Trace Mineral Intake and Deficiencies in Older Adults Living in the Community and Institutions: A Systematic Review

Abstract

The global population is ageing with many older adults suffering from age-related malnutrition, including micronutrient deficiencies. Adequate nutrient intake is vital to enable older adults to continue living independently and delay their institutionalisation, as well as to prevent deterioration of health status in those living in institutions. This systematic review investigated the insufficiency of trace minerals in older adults living independently and in institutions. We examined 28 studies following a cross-sectional or cohort design, including 7203 older adults (≥60) living independently in 13 Western countries and 2036 living in institutions in seven Western countries. The estimated average requirement (EAR) cut-off point method was used to calculate percentage insufficiency for eight trace minerals using extracted mean and standard deviation values. Zinc deficiency was observed in 31% of community-based women and 49% of men. This was higher for those in institutional care (50% and 66%, respectively). Selenium intakes were similarly compromised with deficiency in 49% women and 37% men in the community and 44% women and 27% men in institutions. We additionally found significant proportions of both populations showing insufficiency for iron, iodine and copper. This paper identifies consistent nutritional insufficiency for selenium, zinc, iodine and copper in older adults.

Current State of Evidence: Influence of Nutritional and Nutrigenetic Factors on Immunity in the COVID-19 Pandemic Framework

“…Although cross country comparison is limited by the heterogeneity of data collection protocols and dietary assessment methods, a number of previous dietary surveys have found widespread prevalence of suboptimal intakes for several micronutrients across the European region [ 151 ], ranging from 11 to 30% for copper, Folate, selenium, Vitamin B 12 , and Vitamin C [ 152 ]; and four of the eight trace minerals (i.e., selenium, zinc, Iodine, and copper) show a high prevalence of insufficiency in the elderly, which is worsened by the requirement for institutional care [ 40 ]. Thus, country specific genetic requirements have also been taken into account as a factor to more accurately point out the risk of suboptimal intake of the selected nutrients.…”

“…From this database, COVID-19 features "Incidence" (expressed as cases per 100k people), "Deaths" (meaning mortality rate by COVID-19 expressed as number of deaths per 1M people), and "Deaths%" (meaning relative mortality rate = COVID-19 mortality% vs. cases) were collected (Table 2). Furthermore, specific nutrients whose impact on the optimal working of the immune system is supported by the EFSA were identified (Table 1) and optimal/suboptimal intake levels of each country population were assessed by compilation of data available in adults and elderly populations, in both sexes [37][38][39][40].…”

“…Concerning the 10 micronutrients with a supported role in the immune system, compilation of data available in adults and elderly target populations, in both sexes [37][38][39][40], in a number of European countries was carried out. A country-by-country analysis of the intake of the 10 micronutrients was performed ( Figure 2).…”

Nutritional status of micronutrients as a possible and modifiable risk factor for COVID-19: a UK perspective

“…Common nutritional problems in the community and in care homes are low energy intakes, weight loss and vitamin and mineral deficiencies (26,27) due to loss of appetite and age-related loss of senses of taste and smell for reasons including illness, infections and some medications (28) . Sarcopenia, depression, co-morbidities such as obesity, changing body composition with increased adiposity and loss of lean body mass, hypertension, diseases of the intestinal tract (resulting in impaired absorption of nutrients), lack of intrinsic factor for absorption of vitamin B 12 , respiratory diseases and cognitive impairments are also common (24,25) .…”

“…In a study of seven Western countries of intakes and deficiencies of eight trace elements in older adults (≥60 years) (27) , Se deficiency was observed in 49 % of women and 37 % of men living in the community and 44 % of women and 27 % of men in care homes, nursing homes and retirement homes. Zn deficiency was also observed in 31 % of community-based women and 49 % of men.…”