Dietary protein intake and transition between frailty states in octogenarians living in New Zealand

Funding Information: Funding: This research was funded by Health Research Council of New Zealand (HRC 09/068B; UoA ref: 3624940) and Ministry of Health New Zealand (MOH ref: 345426/00; UoA ref: 3703221) which funded the project management and data collection work; Nga¯ Pae o te Ma¯ramatanga (UoA ref: 3624946) which funded the Ma¯ori engagement and project management. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.Adequate nutritional status may influence progression to frailty. The purpose of this study is to determine the prevalence of frailty and examine the relationship between dietary protein intake and the transition between frailty states and mortality in advanced age. We used data from a longitudinal cohort study of Māori (80–90 years) and non-Māori (85 years). Dietary assessments (24-h multiple pass dietary recalls) were completed at the second year of follow-up (wave 2 and forms the baseline in this study). Frailty was defined using the Fried Frailty criteria. Multi-state modelling examined the association of protein intake and transitions between frailty states and death over four years. Over three quarters of participants were pre-frail or frail at baseline (62% and 16%, respectively). Those who were frail had a higher co-morbidity (p < 0.05), where frailty state changed, 44% showed a worsening of frailty status (robust → pre-frail or pre-frail → frail). Those with higher protein intake (g/kg body weight/day) were less likely to transition from robust to pre-frail [Hazard Ratio (95% Confidence Interval): 0.28 (0.08–0.91)] but also from pre-frail to robust [0.24 (0.06–0.93)]. Increased protein intake was associated with lower risk of transitioning from pre-frailty to death [0.19 (0.04–0.80)], and this association was moderated by energy intake [0.22 (0.03–1.71)]. Higher protein intake in this sample of octogenarians was associated with both better and worse outcomes.publishersversionpublishe

Still living in a war zone: perceived health and wellbeing of partners of Vietnam veterans attending partners' support groups in New South Wales, Australia

Post-traumatic stress disorder (PTSD) in veterans is well documented, less so the long-term impact on the health of their partners and families. The perceived health and wellbeing of women partners of Australian Vietnam veterans who were members of partners of veterans support groups is reported. This qualitative study used data from 76 participants in 10 focus groups in metropolitan, regional, and rural and remote areas of New South Wales (NSW). The data were tape-recorded, transcribed and thematically analysed using constant comparison methods. The impact of living with a partner with war-related PTSD appears to be significant and ongoing with women drawing parallels to living in a war zone. The biggest negative impact was on their mental health. They felt burdened as carers and struggled to find explanations for their husbands' problems. Support groups were very helpful. There are implications for partners of veterans who have returned from active military duty and from peacekeeping in current conflicts

Iodine Status of New Zealand Elderly Residents in Long-Term Residential Care

In response to the re-emergence of iodine deficiency in New Zealand, in 2009 the government mandated that all commercially made breads be fortified with iodized salt. There has been no evaluation of the impact of the program on iodine status of the elderly, despite this population group being vulnerable to iodine deficiency or excess. The aim of this study was to describe the iodine status of elderly New Zealanders in residential aged-care homes following the implementation of the bread fortification program. A cross-sectional survey was conducted, involving 309 residents (median age 85 years) from 16 aged-care homes throughout NZ. Information on socio-demographic, anthropometric, dietary and health characteristics were collected. Casual spot urine samples were analysed for urinary iodine concentration (UIC). Blood samples were analysed for serum thyroglobulin, thyroglobulin antibodies, and other biochemical indices. The median UIC (MUIC) of the residents was 72 μg/L, indicating mild iodine deficiency, and 29% had a UIC &lt; 50 μg/L. Median thyroglobulin concentration was 18 ng/mL and 26% had elevated thyroglobulin concentration (&gt;40 ng/mL), suggesting iodine insufficiency. Diuretic use was associated with lower MUIC (p = 0.043). Synthetic thyroxine use was associated with lower odds of having a UIC &lt; 50 μg/L (OR 0.32, p = 0.030)) and lower median thyroglobulin (−15.2 ng/mL, p = 0.001), compared with untreated participants. Frailty was associated with elevated thyroglobulin (p = 0.029), whereas anemia was associated with lower thyroglobulin (p = 0.016). Iodine insufficiency persists in New Zealanders residing in residential aged-care homes despite increasing iodine intake from fortified bread. Research is required to establish optimal iodine intake and status in the elderly