scholarly journals Effects of a multi-component nutritional telemonitoring intervention on nutritional status, diet quality, physical functioning and quality of life of community-dwelling older adults

2018 ◽  
Vol 119 (10) ◽  
pp. 1185-1194 ◽  
Author(s):  
Marije N. van Doorn-van Atten ◽  
Annemien Haveman-Nies ◽  
Marit M. van Bakel ◽  
Monique Ferry ◽  
Maite Franco ◽  
...  

AbstractThis study aimed to evaluate the effects of an intervention including nutritional telemonitoring, nutrition education, and follow-up by a nurse on nutritional status, diet quality, appetite, physical functioning and quality of life of Dutch community-dwelling elderly. We used a parallel arm pre-test post-test design with 214 older adults (average age 80 years) who were allocated to the intervention group (n97) or control group (n107), based on the municipality. The intervention group received a 6-month intervention including telemonitoring measurements, nutrition education and follow-up by a nurse. Effect measurements took place at baseline, after 4·5 months, and at the end of the study. The intervention improved nutritional status of participants at risk of undernutrition (β(T1)=2·55; 95 % CI 1·41, 3·68;β(T2)=1·77; 95 % CI 0·60, 2·94) and scores for compliance with Dutch guidelines for the intake of vegetables (β=1·27; 95 % CI 0·49, 2·05), fruit (β=1·24; 95 % CI 0·60, 1·88), dietary fibre (β=1·13; 95 % CI 0·70, 1·57), protein (β=1·20; 95 % CI 0·15, 2·24) and physical activity (β=2·13; 95 % CI 0·98, 3·29). The intervention did not have an effect on body weight, appetite, physical functioning and quality of life. In conclusion, this intervention leads to improved nutritional status in older adults at risk of undernutrition, and to improved diet quality and physical activity levels of community-dwelling elderly. Future studies with a longer duration should focus on older adults at higher risk of undernutrition than this study population to investigate whether the impact of the intervention on nutritional and functional outcomes can be improved.

2017 ◽  
Vol 36 (1) ◽  
pp. 267-274 ◽  
Author(s):  
Sjors Verlaan ◽  
Terry J. Aspray ◽  
Juergen M. Bauer ◽  
Tommy Cederholm ◽  
Jaimie Hemsworth ◽  
...  

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 173s-173s
Author(s):  
Y.-F. Chang ◽  
Y.-C. Yu ◽  
J. Tsai Lai

Background and context: Since 1982, cancer has been the leading cause of death in Taiwan, claiming more than 40,000 lives each year. This not only caused huge medical expenses, but also affected the quality of life of patients and their families. However, many cancer survivors and their caregivers do not fully understand lifestyle advice, including nutrition and dietary behaviors, to lower the progression of the disease. Due to cancer and painstaking treatment, cancer patients often suffer from inadequate calories intake and serious body weight (BW) loss, which is highly related to malnutrition or cancer cachexia. After they leave the hospital, they still need nutritional guidance; therefore, the importance of providing nutrition services in the community should be emphasized. Aim: To help cancer survivors achieve better nutritional status by teaching them how to have adequate calories intakes and maintain BW that they're supposed to have better quality of life. Strategy/Tactics: (1) Cancer survivors with nutritional needs were referred from 66 cooperative cancer resources centers of hospitals nationwide. (2) Dietitians assess their nutritional conditions and provide nutritional guidance. (3) Deliver free nutritional supplements to the cancer survivors who are financially disadvantaged or have dysphagia problems. Program/Policy process: The registered dietitians conducted nutritional education through nutrition counseling and guidance. For those who are financially disadvantaged or have dysphagia problems, the 24-hour dietary recall and PG-SGA scale were used to assess the survivors' nutritional status, including BW and calories intake, then free nutritional supplements according to their needs and a regular follow-up to collect their BW and nutritional information changes after our interventions were done. Outcomes: From 2016 to 2017, a total of 434 of cancer survivors who have financial difficulties or dysphagia problems accepted the free nutritional supplements and nutritional guidance services. 178 survivors completed follow-up and collected nutritional information. 40.4% of them are head and neck cancers, 38.2% are digestive system-related cancers that were in poor eating conditions. After our interventions, 70.2% of these survivors can maintain or increase their BW with average BW 57.9 ± 12.8 kg; and 77.0% can maintain or increase the calories intake, which average increased from 1798 ± 252.5 kcal/day to 1541.6 ± 347.9 kcal/day. What was learned: We can effectively help cancer survivors achieve adequate calories intakes and maintain BW to prevent the occurrence of malnutrition by providing the services of nutritional supplements and nutritional guidance.


Author(s):  
Sanne W. T. Frazer ◽  
Rozan van der Veen ◽  
Anneloes Baan ◽  
Mariëlle E. W. Hermans ◽  
Branko F. Olij

There is strong evidence that effective fall prevention elements exist, but the implementation into society remains difficult. The aim of the current study is to describe and evaluate the implementation of the fall prevention programme “Thuis Onbezorgd Mobiel” (TOM). This novel approach combines effective components into a multidisciplinary group-based programme for adults aged 65 years or older with an increased risk of falling. To investigate the impact on several health-related outcomes such as subjective health, quality of life, physical functioning, and falls, we applied a quasi-experimental pre–post design including a follow-up period. A total of 164 older adults subscribed to the programme: 80 were eligible to start and 73 completed it. The impact analysis revealed a significant improvement in subjective health, physical functioning, and quality of life directly after participating in the programme. The impact on subjective health and quality of life persisted six months after the programme. Important facilitators for the implementation of the programme were social contact and clear communication. Lack of a concrete follow-up was seen as an important barrier. The results of the current research help guide further implementation of effective fall prevention interventions in practice.


Author(s):  
Shefaly Shorey ◽  
Ee Heok Kua ◽  
Wilson Tam ◽  
Valerie Chan ◽  
Yong Shian Goh ◽  
...  

In Singapore, many older adults suffer from subsyndromal depression and/or subsyndromal anxiety, which can negatively impact their physical and mental well-being if left untreated. Due to the general public’s reluctance to seek psychological help and the low psychiatrist-to-population ratio in Singapore, this study aims to examine the preliminary efficacy, perceptions, and acceptability of a trained volunteer-led community-based intervention on community-dwelling older adults. Twenty-one participants (control: n = 11; intervention: n = 10) completed the randomized pilot study. A mixed-methods approach (questionnaires, semistructured interviews, examining blood samples, intervention fidelity) was adopted. No significant differences were found between the intervention and the control groups in depression, anxiety, life satisfaction, friendship, and quality of life. However, there was a positive change in quality-of-life scores from baseline to 6 months in the intervention group. The control group had significantly higher cortisol levels and lower annexin-A1 levels at 6 months, while the intervention group did not. Three themes emerged from the interviews: (1) impact of the intervention on older adults’ well-being, (2) attitudes toward intervention, and (3) a way forward. However, intervention efficacy could not be established due to small sample size caused by the coronavirus pandemic. Future randomized controlled trials should evaluate volunteer-led, technology-based psychosocial interventions to support these older adults.


2020 ◽  
Author(s):  
Dipanwita Dasgupta ◽  
Beenish Chaudhry ◽  
Kimberly Greeves ◽  
Joyce Long ◽  
Mayra Duarte ◽  
...  

BACKGROUND Successful Aging is a multidimensional concept that encompasses mental and physical health, chronic disease management and social engagement of older adults. A number of mobile health interventions have been designed to promote Successful Aging, but the majority focus on only one dimension. Moreover, there is a dearth of research studies that explore the feasibility and long-term acceptance of these interventions in community-dwelling older adults from lower socioeconomic strata (SES), who can derive the greatest health and economic benefits from such interventions. OBJECTIVE To study the long-term feasibility of an integrated intervention, which combined mobile technology with social relationships, in improving perceptions of Successful Aging in community-dwelling low-SES older adults. METHODS The intervention combined mobile technology with social relationships. The mobile technology component of the intervention consisted of a tablet-based application, eSeniorCare, that allowed older adults to track their medications and health activities and play proprietary gaming apps from the online app store. Whereas the social component consisted of weekly technology workshops and meetups. Study Design. We used a pre-test post-test experimental design approach with two groups (intervention and control). 25 older adults were recruited in each group. Each participant in the intervention group received a tablet PC pre-installed with the eSeniorCare app and various gaming apps. The control group received usual care. Participants completed self-reported outcomes consisting of SF12v2 and Older Person Quality of Life (OPQOL) questionnaires both at the beginning and at the end of the study. The study lasted for 42 weeks during which the intervention group used the eSeniorCare app to track their medications and health activities, and they also played the installed gaming apps. In addition, they received technology training via weekly workshops, where they interacted with participants in the intervention group and the study staff. RESULTS The results indicate that the integrated intervention significantly improved participants’ perceptions of their mental health and health-related quality of life. Specifically, they found that the eSeniorCare app improved their adherence to medication regimen and motivated them to pursue their health goals. They also thought that playing tablet games was men- tally stimulating and it improved their overall cognitive health. By the end of the study, the intervention group preferred technology over paper for managing their medications and health goals, while no one in the control group wanted to preferred technology over paper. CONCLUSIONS An integrated mobile health intervention is feasible for long-term use by community-dwelling older adults from lower SES and community-based caregivers. It improved perceptions of mental health and health related quality of life among the study participants.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Arkers Kwan Ching WONG ◽  
Frances Kam Yuet WONG ◽  
Jenny Sau Chun NGAI ◽  
Shirley Yu Kan HUNG ◽  
Wah Chun LI

Abstract Background Previous studies supporting discharged patients are hospital-based which admission criteria tend to include mainly those with complex needs and/or specific disease conditions. This study captured the service gap where these non-frail older patients might have no specific medical problem upon discharge but they might encounter residual health and social issues when returning home. Methods Discharged community-dwelling non-frail older adults from an emergency medical ward were recruited and randomized into either intervention (n = 37) or control (n = 38) group. The intervention group received a 12-week complex interventions that included structured assessment, health education, goal empowerment, and care coordination supported by a health-social team. The control group received usual discharge care and monthly social call. The primary outcome was health-related quality of life (HRQoL). Secondary outcomes included activities of daily living (ADL), the presence of depressive symptoms, and the use of health services. The outcomes were measured at pre-intervention (T1) and at three months post-intervention (T2). The independent t-test or the Mann-Whitney U test was used to analyze the group differences in HRQoL, ADL, and presence of depressive symptoms according to the normality of data. Results Analysis showed that the intervention group experienced a statistically significantly improvement in the mental component scale of quality of life (p = .036), activities of daily living (p = .005), and presence of depressive symptoms (p = .035) at T2 compared with at T1. No significant differences were found in the control group. Conclusions Supporting self-care is necessary to enable community-dwelling non-frail older adults to be independent to the fullest extent possible in the community. The promising results found in this pilot study suggested that the integration of the health-social partnership into transitional care practice is effective and can be sustained in the community. Future studies can draw on these findings and maximize the integrated care quality during the transition phase. Trial registration NCT04434742 (date: 17 June 2020, retrospectively registered).


2020 ◽  
Vol 36 (12) ◽  
Author(s):  
Daniela Cristina Sampaio de Brito ◽  
Elaine Leandro Machado ◽  
Ilka Afonso Reis ◽  
Mariangela Leal Cherchiglia

Although renal replacement therapy has contributed to the survival of chronic kidney failure (CKF) patients, mortality remains a major concern. This study aimed to identify the factors associated with mortality in a prospective cohort of CKF patients. Sociodemographic, clinical, nutritional, lifestyle and quality of life data were collected from 712 patients. The instruments used were the Short-Form Health Survey (SF-36), Global Subjective Assessment (GSA) and Charlson Comorbidity Index (CCI) questionnaires. A total of 444 patients died during the study. After five years of follow-up, factors such as not being married (hazard ratio - HR = 1.289, 95%CI: 1.001; 1.660), a low frequency of leisure activities (HR = 1.321; 95%CI: 1.010; 1.727) and not being transplanted (HR = 7.246; 95%CI: 3.359; 15.630) remained independently associated with the risk of mortality. At the end of the follow-up period, factors such as not being married (HR = 1.337, 95%CI: 1.019; 1.756), not being transplanted (HR = 7.341, 95%CI: 3.829; 14.075) and having a worse nutritional status (HR = 1.363, 95%CI: 1.002; 1.853) remained independently associated with an increased risk of mortality, whereas a high schooling level (10 to 12 years, HR = 0.578, 95%CI: 0.344; 0.972; and over 12 years, HR = 0.561, 95%CI: 0.329; 0.956) and a better SF-36 physical functioning score (HR = 0.992, 95%CI: 0.987; 0.998) were protective factors associated with survival. The survival of patients with CKF is associated with factors not restricted to the clinical spectrum. The following factors were associated with high mortality: not being married, low schooling level, a limited social routine, a longer time on dialysis, worse nutritional status, and worse physical functioning.


2020 ◽  
Author(s):  
Gopal Nambi ◽  
Walid Kamal Abdelbasset ◽  
Anju Verma ◽  
Arul Vellaiyan

Abstract Background: Sarcopenia is the major health concern and common consequence of COVID-19 in the aging population. Moreover, this clinical condition has not been considered in usual physical rehabilitation practice and nor its exercise protocol is well defined, which requires a meaningful study in this field.Objective: To find and compare the low and moderate intensity aerobic training protocols on clinical and psychological effects in community dwelling COVID-19 asymptomatic older adults with Sarcopenia symptoms. Methods: By using computer random table method the eligible participants were randomized into two groups. First group received low-intensity aerobic training (LAT; n = 38) and the second group received moderate-intensity aerobic training (MAT; n = 38) for 8 weeks. Clinical (muscle strength, muscle mass and physical performance) and psychological (kinesiophobia and quality of life) measures were measured at baseline, at 4th week, 8th week and at 6 month follow up. Results: Baseline demographic and clinical attributes show homogenous presentation among the study groups (p>0.05). After eight weeks of different aerobic trainings, and at the end of 6 months follow up, the hand grip strength, -3.0 (CI 95% -4.16 to -1.83), chair stand test -2.7 (-3.29 to -2.10), physical performance -0.08 (-0.10 to -0.05), kinesiophobia, 4.2 (3.25 to 5.14), and quality of life -5.7 (-8.4 to -2.9) shows more improvement (p<0.001) in LAT group than MAT group but in muscle mass both groups did not show any significant difference (p>0.05).Conclusion: This study reports that low intensity aerobic training exercises improve the clinical (muscle strength and physical performance) and psychological (kinesiophobia and quality of life) aspects than moderate intensity aerobic training in COVID-19 asymptomatic older adults with Sarcopenia symptoms. At the same time both types of aerobic training exercises have negligible or little role in increasing the muscle quantity - cross sectional area.


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