Nutrition and geriatric psychiatry: a neglected field

Goulburn Valley Health, Шеппартон, Victoria, Australia
Current Opinion in Psychiatry (Impact Factor: 3.55). 12/2005; 18(6):609-14. DOI: 10.1097/01.yco.0000186814.08826.db
Source: PubMed

ABSTRACT Nutritional issues have received little attention in geriatric psychiatry research. This review focuses on literature published in 2003 and 2004 on nutritional factors in mental illness in the elderly and proposes directions for future research.
There has been more research on the role of micronutrients in psychiatric disorders of older adults but studies examining nutritional state in this population are lacking. The former research suggests associations between low folic acid/vitamin B12 status and depression in older adults whereas evidence for other micronutrients is still tentative. In the latter work, there is only one study that examines malnutrition in psychogeriatric patients despite the availability of well-validated screening tools for assessing nutritional state in the elderly and the known impact of undernutrition in ageing and the development of frailty. The role of obesity in ageing is also relevant especially as more people with schizophrenia live longer, although the current evidence in the non-mentally ill elderly suggests that being overweight may have protective effects in the elderly.
Malnutrition is likely to have considerable impact on the mental and physical state of the elderly.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Although a number of studies have reported raised total plasma homocysteine (tHcy) concentrations in free-living older people, there are no data on homocysteine response to a mixed nutrient supplement in older patients. A raised plasma homocysteine concentration in older patients is partly a reflection of their co-morbidity, including impaired renal function, and there is uncertainty about the extent to which dietary interventions can improve plasma tHcy. Aim: To determine the plasma tHcy response to dietary supplements during acute illness. Methods: Two-hundred and thirty-six hospitalized, acutely ill older patients, who were part of a randomized double-blind placebo-controlled trial, were assigned to receive a daily oral nutritional supplement drink containing 1.3 mg of vitamin B2, 1.4 mg of vitamin B6, 1.5 μg of B12, 200 μg of folic acid, or a placebo, for 6 weeks. Outcome measures were plasma tHcy concentration at baseline, 6 weeks, and 6 months. Results: The mean plasma tHcy concentration fell among patients given the supplements (mean difference 4.1 µmol/L [95 % C.I, 0.14 to 8.03), p = 0.043], but tHcy concentration increased between 6 weeks and 6 months, after patients stopped taking the supplements [mean difference -2.0 µmol/L (95 % C.I, -03.9 to -0.18), p = 0.033]. About 46 % of patients in the placebo group and 55 % of patients in the supplement group had hyperhomocysteinemia (>14 µmol/L) at baseline compared with 45 % and 29 % at the end of the treatment period. Conclusions: A mixed nutrient supplement containing physiological amounts of B vitamins significantly reduced plasma tHcy concentrations in older patients recovering from acute illness.
    International Journal for Vitamin and Nutrition Research 08/2012; 82(4):260-266. DOI:10.1024/0300-9831/a000118 · 1.00 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Persons with various forms of dementia suffer from a progressive disease in which memory and the ability to function independently are lost. During moderate to late-stage dementia, individuals experience increased difficulty with eating and require more feeding assistance. Clinicians working with this population must acknowledge the multifactorial aspects of eating behavioral issues, use a team approach, and make careful assessments using appropriate instruments. Interventions should include attention to cognitive impairment, nutritional intake, training of caregivers, modification of the environment, and the quality of the interaction. Planning for care should include promoting the highest quality of life for these individuals and their caregivers. J Am Psychiatr Nurses Assoc, 2008; 13(6), 360-367.
    Journal of the American Psychiatric Nurses Association 01/2008; 13(6):360-7. DOI:10.1177/1078390307309216
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Little research has been done on the relationship between malnutrition and mental health in community living elderly individuals. In the present study, we aimed to assess the associations between mental health (particularly anxiety and depression) and both the risk of malnutrition and body mass index (BMI, kg/m(2)) in a large sample of elderly men and women from Tromsø, Norway. In a cross-sectional survey, with 1558 men and 1553 women aged 65 to 87 years, the risk of malnutrition was assessed by the Malnutrition Universal Screening Tool ('MUST'), and mental health was measured by the Symptoms Check List 10 (SCL-10). BMI was categorised into six groups (< 20.0, 20.0-22.4, 22.5-24.9, 25.0-27.4, 27.5-29.9, ≥ 30.0 kg/m(2)). The risk of malnutrition (combining medium and high risk) was found in 5.6% of the men and 8.6% of the women. Significant mental health symptoms were reported by 3.9% of the men and 9.1% of the women. In a model adjusted for age, marital status, smoking and education, significant mental health symptoms (SCL-10 score ≥ 1.85) were positively associated with the risk of malnutrition (odds ratio 3.9 [95% CI 1.7-8.6] in men and 2.5 [95%CI 1.3-4.9] in women), the association was positive also for subthreshold mental health symptoms. For individuals with BMI < 20.0 the adjusted odds ratio for significant mental health symptoms was 2.0 [95% CI 1.0-4.0]. Impaired mental health was strongly associated with the risk of malnutrition in community living elderly men and women and this association was also significant for subthreshold mental health symptoms.
    BMC Psychiatry 07/2011; 11:112. DOI:10.1186/1471-244X-11-112 · 2.24 Impact Factor