 yr). Information on negative health outcomes (falls, fractures, hospitalization, increased medication use, and comorbid conditions) was collected at baseline and after a three-year follow-up period. Odds ratios or regression coefficients for negative health outcomes were estimated with the frailty index, adjusted for gender, age, level of ID, Down syndrome and baseline adverse health condition. The frailty index was related to an increased risk of higher medication use and several comorbid conditions, but not to falls, fractures and hospitalization. Frailty at baseline was related to negative health outcomes three years later in older people with ID, but to a lesser extent than found in the general population. (C) 2014 Elsevier Ltd. All rights reserved

Bone quality in older adults with intellectual disabilities

Although osteoporosis is a progressive bone disease leading to increased risk of fracture, it has rarely been investigated on a large scale in older people with intellectual disabilities (ID). In this study, 768 persons with ID (aged >= 50 years) were measured with quantitative ultrasound to determine the prevalence of low bone quality. The association of low bone quality with patient characteristics, mobility, physical activity, body mass index (BMI), prior fractures, anticonvulsant drug use, intake of calcium, and vitamin D3 levels was also investigated. The prevalence of low bone quality was 43.9%. Low bone quality was positively associated with female gender, age, more severe level of ID, mobility impairment, and anticonvulsant drug use, and negatively with BMI. In clinical practice, people with ID who are at risk for low bone quality should periodically be screened for osteoporosis and be given advice about nutritional supplements and appropriate lifestyle. (C) 2014 Elsevier Ltd. All rights reserved

Frailty and Disability in Older Adults with Intellectual Disabilities: Results from the Healthy Ageing and Intellectual Disability Study

OBJECTIVES To obtain first insight into prevalence and correlates of frailty in older people with intellectual disability (ID). DESIGN Population-based cross-sectional study in persons using formal ID services. SETTING Three Dutch care provider services. PARTICIPANTS Eight hundred forty-eight individuals with borderline to profound ID aged 50 and older participating in the Healthy Ageing and Intellectual Disability (HA-ID) Study. MEASUREMENTS All participants underwent an extensive health examination. Frailty was diagnosed according to Cardiovascular Health Study criteria. Associations between frailty and participant characteristics were investigated using multivariate logistic regression analysis. RESULTS Prevalence of frailty was 11% at age 50 to 64 and 18% at age 65 and older. Age, Down syndrome, dementia, motor disability, and severe ID were significantly associated with frailty, but only motor disability had a unique association with frailty. In a regression model with these variables, 25% of the variance of frailty was explained. CONCLUSION At age 50 to 64, prevalence of frailty is as high as in the general population aged 65 and older (79%), with a further increase after the age of 65. Motor disability only partially explains frailty. Future studies should address health outcomes, causes, and prevention of frailty in this population. J Am Geriatr Soc 60:934-938, 2012