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Carlsson, Maine
Publications (10 of 15) Show all publications
Farooqi, N., Carlsson, M., Håglin, L., Sandström, T. & Slinde, F. (2018). Energy expenditure in women and men with COPD. Clinical Nutrition ESPEN, 28, 171-178
Open this publication in new window or tab >>Energy expenditure in women and men with COPD
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2018 (English)In: Clinical Nutrition ESPEN, ISSN 2405-4577, Vol. 28, p. 171-178Article in journal (Refereed) Published
Abstract [en]

Background: Many patients with chronic obstructive pulmonary disease (COPD) lose weight. Successful nutritional intervention is vital, thus assessment of energy requirement is required. The aim of this study was to present an improved possibility to assess energy requirement in patients with COPD.

Methods: Pub Med search was conducted for all the studies reporting total energy expenditure (TEE) measured by doubly labeled water (DLW) method in patients with COPD. Four studies were identified, whereof three were conducted in Sweden. The present analysis is based on these three studies of which the data was acquired.

Results: There was a large variation in resting metabolic rate (RMR) and TEE. Body mass index decreased significantly with increase in disease severity (p < .001), and correlated significantly to forced expiratory volume in 1 s (FEV1) % predicted (r = .627, p < .001). FEV1% predicted had a significant correlation with RMR/kg body weight (BW)/day (r = -.503, p = .001), RMR/kg fat-free mass (FFM)/day (r = .338, p = .031), and TEE/kg FFM/day (r = .671, p < .001). Compared to men, women had a lower RMR and TEE/kg BW/day (p < .001 respectively p = .002), and higher RMR and TEE/kg FFM/day (p = .080 respectively p = .005). The correlates of: RMR/kg BW were gender and FEV1% predicted; of TEE/kg BW the correlates were age and gender, and of TEE/kg FFM the correlates were age and FEV1% predicted.

Conclusion: In this study, we have presented a possibility to assess energy requirement per kg BW/day and per kg FFM/day in patients with COPD in clinical settings. However, gender, age, and disease severity must be considered. 

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Energy expenditure in COPD, Doubly labeled water and COPD, FEV1 and energy expenditure
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-153541 (URN)10.1016/j.clnesp.2018.08.008 (DOI)000448887100025 ()30390877 (PubMedID)
Available from: 2018-11-26 Created: 2018-11-26 Last updated: 2019-08-21Bibliographically approved
Burman, M., Säätelä, S., Carlsson, M., Olofsson, B., Gustafson, Y. & Hörnsten, C. (2015). Body Mass Index, Mini Nutritional Assessment, and their Association with Five-Year Mortality in Very Old People. The Journal of Nutrition, Health & Aging, 19(4), 461-467
Open this publication in new window or tab >>Body Mass Index, Mini Nutritional Assessment, and their Association with Five-Year Mortality in Very Old People
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2015 (English)In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 19, no 4, p. 461-467Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: to investigate the prevalence of malnutrition and the association between Body Mass Index (BMI), Mini Nutritional Assessment (MNA) and five-year mortality in a representative population of very old (>85 years) people.

DESIGN: A prospective cohort study.

SETTING: A population-based study of very old people in northern Sweden and western Finland, living in institutional care or in the community.

PARTICIPANTS: Out of 1195 potential participants, 832 were included (mean age 90.2±4.6 years).

MEASUREMENTS: Nutritional status was assessed using BMI and MNA and the association of those two variables with five-year mortality was analyzed.

RESULTS: The mean BMI value for the whole population was 25.1±4.5 kg/m2, with no difference between genders (P=0.938). The mean MNA score was 22.5±4.6 for the whole sample, and it was lower for women than for men (P<0.001). Thirteen percent were malnourished (MNA<17) and 40.3% at risk of malnutrition (MNA 17-23.5) according to MNA. Also, 34.8% of those with a MNA score <17 still had a BMI value ≥22.2 kg/m2. A BMI value <22.2 kg/m2 and a MNA score<17 were associated with lower survival. The association with mortality seemed to be J-shaped for BMI, and linear for MNA.

CONCLUSIONS: Malnutrition according to MNA was common, but a substantial portion of those with a low MNA score still had a high BMI value, and vice versa. The association with mortality appeared to be J-shaped for BMI, and linear for MNA. The MNA seems to be a good measurement of malnutrition in very old people, and BMI might be misleading and could underestimate the prevalence of malnutrition, especially in women.

Place, publisher, year, edition, pages
Paris: Springer, 2015
Keywords
MNA, BMI, very old, five-year mortality
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-101459 (URN)10.1007/s12603-015-0443-x (DOI)000352705800012 ()25809811 (PubMedID)
Available from: 2015-03-31 Created: 2015-03-31 Last updated: 2018-06-07Bibliographically approved
Farooqi, N., Slinde, F., Carlsson, M., Håglin, L. & Sandström, T. (2015). Predicting energy requirement with pedometer-determined physical-activity level in women with chronic obstructive pulmonary disease. The International Journal of Chronic Obstructive Pulmonary Disease, 10, 1129-1137
Open this publication in new window or tab >>Predicting energy requirement with pedometer-determined physical-activity level in women with chronic obstructive pulmonary disease
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2015 (English)In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 10, p. 1129-1137Article in journal (Refereed) Published
Abstract [en]

Background: In clinical practice, in the absence of objective measures, simple methods to predict energy requirement in patients with chronic obstructive pulmonary disease (COPD) needs to be evaluated. The aim of the present study was to evaluate predicted energy requirement in females with COPD using pedometer-determined physical activity level (PAL) multiplied by resting metabolic rate (RMR) equations. Methods: Energy requirement was predicted in 18 women with COPD using pedometer-determined PAL multiplied by six different RMR equations (Harris-Benedict; Schofield; World Health Organization; Moore; Nordic Nutrition Recommendations; Nordenson). Total energy expenditure (TEE) was measured by the criterion method: doubly labeled water. The predicted energy requirement was compared with measured TEE using intraclass correlation coefficient (ICC) and Bland-Altman analyses. Results: The energy requirement predicted by pedometer-determined PAL multiplied by six different RMR equations was within a reasonable accuracy (+/- 10%) of the measured TEE for all equations except one (Nordenson equation). The ICC values between the criterion method (TEE) and predicted energy requirement were: Harris-Benedict, ICC =0.70, 95% confidence interval (CI) 0.23-0.89; Schofield, ICC =0.71, 95% CI 0.21-0.89; World Health Organization, ICC =0.74, 95% CI 0.33-0.90; Moore, ICC =0.69, 95% CI 0.21-0.88; Nordic Nutrition Recommendations, ICC =0.70, 95% CI 0.17-0.89; and Nordenson, ICC =0.40, 95% CI -0.19 to 0.77. Bland-Altman plots revealed no systematic bias for predicted energy requirement except for Nordenson estimates. Conclusion: For clinical purposes, in absence of objective methods such as doubly labeled water method and motion sensors, energy requirement can be predicted using pedometer-determined PAL and common RMR equations. However, for assessment of nutritional status and for the purpose of giving nutritional treatment, a clinical judgment is important regarding when to accept a predicted energy requirement both at individual and group levels.

Keywords
pedometer-determined PAL, women with COPD, energy expenditure, DLW method
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-106033 (URN)10.2147/COPD.S80616 (DOI)000356192100002 ()
Available from: 2015-07-03 Created: 2015-07-03 Last updated: 2018-06-07Bibliographically approved
Vikdahl, M., Carlsson, M., Linder, J., Forsgren, L. & Håglin, L. (2014). Weight gain and increased central obesity in the early phase of Parkinson's disease. Clinical Nutrition, 33(6), 1132-1139
Open this publication in new window or tab >>Weight gain and increased central obesity in the early phase of Parkinson's disease
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2014 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 33, no 6, p. 1132-1139Article in journal (Refereed) Published
Abstract [en]

BACKGROUND & AIMS: Weight loss is strongly associated with Parkinson's disease (PD) and impacts symptoms and disease progression. The aim of this study was to describe changes in body composition and to explore how body weight (BW), relates to disease progression and medication in the early phase of PD.

METHODS: Participants in a prospective community-based case-control study of PD were followed-up three years after initial diagnosis. Anthropometric and bioelectrical impedance spectroscopy (BIS) measurements were used together with Mini Nutritional Assessment (MNA), a 24-h recall (24-HR) and a 3-day food registration (3-DFR) to complete the evaluation of nutritional status. Disease severity was assessed using the Mini Mental State Examination (MMSE), the Unified Parkinson's Disease Rating Scale motor score (UPDRS III), and the Hoehn and Yahr rating.

RESULTS: The PD patients' BW gained 1.62 kg (±4.60, P = 0.009), an increase that significantly correlated with fat mass (FM) (r = 0.74), waist size (r = 0.65), waist/height ratio (r = 0.64), and total skin fold (r = 0.77). Linear regression showed an association between change in BW and physical activity level (PAL) (B = -8.554; P = 0.025) confirmed by the multiple linear regression. Linear regression also revealed an association between change in FM and MMSE (B = 0.654; P = 0.027).

CONCLUSION: In early PD, weight gain was revealed over three years accompanied by an increase in FM and waist circumference. An inverse relation was revealed between change in BW and PAL. The MMSE, UPDRS III, and Hoehn and Yahr rating were unchanged. Medication and swallowing difficulties were not associated with change in BW.

Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
Anthropometry, Body composition, Body weight, Nutrition, Parkinson's disease
National Category
Geriatrics Public Health, Global Health, Social Medicine and Epidemiology Neurology
Identifiers
urn:nbn:se:umu:diva-86209 (URN)10.1016/j.clnu.2013.12.012 (DOI)000347362400030 ()24423747 (PubMedID)
Available from: 2014-02-20 Created: 2014-02-20 Last updated: 2018-06-08Bibliographically approved
Holst, M., Yifter-Lindgren, E., Surowiak, M., Nielsen, K., Mowe, M., Carlsson, M., . . . Rasmussen, H. (2013). Nutritional screening and risk factors in elderly hospitalized patients: association to clinical outcome?. Scandinavian Journal of Caring Sciences, 27(4), 953-961
Open this publication in new window or tab >>Nutritional screening and risk factors in elderly hospitalized patients: association to clinical outcome?
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2013 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 4, p. 953-961Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to test the intervalidity of three different nutrition screening tools towards a broad population of elderly hospitalized patients. The association with risk factors and mortality was investigated. This is a prospective cohort study in three medical, surgical and geriatric settings, in Denmark and Sweden. Patients >65 years were consecutively included. Patients were screened by mini-nutritional assessment (MNA), malnutrition universal screening tool (MUST) and nutritional risk screening (NRS-2002). Anthropometrics, cognitive test (SPMSQ), as well as a questionnaire investigation regarding eating problems and life situation, were performed. Mortality within 12 months was investigated. In total, 233 patients mean (SD) age 81(7.64) years were included. A large variation in prevalence of nutritional risk was determined between the screening tools, MNA was 68% vs. MUST, 47% and NRS 54%, p < 0.0001. An overall agreement of 67% was seen (κ 0.52-0.55). Risk factors were associated with nutritional risk, including depressive mood. Only handgrip strength, fungus in mouth, serum albumin, CRP and cognitive function were associated with mortality. Fungus had the strongest association (OR 3.7; CI 1.19-11.30). The overall mortality rate was 27% during 12 months. However, none of the three screening tools predicted 12-month mortality. The findings show great variation in the prevalence of nutritional risk of under nutrition both between the tools and the settings. The level of agreement between the tools was moderate, and none of the three tools were capable of predicting 12-month mortality. A functional and psychological evaluation including oral health seems recommendable in elderly patients at nutritional risk.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2013
Keywords
elder care, depression, eating problems, clinical decision-making, multiprofessional care, screening
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-86207 (URN)10.1111/scs.12010 (DOI)23181396 (PubMedID)
Available from: 2014-02-20 Created: 2014-02-20 Last updated: 2018-06-08Bibliographically approved
Carlsson, M., Haglin, L., Rosendahl, E. & Gustafson, Y. (2013). Poor nutritional status is associated with urinary tract infection among older people living in residential care facilities. The Journal of Nutrition, Health & Aging, 17(2), 186-191
Open this publication in new window or tab >>Poor nutritional status is associated with urinary tract infection among older people living in residential care facilities
2013 (English)In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 17, no 2, p. 186-191Article in journal (Refereed) Published
Abstract [en]

To investigate factors associated with poor nutritional status in older people living in residential care facilities. Methods: 188 residents (136 women, 52 men) with physical and cognitive impairments participated. Mean age was 84.7 y (range 65-100). The Mini Nutritional Assessment (MNA), Barthel ADL Index, Mini Mental State Examination (MMSE), and Geriatric Depression Scale were used to evaluate nutritional status, activities of daily living, cognitive status and depressive symptoms. Medical conditions, clinical characteristics and prescribed drugs were recorded. Univariate and multivariate regressions were used to investigate associations with MNA scores. Results: The mean MNA score was 20.5 +/- 3.7 (range 5.5-27) and the median was 21 (interquartile range (IQR) 18.8-23.0). Fifteen per cent of participants were classified as malnourished and 66% at risk of malnutrition. Lower MNA scores were independently associated with urinary tract infection (UTI) during the preceding year (beta = -0.21, P = 0.006), lower MMSE scores (beta = 0.16, P = 0.030), and dependent in feeding (beta = -0.14, P = 0.040). Conclusion: The majority of participants were at risk of or suffering from malnutrition. Urinary tract infection during the preceding year was independently associated with poor nutritional status. Dependence in feeding was also associated with poor nutritional status as were low MMSE scores for women. Prospective observations and randomized controlled trials are necessary to gain an understanding of a causal association between malnutrition and UTI.

Keywords
Malnutrition, Mini Nutritional Assessment, residential care facilities, urinary tract infection, cognitive impairment, old people
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-67973 (URN)10.1007/s12603-012-0087-z (DOI)000315537400015 ()
Available from: 2013-04-11 Created: 2013-04-09 Last updated: 2018-06-08Bibliographically approved
Ådén, E., Carlsson, M., Poortvliet, E., Stenlund, H., Linder, J., Edström, M., . . . Håglin, L. (2011). Dietary intake and olfactory function in patients with newly diagnosed Parkinson's disease: a case-control study.. Nutritional neuroscience, 14(1), 25-31
Open this publication in new window or tab >>Dietary intake and olfactory function in patients with newly diagnosed Parkinson's disease: a case-control study.
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2011 (English)In: Nutritional neuroscience, ISSN 1476-8305, Vol. 14, no 1, p. 25-31Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To evaluate energy and nutrient intake in newly diagnosed Parkinson's disease (PD) patients and association between olfaction and nutrient density of the diet.

DESIGN: Baseline data from a prospective cohort study.

SUBJECTS: Eighty-seven patients and 28 age- and sex-matched controls participated in the study.

METHODS: Dietary intake was assessed by using 3-day dietary records and 24-hour dietary recalls. The Brief Smell Identification Test (B-SIT) was used to test olfaction.

RESULTS: Patients, compared with controls, had lower intake of polyunsaturated fatty acids (P = 0.024) and a higher intake of carbohydrates (P = 0.027) in energy percent (E%). Lower intake of protein (E%) (P = 0.045), and a low nutrient density of folate (P = 0.022), magnesium (P = 0.012), and phosphorus (P = 0.029) were associated with lower B-SIT score in both patients and controls. PD patients had a lower B-SIT score than controls (P < 0.001).

CONCLUSION: The results indicate a higher relative contribution of energy from carbohydrates in PD patients. An association between low protein, folate, magnesium, and phosphorus density of the diet and olfaction was seen in the whole population.

Keywords
smell, taste, olfaction, dysphagia, anorexia
National Category
Neurosciences Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-53021 (URN)10.1179/174313211X12966635733312 (DOI)21535918 (PubMedID)
Available from: 2012-03-12 Created: 2012-03-12 Last updated: 2018-06-08Bibliographically approved
Littbrand, H., Carlsson, M., Lundin-Olsson, L., Lindelöf, N., Håglin, L., Gustafson, Y. & Rosendahl, E. (2011). Effect of a high-intensity functional exercise program on functional balance: preplanned subgroup analyses of a randomized controlled trial in residential care facilities.. Journal of The American Geriatrics Society, 59(7), 1274-1282
Open this publication in new window or tab >>Effect of a high-intensity functional exercise program on functional balance: preplanned subgroup analyses of a randomized controlled trial in residential care facilities.
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2011 (English)In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 59, no 7, p. 1274-1282Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To evaluate whether age, sex, depression, dementia disorder, nutritional status, or level of functional balance capacity influences the effect of a high-intensity functional weight-bearing exercise program on functional balance.

DESIGN: Preplanned subgroup analyses of a randomized controlled trial.

SETTING: Nine residential care facilities.

PARTICIPANTS: One hundred ninety-one people aged 65 to 100 dependent in activities of daily living and with Mini-Mental State Examination scores of 10 or greater.

INTERVENTION: A high-intensity functional weight-bearing exercise program or a control activity, each comprising 29 sessions over 3 months.

MEASUREMENTS: Functional balance capacity was assessed blindly using the Berg Balance Scale (BBS) at baseline, 3 months, and 6 months. The BBS consists of 14 tasks, common in everyday life, such as standing up from sitting and, while standing, reaching forward or turning 360°. Interactions between allocation to activity group and each subgroup were evaluated according to the intention-to-treat principle.

RESULTS: The subgroup analyses revealed no statistically significant interaction for age, sex, depression, dementia disorder, nutritional status, or level of functional balance capacity at 3 (P=.65, .65, .51, .78, .09, .67, respectively) or 6 (P=.69, .62, .20, .94, .48, .85, respectively) months. In addition, at 3 and 6 months there was no significant interaction for cognitive level (P=.28, .47, respectively) or number of depressive symptoms (P=.85, .49, respectively).

CONCLUSION: Older age, female sex, depression, mild to moderate dementia syndrome, malnutrition, and severe physical impairment do not seem to have a negative effect on functional balance from a high-intensity functional weight-bearing exercise program. Consequently, people with these characteristics in residential care facilities should not be excluded from offers of rehabilitation including high-intensity exercises.

Place, publisher, year, edition, pages
Wiley, 2011
Keywords
exercise, postural balance, residential facilities, frail elderly, randomized controlled trial
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-47980 (URN)10.1111/j.1532-5415.2011.03484.x (DOI)21718270 (PubMedID)
Available from: 2011-10-05 Created: 2011-10-05 Last updated: 2018-06-08Bibliographically approved
Carlsson, M., Littbrand, H., Gustafson, Y., Lundin-Olsson, L., Lindelöf, N., Rosendahl, E. & Håglin, L. (2011). Effects of high-intensity exercise and protein supplement on muscle mass in ADL dependent older people with and without malnutrition: a randomized controlled trial. The Journal of Nutrition, Health & Aging, 15(7), 554-560
Open this publication in new window or tab >>Effects of high-intensity exercise and protein supplement on muscle mass in ADL dependent older people with and without malnutrition: a randomized controlled trial
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2011 (English)In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 15, no 7, p. 554-560Article in journal (Refereed) Published
Abstract [en]

Background  Loss of muscle mass is common among old people living in institutions but trials that evaluate interventions aimed at increasing the muscle mass are lacking.

Objective, participants and intervention  This randomized controlled trial was performed to evaluate the effect of a high-intensity functional exercise program and a timed protein-enriched drink on muscle mass in 177 people aged 65 to 99 with severe physical or cognitive impairments, and living in residential care facilities.

Design  Three-month high-intensity exercise was compared with a control activity and a protein-enriched drink was compared with a placebo drink. A bioelectrical impedance spectrometer (BIS) was used in the evaluation. The amount of muscle mass and body weight (BW) were followed-up at three and six months and analyzed in a 2 × 2 factorial ANCOVA, using the intention to treat principle, and controlling for baseline values.

Results  At 3-month follow-up there were no differences in muscle mass and BW between the exercise and the control group or between the protein and the placebo group. No interaction effects were seen between the exercise and nutritional intervention. Long-term negative effects on muscle mass and BW was seen in the exercise group at the 6-month follow-up.

Conclusion  A three month high-intensity functional exercise program did not increase the amount of muscle mass and an intake of a protein-enriched drink immediately after the exercise did not induce any additional effect on muscle mass. There were negative long-term effects on muscle mass and BW, indicating that it is probably necessary to compensate for an increased energy demand when offering a high-intensity exercise program.

Keywords
Muscle mass, exercise, nutritional status, residential care facility
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-41377 (URN)10.1007/s12603-011-0017-5 (DOI)
Available from: 2011-03-23 Created: 2011-03-23 Last updated: 2018-06-08Bibliographically approved
Carlsson, M. (2011). Nutritional status, body composition and physical activity among older people living in residential care facilities. (Doctoral dissertation). Umeå: Umeå universitet
Open this publication in new window or tab >>Nutritional status, body composition and physical activity among older people living in residential care facilities
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The main purpose of this thesis was to study, whether drinkable yoghurt enriched with probiotic bacteria could have any effect on constipation and body weight (BW) among older people with dementia. Further, it concerns poor nutritional status among older people with physical and cognitive impairments and its relationship with factors commonly occur in older people living in residential care facilities. It also discusses how body composition changes with ageing and the associations between changes in muscle mass and functional balance after a high-intensity weight-bearing exercise program (the HIFE program) and the ingestion of an additional milk-based protein-enriched energy supplement.

A six-month feasibility study that included a probiotic drink was performed among 15 old people who were living in special units for people with dementia and who all had constipation. The effects of the probiotic drink on stool habits, and BW were studied. The outcome measures were followed daily for bowel movements and at three and six months for BW. The staff found the study easy to carry out and that the drink was well accepted by the participants. No convincing beneficial effects on stool habits were observed. In addition, a mean BW loss of 0.65 kg/month was registered. A poor nutritional intake, low physical activity level, and an over-night fast of almost 15 hours, 4 hours longer than recommended were also observed.

As a part of the FOPANU Study (Frail Older People-Activity and Nutrition Study), a randomized controlled trial was carried out in Umeå - the associations between nutritional status and factors common among old people with physical and cognitive impairments living in residential care facilities was studied. Assessments were made of nutritional status using the Mini Nutritional Assessment (MNA) scale, fat-free mass (FFM) and fat mass (FM) using both bioelectrical impedance spectroscopy (BIS) and skinfold thickness measurements. The effects of a high- intensity functional exercise program with an additional protein-enriched milk drink on ability to build muscle mass were evaluated. Analyses were made to investigate whether nutritional status, assessed using the MNA scale, was associated with medical conditions, drugs, activities of daily living (Barthel ADL index), cognitive impairment (Mini Mental State Examination (MMSE)), and depressive symptoms (Geriatric Depression Scale (GDS)) at baseline. The associations were assessed with multiple linear regression analyses with additional interaction analyses.

An independent association was found between poor nutritional status and having had a urinary tract infection (UTI) during the preceding year and being dependent in feeding for both women and men, and having lower MMSE scores for women. A large proportion of the participants, were at risk of malnutrition or were already malnourished. Women, but not men, had significantly lower Fat-Free Mass Index (FFMI) and Fat Mass Index (FMI) with age.

Bioelectrical impedance spectroscopy results correlated with skinfold thickness measurements, but on different levels on value for FM%.

Despite the high-intensity exercise had long-term effects (at six months, three months after the exercise) on functional balance, walking ability and leg strength. No effects on muscle mass and no additional effects from the protein-enriched drink could be observed after the three months of high intensity exercise. A negative, long-term effect on the amount of muscle mass and BW was revealed at six months (three months after the intervention had ended). The effects from the exercise did not differ for participants who were malnourished. No statistical interactions were observed between sex, depression, dementia disorder, and nutritional status, and the level of functional balance capacity on the outcome at three or six months.

In summary, the majority of the included older people with dementia had a low dietary intake, low physical activity level, and lost BW despite receiving a probiotic drink supplement every day for six months. The supplementation had no detectable effect on constipation. Among the participants in the FOPANU Study, UTI during the preceding year was independently associated with poor nutritional status. Being dependent in feeding was associated with poor nutritional status as were lower MMSE scores for women but not for men. Despite the high-intensity exercise program had long-term effects on the fysical function was no effect on the amount of muscle mass at three months observed. The FFM and FM expressed as indexes of body height were inversely related to age for women, but not for men. A high-intensity exercise program did not have any effect on the amount of muscle mass. The ingestion of a protein-enriched drink immediately after exercise produced no additional effect on the outcome and the results did not differ for participants who were malnourished. The negative long-term effect on amount of muscle mass, and BW, indicate that it is necessary to compensate for increased energy demands during a high-intensity exercise program. High age, female sex, depression, mild to moderate dementia syndrome, malnutrition, and severe physical impairment do not seem to have a negative impact on the effect of a high-intensity functional weight-bearing exercise program. Consequently, people with these characteristics in residential care facilities should not be excluded from training and rehabilitation including nutrition. More research is needed in large randomized controlled trials to further explore the association between energy balance and malnutrition among frail old people, with a special focus on UTI and constipation, but also to study how physical exercise affects older people’s nutritional status.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2011. p. 90
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1428
Keywords
Nutritional status, constipation, BW loss, UTI, body composition, exercise, muscle mass, functional balance
National Category
Nutrition and Dietetics
Research subject
Nutrition
Identifiers
urn:nbn:se:umu:diva-43780 (URN)978-91-7459-229-0 (ISBN)
Public defence
2011-06-11, Aulan, Vårdvetarhuset, Umeå, 10:00 (English)
Opponent
Supervisors
Note
EmbargoAvailable from: 2011-05-13 Created: 2011-05-09 Last updated: 2018-06-08Bibliographically approved
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