Item request has been placed! ×
Item request cannot be made. ×
loading  Processing Request

Evaluation of the impact of a post-hospital discharge Transitional Aged Care Service on frailty, malnutrition and functional ability.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • معلومة اضافية
    • المصدر:
      Publisher: Dietitians Association of Australia Country of Publication: Australia NLM ID: 101143078 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1747-0080 (Electronic) Linking ISSN: 14466368 NLM ISO Abbreviation: Nutr Diet Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: Deakin, ACT : Dietitians Association of Australia, c2002-
    • الموضوع:
    • نبذة مختصرة :
      Aim: To investigate the relationship between nutritional status, functional ability and frailty in older adults participating in a 12-week Transitional Aged Care Service program.
      Methods: A retrospective analysis of a clinical cohort of older adults aged 65+ years after hospital discharge. At entry into the program and at completion, nutritional status was measured using the Mini Nutritional Assessment (MNA), frailty status was measured using the Groningen Frailty Indicator and functional ability was measured using the Modified Barthel Index (MBI). Demographic data were obtained from electronic medical records.
      Results: Baseline data were available for 115 participants (mean age = 81.7 (SD =7.9) years; 20.9% classified as malnourished and 89.6% as frail). A positive association was found between nutritional status and frailty (r = 0.298; P = 0.001), and frailty and functional ability (r = 0.204; P = 0.029). Multiple regression analysis, accounting for the cofounders of baseline MNA, MBI, age, gender, length of hospital stay and living situation, found that nutritional status and functional ability were able to indicate the presence of frailty on admission to the program (P = 0.002, P = 0.007, respectively). In those program completers (n = 79), significant improvements were found in nutritional status, frailty and functional ability (P < 0.0005).
      Conclusions: Nutrition status, frailty and functional ability are closely and positively related, and should therefore be considered simultaneously in rehabilitation for older adults. A post-hospital transitional program with a multidisciplinary approach significantly improved all three outcomes, suggesting its value in enabling frail older people to remain independent for as long as possible.
      (© 2019 Dietitians Association of Australia.)
    • References:
      Badia T, Formiga F, Ferrer A, Sanz H, Hurtos L, Pujol R. Multifactorial assessment and targeted intervention in nutritional status among the older adults: a randomized controlled trial: the Octabaix study. BMC Geriatr 2015; 15: 45.
      Stratton RJ, Elia M. A review of reviews: a new look at the evidence for oral nutritional supplements in clinical practice. Clin Nutr Suppl 2007; 2: 5-23.
      Barker LA, Gout BS, Crowe TC. Hospital malnutrition: prevalence, identification and impact on patients and the healthcare system. Int J Environ Res Public Health 2011; 8: 514-27.
      Feldblum I, German L, Castel H, Harman-Boehm I, Shahar D. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-7.
      Chang HH, Tsai SL, Chen CY, Liu WJ. Outcomes of hospitalized elderly patients with geriatric syndrome: report of a community hospital reform plan in Taiwan. Arch Gerontol Geriatr 2010; 50: S30-3.
      Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: the mini nutritional assessment as part of the geriatric evaluation. Nutr Rev 1996; 54: S59-65.
      Fávaro-Moreira NC, Krausch-Hofmann S, Matthys C et al. Risk factors for malnutrition in older adults: a systematic review of the literature based on longitudinal Data123. Adv Nutr 2016; 7: 507-22.
      Fried LP, Tangen CM, Walston J et al. Frailty in older adults: evidence for a phenotype. J Gerontol 2001; 56: M146-M57.
      Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci 2004; 59: 255-63.
      Rockwood K, Mitnitski A. Frailty defined by deficit accumulation and geriatric medicine defined by frailty. Clin Geriatr Med 2011; 27: 17-26.
      Laur CV, McNicholl T, Valaitis R, Keller HH. Malnutrition or frailty? Overlap and evidence gaps in the diagnosis and treatment of frailty and malnutrition. Appl Physiol Nutr Metab 2017; 42: 449-58.
      Boulos C, Salameh P, Barberger-Gateau P. Malnutrition and frailty in community dwelling older adults living in a rural setting. Clin Nutr 2016; 35: 138-43.
      Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc 2012; 60: 1487-92.
      Morley JE, Vellas B, van Kan GA et al. Frailty consensus: a call to action. J Am Med Dir Assoc 2013; 14: 392-7.
      Mahoney FI, Barthel DW. Functional evaluation: the Barthel index. Md State Med J 1965; 14: 61-5.
      Beswick AD, Rees K, Dieppe P et al. Complex interventions to improve physical function and maintain independent living in elderly people: a systematic review and meta-analysis. Lancet 2008; 371: 725-35.
      Endevelt R, Lemberger J, Bregman J et al. Intensive dietary intervention by a dietitian as a case manager among community dwelling older adults: the EDIT study. J Nutr Health Aging 2011; 15: 624-30.
      Compher C, Kim JN, Bader JG. Nutritional requirements of an aging population with emphasis on subacute care patients. AACN Clin Issues 1998; 9: 441-50.
      van Rijn M, Buurman BM, Macneil Vroomen JL et al. Changes in the in-hospital mortality and 30-day post-discharge mortality in acutely admitted older patients: retrospective observational study. Age Ageing 2016; 45: 41-7.
      Guigoz Y. The mini nutritional assessment (MNA) review of the literature-What does it tell us? J Nutr Health Aging 2006; 10: 466-85; discussion 85-87.
      Gauld LM, Kappers J, Carlin JB, Robertson CF. Height prediction from ulna length. Dev Med Child Neurol 2004; 46: 475-80.
      Steverink NSJ, Schuurmans H, van Lis M. Measuring frailty: development and testing of the Groningen Frailty Indicator (GFI). Gerontologist 2001; 41: 236-7.
      Granger CV, Albrecht GL, Hamilton BB. Outcome of comprehensive medical rehabilitation: measurement by PULSES profile and the Barthel Index. Arch Phys Med Rehabil 1979; 60: 145-54.
      Roth E, Davidoff G, Haughton J, Ardner M. Functional assessment in spinal cord injury: a comparison of the modified Barthel Index and the 'adapted' functional Independence measure. Clin Rehabil 1990; 4: 277-85.
      IBM Corporation. IBM SPSS Statistics for Windows Version 23.0. Armonk, NY: IBM Corporation, 2015.
      Laerd Statistics. Statistical Tutorials and Software Guides, 2017. (Available from: https://statistics.laerd.com/features-overview.php, accessed 30 April 2018).
      Allen J, Hutchinson AM, Brown R, Livingston PM. Quality care outcomes following transitional care interventions for older people from hospital to home: a systematic review. BMC Health Serv Res 2014; 14: 346.
      Bollwein J, Volkert D, Diekmann R et al. Nutritional status according to the mini nutritional assessment (MNA®) and frailty in community dwelling older persons: a close relationship. J Nutr Health Aging 2013; 17: 351-6.
      Bunout D, Barrera G, de la Maza P et al. The impact of nutritional supplementation and resistance training on the health functioning of free-living Chilean elders: results of 18 months of follow-up. J Nutr 2001; 131: 2441s-6s.
      Ramic E, Pranjic N, Batic-Mujanovic O, Karic E, Alibasic E, Alic A. The effect of loneliness on malnutrition in elderly population. Med Arh 2011; 65: 92.
      Lean M, Wiseman M. Malnutrition in hospitals. BMJ 2008; 336: 290.
      Abellan Van Kan G, Vellas B. Is the mini nutritional assessment an appropriate tool to assess frailty in older adults? J Nutr Health Aging 2011; 15: 159-61.
      Dent E, Visvanathan R, Piantadosi C, Chapman I. Use of the mini nutritional assessment to detect frailty in hospitalised older people. J Nutr Health Aging 2012; 16: 764-7.
      Van Heuvelen MJ, Kempen GI, Brouwer WH, de Greef MH. Physical fitness related to disability in older persons. Gerontology 2000; 46: 333-41.
      Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet 2013; 381: 752-62.
      Montero-Odasso M, Muir SW, Hall M et al. Gait variability is associated with frailty in community-dwelling older adults. J Gerontol A 2011; 66: 568-76.
      Lacas A, Rockwood K. Frailty in primary care: a review of its conceptualization and implications for practice. BMC Med 2012; 10: 4.
      Pialoux T, Goyard J, Lesourd B. Screening tools for frailty in primary health care: a systematic review. Geriatr Gerontol Int 2012; 12: 189-97.
      Sternberg SA, Wershof Schwartz A, Karunananthan S, Bergman H, Mark Clarfield A. The identification of frailty: a systematic literature review. J Am Geriatr Soc 2011; 59: 2129-38.
      Pijpers E, Ferreira I, Stehouwer CD, Nieuwenhuijzen Kruseman AC. The frailty dilemma. Review of the predictive accuracy of major frailty scores. Eur J Intern Med 2012; 23: 118-23.
      Shamliyan T, Talley KM, Ramakrishnan R, Kane RL. Association of frailty with survival: a systematic literature review. Ageing Res Rev 2013; 12: 719-36.
      Charlton K, Batterham M, Bowden S et al. A high prevalence of malnutrition in acute geriatric patients predicts adverse clinical outcomes and mortality at 12 months. e-SPEN J 2013; 8: e120-5.
      Charlton KE, Nichols C, Batterham M et al. Poor nutritional status of older rehabilitation patients predicts clinical outcomes and mortality at 18 months of follow up. Eur J Clin Nutr 2012; 66: 1224-8.
      Comans TA, Peel NM, Gray LC, Scuffham PA. Quality of life of older frail persons receiving a post-discharge program. Health Qual Life Outcomes 2013; 11: 58.
      Jortberg BT, Fleming MO. Registered dietitian nutritionists bring value to emerging health care delivery models. J Acad Nutr Diet 2014; 114: 2017-22.
      Morley JE, Argiles JM, Evans WJ et al. Nutritional recommendations for the Management of Sarcopenia. J Am Med Dir Assoc 2010; 11: 391-6.
      Macfarlane S, Charlton KE, Ferguson A et al. Difficulties in recruiting frail older inpatients to intervention studies. Nutr Diet 2016; 73: 348-55.
    • Contributed Indexing:
      Keywords: frailty; functional ability; mini nutritional assessment; older adults; post-hospital discharge; transitional program
    • الموضوع:
      Date Created: 20190126 Date Completed: 20200601 Latest Revision: 20200601
    • الموضوع:
      20250114
    • الرقم المعرف:
      10.1111/1747-0080.12511
    • الرقم المعرف:
      30680867