The journal of nutrition, health & aging
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J Nutr Health Aging · Aug 2009
Dependence of the geriatric depression scores on age, nutritional status, and haematologic variables in elderly institutionalized patients.
To evaluate the relationships between depression and ageing, nutrition, and selected haematologic variables. ⋯ Depression was associated with worsening of nutritional status and the degree of anemia of the entire elderly population and the male, but not the female subjects. The borderline correlation observed between the GDS and MCV for the female subjects suggests that the nutritional deficiencies responsible for the MCV increase are a cause, and not an effect, of depression.
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J Nutr Health Aging · Aug 2009
Factors related to withholding life-sustaining treatment in hospitalized elders.
To look for predictors in the clinical records of orders for "limitation of life sustaining treatment" (LLST) or "do not attempt resuscitation" (DNAR) in hospitalized elders and to assess the relationship between the presence of these orders and the quality of end-of-life (EOL) care. ⋯ LLST-orders were more likely to be written in an EACU for patients with previous severe impairment, co-morbidity, or advanced disease. Written acknowledgement of closeness to death and LLST-orders were predictors of better EOL-management.
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J Nutr Health Aging · May 2009
Randomized Controlled TrialUsage of megestrol acetate in the treatment of anorexia-cachexia syndrome in the elderly.
The aim of this review is to assess the efficacy and safety of megestrol acetate (MA) in geriatric cachexia. The paper presented here reviews a previously published study of MA use in 69 patients in a randomized double blind placebo-controlled trial. This paper will also address the underlying pathogenesis of cachexia (specifically, the role of cytokines) along with the use of MA, its mechanism of action and its side effects. ⋯ At 12 weeks there were no significant differences in weight gain between treatment groups, while MA-treated patients reported significantly greater improvement in appetite, enjoyment of life, and well being. At week 25 (3 months after treatment), 61.9% of MA-treated patients had gained * 1.82 kg (4 lbs) compared to 21.7% of placebo patients. There was no difference in survival between MA and placebo groups. Considering possible confounders, higher initial IL-6, initial TNFR-p75 levels, and final neutrophil percentage were associated with elevated mortality, whereas higher initial pre-albumin, initial albumin, final pre-albumin, final albumin and final weight gain were associated with decreased death.
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J Nutr Health Aging · Apr 2009
Comparative Study Clinical TrialMetabolic response to a ketogenic breakfast in the healthy elderly.
To determine whether the metabolism of glucose or ketones differs in the healthy elderly compared to young or middle-aged adults during mild, short-term ketosis induced by a ketogenic breakfast. ⋯ Elderly people in relatively good health have a similar capacity to produce ketones and to oxidize 13C-beta-hydroxybutyrate as middle-aged or young adults, but oxidize 13C-glucose a little more rapidly than healthy middle-aged adults.
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J Nutr Health Aging · Apr 2009
ReviewSleep disorders and their impacts on healthy, dependent, and frail older adults.
Sleep disorders differ widely in the heterogeneous older adult population. Older adults can be classified into three groups based upon their overall level of disability: healthy, dependent, and frail. Frailty is an emerging concept that denotes older persons at increased risk for poor outcomes. ⋯ Our knowledge in the field of sleep disorders in older adults has increased in recent years, yet some groups within this heterogeneous population, such as frail older adults, remain to be more thoroughly studied and characterized.