Taste loss in hospitalized multimorbid elderly subjects

Loss of the sense of taste is common among older people. Morbidities and polypharmacy may contribute to the age-related decline in gustatory function. The aims of the present study were to investigate taste perception in elderly hospitalized patients by comparing their taste recognition thresholds with those of healthy, free-living elderly individuals and to identify potential determinants of taste loss. The participants in this observational study were 55 elderly patients hospitalized in the acute geriatric section of the Department of Medical and Surgical Sciences at Padova University and 41 free-living individuals aged older than 65 years, randomly recruited from elderly people attending mild fitness programs at public gymnasiums in Padova. Data were collected on nutrition, health, cognitive, and functional status for all participants. Gustatory capabilities were assessed using aqueous solutions of sucrose, sodium chloride, citric acid, and quinine hydrochloride (representing sweet, salty, sour, and bitter stimuli, respectively), and taste recognition thresholds were measured in both groups. In comparison with the free-living elderly subjects, those in hospital were significantly less able to recognize the taste of citric acid (P = 75 years; odds ratio [OR] 3.01, 95% confidence interval [CI] 1.01-9.82), polypharmacy (number of prescribed drugs >= 4; OR 2.74, 95% CI 1.01-7.72), and poor nutritional status (as assessed by Mini Nutritional Assessment score < 23.5; OR 5.08, 95% CI 1.76-14.6). Because gustatory impairment may reduce a person's appetite and lead to inadequate dietary intake, compensatory nutritional measures, such as the use of flavor-enhanced foods, should be strongly encouraged, particularly in the hospital settin

Dietary inflammatory index is associated with lung function in healthy older adults

Aging is associated with low-grade chronic inflammation contributing to a decline in lung performance. The Dietary Inflammatory Index (DII) has been introduced to evaluate the inflammatory potential of different diets, which may further affect individuals' respiratory function. This study investigates the association between DII and lung performance in older adults

Ten-year trends in vitamin intake in free-living healthy elderly people: the risk of subclinical malnutrition

To explore the trends of vitamin intake over a 10-year follow-up in a group of successfully aging elderly people. Longitudinal study; City of Padua, Italy. 78 (34M/44F) free-living and still well-functioning survivors among the Italian participants in the SENECA multicenter project, aged 70-75 y at the baseline. Data were collected by means of a modified validated dietary history, both at baseline and then 10 y later. The dietary intake of vitamins B1, B2, A and C were considered, calculating the percentages of individuals with an intake below the lowest European Recommended Dietary Intake (RDI). Mean energy and macronutrient intake were consistent with dietary guidelines at both time points. There was no decline in total energy intake after a decade. At baseline, the intake of all vitamins exceeded the Lowest European RDI, with the exception of vitamin B1, for which 44% of the men and 60% of the women were already deficient. After a decade, the prevalence of vitamin B2 and vitamin A deficiencies rose to 50% of the sample. Vitamin C deficiencies rose in a decade from 3% to 6% in men and from 2.3% to 4.5% in women and it was the least prevalent. Despite an adequate nutritional/functional status and a total energy intake that could be expected to cover the recommendations for micronutrients too, a considerable proportion of our successfully aging elderly were already deficient in, or at high risk of becoming deficient in several essential vitamins. Multivitamin supplementation may be necessary, even in healthy individuals, to ensure an adequate micronutrient intake in the elderl

CHANGES IN HEALTHY ELDERLY WOMEN'S PHYSICAL PERFORMANCE: A 3-YEAR FOLLOW-UP

Inflammatory states, hypovitaminosis D and secondary hyperparathyroidism may have a role in the age-related loss of muscle mass, and physical performance in healthy old people. The aim of this study is to investigate changes in muscle mass, strength and physical performance in healthy, active elderly females over a 3-year follow-up, correlating them with any inflammatory states and PTH and 25-hydroxyvitamin D (25-OHD) levels. One hundred healthy females over 65 years of age routinely attending a twice-weekly mild fitness program were eligible for the study. Clinical history, serum parameters, body composition by DEXA, handgrip strength, knee extensor isometric/isotonic strength and functional performance measured using the Short Physical Performance Battery (SPPB) were evaluated at the baseline and after 3 years. After 3 years, the women had a significant decrease in weight ( 06:-0.8\ub13.1 kg; p<0.05) and height ( 06:-0.4\ub10,6 cm; p<0.001), while their BMI and body composition parameters did not change. Only IL-6 ( 06: 0.6\ub12.0; p<0.01) and PTH ( 06: 30.7\ub129.2 ng/L; p<0.001) increased significantly, while there were no changes in 25-OHD levels. There was a significant decrease in all the SPPB results and in muscle strength. 06 PTH only correlated with the variation in 4-meter walking speed (r: 0.41; p<0.01). With advancing age, physical performance declines even in healthy, active females despite a spare of muscle mass. The increase in PTH seems to have a role in this decline, that could be clarified by further investigations

Dietary intake and physical performance in healthy elderly women: A 3-year follow-up.

BACKGROUND Aging is generally accompanied by changes in body composition, muscle mass and strength, leading to a decline in motor and functional performance. Physical activity and eating habits could be involved in modulating this paraphysiological deterioration. Aim of our study was to investigate changes in body composition, diet and physical performance in healthy, elderly females over a 3-year follow-up. METHODS 92 healthy elderly females (70.9\ub14.0years) attending a twice-weekly mild fitness program were eligible for the study. They were assessed at baseline and again after 3years in terms of clinical history, diet, body composition by DEXA, resting energy expenditure, handgrip strength, knee extensor isometric/isotonic strength, and functional performance measured using the Short Physical Performance Battery (SPPB). RESULTS After 3years, women had a significant decline in muscle strength ( 06 isotonic: -1.4\ub14.3kg, 06 isokinetic: -2.0\ub16.3kg, 06 handgrip: -3.2\ub15.0kg; p<0.001) and physical performance ( 06 walking time: 0.71\ub10.9s, 06 walking speed: -0.25\ub10.35m/s; p<0.001), while their weight and body composition parameters did not change, except for a small decrease in appendicular skeletal muscle mass (-0.4\ub11.4kg). There was a significant drop in calorie ( 06:-345.7\ub1533.1kcal/d; p<0.001) and protein intake ( 06:-0.14\ub10.23g/d; p<0.001), while resting energy expenditure remained stable. 06 calorie intake correlated with the variation in 4-meter walking time (r: 0.34; p<0.01). CONCLUSIONS With advancing age, physical performance declines even in healthy, fit females despite a spare of weight and body composition. This decline in physical activity could lead to a lower calorie intake, which would explain why there is no variation in body weight. Highlights No important body composition changes over 3 years in very fit elderly women. Muscle strength and physical performance decline by about 15\u201320% despite a spare of body weight and composition. This decline of physical performance seems to conditions a reduced caloric intake to maintain body weight stability

Taste loss in hospitalized multimorbid elderly subjects

Loss of the sense of taste is common among older people. Morbidities and polypharmacy may contribute to the age-related decline in gustatory function. The aims of the present study were to investigate taste perception in elderly hospitalized patients by comparing their taste recognition thresholds with those of healthy, free-living elderly individuals and to identify potential determinants of taste loss. The participants in this observational study were 55 elderly patients hospitalized in the acute geriatric section of the Department of Medical and Surgical Sciences at Padova University and 41 free-living individuals aged older than 65 years, randomly recruited from elderly people attending mild fitness programs at public gymnasiums in Padova. Data were collected on nutrition, health, cognitive, and functional status for all participants. Gustatory capabilities were assessed using aqueous solutions of sucrose, sodium chloride, citric acid, and quinine hydrochloride (representing sweet, salty, sour, and bitter stimuli, respectively), and taste recognition thresholds were measured in both groups. In comparison with the free-living elderly subjects, those in hospital were significantly less able to recognize the taste of citric acid (P = 75 years; odds ratio [OR] 3.01, 95% confidence interval [CI] 1.01-9.82), polypharmacy (number of prescribed drugs >= 4; OR 2.74, 95% CI 1.01-7.72), and poor nutritional status (as assessed by Mini Nutritional Assessment score < 23.5; OR 5.08, 95% CI 1.76-14.6). Because gustatory impairment may reduce a person's appetite and lead to inadequate dietary intake, compensatory nutritional measures, such as the use of flavor-enhanced foods, should be strongly encouraged, particularly in the hospital setting

Association between dietary folate intake and serum insulin-like growth factor-1 levels in healthy old women

High serum levels of insulin-like growth factor-1 (IGF-1) seem to coincide with higher rates of some types of cancer and the risk of all-cause mortality in old people. Eating vegetables seems to reduce IGF-1 levels because they are rich in micronutrients such as vitamins. This study investigates the possible association between vitamin intake and IGF-1 levels in a representative group of healthy elderly women with Mediterranean dietary habits. This cross-sectional study included 124 healthy women with a mean age of 71.3 \ub1 4.2 years and a mean body mass index (BMI) of 27.37 \ub1 3.48 kg/m(2) attending a mild fitness program twice a week at public gyms in Padova. The main parameters considered were IGF-1 (measured by chemiluminescence) and diet, assessed on the basis of a 3-day record and a questionnaire on the frequency with which they usually ate certain foods. The mean IGF-1 level for the sample as a whole was 136.2 \ub1 38.9 \u3bcg/l, and was significantly lower in women with a higher folate intake (p = 0.04). On simple linear analysis, the vitamins found associated with serum IGF-1 levels were: folates (r: -0.25; p = 0.003); vitamin E (r: -0.21; p = 0.01); vitamin D (r: -0.17; p = 0.03); and riboflavin (r: -0.16; p=0.03). After removing the effect of calorie, protein, carbohydrate and fat intake, and other known potential confounders (age, BMI, alcohol intake), only folate intake correlated with IGF-1 levels (r = -0.17; p = 0.04). A folate-rich diet could have the effect of lowering circulating IGF-1 levels in elderly women

Factors influencing serum 25-hydroxivitamin D levels and other bone metabolism parameters in healthy older women

Older women have frequently low serum 25-hydroxivitamin D (25[OH]D) concentrations, high parathormone (PTH) levels and low bone mineral density (BMD) values. Endogenous synthesis, dietary habits, sunlight exposure and fat-mass-mediated storage may influence 25(OH)D levels and bone metabolism, but the relevance of these factors in the elderly has yet to be fully elucidated. We aimed to investigate the influence of dietary vitamin D intake and fat mass on serum 25(OH)D levels and bone metabolism in older women. Design: Cross-sectional. Setting: Community. Participants: 218 fit older women attending a biweekly mild fitness program. Measurements: Dietary habits was investigated through a 3-day record questionnaire. Serum 25(OH)D and intact parathormone (PTH) concentrations were measured by radioimmunoassay and by a 2-step immunoradiometric assay, respectively. BMD and body composition were estimated using dualenergy X-ray absorptiometry with fan-beam technology. Results: Only fat mass showed a significant negative association with 25(OH)D (\u3b2=-3.76, p<0.001), and positive associations with whole body, lumbar, femoral neck and total hip BMD. Binary logistic analysis revealed a protective effect of adiposity on secondary hyperparathyroidism (OR=0.42, 95%CI:0.19-0.92, p=0.03). Dietary vitamin D intake was not associated to any of these outcomes. Conclusion: Fat mass has a greater influence on serum 25(OH)D than dietary vitamin D intake