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Evaluation of the Nutritional Status of Geriatric Individuals with and without Dementia

Year 2021, Volume: 15 Issue: 3, 521 - 530, 10.09.2021
https://doi.org/10.21763/tjfmpc.883284

Abstract

Introduction: It was aimed to compare the malnutrition and nutritional status of geriatric individuals with and without dementia diagnosis, to evaluate the hand grip strength of geriatric individuals and to examine the difference between individuals who were diagnosed with dementia and those who were not diagnosed with dementia. Method: This study was carried out to compare the nutritional status of individuals who applied to Kastamonu State Hospital Neurology Outpatient Clinic, who were diagnosed with dementia and those who did not. The sample of the study consisted of 51 geriatric individuals aged 65 years and over who were diagnosed with dementia and 51 were not diagnosed with dementia. Groups were determined by randomized method. Anthropometric measurements and food consumption records of the participants were taken. Nutrition Risk Screening (NSI), Katz Activities of Daily Living Scale (ADL), Lawton&Brody Instrumental Activities of Daily Living Scale (EGYA) and EAT-26 Eating Behavior Scale were applied. Results: 58.8% (n=30) of individuals diagnosed with dementia are female, 41.2% (n=21) are male, and 70.5% (n=36) of individuals who are not diagnosed with dementia are female and 29.5% (n=15) are male. The average age of individuals diagnosed with dementia was 78.84 ± 7.844 years, and the average age of individuals not diagnosed with dementia was 75.02 ± 72.26 years. It was determined that there is a significant difference between dementia and malnutrition (p = 0.001), and malnutrition increases as dementia increases. The mean scores of ADL and EGFA scales of individuals diagnosed with dementia (4.039 ± 1.469, 2.118 ± 2.414, respectively) were lower than those who were not diagnosed with dementia (5.431 ± 0.922, 5.000 ± 2.569, respectively). There was no statistically significant difference between hand grip strength and dementia (p> 0.05). Conclusion: One of the important and over looked complications of dementia, the number of which is increasing in our country and around the world, is malnutrition. Nutritional status of individuals diagnosed with dementia should be evaluated regularly at the first meeting and in the follow-up of the disease. Adequate and balanced nutrition of the patient should be provided to prevent malnutrition and maintain functional independence. Further studies to examine the effects of nutrition on dementia will benefit medical nutrition therapy

References

  • 1. United Nations, Department of Economic and Social Affairs, Highlights (2017). World Population Ageing 2015;p1 (ST/ESA/SER.A/397).
  • 2. Yaşlı nüfus sayımı, Türkiye İstatistik Kurumu verileri, 2019. Erişim adresi: http://www.tuik.gov.tr/PreHaberBultenleri. do?id=24644. Erişim tarihi: 06.02.2021
  • 3. Greenwood CE, Parrott MD. Nutrition as a component of dementia risk reduction strategies. Healthc Manag Forum 2017 Jan;30(1):40-45. doi: 10.1177/0840470416662885.
  • 4. Cunningham EL, McGuinness B, Herron B. Dementia. Ulster Med J 2015 May;84(2):79-87.
  • 5. Emre M. Classification and diagnosis of dementia: A mechanism-based approach. Eur J Neurol 2009 Feb;16(2):168-73. doi: 10.1111/j.1468-1331.2008.02379.x
  • 6. Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, et al. Dementia prevention, intervention, and care.Lancet 2017 Dec;16;390(10113):2673-2734. doi: 10.1016/S0140-6736(17)31363-6.
  • 7. Volkert D, Chourdakis M, Faxen-Irving G, Frühwald T, Landi F, Suominen MH, et al. ESPEN guidelines on nutrition in dementia. Clin Nutr2015Dec;34(6):1052-73. doi: 10.1016/j.clnu.2015.09.004.
  • 8. 8. Franx BAA, Arnoldussen IAC, Kiliaan AJ, Gustafson DR. Weight loss in patients with dementia: considering the potential impact of pharmacotherapy. Drugs Aging. 2017;34(6):425–36.
  • 9. Chen JH, Lin KP, Chen YC. Risk factors for dementia. JFormos MedAssoc 2009 Oct;108(10):754-64. doi: 10.1016/S0929-6646(09)60402-2.
  • 10. Bendich A. Fundamentals of nutrition and geriatric syndromes. In: Bales CW, Ritchie CS, Wellman NS, editor. Handbook of Clinical Nutrition and Aging. 2th ed. New York: Humana Press; 2009.p.65-235.
  • 11. Özgüneş N. Huzurevinde yaşayan yaşlılarda beslenme durumunun taranması: Tarama testleri kıyaslaması. Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü Beslenme Bilimleri Programı Yüksek Lisans Tezi, Ankara, 2013.
  • 12. Katz S, Ford AB, Moskowitz RW, et al. Studies of illness in the aged. The index of adl: A standardized measure of biological and psychosocial function. JAMA. 1963;185:914-919
  • 13. Arık G, Varan HD, Yavuz BB, et al. Validation of Katz index of indepence in activities of daily living in Turkish older adults. Arch Gerantol Geriatr 2015; 61;344-350.
  • 14. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969; 9(3):179–186.
  • 15. Şahin S, Boyacıoğlu H, Taşar P.T, Kozan E, Sarıkaya O.F, Akçiçek F, Bornova ilçesinde yaşayan 65 yaş üzeri nüfustaki fonksiyonel bağımlılık oranları, Ege Tıp Dergisi 2016;55(2):65-70
  • 16. Güzel A, Üner S, Turan S, Uçan Yamaç S.Lawton ve Brody Enstrümental Günlük Yaşam Aktiviteleri Ölçeği Türkçe Geçerlik ve Güvenilirliği. 3. Uluslararası 21. Ulusal Halk Sağlığı Kongresi, Antalya. 2019;s733
  • 17. Garner DM, Bohr Y, Garfinkel PE. The eating attitudes test: psychometric features and clinical correlates. Psychol Med 1982 Nov;12(4):871-8. doi: 10.1017/s0033291700049163.14.
  • 18. Ergüney-Okumuş FE, Sertel-Berk HO. Yeme Tutum Testi kısa formunun (YTT-26) Üniversite örnekleminde Türkçeye uyarlanması ve psikometrik özelliklerinin değerlendirilmesi. Psikoloji Çalışmaları. 2020;40(1):57–78. https://doi.org/10.26650/SP2019-0039 19. Behrens S, Wengreen H, Lyketsos C, Sanders C, Tschanz J, Schwartz S. Nutritional status and severe dementia, institutionalization, and mortality: The cache county dementia progression study. Alzheimer’s Dement. 2015;11(7):p835.
  • 20. López-Pousa S, Vilalta-Franch J, Llinàs-Regla J, Garre-Olmo J, Román GC. Incidence of dementia in a rural community in Spain: The Girona cohort study. Neuroepidemiology. Neuroepidemiology 2004;23:170–177
  • 21. Galesi LF, Leandro-Merhi VA, de Oliveira MRM. Association between indicators of dementia and nutritional status in institutionalised older people. Int J Older People Nurs 2013 Sep;8(3):236-43. doi: 10.1111/j.1748-3743.2012.00321.x.
  • 22. Gorzoni ML, Pires SL. Aspectos clínicos da demência senil em instituições asilares Clinical aspectcs of the senile dementia in long-term care facilities. Rev Psiq Clin 2006;33(11):18–23.
  • 23. Walker JG, Batterham PJ, Mackinnon AJ, Jorm AF, Hickie I, Fenech M. Oral folic acid and vitamin B-12 supplementation to prevent cognitive decline in community-dwelling older adults with depressive symptoms - The Beyond Ageing Project: A randomized controlled trial. Am J Clin Nutr 2012 Jan;95(1):194-203.
  • 24. Ford AH, Flicker L, Alfonso H, Thomas J, Clarnette R, Martins R. Vitamins B12, B6, and folic acid for cognition in older men. Neurology. 2010 Oct 26;75(17):1540-7.
  • 25. Sanders C, Behrens S, Schwartz S, Wengreen H, Corcoran CD, Lyketsos CG. Nutritional Status is Associated with Faster Cognitive Decline and Worse Functional Impairment in the Progression of Dementia: The Cache County Dementia Progression Study. J Alzheimer’s Dis 2016;Feb 27; 52(1): 33–42.
  • 26. Meyer S, Gräske J, Worch A, Wolf-Ostermann K. Nutritional status of care-dependent people with dementia in shared-housing arrangements - a one-year follow-up. Scand J Caring Sci 2015 Dec;29(4):785-92. doi: 10.1111/scs.12210.
  • 27. Camcı Y. Demans tanılı yaşlıların günlük yaşam aktiviteleri ile MMSE skorları arasındaki ilişki. Akad Geriatri. 2010;2:52-53.
  • 28. Desai AK, Grossberg GT, Sheth DN. Activities of daily living in patients with dementia: clinical relevance, methods of assessment and effects of treatment. CNS Drugs. 2004;18:853-785.
  • 29. Bachman DL, Wolf PA, Linn RT, Knoefel JE, Cobb JL, Belanger AJ, et al. Incidence of dementia and probable Alzheimer’s disease in a general population: the Framingham Study. Neurology. 1993;43:515-519.
  • 30. Hata J, Yoshida D, Hatabe Y, Oishi E, Honda T, Shibata M. Decline in handgrip strength from midlife to late-life is associated with dementia in a Japanese community: the Hisayama Study. J Epidemiol 2020; 30(1): 15–23.
  • 31. Van Lier AM, Payette H. Determinants of handgrip strength in free-living elderly at risk of malnutrition. Disabil Rehabil. 2003 Oct 21;25(20):1181-6. doi: 10.1080/09638280310001599943.

Demans Tanısı Alan ve Almayan Geriatrik Bireylerin Beslenme Durumlarının Değerlendirilmesi

Year 2021, Volume: 15 Issue: 3, 521 - 530, 10.09.2021
https://doi.org/10.21763/tjfmpc.883284

Abstract

Giriş: Demans tanısı alan ve almayan geriatrik bireylerin malnütrisyon ve beslenme durumlarını değerlendirmek, geriatrik bireylerin el kavrama gücü değerlendirilip demans tanısı alan ve almayan bireyler arasındaki farkı belirlemek amaçlanmıştır. Yöntem: Bu çalışma, Kastamonu Devlet Hastanesi Nöroloji Polikliniğine başvuran, demans tanısı alan ve almayan bireylerin beslenme durumlarını karşılaştırmak amacıyla yapılmıştır. Çalışmanın örneklemini 65 yaş ve üzeri 51 demans tanısı alan ve 51 demans tanısı almayan geriatrik birey oluşturmaktadır. Gruplar randomize yöntemle belirlenmiştir. Katılımcıların, antropometrik ölçümleri ve besin tüketim kayıtları alınmıştır. Beslenme Risk Taraması (NSI), Katz Günlük Yaşam Aktiviteleri Ölçeği (GYA), Lawton&BrodyEnstrümental Günlük Yaşam Aktiviteleri Ölçeği (EGYA) ve EAT-26 Yeme Davranışı Ölçeği uygulanmıştır. Bulgular: Demans tanısı alan bireylerin %58,8’si (n=30) kadın, %41,2’si (n=21) erkek, demans tanısı almayan bireylerin ise %70,5’i (n=36) kadın, %29,5’i (n=15) erkektir. Demans tanısı alan bireylerin yaş ortalaması 78,84 ± 7,84 yıl, demans tanısı almayan bireylerin yaş ortalaması 75,02 ± 72,26 yıl olarak saptanmıştır. Demans ile malnütrisyon arasında anlamlı bir farklılık olduğu(p=0,001), demans arttıkça malnütrisyonun arttığı belirlenmiştir. Demans tanısı alan bireylerin GYA ve EGYA ölçek puanlarının ortalaması (sırasıyla; 4,04±1,47, 2,12±2,41) demans tanısı almayan bireylerden (sırasıyla; 5,43±0,92, 5,00±2.57) daha düşüktür. El kavrama gücü ve demans arasında istatistiksel olarak anlamlı bir fark bulunmamıştır (p>0,05). Sonuç: Ülkemizde ve dünyada sayısı giderek artmakta olan demans hastalığının önemli ve gözden kaçabilen komplikasyonlarından birisi de malnutrisyondur. Beslenme durumu demans tanısı konan bireylerde ilk görüşmede ve hastalığın takiplerinde düzenli olarak değerlendirilmelidir. Malnütrisyonun engellenmesi ve fonksiyonel bağımsızlığın sürdürülebilmesi için hastanın yeterli ve dengeli beslenmesi sağlanmalıdır. Beslenmenin demansa olan etkilerinin incelenmesi için daha fazla çalışma yapılması tıbbi beslenme tedavisine fayda sağlayacaktır.

References

  • 1. United Nations, Department of Economic and Social Affairs, Highlights (2017). World Population Ageing 2015;p1 (ST/ESA/SER.A/397).
  • 2. Yaşlı nüfus sayımı, Türkiye İstatistik Kurumu verileri, 2019. Erişim adresi: http://www.tuik.gov.tr/PreHaberBultenleri. do?id=24644. Erişim tarihi: 06.02.2021
  • 3. Greenwood CE, Parrott MD. Nutrition as a component of dementia risk reduction strategies. Healthc Manag Forum 2017 Jan;30(1):40-45. doi: 10.1177/0840470416662885.
  • 4. Cunningham EL, McGuinness B, Herron B. Dementia. Ulster Med J 2015 May;84(2):79-87.
  • 5. Emre M. Classification and diagnosis of dementia: A mechanism-based approach. Eur J Neurol 2009 Feb;16(2):168-73. doi: 10.1111/j.1468-1331.2008.02379.x
  • 6. Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, et al. Dementia prevention, intervention, and care.Lancet 2017 Dec;16;390(10113):2673-2734. doi: 10.1016/S0140-6736(17)31363-6.
  • 7. Volkert D, Chourdakis M, Faxen-Irving G, Frühwald T, Landi F, Suominen MH, et al. ESPEN guidelines on nutrition in dementia. Clin Nutr2015Dec;34(6):1052-73. doi: 10.1016/j.clnu.2015.09.004.
  • 8. 8. Franx BAA, Arnoldussen IAC, Kiliaan AJ, Gustafson DR. Weight loss in patients with dementia: considering the potential impact of pharmacotherapy. Drugs Aging. 2017;34(6):425–36.
  • 9. Chen JH, Lin KP, Chen YC. Risk factors for dementia. JFormos MedAssoc 2009 Oct;108(10):754-64. doi: 10.1016/S0929-6646(09)60402-2.
  • 10. Bendich A. Fundamentals of nutrition and geriatric syndromes. In: Bales CW, Ritchie CS, Wellman NS, editor. Handbook of Clinical Nutrition and Aging. 2th ed. New York: Humana Press; 2009.p.65-235.
  • 11. Özgüneş N. Huzurevinde yaşayan yaşlılarda beslenme durumunun taranması: Tarama testleri kıyaslaması. Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü Beslenme Bilimleri Programı Yüksek Lisans Tezi, Ankara, 2013.
  • 12. Katz S, Ford AB, Moskowitz RW, et al. Studies of illness in the aged. The index of adl: A standardized measure of biological and psychosocial function. JAMA. 1963;185:914-919
  • 13. Arık G, Varan HD, Yavuz BB, et al. Validation of Katz index of indepence in activities of daily living in Turkish older adults. Arch Gerantol Geriatr 2015; 61;344-350.
  • 14. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969; 9(3):179–186.
  • 15. Şahin S, Boyacıoğlu H, Taşar P.T, Kozan E, Sarıkaya O.F, Akçiçek F, Bornova ilçesinde yaşayan 65 yaş üzeri nüfustaki fonksiyonel bağımlılık oranları, Ege Tıp Dergisi 2016;55(2):65-70
  • 16. Güzel A, Üner S, Turan S, Uçan Yamaç S.Lawton ve Brody Enstrümental Günlük Yaşam Aktiviteleri Ölçeği Türkçe Geçerlik ve Güvenilirliği. 3. Uluslararası 21. Ulusal Halk Sağlığı Kongresi, Antalya. 2019;s733
  • 17. Garner DM, Bohr Y, Garfinkel PE. The eating attitudes test: psychometric features and clinical correlates. Psychol Med 1982 Nov;12(4):871-8. doi: 10.1017/s0033291700049163.14.
  • 18. Ergüney-Okumuş FE, Sertel-Berk HO. Yeme Tutum Testi kısa formunun (YTT-26) Üniversite örnekleminde Türkçeye uyarlanması ve psikometrik özelliklerinin değerlendirilmesi. Psikoloji Çalışmaları. 2020;40(1):57–78. https://doi.org/10.26650/SP2019-0039 19. Behrens S, Wengreen H, Lyketsos C, Sanders C, Tschanz J, Schwartz S. Nutritional status and severe dementia, institutionalization, and mortality: The cache county dementia progression study. Alzheimer’s Dement. 2015;11(7):p835.
  • 20. López-Pousa S, Vilalta-Franch J, Llinàs-Regla J, Garre-Olmo J, Román GC. Incidence of dementia in a rural community in Spain: The Girona cohort study. Neuroepidemiology. Neuroepidemiology 2004;23:170–177
  • 21. Galesi LF, Leandro-Merhi VA, de Oliveira MRM. Association between indicators of dementia and nutritional status in institutionalised older people. Int J Older People Nurs 2013 Sep;8(3):236-43. doi: 10.1111/j.1748-3743.2012.00321.x.
  • 22. Gorzoni ML, Pires SL. Aspectos clínicos da demência senil em instituições asilares Clinical aspectcs of the senile dementia in long-term care facilities. Rev Psiq Clin 2006;33(11):18–23.
  • 23. Walker JG, Batterham PJ, Mackinnon AJ, Jorm AF, Hickie I, Fenech M. Oral folic acid and vitamin B-12 supplementation to prevent cognitive decline in community-dwelling older adults with depressive symptoms - The Beyond Ageing Project: A randomized controlled trial. Am J Clin Nutr 2012 Jan;95(1):194-203.
  • 24. Ford AH, Flicker L, Alfonso H, Thomas J, Clarnette R, Martins R. Vitamins B12, B6, and folic acid for cognition in older men. Neurology. 2010 Oct 26;75(17):1540-7.
  • 25. Sanders C, Behrens S, Schwartz S, Wengreen H, Corcoran CD, Lyketsos CG. Nutritional Status is Associated with Faster Cognitive Decline and Worse Functional Impairment in the Progression of Dementia: The Cache County Dementia Progression Study. J Alzheimer’s Dis 2016;Feb 27; 52(1): 33–42.
  • 26. Meyer S, Gräske J, Worch A, Wolf-Ostermann K. Nutritional status of care-dependent people with dementia in shared-housing arrangements - a one-year follow-up. Scand J Caring Sci 2015 Dec;29(4):785-92. doi: 10.1111/scs.12210.
  • 27. Camcı Y. Demans tanılı yaşlıların günlük yaşam aktiviteleri ile MMSE skorları arasındaki ilişki. Akad Geriatri. 2010;2:52-53.
  • 28. Desai AK, Grossberg GT, Sheth DN. Activities of daily living in patients with dementia: clinical relevance, methods of assessment and effects of treatment. CNS Drugs. 2004;18:853-785.
  • 29. Bachman DL, Wolf PA, Linn RT, Knoefel JE, Cobb JL, Belanger AJ, et al. Incidence of dementia and probable Alzheimer’s disease in a general population: the Framingham Study. Neurology. 1993;43:515-519.
  • 30. Hata J, Yoshida D, Hatabe Y, Oishi E, Honda T, Shibata M. Decline in handgrip strength from midlife to late-life is associated with dementia in a Japanese community: the Hisayama Study. J Epidemiol 2020; 30(1): 15–23.
  • 31. Van Lier AM, Payette H. Determinants of handgrip strength in free-living elderly at risk of malnutrition. Disabil Rehabil. 2003 Oct 21;25(20):1181-6. doi: 10.1080/09638280310001599943.
There are 30 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Orijinal Articles
Authors

Gülçin Yılmaz This is me 0000-0002-2790-1525

Kezban Esen Karaca 0000-0002-3625-4761

Publication Date September 10, 2021
Submission Date February 20, 2021
Published in Issue Year 2021 Volume: 15 Issue: 3

Cite

Vancouver Yılmaz G, Karaca KE. Demans Tanısı Alan ve Almayan Geriatrik Bireylerin Beslenme Durumlarının Değerlendirilmesi. TJFMPC. 2021;15(3):521-30.

English or Turkish manuscripts from authors with new knowledge to contribute to understanding and improving health and primary care are welcome.