Análisis longitudinal de parámetros nutricionales en una cohorte de ancianos con y sin demencia / Longitudinal analysis of nutrition parameters in a cohort of elderly people with and without dementia

Introducción. La evaluación nutricional longitudinal, debido a sus frecuentes alteraciones, es especialmente relevante en al anciano con deterioro cognitivo. El objetivo del presente estudio es valorar a lo largo del tiempo el efecto y la posible interacción del deterioro cognitivo y del envejecimiento en los parámetros nutricionales. Material y métodos. Estudio longitudinal prospectivo de 2 años de seguimiento en 301 ancianos (233 mujeres y 68 varones) en el medio residencial, 51 de los cuales tienen criterios de demencia. Los parámetros antropométricos y bioquímicos se obtuvieron según técnicas normalizadas. Resultados. Los ancianos con demencia presentan, en todos los parámetros estudiados, valores inferiores respecto a los ancianos sin demencia. En los pacientes con deterioro cognitivo los valores medios de los parámetros nutricionales permanecen estables y sin diferencias significativas tras 2 años de seguimiento: índice de masa corporal 24,5 ± 4,9 vs 24,2 ± 4,1; pliegue tricipital 15,0 ± 6,0 vs 14,7 ± 6,9; circunferencia braquial 25,9 ± 3,3 vs 25,7 ± 3,5, y albúmina 3,7 ± 0,3 vs 3,7 ± 0,3. En los pacientes sin deterioro cognitivo los valores al final del estudio han descendido respecto a los valores basales, excepto el pliegue bicipital y los triglicéridos. Conclusiones. Tras 2 años de seguimiento no se observa descenso de los parámetros nutricionales estudiados en los ancianos con demencia; sin embargo, sí aparece un descenso en los ancianos sin deterioro cognitivo. Las causas de estas diferencias pueden ser múltiples. Son necesarios más estudios, con mayor número de ancianos y un mayor periodo de seguimiento, para validar estos hallazgos (AU)

Introduction. It is important to assess longitudinal nutritional parameters during the ageing process in order to determine body composition changes. This procedure is more relevant when dealing with institutionalised geriatric patients suffering from cognitive impairment. The aim of this study was to assess the interactions, if any, between mental status and several nutritional parameters in a cohort of elderly people. Material and methods. A longitudinal prospective two years follow-up evaluation was performed on 301 elderly residents (233 females and 68 males) in a nursing home, of whom 51 of them fulfilled the clinical criteria for dementia. Both anthropometric and biochemical parameters were obtained annually, according to standard procedures. Results. The dementia group had lower values when compared to the non-dementia group. Furthermore, nutritional values remained constant in the group with cognitive impairment (no significant differences were observed throughout the study period). BMI 24.5 ± 4.9 vs 24.2 ± 4.1; tricipital skinfold 15.0 ± 6.0 vs 14.7 ± 6.9; brachial circumference 25.9 ± 3.3 vs 25.7 ± 3.5, and albumin 3.7 ± 0.3 vs 3.7 ± 0.3. At the end of the study, the group without cognitive impairment showed lower values in all the parameters analysed when compared to the baseline ones, except for bicipital fold and plasma triglycerides. Conclusions. Our study shows that there are no variations in the elderly with cognitive impairment, as regards the nutritional, anthropometric and biochemist parameters analysed. On the contrary, the group with normal cognitive status showed a reduction in most of the parameters. Further studies analysing larger populations of elderly people and over longer periods of time will provide more information to improve our knowledge on this important issue (AU)

[Longitudinal analysis of nutrition parameters in a cohort of elderly people with and without dementia]. / Análisis longitudinal de parámetros nutricionales en una cohorte de ancianos con y sin demencia.

INTRODUCTION: It is important to assess longitudinal nutritional parameters during the ageing process in order to determine body composition changes. This procedure is more relevant when dealing with institutionalised geriatric patients suffering from cognitive impairment. The aim of this study was to assess the interactions, if any, between mental status and several nutritional parameters in a cohort of elderly people. MATERIAL AND METHODS: A longitudinal prospective two years follow-up evaluation was performed on 301 elderly residents (233 females and 68 males) in a nursing home, of whom 51 of them fulfilled the clinical criteria for dementia. Both anthropometric and biochemical parameters were obtained annually, according to standard procedures. RESULTS: The dementia group had lower values when compared to the non-dementia group. Furthermore, nutritional values remained constant in the group with cognitive impairment (no significant differences were observed throughout the study period). BMI 24.5±4.9 vs 24.2±4.1; tricipital skinfold 15.0±6.0 vs 14.7±6.9; brachial circumference 25.9±3.3 vs 25.7±3.5, and albumin 3.7±0.3 vs 3.7±0.3. At the end of the study, the group without cognitive impairment showed lower values in all the parameters analysed when compared to the baseline ones, except for bicipital fold and plasma triglycerides. CONCLUSIONS: Our study shows that there are no variations in the elderly with cognitive impairment, as regards the nutritional, anthropometric and biochemist parameters analysed. On the contrary, the group with normal cognitive status showed a reduction in most of the parameters. Further studies analysing larger populations of elderly people and over longer periods of time will provide more information to improve our knowledge on this important issue.

Calidad de vida relacionada con la salud del anciano institucionalizado / Health-related quality of life in institutionalised elderly people

Objetivo: describir la calidad de vida relacionada con la salud (CVRS) en ancianos institucionalizados. En residentes con diabetes mellitus se deseaba investigar asimismo la relación entre el grado de control de la enfermedad y las puntuaciones en la encuesta de CVRS. Material y método: Diseño: estudio transversal, con recogida de información a través de cuestionario y de datos provenientes de la historia clínica individual. Participantes: 121 personas de ambos sexos, institucionalizadas en una Residencia de Mayores, con función cognitiva adecuada al propósito del estudio. Mediciones: CVRS, valorada mediante el cuestionario genérico Euroqol-5D. Se contemplan otros tres tipos de variables: demográficas (edad y sexo), antropométricas(peso y talla) y clínicas en el caso de ancianos con diabetes mellitus (hemoglobina glicosilada -HbA1c- y tipo de tratamiento).Resultados: los residentes presentaron una CVRS deteriorada (Escala Visual Analógica media de 66,8, DS: 20,3). El 19% refirieron un estado de salud óptimo. Las mujeres presentaron peor CVRS que los hombres, con resultados significativos en las dimensiones “cuidado personal” y “actividades cotidianas”. Se encontró peor CVRS en sujetos de ≥75 años y resultados contradictorios respecto al peso. Los residentes con diabetes mellitus tenían peor CVRS que los no-diabéticos, con resultados significativos en “movilidad”, “cuidado personal” y “actividades cotidianas”. Conclusiones: dentro de la valoración del anciano institucionalizado, la evaluación de la CVRS permite detectar estados de salud deficitarios y los perfiles más frágiles de nuestros residentes (AU)

Objective: to describe Health-related Quality of Life (HRQoL) in institutionalised elderly individuals. The correlation between the degree of control of the disease and HRQoL scores has also been a subject of study in diabetic residents. Design: Cross-sectional study. Information was collected by means of a questionnaire and data collected from a review of each resident’s medical chart. Participants: 121 residents of both sexes institutionalised in a nursing home, with adequate cognitive function for the purpose of the study.Results: institutionalised residents present a deteriorated HRQoL (mean VAS 66,8,SD 20,3) in comparison with other studies carried out on elderly people in the general population. 19% report to be in optimal health. Women present worse HRQoL than men, with significant results in the dimensions of “personal care” and “activities of daily life”. A worse HRQoL is found in subjects ≥75 years and contradictory results with regard to weight. Diabetic residents have a worse HRQoL than non-diabetic patients, with significant results regarding “mobility”, “personal care” and “activities of daily life”. In the diabetic population, we have found no differences in terms of HRQoL, depending on the degree of control of the diabetes or type of treatment.Conclusions: as part of the assessment of the institutionalised elderly person, the assessment of HRQoL allows the identification of impaired health status and the most fragile profiles of our patients (AU)