Inferior vena cava collapsibility index and trauma severity in elderly fall injuries.

OBJECTIVE: Falls are a serious cause of morbidity and mortality among older people. One of the underlying causes of falls is dehydration. Therefore, ultrasonography has become an essential tool for evaluating volume status in the emergency department. However, the effect of volume status on falls in older people has not been evaluated before. The aim of this study was to determine the relationship between the inferior vena cava collapsibility index and the injury severity score in older patients who presented with fall-related injuries to the emergency department. METHODS: A total of 66 patients were included in the study. The injury severity score was used as the trauma severity score, and the Edmonton Frail Scale was used as the frailty scale. Volume status was evaluated with inferior vena cava collapsibility index. The primary outcome measure was defined as the correlation between inferior vena cava collapsibility index and injury severity score. Secondary outcome measures were defined as the effect of inferior vena cava collapsibility index and injury severity score on hospitalization and mortality. RESULTS: There was no significant correlation between injury severity score and inferior vena cava collapsibility index (p=0.342). Neither inferior vena cava collapsibility index nor injury severity score was an indicator of the mortality of these patients. However, injury severity score was an indicator of hospitalization. The mean Edmonton Frail Scale score was an indicator of mortality among older people who experienced falls (p=0.002). CONCLUSION: Inferior vena cava collapsibility index cannot be used to predict trauma severity in older patients who have experienced falls admitted to the emergency department.

Association between frailty and activities of daily living disability in older adults residing in a high-altitude Peruvian Andean community: the Aunqui-Andes study.

BACKGROUND: The prevalence of frailty and activities of daily living (ADL) disability may be higher in high-altitude Andean regions, due to chronic hypoxia, malnutrition, and physical challenges. and their association is relevant. This study aimed to evaluate the association between frailty and ADL disability among older adults residing in the Totos district in Peru during the year 2022. METHODS: A cross-sectional study was conducted in Totos district (mean altitude: 3286 m above sea level), located in Ayacucho, Peru, during 2022. A complete census was employed including residents aged 60 and above. The exposure variable was frailty, defined by fulfilling 3 or more criteria of the Fried phenotype. The outcome variable was ADL disability, defined as a score below 95 on the Barthel index. Generalized linear models with a Poisson family, logarithmic link function, and robust variances were employed to estimate crude prevalence ratios and adjusted prevalence ratios (aPRs), along with their corresponding 95% confidence intervals (CIs). RESULTS: We evaluated 272 older adults with a mean age of 74 years, of whom 59.9% were female, 62.1% were cohabiting or married and 83.1% had not completed primary education. We found that 19.5% were frail, while 51.1% had ADL disability. In the adjusted regression model, we found frailty increased the prevalence of ADL disability (aPR = 1.77; 95%CI: 1.44-2.16; p < 0.001). CONCLUSION: Frailty was associated with an increased prevalence of ADL disability. These findings could contribute to establishing government intervention plans to manage disability and frailty within the high-risk group comprising older adults living at high altitudes.

Importance of muscle strength to maintain mobility, but not to maintain postural balance in older women: Cross-sectional study.

BACKGROUND: Acknowledging the relationship between postural control and muscle strength in lower limbs is important to find persons with high fall risk and to design fall prevention exercise programs. OBJECTIVE: To investigate the connection between knee muscle strength, semi-static postural balance, and functional mobility in irregularly active older women. METHODS: One hundred and ten older women aged 60 to 85 years underwent a semi-static postural balance test in a force and functional mobility measured by Timed Up & Go (TUG) with and without Cognitive Tasks (CT). Muscle strength of the knee was assessed by isokinetic dynamometry at 60°/s. RESULTS: A negative correlation between the functional mobility (TUG with and without CT) and the muscular strength of the knee was observed. Regarding semi-static balance, there was a low negative correlation with peak torque corrected for body weight of the extensors with the following variables with eyes open: Mean Velocity Dominant limb (D) (r = -0.19; p = 0.03); and anteroposterior range Non-Dominant limb (ND) (r = -0.19; p = 0.04); with eyes closed: mediolateral range ND limb (r = -0.21; p = 0.02) and Mean Velocity ND limb (r = -0.18; p = 0.05). CONCLUSIONS: This study found that better functional mobility was associated with greater muscle strength in the knee in elderly women. There were weak negative correlations between knee extensor strength and some measures of semi-static postural balance, suggesting that different motor control actions are required to maintain semi-static balance and mobility. In the case of semi-static balance, a lower level of muscle response is required than in functional mobility.

Cardiovascular Risk Factors as Predictors of Nutritional Status in Older Mexican Adults.

Aging is commonly accompanied by increased cardiovascular risk and diet plays a crucial role in health condition. The aim of this study was to determine cardiovascular risk factors as predictors of nutritional risk in Mexican older adults. A cross-sectional study on Mexican patients aged ≥60 years with cardiovascular risk factors affiliated with a medical unit in Northeast Mexico was performed from July to December 2021. The nutritional risk evaluations were performed using the Mini Nutritional Assessment (MNA) questionnaire. After a multivariate analysis, the cardiovascular risk factors identified as independent predictors of risk of malnutrition were hypertriglyceridemia (adjusted OR (AOR): 1.8; 95% CI: 1.03-3.14; p = 0.04) and systolic hypertension I (AOR: 2.28; 95% CI: 1.04-5.02; p = 0.041); age over 80 years (AOR: 5.17; 95% CI: 1.83-14.65, p = 0.002) and elementary school education (AOR: 2.34; 95% CI: 1.20-4.55; p = 0.013) were also related. The cross-sectional design and single-center approach of this study limits the generalizability of the results; however, conducting timely evaluations of blood pressure, triglyceride levels, and risk of malnutrition using the MNA tool for patients aged ≥60 years could prevent illness and reduce mortality within this population group.

Comparison of two different frailty screening scales for predicting mortality due to all causes in older inpatients.

OBJECTIVE: This study examines the relationship between two frailty screening tools and 90-day all-cause mortality in geriatric inpatients. METHODS: The study included patients aged ≥60 years who were admitted to the geriatrics unit of a university hospital between June 2021 and August 2022 and whose mortality status and duration of hospitalization data were obtained from the Health Ministry System. During hospitalization, the patients were screened using two different frailty scales: the Simpler Modified Fried Frailty Scale (sMFS) and the Clinical Frailty Scale (CFS). Patients scoring ≥5 on the CFS and ≥3 on the sMFS were considered frail. RESULTS: A total of 84 participants with a mean age of 78.3±7.6 years were included in this study, of which 36.9% were male. Of the total, 60.7% and 89.3% were considered frail according to the CFS and sMFS, respectively, and the prevalence of all-cause mortality within 90 days was 19%. A univariate analysis using the Kaplan-Meier survival method revealed CFS scores to be statistically significantly related to 90-day all-cause mortality (p<0.001), while sMFS scores were not found to be statistically significant (p=0.849). Furthermore, a statistically significant relationship was identified between CFS score and all-cause mortality in multivariate analysis with Cox regression analysis [(p<0.001), hazard ratio (HR): 3.078; (95% confidence interval: 1.746-5.425)]. CONCLUSION: An evaluation of frailty in hospitalized older adults using two different scales revealed the CFS to be superior to the sMFS in predicting all-cause mortality within 90 days.

Assessment of cognitive function in elderly patients with heart failure.

OBJECTIVE: To compare the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) tests for the identification of cognitive deficit (CD) in elderly patients with heart failure (HF). METHODS: This was a cross-sectional study with an observational design involving 43 elderly patients with HF of both sexes, treated by the Unified Health System, who were able to understand and follow the study instructions. A sociodemographic and clinical questionnaire and the MMSE and MoCA neurocognitive tests were applied. RESULTS: The mean age of the patients was 67 years; 67.44% were male; 53.49% were white; 58.14% had 1-4 years of schooling; 58.14% had an income of half to one minimum wage; 55.81% were married; 53.49% had a family history of HF; 90.7% denied smoking; 83.72% denied alcohol intake; 65.12% did not practice physical activity; 83.72% were hypertensive; 30.23% were diabetic; 57.89% had LVEF ≥ 50%; 39.53% have NYHA II; and 88.37% did not have a pacemaker. In the identification of CD, the MMSE test detected it in 25.58% of the patients, while the MoCA test identified it in 23.26% (p=0.043). CONCLUSION: It was concluded that the MMSE test performed better than the MoCA test in the identification of CD in elderly patients with HF.

Translation, validity and reliability of the fall risk scale for older adults.

INTRODUCTION: Falls in older adults are a common and serious threat to health and functional independence. It can cause psychological distress, inability to participate in activities of daily living, brain injury, fractures, and even death. The aim was to analyze the psychometric properties of the self-assessed fall risk scale (FRS) that measures the risk of falls in older adults in a central region of Chile, as well as to verify the concurrent validity against functional fitness tests. MATERIALS AND METHODS: A descriptive cross-sectional study was carried out in 222 older adults (OA) [34 males and 188 females] with an age range of 65 to 85 years. The 13-item self-perceived fall risk scale (FRS) was validated. Anthropometric measures (weight, height and waist circumference) were assessed. Five functional fitness tests were measured (right and left hand grip strength, biceps curl, up-and-go, agility and 6-minute walk test). Validation was performed by construct validation [(exploratory factor analysis (EFA) and confirmatory factor analysis (CFA)] and concurrent validity. RESULTS: The EFA revealed 4 factors in the FRS scale [1: fear of falling (variance 27.1%), 2: use of assistive devices (variance 10.6%), 3: loss of sensation (variance 9.3%), and 4: limited mobility (variance 8.3%)]. Factor loadings ranged from ∼ 0.50 to 0.83 across the 4 components. The Kaiser-Meyer Olkin sample adequacy test (KMO) reflected adequate adequacy (KMO = 0.79, chi-square (X2) = 498.806, gl = 78, p = 0.00). The CFA showed a satisfactory final fit [chi-square (X2) = 126.748, Root mean squared error of approximation (RMSEA) = 0.042, Tucker-Lewis Index (TLI) = 0.946, Comparative fit index (CFI) = 0.935 y Normed fit index (NFI) = 0.90. The relationships between the FRS scale and functional fitness tests (right and left hand grip strength, biceps curl, up-and-go, agility and 6-minute walk test) ranged from low to moderate (r= -0.23 to 0.41). CONCLUSION: The FRS scale showed acceptable validity and reliability in older adults in central region of Chile. It is expected that this scale will be useful for assessing fall risk in clinical and epidemiological settings in the aging Chilean population.

Effects of a case management-based intervention on non-motor risk factors for falls in older people with history of falls: a randomised clinical trial.

BACKGROUND: Falls are directly related to morbidity and mortality of older people. Multifactorial approaches that are individualised and based on fall risk factors are necessary. This study aims to verify the effects of a case management-based intervention on non-motor risk factors for falls in community-dwelling older people with a history of falls. METHODS: The intervention applied a multidimensional assessment of risk factors for falls, a discussion about the identified risk factors, the preparation of an individualised plan with the participant, and the application, monitoring and review of the plan. RESULTS: There was a significant interaction between groups and assessments only in the visuospatial domain (P = 0.031). After simple main effects analysis, differences between groups and assessments were not significant, although there was a tendency of worse visuospatial performance in the control group in the follow-up assessment (P = 0.099). There were no significant differences between groups or between assessments in other variables. CONCLUSION: The intervention has the potential to maintain non-motor risk factors for falls in community-dwelling older people with a history of falls. However, more clinical trials are needed to prove its effects.

Dynapenia and sarcopenia identify walking speed decline in women but not in men.

OBJECTIVE: To determine the best indicator of mobility decline between dynapenia, low skeletal muscle mass index (SMMI), and sarcopenia defined by the EWGSOP2 using different cutoff points for grip strength. METHODS: A longitudinal study was conducted with a follow-up of eight years, involving 2,680 individuals aged 60 and older who participated in the ELSA study with a walking speed greater than 0.8 m/s at baseline. Dynapenia was defined using different cutoff points for grip strength. SMMI was defined by the 20th percentile of the entire ELSA sample distribution and sarcopenia was defined based on the EWGSOP2, using different cutoff points for grip strength. Mobility was analysed using the walking speed test. RESULTS: Over time, the greatest decline in walking speed occurred in dynapenic women with grip strength < 17 kg (-0.005 m/s per year; 95 % CI: -0.01 to -0.001) and < 20 kg (-0.007 m/s per year; 95 % CI: -0.01 to -0.001). With regards to sarcopenia, the greatest walking speed decline occurred in women with probable sarcopenia when defined by grip strength < 17 kg [(-0.006 m/s per year; 95 % CI: -0.01 to -0.001) or grip strength < 20 kg (-0.007 m/s per year; 95 % CI: -0.01 to -0.001)]. Dynapenia in men as well as low SMMI and sarcopenia in men and women did not enable identifying the risk of mobility decline. CONCLUSION: Dynapenia and probable sarcopenia defined by grip strength < 17 kg and < 20 kg enabled identifying walking speed decline over time only in women.

Physiological changes associated with aging: Identification of novel biomarkers for frailty syndrome in women.

This study explores the physiological changes associated with aging that lead to frailty syndrome, characterized by reduced vitality and degeneration across multiple bodily systems, increasing susceptibility to various pathologies. While established scales like the Fried Phenotype and Frailty Trait Scale (FTS) are commonly used for assessing frailty, incorporating biomarkers is crucial for accurate diagnosis and prognosis. Our research examines plasma oxylipin levels in frail elderly individuals to identify novel biomarkers. Diagnostic criteria for frailty included assessments using the Fried Phenotype and FTS-5, with blood samples collected from 71 elderly participants (50 women and 21 men) with mean ages of 73.6 ± 5.9 and 76.2 ± 6.2 years, respectively. Women exhibited elevated platelet counts (p-value 0.0035). The significant differences in oxylipin concentrations associated with the Fried Phenotype were particularly noteworthy, predominantly observed in women. Specifically, in women, decreased grip strength (<15 kg) and slow gait speed (<0.8 m/s) correlated with increased levels of thromboxane B2 (TxB2) and 7-HDoHE (p-values 0.0404, 0.0300, 0.0033, and 0.0033, respectively). Additionally, elevated 7-HDoHE levels correlated with a BMI exceeding 28 kg/m2 (p-value 0.0123) and Physical Activity Scale for the Elderly (PASE) scores surpassing 5 points (p-value 0.0134) in women. In summary, our findings emphasize that frail older individuals, particularly women, exhibit higher levels of TxB2 and 7-HDoHE compared to their non-frail counterparts, aligning with established frailty classification and scale parameters, suggesting their potential as indicative biomarkers.

Use of the Ishii Test for screening sarcopenia in older adults: a systematic review with meta-analysis of diagnostic test accuracy (DTA) studies.

BACKGROUND: The Ishii Test is recommended by the European Working Group on Sarcopenia in Older People (EWGSOP2), however the use of this technique is still little explored in the clinical context and the scientific literature. OBJECTIVE: We aimed to verify the use of the Test of Ishii in screening for sarcopenia in older adults. METHODS: We searched three electronic databases and two reviewers independently screened and assessed the studies. Studies with older adults (60 years or more) of both genders, no year or language restriction and which aimed to evaluate sarcopenia using the Ishii Test and another diagnostic criteria were selected. A summary of the ROC curve, sensitivity and specificity were performed using the MedCalc and SPSS software programs, respectively. RESULTS: A total of 3,298 references were identified in the database, 278 by manually searching, and finally 11 studies were included for the review. The screening test showed good sensitivity and specificity in both genders. All studies showed values above the considered value for the Area Under the Curve (AUC) results, without discriminating power (0.500). Four studies used the original values, and five studies developed a new cut-off point. A summary of the AUC curve showed the diamond close to one, indicating that the Ishii test has good performance for screening sarcopenia (I2=83,66%; p<0.001; 95%CI: 69.38 to 91.28 for men; and I2=60.04%; p<0.001; 95%CI: 13.06 to 81.63 for women). CONCLUSION: The Ishii Test can be considered a useful tool for the early identification of sarcopenia in older adults. However, further studies are still needed to understand the behavior of this screening tool. TRIAL REGISTRATION: CRD42023424392.

Development and Evaluation of a Software Designed by a Nursing and Technology Team to Assess the Health Status of Adults over 65 Years of Age.

Objective: This work sought to develop the Actuasalud platform as a useful tool for nursing that permits assessing health, in term of frailty, in population over 65 years of age. Methods: For the design and development of Actuasalud, two working groups were formed: one from nursing with different profiles, to identify the scientific content and a computer science group responsible for the software programming and development. Both teams adapted the scientific content to the technology so that the tool would allow for population screening with detection of health problems and frailty states. Results: The software was developed in three large blocks that include all the dimensions of frailty: a: sociodemographic variables, b: comorbidities, and c: assessment tools of autonomy-related needs that evaluate the dimensions of frailty. At the end of the evaluation, a detailed report is displayed through bar diagram with the diagnosis of each of the dimensions assessed. The assessment in the participating elderly showed that 44.7% (n = 38) of the population was considered not frail, and 55.3%; (n = 47) as frail. Regarding associated pathologies, high blood pressure (67.1%; n = 57), osteoarthritis and/or arthritis (55.3%; n = 47), diabetes (48.2%; n = 41) and falls during the last year (35.3%; n = 30) were highlighted. Conclusion: Actuasalud is an application that allows nursing professionals to evaluate frailty and issue a quick diagnosis with ordered sequence, which helps to provide individualized care to elderly individuals according to the problems detected during the evaluation.

Geriatric Assessment Scale for Optimal Management of Gastric Cancer in Older Adults Who Underwent Gastrectomy: A Systematic Review.

INTRODUCTION: Stomach cancer is one of the most common causes of cancer worldwide, especially in the population over 65 years. The survival rate of the elderly is lower in comparison with young people, and they are underrepresented in clinical trials and research in general. The evaluation of Multidimensional Geriatric Assessment (MGA) would be key for assessing the prognosis of these patients and therefore having a more informed decision-making process when considering one of the most vulnerable populations. METHODS: A search was performed in the OVID, Embase, and PubBMed databases. There was no restriction on publication time, language, or study design. Eligible studies were those that included geriatric patients with a diagnosis of nonmetastatic stomach cancer who receive oncospecific and surgical management, used Multidimensional/Comprehensive Geriatric Assessment (MGA), and which outcomes included at least overall survival, morbidity, and mortality. RESULTS: Four studies were included, and the MGA battery was not implemented, but rather easily measurable scales such as nutritional status, functional status, cognitive and behavioral disorders, comorbidities, and polypharmacy. Some authors proposed that the assessment of overall survival is not explicit among the included studies; patients with gastric cancer and mild, moderate, severe, and total dependence had higher mortality than independent patients (39% [HR 1.39; 95% CI: 1.09-1.7], 68% [95% CI: 1.46-1.93], 187% [HR 2.87 95% CI: 2.47-3.34], and 234% [95% CI: 2.81-3.97]), respectively. The Zhou study showed an association between sarcopenia, assessed by imaging studies, and a longer hospital stay in days (16 [9] vs. 13 [6], p 0.004). The study by Pujara found that polypharmacy (OR 2.36 CI: 1.08-5.17) and weight loss greater than 10% in the past 6 months were associated with greater postoperative morbidity at 90 days (OR 2.36 CI: 1.08-5.17, OR 11.21 CI: 2.16-58.24). CONCLUSION: MGA was not broadly implemented. Geriatric assessment dependency appears to be a prognostic marker of survival in patients with gastric cancer. Sarcopenia appears to be an important prognostic marker for short- and long-term outcomes. Higher quality studies in this specific population are required to support the systematic use of this assessment for the choice of appropriate therapy according to the patient.

Association between telomere length and anorexia of ageing: a cross-sectional study conducted with community-dwelling older people.

BACKGROUND: To verify whether shorter telomere length is associated with anorexia of ageing in community-dwelling older people. METHODS: Conducted as a cross-sectional investigation, the study enrolled 448 participants residing in an urban area of a municipality in Brazil. Relative telomere length in blood samples was measured using quantitative polymerase chain reaction (qPCR), whereas the presence of anorexia of ageing was determined using the Simplified Appetite Nutritional Questionnaire. Data analysis employed multiple logistic regression. RESULTS: Among the 448 older individuals surveyed, 70.69% were female, and the predominant age bracket ranged from 60 to 69 years (45.08%). Approximately 25% exhibited the shortest telomeric length, with a corresponding anorexia of ageing prevalence of 41.16%. Older individuals with diminished telomere lengths displayed an increased likelihood of experiencing anorexia of ageing (odds ratio [OR] = 1.92; 95% confidence interval [CI] = 1.12-3.29), independent of factors such as gender, age group, depressive symptoms, pain and performance in basic daily life activities. CONCLUSIONS: The observed association between anorexia of ageing and a telomeric biomarker underscores the imperative to meticulously evaluate the nutritional dimensions of older people, with a view to implementing interventions that may enhance their overall health status.

Swallowing performance of elderly people and sociodemographic, cognitive and language factors. / Desempenho de deglutição de idosos e seus fatores sociodemográficos, cognitivos e de linguagem.

PURPOSE: To analyze the correlation between swallowing, language and cognition performance and describe the sociodemographic data of elderly people without previous neurological disorders. METHODS: Analytical cross-sectional study, with non-probabilistic sample for convenience and data collection by telecall. The aspiration screening test (Yale Swallow Protocol) was used to identify and exclude elderly people at risk of aspiration. Then, sociodemographic data were collected, and instruments were applied: activity of daily living (IADLs), risk of dysphagia (EAT-10), cognitive screening (Mini Mental State Examination - MMSE) and language (Montreal-Toulouse Language Battery - MTL-Brazil). RESULTS: The sample consisted of 32 elderly people from the Federal District, with a mean age of 69.00±7.73 years and schooling of 10.00±5.60 years. The scores on the EAT-10, MMSE and MTL Battery instruments were altered in four, 22 and 26 elderly, respectively, indicating, in this case, risk of dysphagia, suggestion of cognitive alteration and language alteration. Regarding food, of the total sample, 13 seniors (40%) complained of needing modified food, as well as 10 of these also obtained MMSE scores suggestive of cognitive alteration. When comparing the groups with and without complaints and/or risk of dysphagia, there was no statistically significant difference in relation to sociodemographic, cognitive and language variables. Binary logistic regression models also showed no statistically significant results. CONCLUSION: The present study, when correlating the swallowing, language and cognition findings, did not obtain statistically significant results. It was observed that the elderly with swallowing complaints also showed results suggestive of cognitive and language changes in the tests performed, but there was no statistically significant difference in relation to the elderly without complaints or swallowing changes.

OBJETIVO: Analisar a correlação entre o desempenho de deglutição, linguagem e cognição e descrever os dados sociodemográficos de idosos sem alterações neurológicas prévias. MÉTODO: Estudo transversal analítico, com amostra não-probabilística por conveniência e coleta de dados por telechamada. Foi aplicado o teste de triagem de broncoaspiração (Yale Swallow Protocol) para identificação e exclusão dos idosos com risco de broncoaspiração. Em seguida, realizou-se coleta de dados sociodemográficos e aplicação dos instrumentos de: atividade de vida diária (AIVDs), risco de disfagia (EAT-10), rastreio cognitivo (Mini Exame do Estado Mental ­ MEEM) e linguagem (Bateria Montreal-Toulouse de Linguagem ­ MTL-Brasil). RESULTADOS: A amostra foi composta por 32 idosos do Distrito Federal, com média de idade de 69,00±7,73 anos e de escolaridade de 10,00±5,60 anos. Os escores nos instrumentos EAT-10, MEEM e Bateria MTL apresentaram-se alterados em quatro, 22 e 26 idosos, respectivamente, indicando, nesse caso, risco de disfagia, sugestão de alteração cognitiva e alteração da linguagem. Sobre a alimentação, do total da amostra, 13 idosos (40%) apresentaram queixa de necessidade de comida modificada, bem como 10 desses também obtiveram escore no MEEM sugestivo de alteração cognitiva. Ao comparar os grupos com e sem queixa e/ou risco de disfagia, não houve diferença estatisticamente significante em relação às variáveis sociodemográficas, cognitivas e de linguagem. Os modelos de regressão logística binária também evidenciaram resultados sem significância estatística. CONCLUSÃO: O presente estudo, ao correlacionar os achados de deglutição, linguagem e cognição, não obteve resultados estatisticamente significantes. Observou-se que os idosos com queixa de deglutição também apresentaram resultados sugestivos de alteração cognitiva e de linguagem nos testes realizados, mas não houve diferença estatisticamente significante em relação aos idosos sem queixa ou alteração de deglutição.

Relationship between mastication and malnutrition in community-dwelling older adults: a meta-analysis.

PURPOSE: To determine the relationship between mastication and malnutrition in community-dwelling older adults. RESEARCH STRATEGIES: To establish the eligibility criteria, the acronym PECOS was used: Population: non-institutionalized older adults; Exposure: older adults with malnutrition; Control: older adults without malnutrition; Outcome: masticatory problems in malnourished older adults; Study types: observational studies. SELECTION CRITERIA: It selected studies assessing malnutrition and mastication difficulties in non-institutionalized adults over 60 years old, of both sexes. Mastication and malnutrition were evaluated with questionnaires on self-reported symptoms and clinical and instrumental assessments. There were no restrictions on language, year of publication, or ethnicity. DATA ANALYSIS: The included studies were evaluated for methodological quality with the Joanna Briggs Institute tool for cross-sectional studies. For the cross-sectional studies included, the odds ratio (OR) was calculated with 95% confidence intervals. RESULTS: After searching the databases, 692 references were retrieved, with three studies selected for quantitative and qualitative analysis. The values obtained in the meta-analysis for association show that malnutrition and mastication difficulties were 2.21 times as likely to occur (OR = 2.21; 95%CI = 0.93 - 5.26; I2 = 94%) as individuals without malnutrition (p < 0.001). The assessment of the risk of bias presented a high-risk, a moderate-risk, and a low-risk study. The certainty of evidence was rated very low with the GRADE tool. CONCLUSION: Individuals at risk of malnutrition are 2.21 times as likely to have mastication difficulties.

A rural teledentistry care experience: a geriatric approach to assessing oral health status and treatment needs in older adults from a Mapuche community in Chile.

Background: Limited attention has been given to oral health challenges faced by older Indigenous populations, especially in rural settings, where disparities exist. This study aims to assess oral health in a rural Mapuche community in southern Chile, utilizing geriatric technology support, and exploring the connection between geriatric health and oral well-being to fill a gap in this context. Methods: A cross-sectional study was conducted involving 76 independent older adults from a rural Mapuche community who required dental care. Assessments were in a remote care setting gathering extensive data including comprehensive geriatric assessments, medical and dental conditions using a geriatric teledentistry platform (TEGO®). Statistical analysis involved descriptive analysis, logistic regression, and both multiple correspondence analysis and k-means cluster analysis. Results: The sample comprised individuals with limited formal education and a high degree of vulnerability. Geriatric assessments unveiled cognitive deterioration, frailty, depression risk, and multimorbidity. A distribution of the DMFT index, number of remaining teeth, number of occluding pairs, number of teeth with restorative needs and other relevant clinical findings was conducted based on sociodemographic, and medical-geriatric-dental characteristics, and additionally, a Multinomial Logistic Regression Analysis of Dentition Variables in Relation to Geriatric Assessments was performed. The dental burden was substantial, with an average DMFT index of 25.96 (SD 4.38), high prevalence of non-functional dentition (89.3%), periodontal disease (83%), xerostomia (63.2%) and oral mucosal lesions (31.5%). Age, lower education, depression, daily medication number and sugary consumption frequency were associated with a decreased average number of teeth (p < 0.05). Multiple correspondence analysis and k-means cluster analysis identified 4 clusters, with the edentulous and functional dentition groups being the most distinct. Conclusion: This study uncovers a substantial dental burden and intricate medical-geriatric conditions interlinked among Indigenous older adults in a rural Chilean Mapuche community. The implementation of a geriatric technological ecosystem in the community enabled the resolution of less complex oral health issues and facilitated remote consultations with specialists, reducing the necessity for travel to health centers. This underscores the need for innovative dental public health initiatives to address health disparities and improve the overall well-being of older Indigenous adults.

Prognostic Value of New Sarcopenia Screening Tool in the Elderly-SARC-GLOBAL.

Sarcopenia screening tools have a low capacity to predict adverse outcomes that are consequences of sarcopenia in the elderly population. This study aimed to evaluate the ability of a new sarcopenia screening tool SARC-GLOBAL to predict negative clinical outcomes in the elderly. A total of 395 individuals were evaluated in a 42-month period. The screening tools SARC-GLOBAL, SARC-F, and SARC-CalF and the diagnosis of sarcopenia according to European Working Group on Sarcopenia in Older Persons (EWGSOP2) were performed at the beginning of the study. Logistic and Poisson regression models were applied to assess the predictive value of the tools for the odds and risks of negative clinical outcomes, respectively. The most common negative clinical outcome in the followed population was falls (12.9%), followed by infections (12.4%), hospitalizations (11.8%), fractures (4.3%), and deaths (2.7%). Both SARC-GLOBAL and SARC-F were similar in predicting the odds of falls and hospitalizations during the follow up period, however SARC-CalF only predicted the odds of hospitalizations at 42 months.

Malnutrition and its determinants among older adults living in foster families in Guadeloupe (French West Indies). A cross-sectional study.

BACKGROUND: Foster families may represent an alternative model for dependent older adults in many countries where nursing homes are insufficiently developed. This study aimed to assess the prevalence of malnutrition and its determinants in older adults living in foster families in Guadeloupe (French West Indies). METHODS: This cross-sectional study was gathered from the KASAF (Karukera Study of Ageing in Foster families) study (n = 107, 41M/66F, Mdn 81.8 years). Nutritional status was assessed with the Mini Nutritional Assessment Short-Form (MNA-SF). Clinical characteristics and scores on geriatric scales (Mini-Mental State Examination (MMSE), Activities of Daily Living (ADL), Short Physical Performance Battery (SPPB), Center for Epidemiologic Studies- Depression (CESD) and Questionnaire Quality of Life Alzheimer's Disease (QoL-AD)) were extracted. Bivariate analysis and logistic models adjusted for age and gender were performed to test the association of nutritional status with socio-demographic variables and geriatric scales. RESULTS: Thirty (28.0%) older adults were malnourished (MNA-SF score ≤7). In bivariate analysis, malnutrition was associated with an increased prevalence of cardiovascular diseases (46.7% versus 19.5%, p = 0.004), the presence of hemiplegia (30.0% versus 6.5%, p = 0.003), a poorer cognitive status (MMSE score 4.7 ± 7.1versus 9.7 ± 10.7; p = 0.031), higher risk of depression (CESD score 27.3 ± 23.0 versus 13.5 ± 14.4; p = 0.035) and dependency (ADL score 1.9 ± 1.9 versus 2.3 ± 2.1; p<0.001). Malnutrition was also associated with lower caregivers'rating of QoL (QoL-AD score 21.8 ± 6.4 versus 26.0 ± 5.7; p = 0.001) but not by older adult's rating (24.1 ± 11.2 versus 28.3 ± 7.7; p = 0.156). Similar associations were observed in logistic models adjusted for age and gender. CONCLUSION: Malnutrition was common among foster families for older adults. Special attention towards the prevention and treatment of malnutrition in older adults from cardiovascular diseases, cognitive impairment, dependency and depression is necessary in this model of dependency support.