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Marjolein Visser - One of the best experts on this subject based on the ideXlab platform.
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Perspectives on the Causes of Undernutrition of Community-Dwelling Older Adults: A Qualitative Study.
The journal of nutrition health & aging, 2017Co-Authors: Rachel Van Der Pols-vijlbrief, Hanneke A. H. Wijnhoven, Marjolein VisserAbstract:Undernutrition is a major health concern particularly in vulnerable older adults. The present study aimed to reveal the causes of Undernutrition as reported by community-dwelling older adults. Twenty-five semi-structured interviews and two focus group discussions were performed and analyzed. Community-dwelling. Older adults. A questionnaire on demographics, Short Nutritional Assessment Questionnaire 65+ and interviews on the potential causes of Undernutrition. 33 older adults agreed to participate in the interviews and focus groups. Our findings indicate that a wide variety of causes of Undernutrition, both modifiable and non-modifiable, were mentioned by the older adults. Many modifiable causes of Undernutrition were reported in the mental, social or food & appetite theme, such as poor food quality provided by meal services, the inability to do groceries, loneliness and mourning. Non-modifiable causes included, forgetfulness, aging, surgery and hospitalization. This study provides guidance to better understand the underlying causes of Undernutrition from an older adult’s perspective. The modifiable causes provide specific direction towards practical implications that might decrease or prevent Undernutrition. Non-modifiable causes should raise awareness of an increased risk of Undernutrition by health professionals in primary and secondary care, caregivers and family members.
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Validity of nutritional screening with MUST and SNAQ in hospital outpatients
European Journal of Clinical Nutrition, 2013Co-Authors: E. Leistra, M.a.e. Van Bokhorst-de Van Der Schueren, A.m. Evers, Jacqueline A.e. Langius, Marjolein Visser, Hinke M. KruizengaAbstract:BACKGROUND/OBJECTIVES: The majority of hospital outpatients with Undernutrition is unrecognized, and therefore untreated. There is a need for an easy and valid screening tool to detect Undernutrition in this setting. The aim of this study was to determine the diagnostic accuracy of the MUST (Malnutrition Universal Screening Tool) and SNAQ (Short Nutritional Assessment Questionnaire) tools for Undernutrition screening in hospital outpatients. METHODS: In a large multicenter-hospital-outpatient population, patients were classified as: severely undernourished (body mass index (BMI) 5% in the last month or >10% in the last 6 months), moderately undernourished (BMI 18.5-20 (
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high prevalence of Undernutrition in dutch community dwelling older individuals
Nutrition, 2012Co-Authors: J Schilp, E. Leistra, A.m. Evers, Hinke M. Kruizenga, Marjolein Visser, Hanneke A. H. Wijnhoven, Dorly J H Deeg, Jaap J Van BinsbergenAbstract:Objective: To examine the prevalence of Undernutrition in community-dwelling older individuals (� 65 y) using data from various settings. Methods: A cross-sectional observational study was performed to examine the prevalence of Undernutrition in three samples (all � 65 y): 1) 1267 community-dwelling individuals participating in a large prospective population-based study, the Longitudinal Aging Study Amsterdam (LASA) in 1998/99; 2) 814 patients receiving home care in 2009/10; and 3) 1878 patients from general practices during the annual influenza vaccination in 2009/10. Undernutrition was assessed by the Short Nutritional Assessment Questionnaire 65þ. Results: Mean age was 77.3 y (SD 6.7) in the LASA sample, 81.6 y (SD 7.4) in the home care sample, and 75.3 y (SD 6.5) in the general practice sample. The prevalence of Undernutrition was highest in the home care sample (35%), followed by the general practice (12%) and LASA (11%) samples. The prevalence of Undernutrition increased significantly with age in the general practice and LASA samples. Gender differences were observed in the general practice and home care samples; women were more likely to be undernourished in the general practice sample and men were more likely to be undernourished in the home care sample. Conclusion: The prevalence of Undernutrition in Dutch community-dwelling older individuals was relatively high, especially in home care patients.
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development and validation of criteria for determining Undernutrition in community dwelling older men and women the short nutritional assessment questionnaire 65
Clinical Nutrition, 2012Co-Authors: Hanneke A. H. Wijnhoven, Hinke M. Kruizenga, Marjolein Visser, J Schilp, Dorly J H Deeg, Marian A E Van Bokhorstde Van Der Schueren, Henrica C W De Vet, Luigi FerrucciAbstract:Summary Background & aims There is no valid, fast and easy-to-apply set of criteria to determine (risk of) Undernutrition in community-dwelling older persons. The aim of this study was to develop and validate such criteria. Methods Selection of potential anthropometric and Undernutrition-related items was based on consensus literature. The criteria were developed using 15-year mortality in community-dwelling older persons ≥ 65 years (Longitudinal Aging Study Amsterdam, n = 1687) and validated in an independent sample (InCHIANTI, n = 1142). Results Groups distinguished were: (1) Undernutrition (mid-upper arm circumference or involuntary weight loss ≥4 kg/6 months); (2) risk of Undernutrition (poor appetite and difficulties climbing staircase); and (3) no Undernutrition (others). Respective hazard ratio's for 15-year mortality were: (1) 2.22 (95% CI 1.83–2.69); and (2) 1.57 (1.22–2.01) ((3) = reference). The area under the curve (AUC) was 0.55. Comparable results were found stratified by sex, excluding cancer/obstructive lung disease/(past) smoking, using 6-year mortality, and applying results to the InCHIANTI study (hazard ratio's 2.12 and 2.46, AUC 0.59). Conclusions The developed set of criteria (SNAQ 65+ ) for determining (risk of) Undernutrition in community-dwelling older persons shows good face validity and moderate predictive validity based on the consistent association with mortality in a second independent study sample.
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early determinants for the development of Undernutrition in an older general population longitudinal aging study amsterdam
British Journal of Nutrition, 2011Co-Authors: J Schilp, Hanneke A. H. Wijnhoven, Dorly J H Deeg, Marjolein VisserAbstract:Undernutrition may be an important modifiable risk factor for poor clinical outcomes in older individuals. To achieve earlier detection or prevention of Undernutrition, more information is needed about risk factors for the development of Undernutrition in community-dwelling older individuals. The objective was to identify early determinants of incident Undernutrition in a prospective population-based study. Baseline data (1992-3) on socio-economic, psychological, medical, functional, lifestyle and social factors of 1120 participants aged 65-85 years of the Longitudinal Aging Study Amsterdam were used. Undernutrition, defined as a BMI < 20 kg/m2 or self-reported involuntary weight loss ≥ 5 % in the last 6 months, was assessed every 3 years during a 9-year follow-up period. Cox proportional-hazards regression analysis was used to investigate the association between early determinants at baseline and incident Undernutrition. In 9 years, 156 participants (13·9 %) developed Undernutrition. In univariate analyses, female sex, depressive symptoms, anxiety symptoms, multiple chronic diseases, high medication use (women), poor appetite, no alcohol use v. light alcohol use, loneliness, not having a partner, limitations in performing normal activities due to a health problem, low physical performance (participants aged < 75 years) and reporting difficulties walking stairs (participants aged < 75 years) were statistically significantly associated with incident Undernutrition. In a multivariate model, poor appetite and reporting difficulties walking stairs (participants aged < 75 years) remained early determinants. The results of the present study can be used to identify subgroups of older individuals with increased risk of Undernutrition and to identify modifiable determinants for the purpose of prevention of Undernutrition.
Hinke M. Kruizenga - One of the best experts on this subject based on the ideXlab platform.
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Validity of nutritional screening with MUST and SNAQ in hospital outpatients
European Journal of Clinical Nutrition, 2013Co-Authors: E. Leistra, M.a.e. Van Bokhorst-de Van Der Schueren, A.m. Evers, Jacqueline A.e. Langius, Marjolein Visser, Hinke M. KruizengaAbstract:BACKGROUND/OBJECTIVES: The majority of hospital outpatients with Undernutrition is unrecognized, and therefore untreated. There is a need for an easy and valid screening tool to detect Undernutrition in this setting. The aim of this study was to determine the diagnostic accuracy of the MUST (Malnutrition Universal Screening Tool) and SNAQ (Short Nutritional Assessment Questionnaire) tools for Undernutrition screening in hospital outpatients. METHODS: In a large multicenter-hospital-outpatient population, patients were classified as: severely undernourished (body mass index (BMI) 5% in the last month or >10% in the last 6 months), moderately undernourished (BMI 18.5-20 (
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high prevalence of Undernutrition in dutch community dwelling older individuals
Nutrition, 2012Co-Authors: J Schilp, E. Leistra, A.m. Evers, Hinke M. Kruizenga, Marjolein Visser, Hanneke A. H. Wijnhoven, Dorly J H Deeg, Jaap J Van BinsbergenAbstract:Objective: To examine the prevalence of Undernutrition in community-dwelling older individuals (� 65 y) using data from various settings. Methods: A cross-sectional observational study was performed to examine the prevalence of Undernutrition in three samples (all � 65 y): 1) 1267 community-dwelling individuals participating in a large prospective population-based study, the Longitudinal Aging Study Amsterdam (LASA) in 1998/99; 2) 814 patients receiving home care in 2009/10; and 3) 1878 patients from general practices during the annual influenza vaccination in 2009/10. Undernutrition was assessed by the Short Nutritional Assessment Questionnaire 65þ. Results: Mean age was 77.3 y (SD 6.7) in the LASA sample, 81.6 y (SD 7.4) in the home care sample, and 75.3 y (SD 6.5) in the general practice sample. The prevalence of Undernutrition was highest in the home care sample (35%), followed by the general practice (12%) and LASA (11%) samples. The prevalence of Undernutrition increased significantly with age in the general practice and LASA samples. Gender differences were observed in the general practice and home care samples; women were more likely to be undernourished in the general practice sample and men were more likely to be undernourished in the home care sample. Conclusion: The prevalence of Undernutrition in Dutch community-dwelling older individuals was relatively high, especially in home care patients.
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development and validation of criteria for determining Undernutrition in community dwelling older men and women the short nutritional assessment questionnaire 65
Clinical Nutrition, 2012Co-Authors: Hanneke A. H. Wijnhoven, Hinke M. Kruizenga, Marjolein Visser, J Schilp, Dorly J H Deeg, Marian A E Van Bokhorstde Van Der Schueren, Henrica C W De Vet, Luigi FerrucciAbstract:Summary Background & aims There is no valid, fast and easy-to-apply set of criteria to determine (risk of) Undernutrition in community-dwelling older persons. The aim of this study was to develop and validate such criteria. Methods Selection of potential anthropometric and Undernutrition-related items was based on consensus literature. The criteria were developed using 15-year mortality in community-dwelling older persons ≥ 65 years (Longitudinal Aging Study Amsterdam, n = 1687) and validated in an independent sample (InCHIANTI, n = 1142). Results Groups distinguished were: (1) Undernutrition (mid-upper arm circumference or involuntary weight loss ≥4 kg/6 months); (2) risk of Undernutrition (poor appetite and difficulties climbing staircase); and (3) no Undernutrition (others). Respective hazard ratio's for 15-year mortality were: (1) 2.22 (95% CI 1.83–2.69); and (2) 1.57 (1.22–2.01) ((3) = reference). The area under the curve (AUC) was 0.55. Comparable results were found stratified by sex, excluding cancer/obstructive lung disease/(past) smoking, using 6-year mortality, and applying results to the InCHIANTI study (hazard ratio's 2.12 and 2.46, AUC 0.59). Conclusions The developed set of criteria (SNAQ 65+ ) for determining (risk of) Undernutrition in community-dwelling older persons shows good face validity and moderate predictive validity based on the consistent association with mortality in a second independent study sample.
P E Ballmer - One of the best experts on this subject based on the ideXlab platform.
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prevalence of Undernutrition on admission to swiss hospitals
Clinical Nutrition, 2010Co-Authors: Reinhard Imoberdorf, Remy Meier, Peter Krebs, Paul J Hangartner, Bernhard Hess, Max Staubli, Daniel Wegmann, M Ruhlin, P E BallmerAbstract:Summary Background & aims According to the literature, Undernutrition is prevalent in 20–60% of patients on hospital admission. The differences in the rate of Undernutrition arise from different diagnostic tools used in the studies. We aimed to investigate the prevalence of Undernutrition in Swiss hospitals using a standardized screening tool. Methods All patients admitted to the departments of internal medicine of 7 Swiss hospitals were screened at entry for nutritional status using the Nutrition Risk Screening 2002 score. Patients with a score of 3 or more, which denotes severe Undernutrition or patient “at risk” for Undernutrition were analyzed. Results Between May 2003 and April 2006 32 837 patients were included in the study. 5978 (18.2%) had a score of 3 or more and were classified as severely undernourished or at high risk for Undernutrition (age 85 y: 28%). A nutritional intervention was made in 4175 patients (12.7%). Conclusions Nearly one in five patients was severely undernourished or “at risk” for Undernutrition. Undernutrition was directly related to age. Patients with a clear indication for nutrition therapy, as suggested by the formal screening procedure, obtained nutritional intervention in 70%.
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Prevalence of Undernutrition on admission to Swiss hospitals.
Clinical nutrition (Edinburgh Scotland), 2009Co-Authors: Reinhard Imoberdorf, Remy Meier, Peter Krebs, Paul J Hangartner, Bernhard Hess, Max Staubli, Daniel Wegmann, M Ruhlin, P E BallmerAbstract:According to the literature, Undernutrition is prevalent in 20-60% of patients on hospital admission. The differences in the rate of Undernutrition arise from different diagnostic tools used in the studies. We aimed to investigate the prevalence of Undernutrition in Swiss hospitals using a standardized screening tool. All patients admitted to the departments of internal medicine of 7 Swiss hospitals were screened at entry for nutritional status using the Nutrition Risk Screening 2002 score. Patients with a score of 3 or more, which denotes severe Undernutrition or patient "at risk" for Undernutrition were analyzed. Between May 2003 and April 2006 32,837 patients were included in the study. 5978 (18.2%) had a score of 3 or more and were classified as severely undernourished or at high risk for Undernutrition (age<45 y: 8%; 45-64 y: 11%; 65-84 y: 22%; >85 y: 28%). A nutritional intervention was made in 4175 patients (12.7%). Nearly one in five patients was severely undernourished or "at risk" for Undernutrition. Undernutrition was directly related to age. Patients with a clear indication for nutrition therapy, as suggested by the formal screening procedure, obtained nutritional intervention in 70%. Copyright 2009 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Natasha S. Hochberg - One of the best experts on this subject based on the ideXlab platform.
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Undernutrition and Tuberculosis: Public Health Implications.
The Journal of infectious diseases, 2018Co-Authors: Pranay Sinha, Juliana Davis, Lauren A. Saag, Christine Wanke, Padmini Salgame, Jackson Mesick, C. Robert Horsburgh, Natasha S. HochbergAbstract:Almost 800 million people are chronically undernourished worldwide, of whom 98% are in low- and middle-income countries where tuberculosis is endemic. In many tuberculosis-endemic countries, Undernutrition is a driver of tuberculosis incidence and associated with a high population attributable fraction of tuberculosis and poor treatment outcomes. Data suggest that Undernutrition impairs innate and adaptive immune responses needed to control Mycobacterium tuberculosis infection and may affect responses to live vaccines, such as BCG. Given its impact on tuberculosis, addressing Undernutrition will be a vital component of the World Health Organization End TB strategy. This narrative review describes the effect of Undernutrition on the immune response, vaccine response, and tuberculosis incidence, severity, and treatment outcomes.
S V Subramanian - One of the best experts on this subject based on the ideXlab platform.
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the association of parental education with childhood Undernutrition in low and middle income countries comparing the role of paternal and maternal education
International Journal of Epidemiology, 2016Co-Authors: Kenneth Harttgen, Sebastian Vollmer, Christian Bommer, Aditi Krishna, S V SubramanianAbstract:Background Most existing research on the association of parental education with childhood Undernutrition focuses on maternal education and often ignores paternal education. We systematically investigate differences in maternal and paternal education and their association with childhood Undernutrition. Methods One hundred and eighty Demographic and Health Surveys from 62 countries performed between 1990 and 2014 were analysed. We used linear-probability models to predict childhood Undernutrition prevalences, measured as stunting, underweight and wasting, for all combinations of maternal and paternal attainment in school. Models were adjusted for demographic and socio-economic covariates for the child, mother and household, country-level fixed effects and clustering. Additional specifications adjust for local area characteristics instead of country fixed effects. Results Both higher maternal and paternal education levels are associated with lower childhood Undernutrition. In regressions adjusted for child age and sex as well as country-level fixed effects, the association is stronger for maternal education than for paternal education when their combined level of education is held constant. In the fully adjusted models, the observed differences in predicted Undernutrition prevalences are strongly attenuated, suggesting a similar importance of maternal and paternal education. These findings are confirmed by the analysis of composite schooling indicators. Conclusions We find that paternal education is similarly important for reducing childhood Undernutrition as maternal education and should therefore receive increased attention in the literature.
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parental bmi and childhood Undernutrition in india an assessment of intrauterine influence
Pediatrics, 2010Co-Authors: S V Subramanian, Leland K Ackerson, George Davey SmithAbstract:+OBJECTIVE: The objective of this study was to examine the influence of parental BMI on childhood Undernutrition in India. METHODS: The study population was a nationally representative cross-sectional sample of singleton children (n 15976) who were aged 0 to 59 months from the 2005–2006 Indian National Family Health Survey. Information was obtained by a face-to-face interview with the mother with a 94.5% response rate. Modified Poisson regression models that account for multistage survey design and sampling weights were applied to estimate the associations between parental BMI and childhood Undernutrition. The outcome measures were child underweight, stunting, and wasting; parental BMI was the primary exposure. RESULTS: In mutually adjusted models, an increase in 1 unit of maternal BMI was associated with a lower relative risk (RR) for childhood Undernutrition (underweight RR: 0.957 [95% confidence interval [CI]: 0.947– 0.967]; stunting RR: 0.985 [95% CI: 0.977– 0.993]; wasting RR: 0. 941 [95% CI: 0.926 – 0.958]). The association between paternal BMI and childhood Undernutrition was similar to that observed for maternal BMI (underweight RR: 0.961 [95% CI: 0.951– 0.971]; stunting RR: 0.986 [95% CI: 0.978 – 0.995]; wasting RR: 0.965 [95% CI: 0.947– 0.982]). CONCLUSIONS: Similarity in the association between paternal/maternal BMI and childhood Undernutrition suggests that intergenerational associations in nutritional status are not driven by maternal intrauterine influences. Pediatrics 2010;126:e663–e671
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socioeconomic inequalities in childhood Undernutrition in india analyzing trends between 1992 and 2005
PLOS ONE, 2010Co-Authors: Malavika A Subramanyam, Ichiro Kawachi, Lisa F Berkman, S V SubramanianAbstract:Background India experienced a rapid economic boom between 1991 and 2007. However, this economic growth has not translated into improved nutritional status among young Indian children. Additionally, no study has assessed the trends in social disparities in childhood Undernutrition in the Indian context. We examined the trends in social disparities in underweight and stunting among Indian children aged less than three years using nationally representative data. Methods We analyzed data from the three cross-sectional rounds of National Family Health Survey of India from 1992, 1998 and 2005. The social factors of interest were: household wealth, maternal education, caste, and urban residence. Using multilevel modeling to account for the nested structure and clustering of data, we fit multivariable logistic regression models to quantify the association between the social factors and the binary outcome variables. The final models additionally included age, gender, birth order of child, religion, and age of mother. We analyzed the trend by testing for interaction of the social factor and survey year in a dataset pooled from all three surveys. Results While the overall prevalence rates of Undernutrition among Indian children less than three decreased over the 1992–2005 period, social disparities in Undernutrition over these 14 years either widened or stayed the same. The absolute rates of Undernutrition decreased for everyone regardless of their social status. The disparities by household wealth were greater than the disparities by maternal education. There were no disparities in Undernutrition by caste, gender or rural residence. Conclusions There was a steady decrease in the rates of stunting in the 1992–2005 period, while the decline in underweight was greater between 1992 and 1998 than between 1998 and 2005. Social disparities in childhood Undernutrition in India either widened or stayed the same during a time of major economic growth. While the advantages of economic growth might be reaching everyone, children from better-off households, with better educated mothers appear to have benefited to a greater extent than less privileged children. The high rates of Undernutrition (even among the socially advantaged groups) and the persistent social disparities need to be addressed in an urgent and comprehensive manner.
