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BackgroundMalnutrition is frequent among older people and is associated with morbi-mortality.The aim of the study is to assess the effectiveness of a multifactorial and multidisciplinary intervention in the nutritional status among the elderly.MethodsRandomized, single-blind, parallel-group, clinical trial conducted from January 2009 to December 2010 in seven primary health care centers in Baix Llobregat (Barcelona). Of 696 referred people, born in 1924, 328 subjects were randomized to an intervention group or a control group. The intervention model used an algorithm and was multifaceted for both the patients and their primary care providers. The main outcome was improvement in nutritional status assessed by Mini Nutritional Assessment (MNA). Data analyses were done by intention-to-treat.ResultsTwo-year assessment was completed for 127 patients (77.4%) in the intervention group and 98 patients (59.7%) in the control group. In the adjusted linear mixed models for MNA, intervention showed no significant effect during all follow-up period with −0.21 (CI: − 0.96; 0.26). In subjects with nutritional risk (MNA ≤ 23.5 / 30) existed a tendency towards improvement in MNA score 1.13 (95% CI −0.48; 2.74) after 2 years.ConclusionA universal multifactorial assessment and target intervention over a two year period in subjects at nutritional risk showed a tendency to improve nutrition but not in the rest of community-dwelling studied subjects. Cognitive impairment was an independent factor strongly associated with a decline in nutritional status.Trial registrationThe clinical trial is registered as part of a US National Institutes of Health Clinical Trial: NCT01141166.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-015-0033-0) contains supplementary material, which is available to authorized users.

BackgroundThe purpose of this study was to assess the effectiveness of a multifactorial intervention to reduce falls among the oldest-old people, including individuals with cognitive impairment or comorbidities.MethodsA randomized, single-blind, parallel-group clinical trial was conducted from January 2009 to December 2010 in seven primary health care centers in Baix Llobregat (Barcelona). Of 696 referred people who were born in 1924, 328 were randomized to an intervention group or a control group. The intervention model used an algorithm and was multifaceted for both patients and their primary care providers. Primary outcomes were risk of falling and time until falls. Data analyses were by intention-to-treat.ResultsSixty-five (39.6%) subjects in the intervention group and 48 (29.3%) in the control group fell during follow-up. The difference in the risk of falls was not significant (relative risk 1.28, 95% confidence interval [CI] 0.94–1.75). Cox regression models with time from randomization to the first fall were not significant. Cox models for recurrent falls showed that intervention had a negative effect (hazard ratio [HR] 1.46, 95% CI 1.03–2.09) and that functional impairment (HR 1.42, 95% CI 0.97–2.12), previous falls (HR 1.09, 95% CI 0.74–1.60), and cognitive impairment (HR 1.08, 95% CI 0.72–1.60) had no effect on the assessment.ConclusionThis multifactorial intervention among octogenarians, including individuals with cognitive impairment or comorbidities, did not result in a reduction in falls. A history of previous falls, disability, and cognitive impairment had no effect on the program among the community-dwelling subjects in this study.

The population is aging throughout the world. Preserving physical and cognitive functions is crucial to successful aging. The aim of this study was to determine the proportion of 85-year-old community-dwelling subjects aging successfully, applying a quantitative approach, and assessing the association of successful aging with sociodemographic data, global geriatric assessment, and co-morbidity. This was a community-based survey of inhabitants aged 85 years, with 328 out of 487 subjects born in 1924 assigned to seven primary health-care teams, representing a participation rate of 67.5%. Sociodemographic variables, Barthel index (BI), the Spanish version of the Mini-Mental State Examination (MEC), Mini Nutritional Assessment (MNA), Charlson Index, Gait Rating Scale, social risk, quality of life (QoL), and prevalent chronic diseases were assessed. Subjects scoring higher than 90 on the BI and higher than 24 on the MEC were compared with the rest. Multiple regression analysis was performed. Using these criteria, successful aging status was defined in 162 (49.3%) subjects. Using multiple logistic regression analysis, successful agers had significantly lower co-morbidity scores (p < 0.02, odds ratio [OR] = 0.791, 95% confidence interval [CI] 0.657-0.952), higher scores on the Gait Rating Scale identifying lower risk of falls (p < 0.0001, OR = 1.753, 95% CI 1.501-2.046), and higher scores on the MNA, indicating lower risk of malnutrition (p < 0.0001, OR = 1.190, 95% CI 1.090-01.299). Regarding QoL, successful agers had significantly higher values than their unsuccessful aging counterparts (p > 0.0001). Almost half of the individuals presented successful aging. Successful agers had less co-morbidity and a lower risk of falls or malnutrition, and they had higher scores on the QoL scale.

Attention based deep learning systems have been demonstrated to be the state of the art approach for aspect-level sentiment analysis, however, end-to-end deep neural networks lack flexibility as one can not easily adjust the network to fix an obvious problem, especially when more training data is not available: e.g. when it always predicts positive when seeing the word disappointed. Meanwhile, it is less stressed that attention mechanism is likely to "over-focus" on particular parts of a sentence, while ignoring positions which provide key information for judging the polarity. In this paper, we describe a simple yet effective approach to leverage lexicon information so that the model becomes more flexible and robust. We also explore the effect of regularizing attention vectors to allow the network to have a broader "focus" on different parts of the sentence. The experimental results demonstrate the effectiveness of our approach.