Bülent Saka

Objectives: Malnutrition (MN) is prevalent in older adults and closely related to sarcopenia, frailty, morbidity, mortality, and decreased quality of life. In this study, we aimed to evaluate the effects of a personalized diet combined with planned physical exercise on nutritional status, physical performance, and quality of life (QoL) in malnourished older adult patients. Methods: In this prospective study, 20 older adults with MN risk according to the Mini Nutritional Assessment—Short Form (MNA-SF) were randomized into (i) personalized diet (PD) and (ii) personalized diet with physical exercise (PDE) groups, and followed up with for 12 weeks. The physical exercise included warm-up, strengthening, balance, and cooldown phases, with a frequency of 3–4 days per week. Anthropometric measurements, physical performance, and quality of life were assessed using standardized tools at baseline and at the 4th, 8th, and 12th weeks. QoL was measured using the EQ–5D index and EQ–5D visual analog scale (VAS) scores. Results: A total of 20 patients (55% male) participated in the study. During the study, BMIs, MNA-SF scores, and hand grip strength were increased, and the patients’ average duration on the Timed Up and Go (TUG) test decreased significantly in both groups. The EQ–5D index score of the PD group and the EQ–5D VAS scores of both groups were increased. Conclusions: A personalized diet with or without physical exercise therapy was associated with improved nutritional status, physical performance, and QoL.

It is necessary for nursing staff to have adequate knowledge of malnutrition in older people in order to provide high quality care. This study was conducted to update the Knowledge of Malnutrition—Geriatric (KoM-G) questionnaire to fit different settings and to cross-culturally adapt it to the German, Czech, Dutch and Turkish languages. In Part 1 of the study, the KoM-G questionnaire was updated and adapted for use in different settings. Content validation of the KoM-G 2.0 was carried out in a Delphi study with 16 experts. The final KoM-G 2.0 questionnaire consists of 16 items with a Scale Content Validity Index/Average of 94.5%. In Part 2, the English KoM-G 2.0 was cross-culturally adapted into the German, Czech, Dutch and Turkish languages. In the pilot test, between 96.9% (The Netherlands) and 97.8% (Austria) of the nursing staff rated the items as understandable. The KoM-G 2.0 is an up-to-date questionnaire with a highly satisfactory Content Validity Index. It was cross-culturally adapted into the German, Czech, Dutch, and Turkish languages, and the understandability was high. At the moment, the necessary comprehensive psychometric testing of the KoM-G 2.0 is in process. Afterwards it can be used to compare nurses’ knowledge between various countries and settings.

Malnutrition,prevalence,inpatients,internal medicine,treatment

Objective: Oral amino-acid-combination supplements have become a common intervention to maintain or potentially increase the lean body mass (LBM) in the elderly. Our aim was to determine the tolerance and efficacy of the 8-week beta-hydroxy beta-methylbutyrate/arginine/glutamine (HMB/Arg/Gln) supplementation on anthropometrics, LBM, muscle strength, and gait speed in elderly patients. Methods: In this longitudinal observational study, a total of 131 elderly patients were evaluated at two consecutive visits, including baseline (Week 0) and single follow-up (Week 8). The use of HMB/Arg/Gln was evaluated in terms of patient compliance, the efficacy on anthropometrics, LBM (kg, measured with bioelectrical impedance analysis-BIA), muscle strength (kg), gait speed, and safety. Results: The mean (standard deviation, SD) age was 74.7 (6.8) years (57.3% of participants were males). Of the patients were diagnosed with malnutrition (according to the Subjective Global Assessment test). The main indications for the HMB/Arg/Gln supplementation were sarcopenia (45.8%) and cancer cachexia (42.0%). Only two patients stopped supplementation because of taste problem (1.5%). Overall, 79.4% of patients were still on HMB/Arg/Gln at the follow-up. The mid-upper-arm circumference (MUAC, 25.3–27.0 cm, p=0.017), mid-upper-arm muscle circumference (MUAMC, 21.7–22.2 cm, p=0.006), hand grip strength (16.0–19.0 kg, p=0.0001), and gait speed (0.5–0.7 m/sec, p=0.008) were increased after the HMB/Arg/Gln supplementation. The adverse events were reported in 14 (10.7%) patients. No serious adverse events were reported in association with HMB/Arg/Gln. Conclusion: Our findings showed that 8 weeks of the HMB/Arg/Gln supplementation applied twice daily were well tolerated and safe in the elderly. The supplementation seems to improve the MUAC, MUAMC, muscle strength, and gait speed.