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1.
Ned Tijdschr Tandheelkd ; 128(1): 9-12, 2021 Jan.
Artigo em Holandês | MEDLINE | ID: mdl-33449058

RESUMO

Periodontitis and obesity are multifactorial diseases. This literature review shows a weak association between obesity and periodontitis. Physiological mechanisms in obesity and periodontitis, such as increased inflammatory state, are more common in both people with obesity and people with periodontitis. In addition, socio-economic problems, low health literacy and an unhealthy lifestyle are more common in people with obesity and in people with periodontitis compared to people without these diseases.


Assuntos
Obesidade , Periodontite , Humanos , Obesidade/complicações , Obesidade/epidemiologia , Periodontite/complicações , Periodontite/epidemiologia
2.
Z Gerontol Geriatr ; 48(5): 473-9, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25117859

RESUMO

BACKGROUND: Population ageing, demographic change and the financial crisis has put the financial sustainability of the German pension system at risk. In reaction to these challenges, Germany recently abandoned generous early retirement policies and moved towards policies encouraging higher employment among the elderly. OBJECTIVES: In this article we evaluate how these labour market and pension policies affected the retirement decisions of older workers in Germany over the last three decades. Complementing previous research on early retirement, we focus in particular on those working past the mandatory retirement age of 65 years and examine whether the composition of this group of postretirement-age workers has changed over time. DATA AND METHODS: We analyse pooled cross-sectional data from three rounds of the German Ageing Survey which allow us to cover the last three decades from 1980 to 2008. Estimating multinomial logit models we distinguish explanatory factors on the individual, organizational and institutional level that frame the decision to leave the labour market before the age of 65, to stop working at 65 or to work past 65. RESULTS: Over the last three decades, the share of German workers leaving the labour market after the mandatory retirement age of 65 has increased markedly. This trend towards working longer has changed particularly among the low educated workforce which in previous decades traditionally has exhibited a tendency to retire early. In contrast to high-skilled workers, the decision to work longer among low-educated workers is mainly driven by financial need (and is usually not in line with their desire or their ability to work for longer). CONCLUSION: Our findings suggest an increase in social inequality in retirement decisions as a result of the policy shift towards activation. We conclude by arguing for a more fine-grained understanding of the reasons why people work longer. Such research would provide valuable insights into how to design future labour market and pension reforms preventing a rise in social inequalities.


Assuntos
Emprego/estatística & dados numéricos , Emprego/tendências , Política Pública/tendências , Aposentadoria/estatística & dados numéricos , Aposentadoria/tendências , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Escolaridade , Feminino , Previsões , Alemanha/epidemiologia , Humanos , Masculino , Pensões/estatística & dados numéricos , Retorno ao Trabalho , Classe Social , Fatores Socioeconômicos
3.
Clin Nutr ; 43(2): 446-452, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-38181522

RESUMO

BACKGROUND & AIMS: Qualitative studies suggest that malnutrition awareness is poor in older adults. The aim of this study was to develop a questionnaire to quantitatively assess malnutrition awareness in community-dwelling older adults aged 60+ years. METHODS: The Malnutrition Awareness Scale (MAS) was developed based on the awareness phase of the Integrated-Change model, and included four domains: knowledge, perceived cues, risk perceptions, and cognizance. Twenty-six scale items were developed using results from mainly qualitative research and the expertise of the authors. Items were piloted in 10 Dutch older adults using the Thinking Aloud method to optimize wording. In a feasibility study, annoyance, difficulty and time to complete the MAS and its comprehensibility were tested. After final revisions, the MAS was applied to a large sample to test its psychometric properties (i.e., inter-item correlations, Cronbach's alpha, score distribution) and relevance of the items was rated on a 5-point scale by 12 experts to determine content validity. RESULTS: The feasibility study (n = 42, 55 % women, 19 % 80+ y) showed that the MAS took 12 ± 6 min to complete. Most participants found it not (at all) annoying (81 %) and not (at all) difficult (79 %) to complete the MAS, and found it (very) comprehensible (83 %). Psychometric analyses (n = 216, 63 % women, 28 % 80+ y) showed no redundant items, but two items correlated negatively with other items, and one correlated very low. After removal, the final MAS consists of 23 items with a min-max scoring range from 0 to 22 (with higher scores indicating higher awareness) and an overall Cronbach's alpha of 0.67. The mean MAS score in our sample (n = 216) was 14.8 ± 3.2. The lowest obtained score was 6 (n = 3) and the highest 22 (n = 1), indicating no floor or ceiling effects. Based on the relevance rating, the overall median across all 22 items was 4.0 with IQR 4.0-5.0. CONCLUSION: The Malnutrition Awareness Scale is a novel, feasible and reliable tool with good content validity to quantitively assess malnutrition awareness in community-dwelling older adults. The scale is now ready to identify groups with poor malnutrition awareness, as a basis to start interventions to increase malnutrition knowledge and awareness.


Assuntos
Vida Independente , Desnutrição , Humanos , Feminino , Idoso , Masculino , Psicometria , Reprodutibilidade dos Testes , Desnutrição/diagnóstico , Inquéritos e Questionários
4.
Appl Physiol Nutr Metab ; 48(12): 1005-1014, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-37890172

RESUMO

Low intake of micronutrients is associated with health-related problems in nursing home residents. As their food intake is generally low, it is expected that their micronutrient intake will be low as well. The nutrient intake of 189 residents (mean age 85.0 years (SD: 7.4)) in five different Dutch nursing homes was measured based on 3-day direct observations of intake. Micronutrient intake, without supplementation, was calculated using the Dutch food composition table, and SPADE software was used to model habitual intake. Intake was compared to the estimated average requirement (EAR) or adequate intake (AI) as described in the Dutch dietary reference values. A low intake was defined as >10% not meeting the EAR or when the P50 (median) intake was below the AI. Vitamin A, thiamin, riboflavin, niacin, B6, folate, B12, C, D, E, copper, iron, zinc, calcium, iodine, magnesium, phosphorus, potassium, and selenium were investigated. Our data showed that vitamin and mineral intake was low for most assessed nutrients. An AI was only seen for vitamin B12 (men only), iodine (men only), and phosphorus. A total of 50% of the population had an intake below the EAR for riboflavin, vit B6, folate, and vitamin D. For reference values expressed in AI, P50 intake of vitamin E, calcium, iodine, magnesium, potassium, and selenium was below the AI. To conclude: micronutrient intake in nursing home residents is far too low in most of the nursing home population. A "food-first" approach could increase dietary intake, but supplements could be considered if the "food-first" approach is not successful.


Assuntos
Iodo , Selênio , Masculino , Humanos , Idoso de 80 Anos ou mais , Estudos Transversais , Magnésio , Cálcio , Dieta , Vitaminas , Micronutrientes , Ácido Fólico , Cálcio da Dieta , Riboflavina , Ingestão de Alimentos , Fósforo , Casas de Saúde , Potássio
5.
J Nutr Health Aging ; 26(8): 749-759, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35934819

RESUMO

OBJECTIVES: To investigate the cross-sectional and prospective associations between behavior and cognitive problems and malnutrition in long-term care facilities (LTCF). DESIGN: Cross-sectional and prospective routine care cohort study. SETTING: 6874 Residents in Dutch LTCFs (period 2005-2020). PARTICIPANTS: Data were obtained from the InterRAI-LTCF instrument. Cross-sectional analyses on prevalence of malnutrition at admission included 3722 residents. Prospective analyses studied incident malnutrition during stay (total follow-up time 7104 years) and included data of 1826 residents with first measurement on admission ('newly-admitted') and n=3152 with first measurement on average ~1 year after admission ('existing'). MEASUREMENTS: InterRAI scales for communication problems (CS), aggressive behavior (ABS), social engagement (RISE), depressive symptoms (DRS), cognitive performance (CPS) and the total number of behavior and cognitive problems were investigated as independent variables and malnutrition (ESPEN 2015 definition) as dependent variable in regression analyses. Results were stratified for gender and group 'newly-admitted' vs. 'existing'. RESULTS: On admission, 9.5% of residents was malnourished. In men, low social engagement was associated with prevalence of malnutrition. In women, all behavior and cognitive problems except depression were associated with malnutrition in the unadjusted analyses, but this attenuated in the full model taking all problems into account. The incidence of malnutrition during stay amounted to 8.9%. No significant associations of behavior and cognitive problems with malnutrition incidence were seen in 'newly-admitted' male residents while in 'existing' male residents all determinants were significantly associated. In 'newly-admitted' female residents CS, ABS and CPS, and in 'existing' female residents CS, RISE, ABS and CPS were significantly associated with incident malnutrition. All associations slightly attenuated after adjustment. Malnutrition incidence increased with increasing number of combined behavior and cognitive problems. CONCLUSION: Residents with behavior and cognitive problems are at an increased risk of being malnourished at admission, or becoming malnourished during stay in a LTCF, especially residents with multiple behavior and cognitive problems.


Assuntos
Desnutrição , Casas de Saúde , Cognição , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Assistência de Longa Duração , Masculino , Desnutrição/epidemiologia , Estudos Prospectivos
6.
Clin Nutr ESPEN ; 49: 163-171, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35623807

RESUMO

BACKGROUND & AIM: Malnutrition adversely influences a broad range of physical and psychological symptoms. Although polypharmacy is often mentioned to be associated with malnutrition, especially in older people it is unclear to what extent. The aim of this systematic review was to investigate the extent of the association between polypharmacy and malnutrition in older people. METHODS: The methodology followed the guidelines of the Cochrane Collaboration. Literature search was performed in PubMed, CINAHL and Embase. The population of interest for this systematic review were people of 65 years and older with polypharmacy. Because there is ambiguity with regard to the actual definition of malnutrition and polypharmacy, in this systematic review all articles describing malnutrition prevalence rates were included, regardless of the criteria used. Both observational and intervention studies were screened for eligibility. Selection and quality assessment of the included full text studies was assessed by two reviewers independently. A level of evidence and methodological quality score was adjudged to each article based on this assessment. RESULTS: A total of 3126 studies were retrieved by the literature search, of which seven studies were included in this systematic review. There was considerable variation in the definition of polypharmacy between studies. Two studies defined polypharmacy as the use of five or more drugs, two studies as the use of six or more drugs, two studies provided a mean and standard deviation that corresponded to the minimum of five drugs, and one study distinguished between polypharmacy (five or more drugs) and excessive polypharmacy (ten or more drugs). However, all studies showed a statistically significant association between (the risk) of becoming malnourished and polypharmacy regardless the instrument or criterion used to define risk of malnutrition. Studies presented the associations respectively as OR ≥ 1.177, p-value ≤ 0.028, ß ≥ -0.62 and r  ≥ -0.31. CONCLUSION: This review demonstrated a statistically significant association between polypharmacy and malnutrition. Further research is required to determine the magnitude of the effect by increased number of drugs in combination with the type of drugs, on the risk of malnutrition.


Assuntos
Desnutrição , Polimedicação , Idoso , Humanos , Desnutrição/epidemiologia , Prevalência
8.
Sci Rep ; 7(1): 4889, 2017 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-28687767

RESUMO

The present study investigated the effects of suggestion on the processing of visual stimuli. Participants counted rare visual stimuli presented on a screen, once during a hypnosis condition where they were suggested that their vision of the screen is blocked by a virtual wooden board in front of their eyes and once during a control condition without suggestion. In the hypnosis condition, counting performance was about 20% worse than in the control condition. At the same time, the P3b amplitude of the event-related brain potential was about 37% reduced. Smaller P3b amplitudes were significantly associated with deficient counting performance, and this effect was largest in participants who reported the blockade as real. In contrast, earlier brain responses (N1, P2) that reflect basic processing of the visual stimuli were not affected by the suggested blockade. We conclude that the suggestion of the blockade affects later stages of visual perception, leaving early processes intact. This illustrates the impact of suggestions and the power of mind.


Assuntos
Hipnose/métodos , Percepção Visual , Adulto , Eletroencefalografia , Potenciais Evocados , Feminino , Alemanha , Voluntários Saudáveis , Humanos , Masculino , Adulto Jovem
9.
J Neurol ; 252(12): 1465-71, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16021357

RESUMO

OBJECTIVE: It is controversial whether alteration of cerebral perfusion plays an important role in the pathophysiology of patients with idiopathic normal pressure hydrocephalus (NPH) and can help to predict the outcome after shunt surgery. MATERIALS AND METHODS: 28 patients with suspected NPH were examined clinically (Homburg Hydrocephalus Scale, walking test, incontinence protocol) and by 3D dynamic susceptibility based perfusion weighted magnetic resonance imaging (PWI-MRI) before and after cerebrospinal fluid release (spinal tap test, STT). The perfusion parameters (negative integral (NI), time of arrival (T0), time to peak (TTP), mean transit time, and the difference TTP-T0 were analysed. RESULTS: Three different groups of patients were identified preoperatively: In group 1 seven patients showed an increase in the cerebral perfusion and a clinical improvement after STT. The second group (9 patients) also revealed an increase of the cerebral perfusion, but no significant alteration of the clinical assessment could be found. In the third group neither the cerebral perfusion nor the clinical assessment changed. 14 of the 16 patients (group 1 and 2) were examined three months after shunt placement. 11 patients showed a good or excellent result, 2 patients revealed a fair assessment, and only 1 patient had transiently improved. No patient was downgraded after shunting. In the patient group 1 and 2 the NI increased significantly (effect size: 34%), whereas in group 3 no significant alteration of NI was observed. CONCLUSION: PWI-MRI improves the prediction of outcome after shunt placement in patients with NPH and can offer new insights into the pathophysiology.


Assuntos
Circulação Cerebrovascular/fisiologia , Hidrocefalia de Pressão Normal/patologia , Hidrocefalia de Pressão Normal/fisiopatologia , Imageamento Tridimensional , Perfusão/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Mapeamento Encefálico , Derivações do Líquido Cefalorraquidiano/métodos , Feminino , Seguimentos , Humanos , Hidrocefalia de Pressão Normal/cirurgia , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Sensibilidade e Especificidade , Punção Espinal/métodos , Fatores de Tempo
10.
J Nutr Health Aging ; 19(5): 525-30, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25923481

RESUMO

OBJECTIVES: To investigate the effects of protein enriched bread and drinking yoghurt, substituting regular products, on the total protein intake and the distribution of protein intake over the day in older adults. DESIGN: A single blind randomised controlled trial. SETTING: Rehabilitation centre. PARTICIPANTS: Older adults (≥ 55 years) admitted to a rehabilitation centre after hospital discharge (n=34). INTERVENTION: Participants received a high protein diet (protein enriched bread and protein enriched drinking yoghurt; n=17) or a regular diet (regular bread and regular drinking yoghurt; n=17) for three consecutive weeks. MEASUREMENTS: Total protein intake and protein intake per meal, measured twice weekly over a three weeks period (six measurements per participant). RESULTS: Compared with controls, patients who received the protein enriched products had a significantly higher protein intake (115.3 g/d vs 72.5 g/d, P<0.001; 1.6 g/kg/d vs 1.1 g/kg/d, P<0.001). The intervention group consumed quantities over the recommended level (25-30 g/meal) during each of the three meals (32.5 g, 30.0 g, 34.8 g/meal), where the control group consumed quantities below the recommended level during breakfast (17.7 g) and lunch (18.4 g). CONCLUSIONS: The use of protein enriched products, replacing regular products, results in a significant increased daily protein intake in older adults. In addition, the daily consumption of protein enriched products improves protein distribution over the day.


Assuntos
Pão , Proteínas Alimentares/administração & dosagem , Centros de Reabilitação , Iogurte , Idoso , Dieta/estatística & dados numéricos , Ingestão de Alimentos , Feminino , Humanos , Masculino , Refeições , Pessoa de Meia-Idade , Método Simples-Cego
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