The SOLINUT study: Analysis of the interaction between nutrition and loneliness in persons aged over 70 years

CH de Valence et Centre de Prevention (CDPRV-26) 24 rue du Jeu de Paume 26000 Valence, France.
The Journal of Nutrition Health and Aging (Impact Factor: 3). 01/2005; 9(4):261-8.
Source: PubMed


Insufficient nutritional status is a frequent problem in the elderly, correlated with aging, diseases, but also environmental factors in this growing part of the population. Loneliness should be one of these factors.
the aim of the SOLINUT study was to determine the relationship between loneliness and nutritional status in persons aged over 70 years, in order to improve the detection and management of the isolated elderly at high risk of malnutrition. It was both an epidemiological and cross-sectional anthropological study, based on quantitative and qualitative nutritional and sociological investigation, carried out between March 2002 and May 2003 in 150 elderly persons (mean age 80.8 years, oldest subject 99 years) living alone at home.
a large number of subjects had a dietary intake which was inadequate to cover their nutritional needs--42.6% less than 25 kcal/kg/day, threshold for undernutrition in the elderly--21.3% had established undernutrition, ( average in epidemiological studies in non isolated elderly populations: 3-7%)--44% were not able to carry a shopping bag weighing 5 kg and so could not buy their own food. Lastly, 32% never shared a meal with family or friends, which reveals their degree of social isolation.
It has been demonstrated that greater coordination between the various service providers would prevent a large number of isolated persons from failing to obtain the various allocations and services available to them. We must stress the extreme importance of preemptive intervention, by an active screening policy which could simultaneously prevent undernutrition and encourage physical activity in isolated persons to avoid their becoming "excluded recluses".

Download full-text


Available from: Monique Ferry
  • Source
    • "Préserver les contacts sociaux, l'autonomie financière et lutter contre la dépression La solitude est en soi un facteur de risque de dénutrition [37]. Elle est en outre un moteur de la dépression, ellemême considérée comme un facteur de risque de mauvais vieillissement [38] car la capacité à composer avec les stress lors de l'avance en âge fait partie des aptitudes à bien vieillir [39], tout comme un bon sommeil [40]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Aging is an inevitable biological feature of living organisms. Moreover, human lifespan is increasing. In last years, many studies featured a molecular basis and biological events that contribute to the progressive decline in cellular functioning at the time of senescence.The aging itself may be at the origin of various states that render this population very heterogeneous because subjects, at equivalent age, can be: in a state of good health at home, active – “fragile”, less active and at risk of diseases – ill, acute or chronic, dependent or independent. But they can also benefit from “successful aging” described for the first time by Rowe and Kahn in 1987 as an aging without disease or handicap, allowing a high level of physical activity and cognitive function and accompanied by an engagement and activities in the social life. The optimal nutrition is one of the most accessible modifiable factors to module the aging by means of targeted strategies in order to favor a successful aging. One of the first is the identification of persons at risk of nutritional diseases, either being by overcharge or by defects, and even by deficiencies such as denutrition. Because of physiological changes linked to aging itself can reach the capacities of eating and cause consequences on the nutritional state: loss of appetite, precocious satiety, and decreased taste perception. The nutrition plays a role on practically all factors of senescence. We will limit the subject to some fundamental mechanisms on which the nutritional impact is recognized: insulin resistance, oxidative stress, stabilization of the weight and the loss of the muscular mass called sarcopenia whose consequences are deleterious. Two levers for action are synergetic: the alimentation and the moderate physical exercise which improves its efficiency. Some practical means will then be proposed to equilibrate food, on the sight of the study results, that follows Euronut-Seneca, Healthy Aging: Longitudinal Study in Europe (HALE) which proposes a multi disciplinary approach to the successful aging and to its determinants in 11 European countries, by featuring the positive factors of successful aging in volunteers having reached a long longevity, in a good state of physical and psychological health… These advises are also those allowing to preserve a good cardiovascular, metabolic, and even vascular cerebral state, so a good cognitive status.Finally, to preserve the status in micronutrients, without hoping that global alimentary supplements allow compensating all deficiencies due to the aberrant alimentations, in particular restrictive. The epidemiological studies show that subjects taking the most of supplements are those having no deficits… in particular in antioxidatives, which increases the risk of limiting the necessary apoptosis of damaged cells.In conclusion: to conserve the desire to eat, a varied diet in moderation, in convivial manner each time is possible and without monotony which is deleterious for alimentation like sedentarity for physical well-being.
    Full-text · Article · Apr 2008 · Cahiers de Nutrition et de Diététique
  • Source
    • "Evidence of inadequate dietary intakes of vitamin A, vitamin E and folates is lacking and the biochemical indicators suggest that the circulating levels of vitamins are in the cutoff point of normality. These findings are in disagreement with some literature data on similarly aged Europeans who have inadequate vitamin A and folate intake and limiting vitamin nutritional status (Euronut SENECA investigators, 1991; Maiani et al., 1992; Hallfrish et al., 1994; Haveman-Nies et al., 2001; Pirlich and Lochs, 2001; Ferry et al., 2005; Tur et al., 2005). In our study, no vitamin deficiencies are observed in all age groups, probably because of the specific selection criteria used for the enrollment of apparently healthy free-living volunteers (Table 1). "
    [Show abstract] [Hide abstract]
    ABSTRACT: To assess the effects of zinc supplementation on vitamin status in middle-aged and older volunteers. Three hundred and eighty-seven healthy middle-aged (55-70 years) and older (70-85 years) men and women, randomly allocated to three groups to receive 15 or 30 mg Zn/day or placebo for 6 months. Dietary intake was assessed by means of a validated 4-day recall record. Fasting blood samples were simultaneously analysed for levels of plasma retinol and alpha-tocopherol by high-performance liquid chromatography. Erythrocyte folates were measured by a competitive immunoassay with direct chemiluminescence detection on an automatized immunoanalyser. Biochemical measurements were performed at baseline and after 3 and 6 months of zinc supplementation. Plasma vitamin A levels were significantly increased proportionally with zinc dose and period of treatment, particularly at 6 months (for 15 mg Zn/day, P<0.05; for 30 mg Zn/day, P<0.0001); no significant changes were observed in the placebo group. There was no effect of zinc supplementation on vitamin E/cholesterol ratio and erythrocyte folates. Our results show that a long-term zinc supplementation increases plasma vitamin A levels in middle-aged and older people of similar characteristics to those involved in this study. Moreover, supplementation influences serum zinc levels but does not affect erythrocyte zinc concentration and both plasma vitamin E and erythrocyte folate status.
    Full-text · Article · Aug 2007 · European Journal of Clinical Nutrition
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: 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. VALIDATION AND VALIDITY: 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. NUTRITIONAL SCREENING: 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. CHARACTERISTICS: 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. NUTRITIONAL INTERVENTION: 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. CONCLUSION: 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.
    Full-text · Article · Nov 2005 · The Journal of Nutrition Health and Aging
Show more