Changes in Activities of Daily Living, Nutrient Intake, and Systemic Inflammation in Elderly Adults Receiving Recuperative Care

Dennis, Richard A.; Johnson, Larry E.; Roberson, Paula K.; Heif, Muhannad; Bopp, Melinda M.; Garner, Kimberly K.; Padala, Kalpana P.; Padala, Prasad R.; Sullivan, Dennis H.

doi:10.1111/jgs.12007

Cited by 14 publications

(13 citation statements)

References 52 publications

(89 reference statements)

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“…We do not report these results here but they are available from the authors on request. Our results support Dennis et al (2012) who find strong interrelation with functional health and systematic inflammation and muscle function representing physical health. ADL has been show to be a robust measure for physical health.…”

supporting

confidence: 88%

The dynamics of physical and mental health in the older population

Ohrnberger

Fichera

Sutton

2017

The Journal of the Economics of Ageing

105

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Mental and physical aspects are both integral to health but little is known about the dynamic relationship between them. We consider the dynamic relationship between mental and physical health using a sample of 11,203 individuals in six waves (2002–2013) of the English Longitudinal Study of Ageing (ELSA). We estimate conditional linear and non-linear random-effects regression models to identify the effects of past physical health, measured by Activities of Daily Living (ADL), and past mental health, measured by the Centre for Epidemiological Studies Depression (CES-D) scale, on both present physical and mental health. We find that both mental and physical health are moderately state-dependent. Better past mental health increases present physical health significantly. Better past physical health has a larger effect on present mental health. Past mental health has stronger effects on present physical health than physical activity or education. It explains 2.0% of the unobserved heterogeneity in physical health. Past physical health has stronger effects on present mental health than health investments, income or education. It explains 0.4% of the unobserved heterogeneity in mental health. These cross-effects suggest that health policies aimed at specific aspects of health should consider potential spill-over effects.

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supporting

confidence: 88%

The dynamics of physical and mental health in the older population

Ohrnberger

Fichera

Sutton

2017

The Journal of the Economics of Ageing

105

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“…Another study found that older adults from the Health, Aging, and Body Composition Study (almost 2,000 community‐dwelling adults aged 70–79) with protein intake less than 1.0 g/kg aBW/d were at greater risk of developing mobility limitations over 6 years . Studies in different settings with different designs and shorter follow‐up periods have found more mixed results . A 12‐week intervention trial with protein‐enriched foods and drinks in 75 older adults (mean age 76.8) followed for 6 months after hospital discharge did not show an effect of higher protein intake (112 g/d vs 78 g/d) on incidence of difficulty performing ADLs …”

Section: Discussionmentioning

confidence: 97%

Protein Intake and Disability Trajectories in Very Old Adults: The Newcastle 85+ Study

Mendonça

Granic

Hill

et al. 2018

J American Geriatrics Society

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ObjectivesTo determine whether protein intake is associated with better disability trajectories in the oldest adults (≥85) and whether muscle mass and muscle strength would partially mediate this.DesignProspective cohort study.SettingNewcastle‐upon‐Tyne and North Tyneside, United Kingdom.ParticipantsCommunity‐dwelling older adults aged 85 at baseline (N=722).MethodsProtein intake was estimated using two 24‐hour multiple‐pass recalls at baseline. Disability was measured as difficulty performing 17 activities of daily living at baseline and 18, 36, and 60 months. Trajectories were derived using mortality‐adjusted group‐based trajectory modelling. The effect of protein intake (g/kg of adjusted body weight (aBW)/d) on disability trajectories was examined using multinomial logistic regression.ResultsParticipants had 4 distinct disability trajectories (between the ages of 85 and 90: constant very low (AT1), mild (AT2), moderate (AT3), and severe (AT4). Each unit increase in protein (g) per kg of aBW/d was associated with greater odds of AT1 (odds ratio (OR=7.97, 95% confidence interval (CI)=1.96–32.43, p = .004) and AT2 (OR=3.28, 95% CI=1.09–9.87, p = .03) than of AT4 over 5 years in models adjusted for selected covariates. Participants with protein intake of 1.0 g/kg aBW/d or more were more likely to belong to AT1 (OR=3.65, 95% CI=1.59–8.38, p = .009) and AT2 (OR=2.12, 95% CI=1.16–3.90, p = .01) than to AT4.ConclusionHigher protein intake, especially 1.0 g/kg aBW/d or more, was associated with better disability trajectories in the oldest adults. These findings will inform new dietary strategies to support active, healthy ageing. J Am Geriatr Soc 67:50–56, 2019.

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“…In fact, not only does the admission level of CRP predict a prolonged length of hospital stay, but also earlier re‐admission in elderly patients . Furthermore, previous studies have found negative associations between CRP and muscle mass, lung function, and also the recovery of physical function and muscle strength in elderly patients . Attenuated resistance training‐induced hypertrophy has also been found in elderly patients with high degree of inflammation .…”

Section: Inflammationmentioning

confidence: 99%

“…Notably, it has been estimated that a mean protein intake of ~1.1 g protein kg d −1 is necessary to reach a neutral nitrogen balance during short‐term hospitalization of elderly . Moreover, long‐term (~24 days) patients with a high protein intake are more likely to increase physical function during hospitalization . In a recent study, elderly patients were given in‐hospital protein supplementation (~14 g d −1 ) in addition to 12 weeks of resistance training following discharge .…”

Section: Nutritionmentioning

confidence: 99%

Changes in muscle mass during acute short-term hospitalization of elderly patients: A mini-review

Norheim

2018

Transl Sports Med

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It has long been a presumption that hospitalization is associated with a loss of muscle mass in elderly patients. However, only a handful of studies have directly measured whether such a loss actually occurs. This mini-review highlights some of the most recent research related to changes in muscle mass during acute shortterm hospitalization of elderly patients. Despite a high prevalence of physical inactivity during hospitalization, there is a lack of research measuring changes for habitual levels. The effect of inflammation on muscle mass in elderly patients is still uncertain. Nutritional supplementation beyond what is currently being prescribed in hospitals may have additional benefits on muscle mass. Dehydration prior to hospital admission may obscure true changes in muscle mass when using current state-of-the-art measures due to in-hospital rehydration. The current literature does not support the notion of in-hospital loss of muscle mass in acutely admitted elderly patients; however, there is a need for more precise measures of muscle mass that are able to account for fluctuations in hydration status. Moreover, future studies assessing changes in muscle mass should also measure changes in physical activity levels, inflammation status, and nutritional intake during acute hospitalization. K E Y W O R D Satrophy, disuse, elderly, hydration status, inflammation, protein intake | INTRODUCTIONThere are several physiological changes related to increasing age in humans, one of which is the progressive loss of skeletal muscle mass. 1 This loss, which has been termed sarcopenia, is multifactorial in nature and its exact etiology is yet to be established. A large body of research has been put into understanding this phenomenon, mostly focusing on factors such as physical inactivity, poor nutrition, inflammatory processes, and endocrine changes. Interestingly, some researchers have suggested that repeated hospitalizations in elderly may accelerate sarcopenia. 2 It has long been a presumption that hospitalization is associated with a loss of muscle mass in elderly patients. However, only a handful of studies have directly measured whether such a loss actually occurs during acute hospitalization. A recent meta-analysis investigated changes in muscle mass in older patients during either elective or acute admission. 3 The electively admitted patients showed a decrease in muscle mass [standardized mean difference (95% confidence interval): À0.44 (À0.61, À0.27)], whereas the acutely admitted showed no change [À0.25 (À0.58, 0.09)]. Although only two studies were used in the analysis of acutely admitted patients, other studies that were not included show similar results. 4,5 Several factors may explain these findings. This mini-review highlights some of the most recent studies in the field of geriatrics with a focus on changes in muscle mass during acute short-term hospitalization of elderly patients. The main putative mechanisms explaining these findings are discussed, and a hypothetical model illustrating changes in muscle m...

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Changes in Activities of Daily Living, Nutrient Intake, and Systemic Inflammation in Elderly Adults Receiving Recuperative Care

Cited by 14 publications

References 52 publications

The dynamics of physical and mental health in the older population

The dynamics of physical and mental health in the older population

Protein Intake and Disability Trajectories in Very Old Adults: The Newcastle 85+ Study

Changes in muscle mass during acute short-term hospitalization of elderly patients: A mini-review

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