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Nutritional risk and its relationship with physical function in community-dwelling older adults

Nutritional risk and its relationship with physical function in community-dwelling older adults
Nutritional risk and its relationship with physical function in community-dwelling older adults

Background: Malnutrition is a serious concern in older populations. Simple screening approaches are needed to identify signs of early nutritional risk in older people, to allow intervention before overt malnutrition develops, along with the poorer health outcomes associated with it, such as sarcopaenia and frailty. The main aim of this study was to compare nutrition risk scores, calculated from the DETERMINE Checklist (‘Determine Your Nutritional Health’, also known as the Nutrition Screening Initiative Checklist), with physical function variables in a group of community-dwelling older adults. Another aim was to assess the prevalence of nutrition risk using the DETERMINE and the MUST (Malnutrition Universal Screening Tool). Methods: Participants of the Hertfordshire Cohort Study (HCS) were recruited and visited at home by a trained researcher. Self-reported physical function was assessed using the SF-36 PF (Short Form-36 Physical Function) scale. The Short Physical Performance Battery (SPPB) was performed, which included the assessment of gait speed, chair rise time and standing balance. Handgrip strength was measured using a Jamar dynamometer. Frailty was assessed according to the presence of at least three of the following Fried frailty criteria: unintentional weight loss, weakness, self-reported exhaustion, slow gait speed and low physical activity. Nutrition risk scores were calculated from the DETERMINE checklist (range 0–21). Nutritional risk was also assessed using the MUST. Analyses were adjusted for sex, age, age left education and number of comorbidities. Results: In the study, 176 participants (94 men and 82 women), median age 83.3 (IQR 81.5–85.7) years, were assessed. Almost half (47%) scored either ‘moderate’ (score 3–5) or ‘high’ (score ≥ 6) nutritional risk (9% were at high risk), using the DETERMINE checklist, whereas 8% were at risk using the MUST. Higher nutrition risk scores, calculated from DETERMINE, were associated with poorer self-reported physical function (difference in SF-36 PF score: − 0.36, 95% CI (− 0.60, − 0.12) SD per unit increase in nutrition risk score, P = 0.004) and higher odds of being frail (odds ratio Fried frailty: 2.23, 95% CI (1.15, 4.33), P = 0.017). There were no significant associations between DETERMINE nutrition risk scores and the other variables examined. Conclusion: Cross-sectional associations between higher nutrition risk scores, assessed from the DETERMINE checklist, and poorer self-reported physical function and greater likelihood of frailty suggest that this screening tool may have utility for screening older populations. Prospective studies are required to explore the ability of the tool to predict poor physical function and frailty, though these data suggest it has potential for early, simple detection of nutritional problems in community-living older adults.

Community, Nutritional risk, Older adults, Physical function, Screening tool
1594-0667
Bloom, Ilse
af2a38ab-3255-414d-afa1-e3089ee45e3f
Zhang, Jean
437abe90-46ac-46de-8183-042c36ed3398
Parsons, Camille
9730e5c3-0382-4ed7-8eaa-6932ab09ec15
Bevilacqua, Gregorio
e93e3b18-7d1e-4da5-9fcd-e6b4637e1c2e
Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Ward, Kate
39bd4db1-c948-4e32-930e-7bec8deb54c7
Bloom, Ilse
af2a38ab-3255-414d-afa1-e3089ee45e3f
Zhang, Jean
437abe90-46ac-46de-8183-042c36ed3398
Parsons, Camille
9730e5c3-0382-4ed7-8eaa-6932ab09ec15
Bevilacqua, Gregorio
e93e3b18-7d1e-4da5-9fcd-e6b4637e1c2e
Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Ward, Kate
39bd4db1-c948-4e32-930e-7bec8deb54c7

Bloom, Ilse, Zhang, Jean, Parsons, Camille, Bevilacqua, Gregorio, Dennison, Elaine, Cooper, Cyrus and Ward, Kate (2022) Nutritional risk and its relationship with physical function in community-dwelling older adults. Aging Clinical and Experimental Research. (doi:10.1007/s40520-022-02171-3).

Record type: Article

Abstract

Background: Malnutrition is a serious concern in older populations. Simple screening approaches are needed to identify signs of early nutritional risk in older people, to allow intervention before overt malnutrition develops, along with the poorer health outcomes associated with it, such as sarcopaenia and frailty. The main aim of this study was to compare nutrition risk scores, calculated from the DETERMINE Checklist (‘Determine Your Nutritional Health’, also known as the Nutrition Screening Initiative Checklist), with physical function variables in a group of community-dwelling older adults. Another aim was to assess the prevalence of nutrition risk using the DETERMINE and the MUST (Malnutrition Universal Screening Tool). Methods: Participants of the Hertfordshire Cohort Study (HCS) were recruited and visited at home by a trained researcher. Self-reported physical function was assessed using the SF-36 PF (Short Form-36 Physical Function) scale. The Short Physical Performance Battery (SPPB) was performed, which included the assessment of gait speed, chair rise time and standing balance. Handgrip strength was measured using a Jamar dynamometer. Frailty was assessed according to the presence of at least three of the following Fried frailty criteria: unintentional weight loss, weakness, self-reported exhaustion, slow gait speed and low physical activity. Nutrition risk scores were calculated from the DETERMINE checklist (range 0–21). Nutritional risk was also assessed using the MUST. Analyses were adjusted for sex, age, age left education and number of comorbidities. Results: In the study, 176 participants (94 men and 82 women), median age 83.3 (IQR 81.5–85.7) years, were assessed. Almost half (47%) scored either ‘moderate’ (score 3–5) or ‘high’ (score ≥ 6) nutritional risk (9% were at high risk), using the DETERMINE checklist, whereas 8% were at risk using the MUST. Higher nutrition risk scores, calculated from DETERMINE, were associated with poorer self-reported physical function (difference in SF-36 PF score: − 0.36, 95% CI (− 0.60, − 0.12) SD per unit increase in nutrition risk score, P = 0.004) and higher odds of being frail (odds ratio Fried frailty: 2.23, 95% CI (1.15, 4.33), P = 0.017). There were no significant associations between DETERMINE nutrition risk scores and the other variables examined. Conclusion: Cross-sectional associations between higher nutrition risk scores, assessed from the DETERMINE checklist, and poorer self-reported physical function and greater likelihood of frailty suggest that this screening tool may have utility for screening older populations. Prospective studies are required to explore the ability of the tool to predict poor physical function and frailty, though these data suggest it has potential for early, simple detection of nutritional problems in community-living older adults.

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Accepted/In Press date: 6 June 2022
e-pub ahead of print date: 1 July 2022
Published date: 1 July 2022
Additional Information: Funding Information: This research is supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre and the Medical Research Council. IB is supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre and Southampton Academy of Research. Publisher Copyright: © 2022, The Author(s).
Keywords: Community, Nutritional risk, Older adults, Physical function, Screening tool

Identifiers

Local EPrints ID: 468315
URI: http://eprints.soton.ac.uk/id/eprint/468315
ISSN: 1594-0667
PURE UUID: 430dfe27-a91d-4f1b-b8c0-e04ef9e8e44e
ORCID for Ilse Bloom: ORCID iD orcid.org/0000-0002-4893-1790
ORCID for Gregorio Bevilacqua: ORCID iD orcid.org/0000-0001-7819-1482
ORCID for Elaine Dennison: ORCID iD orcid.org/0000-0002-3048-4961
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Kate Ward: ORCID iD orcid.org/0000-0001-7034-6750

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Date deposited: 10 Aug 2022 16:35
Last modified: 13 Aug 2022 01:51

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Contributors

Author: Ilse Bloom ORCID iD
Author: Jean Zhang
Author: Camille Parsons
Author: Gregorio Bevilacqua ORCID iD
Author: Elaine Dennison ORCID iD
Author: Cyrus Cooper ORCID iD
Author: Kate Ward ORCID iD

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