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Donini L.M.,University of Rome La Sapienza | Dominguez L.J.,University of Palermo | Barbagallo M.,University of Palermo | Savina C.,Rehabilitation Clinical Institute Villa Delle Querce | And 7 more authors.
Journal of Nutrition, Health and Aging | Year: 2011

Objectives: Anorexia is the most frequent modification of eating habits in old age, which may lead to malnutrition and consequent morbidity and mortality in older adults. We aimed to estimate the prevalence and factors associated to anorexia in a sample of Italian older persons living in different settings. Our secondary aim was to evaluate the impact of senile anorexia on nutritional status and on eating habits, as well as on functional status. Design and Setting: Observational study in nursing homes, in rehabilitation and acute geriatric wards, and in the community in four Italian regions (Lazio, Sicily, Emilia-Romagna, and Veneto). Participants: 526 over 65 years old participants were recruited; 218 free-living subjects, 213 from nursing homes, and 96 patients from rehabilitation and acute geriatric wards in the context of a National Research Project (PRIN) from the Italian Ministry of Instruction, University and Research (2005-067913 "Cause e Prevalenza dell'Anoressia senile"). Measurements: Anthropometric and nutritional evaluation, olfactory, chewing, and swallowing capacity, food preferences, cognitive function, functional status, depression, quality of life, social aspects, prescribed drugs, and evaluation of gastrointestinal symptoms and pain. Laboratory parameters included prealbumin, albumin, transferrin, C-reactive protein, mucoprotein, lymphocyte count, as well as neurotransmitters leptin, and ghrelin. Anorexia was considered as ≥50% reduction in food intake vs. a standard meal (using 3-day "Club Francophone de Gériatrie et Nutrition" form), in absence of oral disorders preventing mastication. Results: The overall prevalence of anorexia was 21.2% with higher values among hospitalized patients (34.1% women and 27.2% men in long-term facilities; 33.3% women and 26.7% men in rehabilitation and geriatric wards; 3.3% women and 11.3% men living in the community) and in the oldest persons. Anorexic subjects were significantly less self-sufficient and presented more often a compromised nutritional and cognitive status. Diet composition analyses of anorexic older adults revealed a lower intake of all food groups and a general tendency to a monotonous diet. Conclusion: Anorexia is a frequent condition in older Italians, particularly those hospitalized, with important consequences in the nutritional and functional status. The analysis of dietary components and its quality along with the frequency of intake of single food groups may be useful to plan intervention strategies aiming to improve the nutritional and health status of older adults with anorexia. An early detection of anorexia followed by an adequate intervention in older hospitalized patients to avoid further worsening of clinical and functional status is warranted. © 2011 Serdi and Springer Verlag France. Source

Hagedorn T.,Rehabilitation Clinical Institute Villa Delle Querce | Savina C.,Rehabilitation Clinical Institute Villa Delle Querce | Coletti C.,Rehabilitation Clinical Institute Villa Delle Querce | Paolini M.,Rehabilitation Clinical Institute Villa Delle Querce | And 4 more authors.
Mediterranean Journal of Nutrition and Metabolism | Year: 2011

In patients with obesity, it is important to know the exact metabolic function in order to assess balanced nutritional support, reducing the risks of the initial situation. For an adequate detection of the resting metabolic rate (RMR), commonly indirect calorimeters are used. In the present study, two different indirect calorimeters [an expiratory collection open-circuit system (Fitmate) and a ventilated open-circuit system (Quark RMR)], were correlated and analysed for better adequacy. The predictive equation of Harris-Benedict (HBE) was confronted with the measured RMR of the better evaluated indirect calorimeter. 42 obese women (age 55 ± 12 years and BMI 42.9 ± 6.8 kg/m2) were included in the study after selecting patients according to the predefined inclusion and exclusion criteria. Measurement durations of each 15 min were performed after an overnight fast with both calorimeters. Received values of Fitmate and Quark were compared while the calorimeter with the more reliable values was compared with the HBE. Significant correlations (P<0.001) between the devices were achieved, although a significant difference of 1,051 kJ/day (14.9%) between Fitmate (7,542 ± 1,230 kJ/day) and Quark RMR (6,491 ± 806 kJ/day) was detected. The mean calculated RMR of the HBE (7,181 ± 716 kJ/day), in comparison with Quark RMR was significantly different (P<0.001). The correlation of the two indirect calorimeters, their different functioning, led to significant differences between devices and RMR measurements. The HBE was found to overestimate the measured RMR of Quark RMR. Though the HBE was developed on lean subject, it cannot be considered as a reliable equation for obese subjects. © 2011 Springer-Verlag. Source

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