TEACHER ATO M'S ART CLASS

BSN3Y1-2
NCMB3 14A
RLE: WEEK 3
Asilo, Roset t e Ju st in e D .
• Dur ing aging, mal nut r it ion is one of t he pr obl em
among t he ol der adul t s. Ident if y 3 causes of
mal nut r it ion f or t he el der l y wit h y our nur sing
r esponsibil it ies.
• Cit e a r eading mat er ial r el at ed t o t his t opic at OLFU
LRC: Ebscohost and Science Dir ect (need t he l ink
onl y ).
• Answer s f or not l ess t han 200 wor ds.
 • Few st u d ies h ave exp lored t h e associat ion b et w een m aln u t rit ion , d efin ed b y t h e Geriat ric Nu t rit ion al
Risk In d ex (GNRI), an d all-cau se m ort alit y, p art icu larly in t h e Ch in ese p op u lat ion . Th is st u d y aim ed t o
in vest ig at e t h e associat ion b et w een t h e GNRI an d all-cau se m ort alit y in t h e eld erly p op u lat ion .
M aln u t rit ion , a g lob al h ealt h p rob lem , h as b ecom e in creasin g ly seriou s b ecau se of ch an g es t o t h e ag e
p yram id w orld w id e. Becau se of low b irt h rat es an d h ig h er life exp ect an cies, t h e p rop ort ion of p op u lat ion
ag e d ≥8 0 ye ars w ill in cre ase g lo b ally fro m 11.5% to 21.0 % b e tw e e n 20 10 an d 20 50 .C o n se q u e n tly,th e
n u t rit io n a l s t a t u s o f t h e e ld e rly n e e d s fu rt h e r a t t e n t io n .
Se ru m a lb u m in , a n o t h e r in d ic a t o r u s e d t o id e n t ify n u t rit io n a l s t a t u s , is n o t o n ly a n u t rit io n a l in d ic a t o r b u t
a ls o re fle c t s t h e a c t ivit ie s o f in fla m m a t io n . It h a s a ls o b e e n u s e d t o p re d ic t t h e ris k o f p o s t o p e ra t ive
in fe c t io n , c o m p lic a t io n s , a n d m o rt a lit y. In b o d y flu id s , h u m a n ALB t ra n s p o rt s fa t t y a c id s , c h o lo c h ro m e s ,
a m in o a c id s , s t e ro id h o rm o n e s , m e t a l io n s , a n d m a n y t h e ra p e u t ic m o le c u le s a n d m a in t a in s t h e n o rm a l
o s m o t ic p re s s u re o f t h e b lo o d .
Th erefore, a lack of ALB m ay in flu en ce p h ysiolog ical fu n ct ion s, su ch as osm ot ic p ressu re d isord ers, lack of
t h e ra p e u t ic fa c t o rs in in fla m m a t o ry s it e s , a n d a n in a b ilit y o f s t e ro id h o rm o n e s t o b e t ra n s p o rt e d t o t a rg e t
o rg a n s . In fa c t , p a t ie n t s w it h a lo w e r ALB w e re a s s o c ia t e d w it h lo n g e r h o s p it a l s t a ys , a h ig h e r ris k o f
h yp o p ro t e in e m ia , a n d h ig h e r t re a t m e n t c o s t s .
• · Th e m a jo r c a u s e s o f d e a t h in t h e e ld e rly a re n o n c o m m u n ic a b le d is e a s e s , fo r w h ic h a n u n h e a lt h y
d ie t is o n e o f t h e d e t e rm in a n t ris k fa c t o rs . Nu t rit io n a l w e ll-b e in g is a ls o a n e s s e n t ia l c o m p o n e n t o f
q u a lit y o f life fo r s e n io r c it ize n s .
Sp e c ific n u t rit io n a l n e e d s in t h e e ld e rly a re d e t e rm in e d b y a g e -re la t e d p h ys io lo g ic a l a n d p a t h o lo g ic a l
c h a n g e s . Nu t rit io n a l s t a t u s a s s e s s m e n t im p lie s a c o m p re h e n s ive a p p ro a c h (ABCD a b b re via t io n ):
a n t h ro p o m e t ric , b io c h e m ic a l/la b o ra t o ry, c lin ic a l, a n d d ie t a ry a s s e s s m e n t . A m o d e l o f n u t rit io n in t h e e ld e rly
is ve ry p a rt ic u la r, c o n s id e rin g d ie t a ry re q u ire m e n t s , e a t in g p a t t e rn s , a n d in d e p e n d e n c e fo r e a t in g s k ills .
Th e t reat m en t of m aln u t rit ion in t h e eld erly is b ased on sym p t om m an ag em en t . Preven t ion an d t reat m en t
o f m a ln u t rit io n b o t h n e e d a d e q u a t e n u t rit io n w it h s o c ia l s u p p o rt , p s yc h o e m o t io n a l s t im u la t io n , a n
a d a p t e d m o d e l o f n u t rit io n , a n d n u t rie n t -e n e rg y t h a t is p ro vid e d w it h fo o d va rie t y a s w e ll a s n u t rie n t a n d
p h yt o c h e m ic a l d e n s it y.
• · Ma ln u t rit io n is a s s o c ia t e d w it h p ro lo n g e d h o s p it a l s t a ys a n d m o rt a lit y in p a t ie n t s w h o re q u ire
h o s p it a liza t io n a n d s e ve ra l t o o ls h a ve b e e n d e ve lo p e d t o e va lu a t e t h e n u t rit io n a l s t a t u s o f p a t ie n t s .
Ad d it io n a lly, s e ve ra l g ro u p s a n d s o c ie t ie s h a ve p ro p o s e d a va rie t y o f n u t rit io n a l a s s e s s m e n t c rit e ria ;
h o w e ve r, t h e la c k o f c o n s e n s u s re g a rd in g d ia g n o s t ic c rit e ria fo r a p p lic a t io n s in c lin ic a l s e t t in g s re n d e rs
it d iffic u lt t o c o m p a re t h e im p a c t o f m a ln u t rit io n o n p a t ie n t p re va le n c e a n d m o rt a lit y in d iffe re n t
p o p u la t io n s . Alt h o u g h m a ln u t rit io n is a n im p o rt a n t a n d in d e p e n d e n t ris k fa c t o r fo r m o rb id it y a n d
m o rt a lit y in p a t ie n t s w it h h e a rt fa ilu re it s re p o rt e d p re va le n c e a n d p ro g n o s t ic im p lic a t io n s h a ve va rie d
w id e ly, m o s t ly d u e t o d iffe re n c e s in t h e t o o l u s e d fo r t h e d ia g n o s is o f m a ln u t rit io n .
Th e coh ort w as classified in t o g rou p s b ased on m aln u t rit ion accord in g t o t h e GLIM crit eria, as w ell as
a c c o rd in g t o t h e GNRI. Gro u p d iffe re n c e s w e re e va lu a t e d u s in g o n e -w a y a n a lys is o f va ria n c e o r t h e Kru s k a l–
W a llis t e s t fo r c o n t in u o u s va ria b le s , a n d t h e c h i-s q u a re d o r Fis h e r's e xa c t t e s t fo r d ic h o t o m o u s va ria b le s , a s
a p p ro p ria t e .
Su rviva l w a s e va lu a t e d u s in g t h e Ka p la n –Me ie r m e t h o d , a n d c o m p a re d w it h lo g -ra n k s t a t is t ic s . Th e p rim a ry
o u t c o m e w a s a ll-c a u s e d e a t h , a n d t h e Me t a -a n a lys is . Th e Glo b a l Gro u p in Ch ro n ic He a rt Fa ilu re (MAGGIC)
ris k s c o re a n d (lo g -t ra n s fo rm e d ) BNP le ve ls a t d is c h a rg e w e re u s e d a s a d ju s t m e n t va ria b le s in t h e
m u lt iva ria b le p ro g n o s t ic m o d e ls fo r t h e o u t c o m e o f a ll-c a u s e d e a t h , a s t h e MAGGIC s c o re is a w e ll-
va lid a t e d ris k s c o re fo r J a p a n e s e p a t ie n t s w it h h e a rt fa ilu re .
 https://www.sciencedirect.com/science/article/pii/S0939475320303410

https://www.sciencedirect.com/science/article/pii/B9780128196670000202

https://www.sciencedirect.com/science/article/pii/S0261561421000248