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      The Nutritional, Glutathione and Oxidant Status of Elderly Subjects Admitted to a University Hospital

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          Abstract

          Background/Aim:

          Malnutrition in elderly patients is common in hospitals, and many of the age associated chronic diseases have a common factor, which is oxidative stress. The aim of the study was to evaluate the nutritional status, glutathione, and oxidant status of elderly patients.

          Patients and Methods:

          The mini-nutritional assessment (MNA) was used to determine the nutritional status of elderly patients. Glutathione concentration in the whole blood, plasma albumin, and thiobarbituric acid-reactive substances (TBARS) levels was measured spectrophotometrically by the enzymatic recycling method. In addition, length of hospital stay was estimated. All measurements were taken within 48 h after admission.

          Results:

          The results showed that more than two-thirds of the elderly were classified as at risk of malnutrition and malnourished. About 45% and 53% elevation in the TBARS was found in at risk of being malnourished and in the malnourished groups, respectively, compared to the well-nourished group, but the elevation did not reach the significant level. No significant differences in the glutathione concentration and in the length of hospital stay were found among the three mini-nutritional assessment categories.

          Conclusions:

          The study indicated the necessity of performing the MNA test for elderly upon admission to hospitals, and more attention needs to be paid to this vulnerable group of people.

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          Most cited references50

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          Enzymic method for quantitative determination of nanogram amounts of total and oxidized glutathione: Applications to mammalian blood and other tissues

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            The Mini Nutritional Assessment (MNA) review of the literature--What does it tell us?

            Y Guigoz (2015)
            To review the literature on the MNA to Spring 2006, we searched MEDLINE, Web of Science and Scopus, and did a manual search in J Nutr Health Aging, Clin Nutr, Eur J Clin Nutr and free online available publications. The MNA was validated against two principal criteria, clinical status and comprehensive nutrition assessment using principal component and discriminant analysis. The MNA shortform (MNA-SF) was developed and validated to allow a 2-step screening process. The MNA and MNA-SF are sensitive, specific, and accurate in identifying nutrition risk. The prevalence of malnutrition in community-dwelling elderly (21 studies, n = 14149 elderly) is 2 +/- 0.1% (mean +/- SE, range 0- 8%) and risk of malnutrition is 24 +/- 0.4% (range 8-76%). A similar pattern is seen in out-patient and home care elderly (25 studies, n = 3119 elderly) with prevalence of undernutrition 9 +/- 0.5% (mean +/- SE, range 0-30%) and risk of malnutrition 45 +/- 0.9% (range 8-65%). A high prevalence of undernutrition has been reported in hospitalized and institutionalized elderly patients: prevalence of malnutrition is 23 +/- 0.5% (mean +/- SE, range 1- 74%) in hospitals (35 studies, n = 8596) and 21 +/- 0.5% (mean +/- SE, range 5-71%) in institutions (32 studies, n = 6821 elderly). An even higher prevalence of risk of malnutrition was observed in the same populations, with 46 +/- 0.5% (range 8-63%) and 51 +/- 0.6% (range 27-70%), respectively. In cognitively impaired elderly subjects (10 studies, n = 2051 elderly subjects), detection using the MNA, prevalence of malnutrition was 15 +/- 0.8% (mean +/- SE, range 0-62%), and 44 +/- 1.1% (range 19-87%) of risk of malnutrition. The large variability is due to differences in level of dependence and health status among the elderly. In hospital settings, a low MNA score is associated with an increase in mortality, prolonged length of stay and greater likelihood of discharge to nursing homes. Malnutrition is associated with functional and cognitive impairment and difficulties eating. The MNA(R) detects risk of malnutrition before severe change in weight or serum proteins occurs. Intervention studies demonstrate that timely intervention can stop weight loss in elderly at risk of malnutrition or undernourished and is associated with improvements in MNA scores. The MNA can also be used as a follow up assessment tool. The MNA is a screening and assessment tool with a reliable scale and clearly defined thresholds, usable by health care professionals. It should be included in the geriatric assessment and is proposed in the minimum data set for nutritional interventions.
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              Glutathione metabolism and its selective modification.

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                Author and article information

                Journal
                Saudi J Gastroenterol
                SJG
                Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association
                Medknow Publications (India )
                1319-3767
                1998-4049
                Jan-Feb 2011
                : 17
                : 1
                : 58-63
                Affiliations
                Clinical Nutrition Program, Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Saudi Arabia
                [1 ]Department of Surgery, College of Medicine, King Saud University, Saudi Arabia
                Author notes
                Address for correspondence: Dr. Adel Abdulwahab Alhamdan, Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, PO Box 10219, Riyadh 11433, Saudi Arabia. E-mail: adel@ 123456ksu.edu.sa
                Article
                SJG-17-58
                10.4103/1319-3767.74474
                3099083
                21196655
                188e43c0-efd1-4011-9e26-ad00ce256bd2
                © Saudi Journal of Gastroenterology

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 09 November 2009
                : 09 April 2010
                Categories
                Original Article

                Gastroenterology & Hepatology
                nutritional status,glutathione,thiobarbituric acid-reactive substances,old subjects

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