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Optimising Nutrition to Alleviate Age-Associated Functional Decline

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (1 January 2021) | Viewed by 54750

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Special Issue Editor

Dr. Tomasz Kostka

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Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, 92-115 Lodz, Poland
Interests: older people; nutrition; nutritional status; functional decline; muscle function; quality of life
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Nutrition and physical activity are cornerstones of preventive gerontology. Nutritional status changes with advancing age. In younger seniors, typical problems usually include overweight/obesity, hyperlipidemia and hyperglicemia. Prevention and treatment are focused on cardiometabolic disorders. In older seniors, problems of protein–energy malnutrition, sarcopenia and frailty become dominant. Research in recent years has provided us with new data and scientific approaches on how to drive nutritional behaviours to prevent cardiometabolic disorders on the one hand, and to foster the intrinsic capacity to alleviate age-associated fumctional decline on the other. With this Special Issue of Nutrients, we hope to gather new data on nutritional recommendations in seniors of different ages, functional statuses and comorbidities. We welcome the submission of different types of manuscripts, including original research articles and up-to-date reviews (systematic reviews and meta-analyses).

Prof. Tomasz Kostka
Guest Editor

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Keywords

overweight
obesity
malnutrition
nutritional status
functional status
physical activity
intrinsic capacity
sarcopenia
frailty
elderly
disability

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Published Papers (10 papers)

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Editorial

Jump to: Research, Review

3 pages, 184 KiB

Open AccessEditorial

Special Issue: “Optimising Nutrition to Alleviate Age-Associated Functional Decline”

by Tomasz Kostka

Nutrients 2021, 13(8), 2824; https://doi.org/10.3390/nu13082824 - 17 Aug 2021

Cited by 1 | Viewed by 1704

Abstract

Appropriate nutrition is a cornerstone of preventive gerontology [...] Full article

(This article belongs to the Special Issue Optimising Nutrition to Alleviate Age-Associated Functional Decline)

Research

Jump to: Editorial, Review

17 pages, 2633 KiB

Open AccessArticle

Identification of Mortality Risks in the Advancement of Old Age: Application of Proportional Hazard Models Based on the Stepwise Variable Selection and the Bayesian Model Averaging Approach

by Ewelina Łukaszyk, Katarzyna Bień-Barkowska and Barbara Bień

Nutrients 2021, 13(4), 1098; https://doi.org/10.3390/nu13041098 - 27 Mar 2021

Cited by 5 | Viewed by 2475

Abstract

Identifying factors that affect mortality requires a robust statistical approach. This study’s objective is to assess an optimal set of variables that are independently associated with the mortality risk of 433 older comorbid adults that have been discharged from the geriatric ward. We used both the stepwise backward variable selection and the iterative Bayesian model averaging (BMA) approaches to the Cox proportional hazards models. Potential predictors of the mortality rate were based on a broad range of clinical data; functional and laboratory tests, including geriatric nutritional risk index (GNRI); lymphocyte count; vitamin D, and the age-weighted Charlson comorbidity index. The results of the multivariable analysis identified seven explanatory variables that are independently associated with the length of survival. The mortality rate was higher in males than in females; it increased with the comorbidity level and C-reactive proteins plasma level but was negatively affected by a person’s mobility, GNRI and lymphocyte count, as well as the vitamin D plasma level. Full article

(This article belongs to the Special Issue Optimising Nutrition to Alleviate Age-Associated Functional Decline)

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11 pages, 2078 KiB

Open AccessArticle

Association of Lower Nutritional Status and Education Level with the Severity of Depression Symptoms in Older Adults—A Cross Sectional Survey

by Zuzanna Chrzastek, Agnieszka Guligowska, Bartlomiej Soltysik, Malgorzata Pigłowska, Ewa Borowiak, Joanna Kostka and Tomasz Kostka

Nutrients 2021, 13(2), 515; https://doi.org/10.3390/nu13020515 - 4 Feb 2021

Cited by 27 | Viewed by 3319

Abstract

The study analyzes the relationship between nutritional status and depression symptoms severity in the older population. A total of 1975 older outpatients (1457 women and 518 men, median age 75) were included in the study. Depression symptoms severity was assessed using the Geriatric Depression Scale (GDS). Participants were divided into two subgroups according to GDS score. Group A: 0–5 points—without depression symptoms (1237, W:898, M:339), and group B: 6–15 points—with depression symptoms (738, W:559, M:179). The nutritional status of the patients was assessed with Mini Nutritional Assessment (MNA) and basic anthropometric variables (waist, hips, calf circumferences, body mass index (BMI), waist to hip ratio (WHR), and waist to height ratio (WHtR)). Education years and chronic diseases were also noted. Women with higher depression symptoms severity had significantly lower MNA scores [A: 26.5 (24–28) (median (25%−75% quartiles)) vs. B:23 (20.5–26)], shorter education time [A:12 (8–16) vs. B:7 (7–12)], smaller calf circumference [A:36 (33–38) vs. B: 34 (32–37)], and higher WHtR score [A:57.4 (52.3–62.9) vs. B:58.8 (52.1–65.6)]. Men with depression symptoms had lower MNA scores [A:26.5 (24.5–28) vs. B:24 (20.5–26.5)], shorter education [A:12 (9.5–16), B:10 (7–12)], and smaller calf circumference [A:37 (34–39), B:36 (33–38)]. In the model of stepwise multiple regression including age, years of education, anthropometric variables, MNA and concomitant diseases nutritional assessment, and education years were the only independent variables predicting severity of depression symptoms both in women and men. Additionally, in the female group, odds were higher with higher WHtR. Results obtained in the study indicate a strong relationship between proper nutritional status and education level with depression symptoms severity in older women and men. Full article

(This article belongs to the Special Issue Optimising Nutrition to Alleviate Age-Associated Functional Decline)

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10 pages, 428 KiB

Open AccessArticle

Comparison of Nutrition Risk Screening 2002 and Subjective Global Assessment Form as Short Nutrition Assessment Tools in Older Hospitalized Adults

by Łukasz Kroc, Elizaveta Fife, Edyta Piechocka-Wochniak, Bartłomiej Sołtysik and Tomasz Kostka

Nutrients 2021, 13(1), 225; https://doi.org/10.3390/nu13010225 - 14 Jan 2021

Cited by 20 | Viewed by 3635

Abstract

The aim of the present study was to compare two widely recommended short nutrition assessment tools—Nutrition Risk Screening 2002 (NRS-2002) and Subjective Global Assessment Form (SGA)—with other Comprehensive Geriatric Assessment (CGA) measurements. The study included 622 consecutively hospitalized older subjects, aged 81.7 ± 7.8 years. The criteria to participate were the ability to communicate and given consent. Both NRS-2002 and SGA were inversely related to anthropometric measurements, functional assessment tests, Mini-Mental State Examination (MMSE) and positively associated with the Vulnerable Elders Survey-13 (VES-13) score. Results of SGA and NRS-2002 were not related to sex and 15-item Geriatric Depression Scale (GDS) score. Comparison of well-nourished subjects and patients with suggested problems with nutrition according to NRS-2002 (0–2 vs. 3–7) and SGA (A vs. B + C) gave comparable results. Both nutritional scales at given cut-off points similarly discriminated anthropometric data and other CGA tools in the populations of well-nourished vs. malnourished hospitalized older subjects. In conclusion, we can recommend using both NRS-2002 and SGA to detect malnutrition or risk of malnutrition in a routine clinical practice of the geriatric department ward. Full article

(This article belongs to the Special Issue Optimising Nutrition to Alleviate Age-Associated Functional Decline)

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15 pages, 1182 KiB

Open AccessArticle

Epidemiology of Hypoalbuminemia in Hospitalized Patients: A Clinical Matter or an Emerging Public Health Problem?

by Stefania Moramarco, Laura Morciano, Luca Morucci, Mario Messinese, Paola Gualtieri, Mariachiara Carestia, Fausto Ciccacci, Stefano Orlando, Ersilia Buonomo, Jacopo Maria Legramante, Antonino De Lorenzo and Leonardo Palombi

Nutrients 2020, 12(12), 3656; https://doi.org/10.3390/nu12123656 - 27 Nov 2020

Cited by 18 | Viewed by 2822

Abstract

Serum albumin levels are strongly associated with the morbidity, prognosis, and mortality rates of patients with hypoalbuminemia, which is a frequent problem during hospitalization. An observational retrospective study was carried out to analyze changes in albumin levels in hospitalized patients at the “Fondazione Policlinico Tor Vergata—PTV” in 2018. The prevalence of preexisting hypoalbuminemia at the time of discharge from hospital was investigated using a sample of 9428 patients. Information was collected from the discharge files recorded in the central informatics system of the hospital. Analysis of albumin levels at admission and at discharge was conducted by classes of albuminemia and then stratified by age. At the time of admission, hypoalbuminemia was found to be present in more than half of the sample, with no sex differences. The serum albumin level tended to decrease with age, with pathologic levels appearing from 50 years and progressive worsening thereafter. The condition of marked and mild hypoalbuminemia was more prevalent in patients over 65 years of age. Our findings suggest that hypoalbuminemia should be considered a dangerous condition in itself and a serious public health problem. We aimed to emphasize the role of albumin as useful marker of the in-hospital malnutrition and frailty, to be integrated in the routinely assessment of patients for reconsidering ad hoc healthcare pathways after discharge from hospital, especially when dealing with fragile populations. Full article

(This article belongs to the Special Issue Optimising Nutrition to Alleviate Age-Associated Functional Decline)

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11 pages, 1043 KiB

Open AccessArticle

Tryptophan Intake and Metabolism in Older Adults with Mood Disorders

by Cezary Chojnacki, Tomasz Popławski, Jan Chojnacki, Michał Fila, Paulina Konrad and Janusz Blasiak

Nutrients 2020, 12(10), 3183; https://doi.org/10.3390/nu12103183 - 18 Oct 2020

Cited by 30 | Viewed by 4183

Abstract

The role of serotonin in the pathogenesis of depression is well-documented, while the involvement of other tryptophan (TRP) metabolites generated in the kynurenine pathway is less known. The aim of this study was to assess the intake and metabolism of TRP in elderly patients with mood disorders. Ninety subjects in three groups, 30 subjects each, were enrolled in this study: controls (healthy young adults, group I) and elderly individuals without (group II) or with (group III) symptoms of mild and moderate depression, as assessed by the Hamilton Depression Rating Scale (HAM-D) and further referred to as mood disorders. The average TRP intake was evaluated with the nutrition calculator. Urinary levels of TRP, 5-hydroxyindoleacetic acid (5-HIAA), L-kynurenine (KYN), kynurenic acid (KynA), xanthurenic acid (XA), and quinolinic acid (QA) were determined by liquid chromatography with tandem mass spectrometry and related to creatinine level. The average daily intake of TRP was significantly lower in group III than the remaining two groups, but group III was also characterized by higher urinary levels of KYN, KynA, XA, and QA as compared with younger adult individuals and elderly patients without mood disorders. Therefore, mild and moderate depression in the elderly may be associated with a lower intake of TRP and changes in its kynurenine metabolic pathway, which suggests a potential dietary TRP-based intervention in this group of patients. Full article

(This article belongs to the Special Issue Optimising Nutrition to Alleviate Age-Associated Functional Decline)

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Review

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16 pages, 1753 KiB

Open AccessReview

Nutrition in Cancer Therapy in the Elderly—An Epigenetic Connection?

by Janusz Blasiak, Jan Chojnacki, Elzbieta Pawlowska, Joanna Szczepanska and Cezary Chojnacki

Nutrients 2020, 12(11), 3366; https://doi.org/10.3390/nu12113366 - 1 Nov 2020

Cited by 17 | Viewed by 4844

Abstract

The continuous increase in life expectancy results in a steady increase of cancer risk, which consequently increases the population of older adults with cancer. Older adults have their age-related nutritional needs and often suffer from comorbidities that may affect cancer therapy. They frequently are malnourished and present advanced-stage cancer. Therefore, this group of patients requires a special multidisciplinary approach to optimize their therapy and increase quality of life impaired by aging, cancer, and the side effects of therapy. Evaluation strategies, taking advantage of comprehensive geriatric assessment tools, including the comprehensive geriatric assessment (CGA), can help individualize treatment. As epigenetics, an emerging element of the regulation of gene expression, is involved in both aging and cancer and the epigenetic profile can be modulated by the diet, it seems to be a candidate to assist with planning a nutritional intervention in elderly populations with cancer. In this review, we present problems associated with the diet and nutrition in the elderly undergoing active cancer therapy and provide some information on epigenetic aspects of aging and cancer transformation. Nutritional interventions modulating the epigenetic profile, including caloric restriction and basal diet with modifications (elimination diet, supplementary diet) are discussed as the ways to improve the efficacy of cancer therapy and maintain the quality of life of older adults with cancer. Full article

(This article belongs to the Special Issue Optimising Nutrition to Alleviate Age-Associated Functional Decline)

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20 pages, 1547 KiB

Open AccessReview

Nutrition Can Help DNA Repair in the Case of Aging

by Julia Kaźmierczak-Barańska, Karolina Boguszewska and Boleslaw T. Karwowski

Nutrients 2020, 12(11), 3364; https://doi.org/10.3390/nu12113364 - 1 Nov 2020

Cited by 26 | Viewed by 9068

Abstract

Micronutrients such as vitamins and trace elements are crucial for maintaining the health of all organisms. Micronutrients are involved in every cellular/biochemical process. They play roles in proper heart and brain functioning, influence immunological responses, and antioxidant defense systems. Therefore, prolonged deficiency in one or more micronutrients leads to cardiovascular or neurodegenerative disorders. Keeping micronutrients at adequate levels is especially important for seniors. They are prone to deficiencies due to age-associated functional decline and often to a diet poor in nutrients. Moreover, lack of micronutrients has an indirect impact on the genome. Their low levels reduce the activity of antioxidant enzymes, and therefore inhibit the efficiency of defense against free radicals which can lead to the formation of DNA lesions. The more DNA damage in the genetic material, the faster aging at the cellular level and a higher risk of pathological processes (e.g., carcinogenesis). Supplementation of crucial antioxidative micronutrients such as selenium, zinc, vitamin C, and vitamin E seems to have the potential to positively influence the condition of an aging organism, including minimizing inflammation, enhancing antioxidative defense, and limiting the formation of DNA lesions. In consequence, it may lead to lowering the risk and incidence of age-related diseases such as cardiovascular diseases, neurodegenerative diseases, and malnutrition. In this article, we attempt to present the synergistic action of selected antioxidant micronutrients (vitamin C, vitamin E, selenium, and zinc) for inhibiting oxidative stress and DNA damage, which may impede the process of healthy aging. Full article

(This article belongs to the Special Issue Optimising Nutrition to Alleviate Age-Associated Functional Decline)

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16 pages, 1331 KiB

Open AccessReview

Diet to Reduce the Metabolic Syndrome Associated with Menopause. The Logic for Olive Oil

by Juan José Hidalgo-Mora, Laura Cortés-Sierra, Miguel-Ángel García-Pérez, Juan J. Tarín and Antonio Cano

Nutrients 2020, 12(10), 3184; https://doi.org/10.3390/nu12103184 - 18 Oct 2020

Cited by 10 | Viewed by 5485

Abstract

The rates of metabolic syndrome are increasing in parallel with the increasing prevalence of obesity, primarily due to its concomitant insulin resistance. This is particularly concerning for women, as the years around menopause are accompanied by an increase in visceral obesity, a strong determinant of insulin resistance. A fall in estrogens and increase in the androgen/estrogen ratio is attributed a determining role in this process, which has been confirmed in other physiological models, such as polycystic ovary syndrome. A healthy lifestyle, with special emphasis on nutrition, has been recommended as a first-line strategy in consensuses and guidelines. A consistent body of evidence has accumulated suggesting that the Mediterranean diet, with olive oil as a vital component, has both health benefits and acceptable adherence. Herein, we provide an updated overview of current knowledge on the benefits of olive oil most relevant to menopause-associated metabolic syndrome, including an analysis of the components with the greatest health impact, their effect on basic mechanisms of disease, and the state of the art regarding their action on the main features of metabolic syndrome. Full article

(This article belongs to the Special Issue Optimising Nutrition to Alleviate Age-Associated Functional Decline)

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21 pages, 450 KiB

Open AccessReview

Application of Citicoline in Neurological Disorders: A Systematic Review

by Patryk Jasielski, Faustyna Piędel, Mikołaj Piwek, Agata Rocka, Véronique Petit and Konrad Rejdak

Nutrients 2020, 12(10), 3113; https://doi.org/10.3390/nu12103113 - 12 Oct 2020

Cited by 47 | Viewed by 16071

Abstract

Citicoline is a chemical compound involved in the synthesis of cell membranes. It also has other, not yet explained functions. Research on the use of citicoline is conducted in neurology, ophthalmology, and psychiatry. Citicoline is widely available as a dietary supplement. It is often used to enhance cognitive functions. In our article, accessible databases were searched for articles regarding citicoline use in neurological diseases. This article has a systemic review form. After rejecting non-eligible reports, 47 remaining articles were reviewed. The review found that citicoline has been proven to be a useful compound in preventing dementia progression. It also enhances cognitive functions among healthy individuals and improves prognosis after stroke. In an animal model of nerve damage and neuropathy, citicoline stimulated regeneration and lessened pain. Among patients who underwent brain trauma, citicoline has an unclear clinical effect. Citicoline has a wide range of effects and could be an essential substance in the treatment of many neurological diseases. Its positive impact on learning and cognitive functions among the healthy population is also worth noting. Full article

(This article belongs to the Special Issue Optimising Nutrition to Alleviate Age-Associated Functional Decline)

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