Psychosocial approach of risk of malnutrition in dementia : association of vulnerability factors between community-dwelling elderly and family caregivers

Ce travail a pour objectif d’étudier, selon une approche psychosociale, les facteurs de vulnérabilité associés au risque de malnutrition au sein du binôme personne âgée démente/aidant familial. Cette étude transversale a été réalisée dans le cadre d’une intervention psychosociale effectuée à domicile et proposée par un Centre Local d’Information et de Coordination (CLIC) en milieu rural. Les caractéristiques socio-démographiques et des mesures sur la santé psychologique et physique ont été recueillies auprès d’un échantillon composé de 56 binômes. Nos résultats montrent que le risque de malnutrition des personnes âgées démentes serait plus particulièrement expliqué par leur dépendance dans les activités de base de la vie quotidienne et par le propre risque de malnutrition des aidants familiaux. Ce dernier serait lui-même expliqué par la dépression, leur niveau de dépendance, et la sévérité de l’apathie de leur proche dément. Après avoir défini des profils nutritionnels de binômes et les facteurs de vulnérabilité qui y sont associés, la description de leur vécu et de leurs interactions autour de l’alimentation permet de mieux comprendre les problématiques psychologiques en jeu. Ces résultats sont discutés en fonction de la dimension psychosociale de l’alimentation, entre dépendance comme facteur de vulnérabilité et interdépendance comme fonction d’affirmation et de maintien du lien au sein du binôme. Finalement, ces éléments de réponses ainsi que les limites identifiées nous amènent à proposer des perspectives de recherche et de prise en chargeThis work aims to study psychosocial factors associated with risk of malnutrition in the dyad demented elderly/ family caregiver. This cross-sectional study comprising 56 community-dwelling demented elderly and 56 family caregivers was performed in a French gerontological institution providing psychosocial interventions. The data collected included their socio-demographic characteristics and measures of their psychological and physical health. Our results show that the risk of malnutrition of demented elderly would be particularly explained by their dependence in activities of daily life and the own risk of malnutrition of family caregivers. This one would be explained by their dependence, depression, and the severity of apathy of demented elderly. Nutritional profiles of caregiving dyads and vulnerability factors associated are presented. According to these profiles, description of their emotional experiences and their interactions concerning feeding-related activities is interesting to better understand the psychological issues. These results are discussed according to psychosocial dimension of feeding, between dependence as a vulnerability factor and interdependence as a function to affirm and preserve the link within caregiving dyad. Finally, the limits of this work and its implications for both clinical and research are argued

Psychosocial approach of risk of malnutrition in dementia : association of vulnerability factors between community-dwelling elderly and family caregivers

Ce travail a pour objectif d’étudier, selon une approche psychosociale, les facteurs de vulnérabilité associés au risque de malnutrition au sein du binôme personne âgée démente/aidant familial. Cette étude transversale a été réalisée dans le cadre d’une intervention psychosociale effectuée à domicile et proposée par un Centre Local d’Information et de Coordination (CLIC) en milieu rural. Les caractéristiques socio-démographiques et des mesures sur la santé psychologique et physique ont été recueillies auprès d’un échantillon composé de 56 binômes. Nos résultats montrent que le risque de malnutrition des personnes âgées démentes serait plus particulièrement expliqué par leur dépendance dans les activités de base de la vie quotidienne et par le propre risque de malnutrition des aidants familiaux. Ce dernier serait lui-même expliqué par la dépression, leur niveau de dépendance, et la sévérité de l’apathie de leur proche dément. Après avoir défini des profils nutritionnels de binômes et les facteurs de vulnérabilité qui y sont associés, la description de leur vécu et de leurs interactions autour de l’alimentation permet de mieux comprendre les problématiques psychologiques en jeu. Ces résultats sont discutés en fonction de la dimension psychosociale de l’alimentation, entre dépendance comme facteur de vulnérabilité et interdépendance comme fonction d’affirmation et de maintien du lien au sein du binôme. Finalement, ces éléments de réponses ainsi que les limites identifiées nous amènent à proposer des perspectives de recherche et de prise en chargeThis work aims to study psychosocial factors associated with risk of malnutrition in the dyad demented elderly/ family caregiver. This cross-sectional study comprising 56 community-dwelling demented elderly and 56 family caregivers was performed in a French gerontological institution providing psychosocial interventions. The data collected included their socio-demographic characteristics and measures of their psychological and physical health. Our results show that the risk of malnutrition of demented elderly would be particularly explained by their dependence in activities of daily life and the own risk of malnutrition of family caregivers. This one would be explained by their dependence, depression, and the severity of apathy of demented elderly. Nutritional profiles of caregiving dyads and vulnerability factors associated are presented. According to these profiles, description of their emotional experiences and their interactions concerning feeding-related activities is interesting to better understand the psychological issues. These results are discussed according to psychosocial dimension of feeding, between dependence as a vulnerability factor and interdependence as a function to affirm and preserve the link within caregiving dyad. Finally, the limits of this work and its implications for both clinical and research are argued

Approche psychosociale du risque de malnutrition dans la démence (intrication des facteurs de vulnérabilité des personnes âgées vivant à domicile et de leur proche aidant)

Ce travail a pour objectif d étudier, selon une approche psychosociale, les facteurs de vulnérabilité associés au risque de malnutrition au sein du binôme personne âgée démente/aidant familial. Cette étude transversale a été réalisée dans le cadre d une intervention psychosociale effectuée à domicile et proposée par un Centre Local d Information et de Coordination (CLIC) en milieu rural. Les caractéristiques socio-démographiques et des mesures sur la santé psychologique et physique ont été recueillies auprès d un échantillon composé de 56 binômes. Nos résultats montrent que le risque de malnutrition des personnes âgées démentes serait plus particulièrement expliqué par leur dépendance dans les activités de base de la vie quotidienne et par le propre risque de malnutrition des aidants familiaux. Ce dernier serait lui-même expliqué par la dépression, leur niveau de dépendance, et la sévérité de l apathie de leur proche dément. Après avoir défini des profils nutritionnels de binômes et les facteurs de vulnérabilité qui y sont associés, la description de leur vécu et de leurs interactions autour de l alimentation permet de mieux comprendre les problématiques psychologiques en jeu. Ces résultats sont discutés en fonction de la dimension psychosociale de l alimentation, entre dépendance comme facteur de vulnérabilité et interdépendance comme fonction d affirmation et de maintien du lien au sein du binôme. Finalement, ces éléments de réponses ainsi que les limites identifiées nous amènent à proposer des perspectives de recherche et de prise en chargeThis work aims to study psychosocial factors associated with risk of malnutrition in the dyad demented elderly/ family caregiver. This cross-sectional study comprising 56 community-dwelling demented elderly and 56 family caregivers was performed in a French gerontological institution providing psychosocial interventions. The data collected included their socio-demographic characteristics and measures of their psychological and physical health. Our results show that the risk of malnutrition of demented elderly would be particularly explained by their dependence in activities of daily life and the own risk of malnutrition of family caregivers. This one would be explained by their dependence, depression, and the severity of apathy of demented elderly. Nutritional profiles of caregiving dyads and vulnerability factors associated are presented. According to these profiles, description of their emotional experiences and their interactions concerning feeding-related activities is interesting to better understand the psychological issues. These results are discussed according to psychosocial dimension of feeding, between dependence as a vulnerability factor and interdependence as a function to affirm and preserve the link within caregiving dyad. Finally, the limits of this work and its implications for both clinical and research are argued.BORDEAUX2-Bib. électronique (335229905) / SudocSudocFranceF

J Gerontol A Biol Sci Med Sci

Background: Hearing loss in older adults is suspected to play a role in social isolation, depression, disability, lower quality of life, and risk of dementia. Such suspected associations still need to be consolidated with additional research. With a particularly long follow-up, this study assessed the relationship between hearing status and four major adverse health events: death, dementia, depression, and disability. Methods: Prospective community-based study of 3,777 participants aged >/=65 followed up for 25 years. At baseline, 1,289 reported hearing problems and 2,290 reported no trouble. The risk of occurrence of the negative outcomes, including death, dementia, depressive symptoms, disability in activities of daily living (ADL), and instrumental ADL (IADL), was assessed with Cox proportional hazards models. Results: Adjusting for numerous confounders, an increased risk of disability and dementia was found for participants reporting hearing problems. An increased risk of depression was found in men reporting hearing problems. In additional exploratory analyses, such associations were not found in those participants using hearing aids. Mortality was not associated with self-reported hearing loss. Conclusions: Our study confirms the strong link between hearing status and the risk of disability, dementia, and depression. These results highlight the importance of assessing the consequences of treating hearing loss in elders in further studies

Int J Geriatr Psychiatry

The objective of this study was to explore the associations of individual characteristics of both older people with dementia and family caregivers with the nutritional status of older people with dementia. This cross-sectional study comprising 56 community-dwelling older persons with dementia and 56 family caregivers was conducted at home by a psychogerontologist working for a community gerontological center. Older people with dementia were assessed with Mini mental state examination, Instrumental Activities of Daily Living, Activities of Daily Living (ADL), and NeuroPsychiatric Inventory (NPI) and family caregivers with the Burden Interview (Zarit scale), the State-Trait Anxiety Inventory, the Center for Epidemiologic Studies Depression Scale, and the emotional impact measure of NPI. For both, nutritional status was evaluated using the Mini Nutritional Assessment (MNA). Among older people with dementia, 58.9% were at risk of malnutrition and 23.2% presented a poor nutritional status, and among the family caregivers, 32.1% and 5.4%, respectively. The MNA score of older people with dementia was strongly and inversely associated with the ADL score and was strongly and positively associated with the MNA score of family caregiver. These two factors significantly explained 32% of variation of MNA score of older people with dementia. These findings confirm the value of investigating nutritional deficiencies in dementia within the caregiving dyad and suggest that the functional status of older people with dementia and the nutritional status of family caregivers should be carefully assessed

Psychosocial correlates of nutritional status of family caregivers of persons with dementia

ABSTRACTBackground:This exploratory study investigated the associations of individual characteristics of both persons with dementia and family caregivers with the nutritional status of caregivers.Methods:This cross-sectional study was conducted at home by psychogerontologist within the frame of a community gerontological center in rural areas of south west France. The study participants comprised 56 community-dwelling persons with dementia (mean 80.7 years, SD 6.5) and 56 family caregivers (mean 70.9 years, SD 11.0). Persons with dementia were assessed with Mini-Mental State Examination (MMSE), Basic Activities Of Daily Living (ADL), Instrumental ADL (IADL), and NeuroPsychiatric Inventory (NPI), and family caregivers with the Burden Interview (Zarit scale), the State-Trait Anxiety Inventory (STAI Y-B), the Center for Epidemiologic Studies Depression Scale (CES-D), the emotional impact measure of NPI and the Autonomy, Gerontology and Group Resources scale (AGGIR scale). For both, nutritional status was evaluated using the Mini Nutritional Assessment (MNA®).Results:Among family caregivers, 32.1% were at risk of malnutrition and 5.4% were malnourished, and among people with dementia, 58.9% and 23.2%, respectively. NPI severity score of apathy of persons with dementia (Beta = −0.342, p = 0.001), dependency on AGGIR scale (Beta = −0.336, p = 0.002), and CES-D score of caregivers (Beta = −0.365, p = 0.001) were associated with caregivers’ MNA score (AdjustedR2= 0.480, p < 0.001).Conclusion:These preliminary findings emphasize the need for routine assessment of depressive symptoms, functional and nutritional status in dementia family caregivers, and confirm the value of investigating caregivers’ nutritional risk through an integrative view including psychosocial approach