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Unintentional Weight Loss (unintentional + weight_loss)
Selected AbstractsPrevention of Unintentional Weight Loss in Nursing Home Residents: A Controlled Trial of Feeding AssistanceJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2008Sandra F. Simmons PhD OBJECTIVES: To determine the effects of a feeding assistance intervention on food and fluid intake and body weight. DESIGN: Crossover controlled trial. SETTING: Four skilled nursing homes (NHs). PARTICIPANTS: Seventy-six long-stay NH residents at risk for unintentional weight loss. INTERVENTION: Research staff provided feeding assistance twice per day during or between meals, 5 days per week for 24 weeks. MEASUREMENTS: Research staff independently weighed residents at baseline and monthly during a 24-week intervention and 24-week control period. Residents' food and fluid intake and the amount of staff time spent providing assistance to eat was assessed for 2 days at baseline and 3 and 6 months during each 24-week period. RESULTS: The intervention group showed a significant increase in estimated total daily caloric intake and maintained or gained weight, whereas the control group showed no change in estimated total daily caloric intake and lost weight over 24 weeks. The average amount of staff time required to provide the interventions was 42 minutes per person per meal and 13 minutes per person per between-meal snack, versus usual care, during which residents received, on average, 5 minutes of assistance per person per meal and less than 1 minute per person per snack. CONCLUSION: Two feeding assistance interventions are efficacious in promoting food and fluid intake and weight gain in residents at risk for weight loss. Both interventions require more staff time than usual NH care. The delivery of snacks between meals requires less time than mealtime assistance and thus may be more practical to implement in daily NH care practice. [source] Relationship Between Frailty and Cognitive Decline in Older Mexican AmericansJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2008Rafael Samper-Ternent MD OBJECTIVES: To examine the association between frailty status and change in cognitive function over time in older Mexican Americans. DESIGN: Data used were from the Hispanic Established Population for the Epidemiological Study of the Elderly. SETTING: Five southwestern states: Texas, New Mexico, Colorado, Arizona, and California. PARTICIPANTS: One thousand three hundred seventy noninstitutionalized Mexican-American men and women aged 65 and older with a Mini-Mental State Examination (MMSE) score of 21 or higher at baseline (1995/96). MEASUREMENTS: Frailty, defined as three or more of the following components: unintentional weight loss of more than 10 pounds, weakness (lowest 20% in grip strength), self-reported exhaustion, slow walking speed (lowest 20% in 16-foot walk time in seconds), and low physical activity level (lowest 20% on Physical Activity Scale for the Elderly score). Information about sociodemographic factors, MMSE score, medical conditions (stroke, heart attack, diabetes mellitus, arthritis, cancer, and hypertension), depressive symptoms, and visual impairment was obtained. RESULTS: Of the 1,370 subjects, 684 (49.9%) were not frail, 626 (45.7%) were prefrail (1,2 components), and 60 (4.4%) were frail (,3 components) in 1995/96. Using general linear mixed models, it was found that frail subjects had greater cognitive decline over 10 years than not frail subjects (estimate=,0.67, standard error=0.13; P<.001). This association remained statistically significant after controlling for potential confounding factors. CONCLUSION: Frail status in older Mexican Americans with MMSE scores of 21 or higher at baseline is an independent predictor of MMSE score decline over a 10-year period. Future research is needed to establish pathophysiological components that can clarify the relationship between frailty and cognitive decline. [source] Prevention of Unintentional Weight Loss in Nursing Home Residents: A Controlled Trial of Feeding AssistanceJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2008Sandra F. Simmons PhD OBJECTIVES: To determine the effects of a feeding assistance intervention on food and fluid intake and body weight. DESIGN: Crossover controlled trial. SETTING: Four skilled nursing homes (NHs). PARTICIPANTS: Seventy-six long-stay NH residents at risk for unintentional weight loss. INTERVENTION: Research staff provided feeding assistance twice per day during or between meals, 5 days per week for 24 weeks. MEASUREMENTS: Research staff independently weighed residents at baseline and monthly during a 24-week intervention and 24-week control period. Residents' food and fluid intake and the amount of staff time spent providing assistance to eat was assessed for 2 days at baseline and 3 and 6 months during each 24-week period. RESULTS: The intervention group showed a significant increase in estimated total daily caloric intake and maintained or gained weight, whereas the control group showed no change in estimated total daily caloric intake and lost weight over 24 weeks. The average amount of staff time required to provide the interventions was 42 minutes per person per meal and 13 minutes per person per between-meal snack, versus usual care, during which residents received, on average, 5 minutes of assistance per person per meal and less than 1 minute per person per snack. CONCLUSION: Two feeding assistance interventions are efficacious in promoting food and fluid intake and weight gain in residents at risk for weight loss. Both interventions require more staff time than usual NH care. The delivery of snacks between meals requires less time than mealtime assistance and thus may be more practical to implement in daily NH care practice. [source] Chronic Cytomegalovirus Infection and Inflammation Are Associated with Prevalent Frailty in Community-Dwelling Older WomenJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2005Heidi N. Schmaltz MDCM Objectives: To evaluate the association between asymptomatic chronic cytomegalovirus (CMV) infection and the frailty syndrome and to assess whether inflammation modifies this association. Design: Cross-sectional analysis. Setting: Women's Health and Aging Study I & II, Baltimore, Maryland. Participants: Seven hundred twenty-four community-dwelling women aged 70 to 79 with baseline measures of CMV, interleukin-6 (IL-6), and frailty status. Measurements: CMV serology and IL-6 concentrations were measured using enzyme-linked immunosorbent assay. Frailty status was based on previously validated criteria: unintentional weight loss, weak grip strength, exhaustion, slow walking speed, and low level of activity. Frail women had three or more of the five components, prefrail women had one or two components, and women who were not frail had none of the components. Multinomial logistic regression adjusted for potential confounders. Results: Eighty-seven percent of women were CMV seropositive, an indication of chronic infection. CMV was associated with prevalent frailty, adjusting for age, smoking history, elevated body mass index, diabetes mellitus, and congestive heart failure (CMV frail adjusted odds ratio (AOR)=3.2, P=.03; CMV prefrail AOR=1.5, P=.18). IL-6 interacted with CMV, significantly increasing the magnitude of this association (CMV positive and low IL-6 frail AOR=1.5, P=.53; CMV positive and high IL-6 frail AOR=20.3, P=.007; CMV positive and low IL-6 prefrail AOR=0.9, P=.73; CMV positive and high IL-6 prefrail AOR=5.5, P=.001). Conclusion: Chronic CMV infection is associated with prevalent frailty, a state with increased morbidity and mortality in older adults; inflammation enhances this effect. Further prospective studies are needed to establish a causal relationship between CMV, inflammation, and frailty. [source] Energy Regulation and Aging: Recent Findings and Their ImplicationsNUTRITION REVIEWS, Issue 4 2000Susan B. Roberts Ph.D. Old age is a time of vulnerability to unintentional weight loss, a factor that is associated with increased morbidity and premature death. Many possible causes of weight loss in old age have been suggested. The so-called anorexia of aging may play a particular role, by either reducing food intake directly or reducing food intake in response to such adverse factors as age-associated reductions in taste and smell, poor dentition, use of multiple prescription medicines, and depression. Recent studies also raise the question of whether a reduction in dietary variety may be important. These findings emphasize the need for regular monitoring of body weight to detect unintentional weight loss in older individuals and suggest testable ways to minimize the impact of the anorexia of aging on body weight through improved dietary management. [source] Weight loss causes increased mortality: prosOBESITY REVIEWS, Issue 1 2003T. I. A. Sørensen Summary There are many good reasons to expect that weight loss in overweight and obese subjects should lead to reduced mortality, not least because the general risk factor profile of several diseases responsible for the excess mortality associated with overweight and obesity improves with weight loss. However, observational long-term population studies have shown that weight loss in overweight subjects leads to increased long-term mortality, even if the studies are well controlled with regard to known confounding factors, including hazardous behaviour and underlying diseases that may lead to both weight loss and increased mortality. It seems unfeasible to wait for the multiple randomized clinical trials of sufficient quality, size and duration that may resolve this question. Therefore, the recommendations about weight loss must be based on the weaker evidence that can be obtained in short-term clinical trials and the observational population studies. Several studies have tried to address the problem by distinguishing intentional from unintentional weight loss, but only few do so by gathering information about the intention to lose weight before weight loss is observed. These studies suggest that intentional weight loss is associated with increased mortality. Recommendations to healthy overweight and obese subjects to lose weight must be based on an explicit weighing of the short-term well-documented benefits of weight loss, including improvement of quality of life, against the possible risk of an increased mortality in the long term [source] Leptin and ghrelin concentrations and weight loss in Parkinson's diseaseACTA NEUROLOGICA SCANDINAVICA, Issue 4 2010U. Fiszer Fiszer U, Micha,owska M, Baranowska B, Woli,ska-Witort E, Jeske W, Jethon M, Pia,cik-Gromada M, Marcinowska-Suchowierska E. Leptin and ghrelin concentrations and weight loss in Parkinson's disease. Acta Neurol Scand: 2010: 121: 230,236. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objectives,,, To investigate the role of leptin, ghrelin, GH and IGF-1 in energy balance disturbances in Parkinson's disease (PD). Materials and methods,,, Thirty-nine patients were included: 11 PD patients with unintentional weight loss, 16 PD patients without weight loss and 12 controls. UPDRS, MMSE, MADRS, appetite scale, BMI, adipose tissue content, plasma leptin and active ghrelin concentrations and serum GH, IGF-1, TSH, T3 and T4, concentrations were evaluated. Results,,, A lower plasma leptin concentration and a higher serum IGF-1 concentration were found in PD patients with weight loss. BMI and the content of adipose tissue were positively correlated with leptin concentration in all PD patients. Paradoxically, the lower BMI was, the lower plasma active ghrelin concentration was in PD patients with the weight loss. Conclusion,,, These findings confirm that changes of plasma leptin concentration occur in PD patients with loss of weight. [source] | ||||||||||