Browsing by Subject "terveystieteet"

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  • Larmo, Katri (Helsingin yliopisto, 2010)
    Verkkari 2010 (6)
  • Unknown author (Helsingin yliopisto, 2006)
    Verkkari 2006 (4)
  • Unknown author (Helsingin yliopisto, 2006)
    Verkkari 2006 (3)
  • Unknown author (Helsingin yliopisto, 2006)
    Verkkari 2006 (6)
  • Unknown author (Helsingin yliopisto, 2006)
    Verkkari 2006 (5)
  • Larmo, Katri (Helsingin yliopisto, 2009)
    Verkkari 2009 (8)
  • Salomaa, Ulla (Helsingin yliopisto, 2006)
    Verkkari 2006 (9)
  • Tavast, Annakaisa (Helsingin yliopisto, 2006)
    Verkkari 2006 (8)
  • Pekkarinen, Päivi (Helsingin yliopisto, 2009)
    Verkkari 2009 (4)
  • Pohjanpää, Lassi (Helsingin yliopisto, 2006)
    Verkkari 2006 (9)
  • Salomaa, Ulla (Helsingin yliopisto, 2006)
    Verkkari 2006 (7)
  • Sandgren, Terhi (Helsingin yliopisto, 2006)
    Verkkari 2006 (4)
  • Koivula, Anna-Mari (Helsingin yliopisto, 2010)
    Verkkari 2010 (1)
  • Jyväkorpi, Satu (Helsingin yliopisto, 2016)
    Background: Nutrition among older people is associated with functional ability and quality of life (QoL). Malnutrition is most often observed in institutionalized older people and dependent home-careclients. Furthermore, home-dwelling older people with comorbidities, including Alzheimer’s disease (AD), are a risk group for malnutrition. However, few studies have examined the detailed nutrient intakes of older people. In many studies, low nutrient intakes and low diet quality have been observed. Prevention of deterioration in nutritional status is crucial, because poor protein and micronutrient intakes increase the risk of frailty and impaire immunity. As the number of older people increases, more information on nutrition in older populations will be needed. It is important to recognize malnutrition at its early stage and to improve nutrient intake and maintain good nutritional status of older people. The effects of nutritional counseling and education on older people’s nutritional status, nutrient intakes, diet quality, and QoL have not been rigorously studied. Objectives of the study: to determine nutritional status, nutrient intakes and associated factors in both home-dwelling and institutionalized older people at various stages of functioning, and the effectiveness of tailored nutritional counseling and nutrition education on healthy home-dwelling older people’s and AD participants’ nutritional status, nutrient intakes, number of falls, and QoL . Subjects and methods: A cross-sectional study (I, II) included institutionalized (n = 374) and home-dwelling older people with varied cognition and mobility (n = 526). Five datasets were combined: home-dwelling older people participating in nutrition education and cooking classes (NC) (n = 54), participants from the Helsinki Businessmen Study (HBS) (n = 68), home-dwelling people with AD (n = 99) and their spousal caregivers (CGs) (n = 97), participants from the Porvoo Sarcopenia and Nutrition Trial (PSNT) (n = 208), and residents of Helsinki assisted living facilities (ALFs) (n = 374). The participants’ nutritional status was examined, using the Mini Nutritional Assessment (MNA), and nutrient intakes were retrieved from 1–3-day food records. Data on background information, comorbidities, and cognition were collected. The nutrient intakes were compared with recommended intakes. The adequacy of the nutrient intakes was determined by comparing micronutrient intakes with the average requirements. The sensitivity and specificity of the MNA in identifying older people with low energy and protein intakes were tested. In a follow-up study (III), the effect of NC classes on diet quality, nutrient intakes, and psychological well-being (PWB) was examined in independent and healthy, home-dwelling older people. The Nutrition and Alzheimer ’s disease (NuAD) trial (IV, V) was a 1-year randomized controlled trial (RCT) examining the effect of tailored nutritional counseling on home-dwelling AD participants’ nutrient intakes, QoL, and risk of falls. Couples received tailored nutritional guidance during home visits in a 1-year follow-up. The primary outcome measure was weight change and the secondary outcome measure comprised changes in protein and micronutrient intakes from 3-day food records, Health-Related Quality of Life (15D HRQoL), and rate of falls among participants with AD. Results: The groups of older people (I, II) differed in all their background characteristics. The prevalence of malnutrition (17%) and risk of malnutrition (68%) were highest among the ALF residents, followed by the PSNT group (3% and 60%, respectively). In the other groups, there were no malnourished participants. Among the home-dwelling AD participants, the risk of malnutrition was 43% and among the CGs 16%, whereas the respective figures in the HBS and NC classes were 9% and 7%. Insufficient intakes were most often encountered in the malnourished group, but poor protein and micronutrient intakes were also observed in people with normal nutritional status. Insufficient intakes of nutrients were associated with the female sex, cognitive decline, place of residence (institution), and immobility. Of all the participants, 77% had lower than recommended protein intakes. The participants suffering from mobility limitation and cognitive decline had the poorest nutritional status (p < 0.001; adjusted for age, sex, and comorbidities). However, low intakes of energy, protein, and micronutrients were observed in high proportions in all functional groups, those showing inadequate intakes of vitamins D, E, folate, and thiamine being the most common. Higher nutrient intakes were lineally associated with better nutritional status according to MNA, but the sensitivity and specificity of the MNA in identifying suboptimal energy and protein intakes was low. People who participated in NC classes improved their diet quality, PWB, vitamin-C, and fiber intakes postintervention compared with preintervention. The effect sizes varied between small to nearly medium (0.2-0.35). In the NuAD trial, 40% of participants with AD were at risk of malnutrition. There was no difference in weight change between the intervention and control groups during the 1-year study period. At 12 months, the protein intake improved in the intervention group, whereas it declined in the control group (p = 0.031, adjusted for baseline value, age, sex, Mini-Mental State Examination (MMSE), and body mass index (BMI). The participants’ HRQoL improved by 0.006 in the intervention group and declined by -0.036 in the control group (p = 0.007, adjusted for baseline value, age, sex, MMSE, and BMI). The annual rate of falls per person was 0.55 in the intervention group and 1.39 in the control group (p < 0.001 adjusted for age, sex, and MMSE). Conclusions: Poor diet quality, insufficient protein, and micronutrient intakes were commonly found in all functional groups of older people. The sensitivity and specificity of the MNA in identifying low energy and protein intakes was low. Tailored nutritional interventions improved diet quality, nutrient intakes, and HRQoL or PWB. In home-dwelling people with AD, falls decreased due to the intervention. 
  • Larmo, Katri (Helsingin yliopisto, 2011)
    Verkkari 2011 (5)
  • Salomaa, Ulla (Helsingin yliopisto, 2006)
    Verkkari 2006 (8)
  • Larmo, Katri (Helsingin yliopisto, 2012)
    Verkkari 2012 (6)
  • Neuvonen, Ulla (Helsingin yliopisto, 2006)
    Verkkari 2006 (7)
  • Larmo, Katri (Helsingin yliopisto, 2013)
    Verkkari 2013 (6)