Do Determinants of Quality of Life Differ in Older People Living in the Community and Nursing Homes?

Objectives: The aim of the present study was to examine and compare the relationship between nutritional status, physical activity (PA) level, concomitant chronic diseases, and quality of life (QoL) in community-dwelling (CD) older people and nursing home (NH) residents. Material and Methods: One hundred NH residents aged 60 years and above and one hundred sex- and age-matched CD older adults were examined. The QoL was examined with the EuroQol-5D questionnaire. Nutritional status was assessed with the Mini Nutritional Assessment questionnaire (MNA), anthropometric measures, and bioimpedance analysis (BIA). The 7-Day Recall Questionnaire and the Stanford Usual Activity Questionnaire were performed to evaluate the PA energy expenditure level (PA-EE) and the health-related behaviours (PA-HRB), respectively. Results: CD subjects presented a significantly higher self-assessment in the VAS scale in comparison with NH residents (CD: 65.3 ± 19.4 vs. NH 58.2 ± 21.4; p < 0.05), but there were no differences within the five dimensions of QoL. In NH patients, the VAS scale was not correlated with any of the variables evaluating the nutritional status and body composition, while in the CD group correlated positively with MNA (rS = 0.36; p < 0.001), % of FFM (rS = 0.22; p< 0.05), body density (rS = 0.22; p < 0.05) and negatively with % of FM (rS = −0.22; p < 0.05). In an institutional environment, only concomitant diseases (mainly urinary incontinence) were found as independent determinants for QoL. In the community, independent determinants of QoL besides concomitant diseases (mainly ischaemic heart disease) were nutritional status or PA-HRB. Conclusions: Determinants of QoL are different depending on the living environment the older adults. Proper nutritional status and beneficial PA behaviours, are crucial for higher QoL of CD elderly, while for NH residents, the main determinants of QoL are chronic conditions

Nutritional Status Plays More Important Role in Determining Functional State in Older People Living in the Community than in Nursing Home Residents

The aim of this study was to verify whether the relationship between nutritional and functional status differs between seniors in the community and those in long-term care institutions. One hundred nursing home (NH) residents aged 60 years and above and 100 sex- and age-matched community-dwelling (CD) older adults were examined. Functional status was assessed using the Comprehensive Geriatric Assessment (CGA) and nutritional status using anthropometric measures, the Mini Nutritional Assessment questionnaire (MNA) and bioimpedance analysis (BIA). Significant environmental interactions were observed with resting metabolic rate (RMR), extracellular water (ECW) and intracellular water (ICW) ratio, skeletal muscle mass (SMM), skeletal muscle index (SMI) and impedance (Z) and resistance (R) to the results of the Timed Up and Go (TUG) test. The two groups demonstrated different relationships between Z and R and handgrip strength and between Geriatric Depression Scale (GDS) score and fat free mass (FFM), body density, total body water (TBW) and phase angle (PhA). Nutritional status seems to be more important for functional state in CD older people than in NH residents. Therefore, to ensure the functional independence of seniors living in the community, it is crucial to maintain the correct nutritional parameters. Further studies are necessary to account for the fact that this relationship is less significant among NH residents and to identify other factors that may contribute to these discrepancies between community and institutional environments

Do Determinants of Quality of Life Differ in Older People Living in the Community and Nursing Homes?

Objectives: The aim of the present study was to examine and compare the relationship between nutritional status, physical activity (PA) level, concomitant chronic diseases, and quality of life (QoL) in community-dwelling (CD) older people and nursing home (NH) residents. Material and Methods: One hundred NH residents aged 60 years and above and one hundred sex- and age-matched CD older adults were examined. The QoL was examined with the EuroQol-5D questionnaire. Nutritional status was assessed with the Mini Nutritional Assessment questionnaire (MNA), anthropometric measures, and bioimpedance analysis (BIA). The 7-Day Recall Questionnaire and the Stanford Usual Activity Questionnaire were performed to evaluate the PA energy expenditure level (PA-EE) and the health-related behaviours (PA-HRB), respectively. Results: CD subjects presented a significantly higher self-assessment in the VAS scale in comparison with NH residents (CD: 65.3 ± 19.4 vs. NH 58.2 ± 21.4; p p pp p < 0.05). In an institutional environment, only concomitant diseases (mainly urinary incontinence) were found as independent determinants for QoL. In the community, independent determinants of QoL besides concomitant diseases (mainly ischaemic heart disease) were nutritional status or PA-HRB. Conclusions: Determinants of QoL are different depending on the living environment the older adults. Proper nutritional status and beneficial PA behaviours, are crucial for higher QoL of CD elderly, while for NH residents, the main determinants of QoL are chronic conditions

Wsparcie ICT i środowiskowe dla pacjentów z zespołem słabości: projekt CareWell, projekt Focus i projekt SUNFRAIL

Maintaining wellbeing and independence by elderly people results from implementing the rules of “successful aging” , based on activity and participation in professional and social life, as well promotion of healthy lifestyle. Increasingly greater importance is attributed to frailty syndrome among patients of old age. These patients are characterized by increased sensitivity to stimuli, impaired ability to cope with inner and environmental stressinducing factors, and they also have limited ability to maintain the state of physiological and psychosocial homeostasis. In such cases it is necessary to provide the patients with integrated care based on the support of the environment and the latest technology. Providing the residents of Lower Silesian Province with high quality of life, adjusting social services to residents’ needs, and social integration alone are compliant with The Strategy of Social Integration in Lower Silesia. For that reason, supporting such patients with technology in Lower Silesia was started with the CareWell and WRP® pilot projects. The use of the latest technologies requires a social campaign, media-distributed information, and awakening social interest or even a trend related to their use. It will allow the refining of new services, reduce costs and improve safety for people. Instead of costly specialist care, elderly patients will receive individualized care located within the environment, which will be less costly but more intensive. The FOCUS project deals with reducing the frailty syndrome load in the population of elderly Founpeople in Europe, taking note of enhancing the environmental support. The purpose of the SUNFRAIL project is to improve the identification, prevention and management of frailty, and care of multimorbidity by regional centers and institutions in EU countries of people aged 65 years and over living in the local community.Zachowania dobrostanu i samodzielności przez osoby starsze wynika z wdrażania zasad „dobrego starzenia się” opartego na aktywności i uczestnictwie w życiu zawodowym i społecznym oraz promocji zdrowego stylu życia. Coraz większe znaczenie przypisuje się rozpowszechnieniu zespołu słabości wśród pacjentów w wieku podeszłym. Pacjenci ci charakteryzują się zwiększoną wrażliwością na bodźce, upośledzoną zdolnością do radzenia sobie z wewnętrznymi i środowiskowymi czynnikami stresogennymi, a także posiadają ograniczoną zdolność do utrzymania stanu fizjologicznej i psychospołecznej homeostazy W takich przypadkach konieczne jest wsparcie pacjentów opieką zintegrowaną polegającą na wsparciu środowiska oraz najnowszej technologii. Zapewnienie mieszkańcom województwa dolnośląskiego wysokiej jakości życia, dopasowanie usług społecznych do potrzeb mieszkańców oraz sama integracja społeczna są zgodne ze Strategia Integracji Społecznej na Dolnym Śląsku. Dlatego też, na Dolnym Śląsku wsparcie takich pacjentów technologią, zostało zapoczątkowane pilotażem projektu CareWell i WRP®. Zastosowanie nowych technologii wymaga kampanii społecznej, informacji w mediach i wzbudzenia społecznego zaciekawienia, wręcz mody na ich stosowanie. Pozwoli to na doskonalenie nowych usług, obniżenie kosztów i poprawę bezpieczeństwa ludzi. W miejsce kosztownej opieki specjalistycznej pacjenci w wieku podeszłym uzyskują opiekę indywidualizowaną, lokowaną w środowisku, mniej kosztowną lecz bardziej intensywną. Projekt FOCUS zajmuje się zmniejszeniem obciążenia zespołem słabości w populacji osób w wieku podeszłym w Europie z uwzględnieniem wzmocnienia wsparcia środowiskowego. Celem projektu SUNFRAIL jest poprawa identyfikacji, zapobiegania i zarządzanie zespołem słabości oraz opieką nad wielochorobowością wśród osób po 65 roku życia mieszkających w społeczności lokalnej przez regionalne ośrodki i instytucje krajów UE

Relationship of muscle function to circulating myostatin, follistatin and GDF11 in older women and men

Abstract Background Myostatin, its inhibitor follistatin, and growth/differentiation factor 11 (GDF11) have been proposed as factors that could potentially modify biological aging. The study aimed to test whether there is a relationship between these plasma circulating proteins and muscle strength, power and optimal shortening velocity (υopt) of older adults. Methods The cross-sectional study included 56 women and 45 men aged 60 years and older. Every participant underwent examination which included anthropometric and bioimpedance analysis measurements, functional and cognitive performance tests, muscle strength of upper and lower extremities, muscle power testing with two different methods and blood analyses. Results Women had higher plasma levels of myostatin and GDF11 than men. Men had higher plasma level of follistatin than women. In women, plasma level of myostatin was negatively correlated with left handgrip strength and υopt. Follistatin was negatively correlated with maximum power output (Pmax), power relative to kg of body mass (Pmax∙kg− 1) (friction-loaded cycle ergometer) and power at 70% of the 1-repetition maximum (1RM) strength value (P70%) of leg press (Keiser pneumatic resistance training equipment), and positively correlated with the Timed Up & Go (TUG) test. GDF11 was negatively correlated with body mass, body mass index, waist circumference, fat mass and the percentage of body fat. In men, there were no significant correlations observed between circulating plasma proteins and muscle function measures. Conclusions The circulating plasma myostatin and follistatin are negatively associated with muscle function in older women. There is stronger relationship between these proteins and muscle power than muscle strength. GDF11 has a higher association with the body mass and composition than muscle function in older women

Association between kidney function, nutritional status and anthropometric measures in older people : The Screening for CKD among Older People across Europe (SCOPE) study.

BACKGROUND: Different mechanisms connect the nutritional status with the occurrence and the course of chronic kidney disease (CKD). The end-stage renal disease is complicated by catabolic inflammatory reactions and cachexia which leads to malnutrition (undernutrition). On the other hand, obesity is an important risk factor for the development and acceleration of CKD. METHODS: In the SCOPE study, community-dwelling persons aged 75 years and over, from 6 European countries and Israel were examined at the baseline phase. We assessed the relationship between anthropometric measures (Body Mass Index (BMI), circumferences of arm (AC), waist (WC), hip (HC), and calf (CC), waist-to-hip ratio - WHR, waist-to-height ratio - WHtR, risk of malnutrition (Mini Nutritional Assessment - MNA), serum albumin) and estimated glomerular filtration rate (eGFR) calculated by Berlin Initiative Study (BIS) equation. RESULTS: We studied 2151 subjects (932 men and 1219 women) with a mean age of 79.5 ± 5.9 years. A total of 1333 (62%) participants had CKD (GRF &lt; 60 ml/min/1.73 m2). Negative correlations between eGFR and weight, AC, WC, HC, CC, BMI, WHtR were observed. Positive correlation occurred between eGFR and MNA score (Spearman's rho = 0.11) and albumin concentration (rho = 0.09). Higher weight, AC, WC, HC, CC, BMI and WHtR increased the odds ratio of CKD; higher MNA (OR = 0.98, 95% CI 0.94-1.0) and higher serum albumin (OR = 0.73, 95% CI 0.53-1.0) were weakly associated with reduced odds. The risk of malnutrition was the highest with eGFR &lt; 30 as compared to eGFR &gt; 60 (OR = 2.95, 95%CI = 1.77-4.94 for MNA &lt; 24; OR = 5.54, 95%CI = 1.66-18.5 for hypoalbuminemia &lt; 3.5 g/dL). CONCLUSION: The population of community dwelling people aged 75+ with CKD shows general features of overweight and obesity with a small prevalence of malnutrition. For anthropometric measures, the strongest association with eGFR and the highest odds of CKD were identified using WC, HC, CC and WHtR. Albumin level and MNA, but not MNA Short Form, indicated an increased odds of malnutrition with a decrease in eGFR