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      Avaliação do risco nutricional em idosos utentes de um Centro de Saúde de Lisboa Translated title: Assessment of nutritional risk of elderly patients from a Lisbon Health Center

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          Abstract

          Introdução: O envelhecimento populacional é considerado um fenómeno mundial. A identificação precoce da desnutrição é fundamental para uma intervenção individualizada promovendo e protegendo a saúde do idoso. Objetivos: Avaliar a prevalência do risco nutricional numa amostra de idosos utentes de um Centro de Saúde de Lisboa pertencente à Administração Regional de Saúde de Lisboa e Vale do Tejo. Metodologia: Estudo observacional analítico do tipo transversal realizado em 30 idosos (75,4 ± 7,6 anos), utentes de um centro de Saúde de Lisboa. Os dados socioeconómicos, clínicos e de estilo de vida foram obtidos pela aplicação de um questionário de resposta fechada. O peso e a altura foram medidos de acordo com as recomendações da Direção-Geral da Saúde. O Índice de Massa Corporal foi avaliado por comparação com o valor de referência de Lipschitz. A prevalência de desnutrição e risco de desnutrição foi avaliada pela aplicação do Mini Nutritional Assessment - MNA® . Resultados: A maioria dos idosos (93,3%) realiza 3 refeições diárias e 96,7% dos participantes consome menos água diariamente do que o recomendado pela European Food Safety Authority. Dos idosos avaliados, 36,7% dormia menos de 6 horas/noite. A avaliação do Índice de Massa Corporal segundo classificação de Lipschitz indicou que 54,1% dos homens e 65,2% das mulheres tinham excesso de peso. Os resultados da aplicação do MNA® evidenciaram que 16,7% dos idosos estava em risco de desnutrição. Conclusões: A prevalência do risco de desnutrição na amostra estudada é relevante, sendo crucial o acompanhamento nutricional dos participantes em risco nutricional e/ou com excesso de peso, de forma a evitar deterioração no seu estado de saúde e promover um estilo de vida saudável.

          Translated abstract

          Introduction: Population aging is considered a worldwide phenomenon. The early identification of malnutrition is essential for an individualized intervention that promotes and protects the health of the elderly. Objectives: to evaluate the prevalence of nutritional risk in a sample of elderly users of a Lisbon Health Center belonging to the Regional Health Administration of Lisbon and Vale do Tejo. Methodology: An observational analytical, cross-sectional study was carried out on 30 elderly patients from a health center in Lisbon. Socioeconomic, clinical and lifestyle data were obtained by the application of a closed response questionnaire. Weight and height were measured according to the recommendations of the Directorate-General of Health. Body Mass Index was assessed by comparison with the Lipschitz reference value. The prevalence of malnutrition and risk of malnutrition was evaluated by the application of the Mini Nutritional Assessment - MNA®. Results: The majority of the elderly (93.3%) consume 3 meals a day and 96.7% of the participants consume daily less water than the recommended by the European Food Safety Authority. Of the elderly evaluated, 36.7% slept less than 6 hours/night. The assessment of Body Mass Index according to Lipschitz’s classification indicated that 54.1% of men and 65.2% of women were overweight. The results of the application of MNA® showed that 16.7% of the elderly were at risk of malnutrition. Conclusions: The prevalence of the risk of malnutrition in the studied sample is relevant, and nutritional monitoring of participants at nutritional and/or overweight risk is crucial to avoid deterioration in their health status and to promote a healthy lifestyle.

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          Screening for nutritional status in the elderly.

          A comprehensive assessment of nutritional status is a critically important component of any patient evaluation. Based upon clinical information, anthropometric data, and a small number of laboratory investigations, an accurate appraisal of nutritional status should be possible and an appropriate intervention plan can be developed. The actual approach depends on the particular problem discovered. These are discussed in detail elsewhere in this issue.
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            The role of sleep hygiene in promoting public health: A review of empirical evidence.

            The ineffectiveness of sleep hygiene as a treatment in clinical sleep medicine has raised some interesting questions. If it is known that, individually, each specific component of sleep hygiene is related to sleep, why wouldn't addressing multiple individual components (i.e., sleep hygiene education) improve sleep? Is there still a use for sleep hygiene? Global public health concern over sleep has increased demand for sleep promotion strategies accessible to the population. However, the extent to which sleep hygiene strategies apply outside clinical settings is not well known. The present review sought to evaluate the empirical evidence for sleep hygiene recommendations regarding exercise, stress management, noise, sleep timing, and avoidance of caffeine, nicotine, alcohol, and daytime napping, with a particular emphasis on their public health utility. Thus, our review is not intended to be exhaustive regarding the clinical application of these techniques, but rather to focus on broader applications. Overall, though epidemiologic and experimental research generally supported an association between individual sleep hygiene recommendations and nocturnal sleep, the direct effects of individual recommendations on sleep remains largely untested in the general population. Suggestions for clarification of sleep hygiene recommendations and considerations for the use of sleep hygiene in nonclinical populations are discussed.
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              The impact of insomnia on cognitive functioning in older adults.

              To examine whether self-reported symptoms of insomnia independently increase risk of cognitive decline in older adults. Longitudinal cohort study. The four sites of the Established Populations for Epidemiologic Studies of the Elderly. Six thousand four hundred forty-four community-dwelling men and women age 65 and older who had no more than one error on the Short Portable Mental Status Questionnaire (SPMSQ) at baseline and an in-person interview at the third annual follow-up (FU3). Insomnia was defined as report of trouble falling asleep or waking up too early most of the time. Cognitive decline was defined as two or more errors on the SPMSQ at FU3. Logistic regression was used to determine risk of cognitive decline associated with insomnia, controlling for demographic, behavioral, and health-related factors. Analyses were stratified by sex and depressed mood. Among nondepressed men, those reporting symptoms of insomnia at both baseline and FU3 had an adjusted odds ratio (OR) of 1.49 (95% CI = 1.03-2.14) for cognitive decline, relative to those with no insomnia at FU3. Men with insomnia at FU3 only were not at increased risk (OR = 1.16, 95% CI = 0.82-1.65). These relationships were not found in women. Men and women with depressive symptoms at FU3 were at increased risk for cognitive decline independent of insomnia. Chronic insomnia independently predicts incident cognitive decline in older men. More sensitive measures of cognitive performance may identify more subtle declines and may confirm whether insomnia is associated with cognitive decline in women.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                apn
                Acta Portuguesa de Nutrição
                Acta Port Nutr
                Associação Portuguesa de Nutrição (Porto, , Portugal )
                2183-5985
                September 2018
                : 14
                : 06-09
                Affiliations
                [02] Lisboa orgnameUniversidade de Lisboa orgdiv1Faculdade de Medicina orgdiv2Instituto de Saúde Ambiental Portugal
                [03] Lisboa orgnameMinistério da Saúde orgdiv1Centro de Saúde da Alameda Portugal
                [01] Barcarena orgnameAtlântica - Escola Universitária de Ciências Empresariais, Saúde, Tecnologias e Engenharia Portugal
                Article
                S2183-59852018000300002
                10.21011/apn.2018.1402
                4bfbb9a0-47ef-42f6-84b8-56f5b881ef9e

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 29 March 2018
                : 31 August 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 26, Pages: 4
                Product

                SciELO Portugal

                Categories
                Artigo Original

                Estado nutricional,Excesso de peso,Desnutrição,Idoso,Nutritional status,Overweight,Malnutrition,Elderly

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