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Item Sarcopenia Prevalence and Risk Factors among Residents in Aged Care(MDPI (Basel, Switzerland), 2022-05-01) Darroch P; O'Brien WJ; Mazahery H; Wham CThe aim of this study was to investigate the prevalence of sarcopenia and associated risk factors among older adults living in three residential aged care (RAC) facilities within Auckland, New Zealand. A total of 91 older adults (63% women, mean age ± SD; 86.0 ± 8.3 years) were recruited. Using the European Working Group on Sarcopenia in Older People criteria, sarcopenia was diagnosed from the assessment of: appendicular skeletal muscle mass/height2, using an InBody S10 body composition analyser and a SECA portable stadiometer or ulna length to estimate standing height; grip strength using a JAMAR handheld dynamometer; and physical performance with a 2.4-m gait speed test. Malnutrition risk was assessed using the Mini Nutrition Assessment–Short Form (MNA-SF). Most (83%) of residents were malnourished or at risk of malnutrition, and 41% were sarcopenic. Multivariate regression analysis showed lower body mass index (Odds Ratio (OR) = 1.4, 95% CI: 1.1, 1.7, ρ = 0.003) and lower MNA-SF score (OR = 1.6, 95% CI: 1.0, 2.4, ρ = 0.047) were predictive of sarcopenia after controlling for age, level of care, depression, and number of medications. Findings highlight the need for regular malnutrition screening in RAC to prevent the development of sarcopenia, where low weight or unintentional weight loss should prompt sarcopenia screening and assessment.Item Tackling malnutrition with a new compact oral nutrient supplement among residents in aged care: a pilot study(CSIRO Publishing, 2022) O'Brien WJ; Jellicoe J; Mazahery H; Wham CIntroduction: There is a high prevalence of malnutrition among older adults entering residential aged care (RAC). Aim: To determine whether 60 mL of a compact oral nutrition supplement (ONS; daily total: 576 kcal, 35 g protein) consumed four times daily with medication rounds improves malnutrition status, body weight, and body composition measures among older adults in RAC. Methods: Residents (n = 20; mean age: 86.7 ± 6.8 years; 50% female) screened for malnutrition (20% malnourished, 80% at risk of malnutrition) using the Mini Nutritional Assessment-short form were recruited during April–June 2021. Participants received 60 mL of an ONS four times daily using the Medication Pass Nutrition Supplement Programme (Med Pass). The ONS intake and participant compliance were recorded. Body mass index, fat, and muscle mass (bioelectrical impedance), malnutrition risk, depressive symptoms, and quality of life were assessed at baseline and following the 18-week intervention. Results: Median overall compliance was 98.6%. An ONS intake did not significantly increase mean ± s.d. any body composition measures or improve health and wellbeing outcomes; however, it resulted in increased body weight and body mass index (BMI; 13/20 (65%) participants), body fat mass and percentage (10/16 (63%) participants) and muscle mass (9/16 (56%) participants). Malnutrition risk scores improved in 65% (13/20) of participants, resulting in 10% being assessed as malnourished, 65% at risk of malnutrition, and 25% with normal nutrition status. Discussion: Delivery of a compact oral nutrition supplement with the medication round was accepted by residents. Its efficacy in improving malnutrition risk and body composition among residents warrants further investigation.Item Malnutrition Risk: Four Year Outcomes from the Health, Work and Retirement Study 2014 to 2018(MDPI (Basel, Switzerland), 2022-05-26) Wham C; Curnow J; Towers AThis study aimed to determine four-year outcomes of community-living older adults identified at 'nutrition risk' in the 2014 Health, Work and Retirement Study. Nutrition risk was assessed using the validated Seniors in the Community: Risk Evaluation for Eating and Nutrition, (SCREENII-AB) by postal survey. Other measures included demographic, social and health characteristics. Physical and mental functioning and overall health-related quality of life were assessed using the 12-item Short Form Health Survey (SF-12v2). Depression was assessed using the verified shortened 10 item Center for Epidemiologic Studies Depression Scale (CES-D-10). Social provisions were determined with the 24-item Social Provisions Scale. Alcohol intake was determined by using the Alcohol Use Disorders Identification Test (AUDIT-C). Among 471 adults aged 49-87 years, 33.9% were at nutrition risk (SCREEN II-AB score ≤ 38). The direct effects of nutrition risk showed that significant differences between at-risk and not-at-risk groups at baseline remained at follow up. Over time, physical health and alcohol use scores reduced. Mental health improved over time for not-at-risk and remained static for those at-risk. Time had non-significant interactions and small effects on all other indicators. Findings highlight the importance of nutrition screening in primary care as nutrition risk factors persist over time.Item Is the Utility of the GLIM Criteria Used to Diagnose Malnutrition Suitable for Bicultural Populations? Findings from Life and Living in Advanced Age Cohort Study in New Zealand (LiLACS NZ)(Springer Nature, 2023-01) MacDonell SO; Moyes SA; Teh R; Dyall L; Kerse N; Wham CObjectives To investigate associations between nutrition risk (determined by SCREEN-II) and malnutrition (diagnosed by the GLIM criteria) with five-year mortality in Māori and non-Māori of advanced age. Design A longitudinal cohort study. Setting Bay of Plenty and Lakes regions of New Zealand. Participants 255 Māori; 400 non-Māori octogenarians. Measurements All participants were screened for nutrition risk using the Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN-II). Those at high nutrition risk (SCREEN-II score <49) had the Global Leadership Initiative in Malnutrition (GLIM) criteria applied to diagnose malnutrition or not. Demographic, physical and health characteristics were obtained by trained research nurses using a standardised questionnaire. Five-year mortality was calculated from Government data. The association of nutrition risk (SCREEN-II) and a malnutrition diagnosis (GLIM) with five-year mortality was examined using logistic regression and cox proportional hazard models of increasing complexity. Results 56% of Māori and 46% of non-Māori participants had low SCREEN-II scores indicative of nutrition risk. The prevalence of GLIM diagnosed malnutrition was lower for both Māori and non-Māori (15% and 19% of all participants). Approximately one-third of participants (37% Māori and 32% non-Māori) died within the five-year follow-up period. The odds of death for both Māori and non-Māori was significantly lower with greater SCREEN II scores (better nutrition status), (OR (95% CI); 0.58 (0.38, 0.88), P < 0.05 and 0.53 (0.38, 0.75), P < 0.001, respectively). GLIM diagnosed malnutrition was not significantly associated with five-year mortality for Māori (OR (95% CI); 0.88 (0.41, 1.91), P >0.05) but was for non-Māori. This association remained significant after adjustment for other predictors of death (OR (95% CI); 0.50 (0.29, 0.86), P< 0.05). Reduced food intake was the only GLIM criterion predictive of five-year mortality for Māori (HR (95% CI); 10.77 (4.76, 24.38), P <0.001). For non-Māori, both aetiologic and phenotypic GLIM criteria were associated with five-year mortality. Conclusion Nutrition risk, but not malnutrition diagnosed by the GLIM criteria was significantly associated with mortality for Māori. Conversely, both nutrition risk and malnutrition were significantly associated with mortality for non-Māori. Appropriate phenotypic criteria for diverse populations are needed within the GLIM framework.