Malnutrition, low diet quality and its risk factors among older adults with low socio-economic status: a scoping review.

Low socio-economic status (SES) is often associated with various health-related problems. Therefore, the present paper aims to review the available literature to identify the prevalence of malnutrition, prevalence of poor diet quality and its associated risk factors among older adults with low SES. A literature search was performed using four databases, namely PubMed, Google Scholar, Springer and Science Direct. The search terms used were 'diet quality', 'nutritional status', 'dietary intake', 'overweight', 'obesity', 'underweight', 'older people' and 'low socioeconomic status (SES)'. The overall prevalence of undernutrition among older adults with low SES worldwide was in the range of 28·9 to 48 %, while overnutrition was reported to be between 8·1 to 28·2 %. In Asia, the prevalence of undernourished older adults ranged from 3 to 64·9 %, while 2·5 to 32·8 % were overnourished. Most of the studies (60 %) included in the present review used BMI as the tool to identify malnutrition, but none of the nutritional screening tools were considered to be the 'gold standard'. For dietary assessment, FFQ and multiple 24 h dietary recall improved the estimation of individual dietary intake. Risk factors for poor diet quality included financial hardship, functional limitation, sex, place of residence, smoking and oral health. Poor nutritional status, especially lack of good-quality diet, and thinness are prevalent among older adults with low SES. Hence, it is important to establish nutrition-related programmes and intervention studies among this group of individuals for improving their health status and quality of life.

Computed tomography assessment of bone lesions in patients with POEMS syndrome.

OBJECTIVES: To describe the imaging findings on computed tomography (CT) and skeletal survey (SS) in patients with POEMS syndrome. METHODS: We retrospectively reviewed, with institutional review board approval, the dysproteinemia database at our institution for patients with new diagnosis of POEMS syndrome between January 1998 and December 2008. Twenty-four patients were identified with PET/CT or CT and had skeletal survey (SS) available for review. RESULTS: Twenty-four patients were included in the study group with median age of 47 years. All CTs demonstrated at least one sclerotic lesion. The most common pattern was multiple small lesions, with 18 patients (75%) having at least 5 lesions less than 1 cm. The larger lesions had a central lytic component and were FDG avid. SS had a false negative rate of 36% (8 patients). Serial CT after treatment showed a decrease in size and number of sclerotic lesions in 53% of cases (13 patients), the majority showing increased sclerosis. Two patients had complete resolution of sclerotic lesions. CONCLUSIONS: CT identified sclerotic lesions in all study patients with POEMS syndrome, the majority being less than 1 cm in size, which were not identified radiographically. CT may demonstrate increased sclerosis or even resolution of sclerotic lesions corresponding to treatment response. KEY POINTS: • CT has high sensitivity in identifying sclerotic lesions in POEMS syndrome • Most common CT patterns are multiple, less than 1 cm, sclerotic lesions • Larger lesions have lytic centres and sclerotic margins • Skeletal surveys may have a false negative rate of 36% • Treatment response includes increased sclerosis, decrease in size or resolution of lesions.