Introduction: The profile of institutionalized elderly in a nursing home is_x000D_ characterized by mostly women, older than 80 years, with chronic comorbidity and_x000D_ cognitive impairment, often associated with dementia, which involves physical and_x000D_ mental dependence. Aging is the major risk factor for cognitive decline and dementia;_x000D_ oxidative stress plays an important role in aging and, therefore, the loss of brain_x000D_ function due to the high susceptibility of this organ to the reactive species oxygen._x000D_ Malnutrition is a common problem in these kinds of people, and has also been_x000D_ associated with cognitive impairment, as the nutrients are involved in brain physiology_x000D_ as well as antioxidant defense. The care provided to seniors are of vital importance to_x000D_ maintaining good nutritional status and, consequently, their cognitive status, so it was_x000D_ considered interesting to assess the nutritional and functional profile of a group of_x000D_ institutionalized elderly in a nursing home and its relationship to cognitive state, in_x000D_ order to know the most important factors to consider when establishing a plan of care_x000D_ and interventions, to try to reduce cognitive impairment exists in these institutions_x000D_ through improved nutritional status of residents._x000D_ Material and methods: We conducted a cross-sectional study on a sample of 36_x000D_ elderly (14 men and 22 women), and a longitudinal study of the 22 surviving residents_x000D_ after one year. We valued the overall nutritional status with the Mini Nutritional_x000D_ Assessment, cognitive function with the Mini Mental State Examination of Lobo,_x000D_ emotional state with the Geriatric Depression Scale of Yesavage, physical functional_x000D_ capacity with the Nursing Home Physical Performance Test. BMI was determined, and_x000D_ measured various skin folds and body circumferences, and body composition was_x000D_ assessed by bioimpedance. We quantified various hematological and biochemical_x000D_ parameters and fatty acid profile and oxidative stress profile. Supply and intake of_x000D_ energy and nutrients was measured by using the double weighed food method and the_x000D_ 24 hours dietary record._x000D_ Results: Residents displayed risk of malnutrition, cognitive impairment, mild_x000D_ depression, reduction of the muscle strength and, in a 67%, of the maximum physical_x000D_ functional capacity, and also under weight; showed concentrations of red blood cells,_x000D_ hemoglobin, hematocrit, vitamins B6 and B12, folate, and several compounds with antioxidant activity (albumin, coenzyme Q10, β-carotene, retinol, γ-tocopherol, vitamin_x000D_ C and selenium) near the lower limit and deficit of total thiols. Their food intake was_x000D_ significantly less than the supply, low-calorie, excessive in saturated fatty acids and_x000D_ deficit in monounsaturated and total polyunsaturated, including omega-3 fatty acids,_x000D_ fiber, riboflavin, niacin, pyridoxine, folic acid, vitamins D and E, calcium, iron,_x000D_ magnesium, copper, zinc, selenium, iodine and potassium. Cognitively normal elderly_x000D_ showed better overall nutritional status, greater muscle strength and physical functional_x000D_ capacity, lower cardiovascular risk, greater serum vitamin B12 and antioxidant defense_x000D_ (uric acid, albumin, γ-tocopherol and lutein-zeaxanthin), and performed a higher intake_x000D_ in monounsaturated fatty acids, fiber, folic acid, vitamins C and E, copper and iodine._x000D_ After a year, the elderly showed a decline in cognitive function, overall nutritional_x000D_ status, physical functional capacity, muscular strength, body weight, at the expense of_x000D_ body fat and muscle mass, and selenium intake._x000D_ Conclusions: The values of social-health, anthropometric and body_x000D_ composition, hematological and biochemical, and dietary profile that residents initially_x000D_ presented, and their evolution after one year, may have contributed to the decline of_x000D_ cognitive function as well as nutritional status and physical functional capacity, and has_x000D_ been able to establish a negative feedback between the three areas. Control of drug_x000D_ indirect effects and BMI, proper treatment and monitoring of respiratory disease, high_x000D_ blood pressure, diabetes mellitus and / or anemia, the establishment of a physical_x000D_ activity program, the monitoring indicators hematological (erythrocytes, hemoglobin,_x000D_ hematocrit) and biochemical (glucose, albumin, uric acid, ferritin, lipid profile, CRP),_x000D_ the optimal management of menus, the control of food intake, and monitoring of_x000D_ nutritional status, could help reduce the risk of cognitive impairment, but it’s necessary_x000D_ to establish an interdisciplinary care team.
| Date of Award | 3 Nov 2010 |
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| Original language | Spanish |
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| Supervisor | Ramon Segura Cardona (Director) |
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