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F Nourhashemi

Publications and source records attributed to F Nourhashemi.

At least 37 records · Page 2Linked to original sources
PubMed1999

[A tool for nutritional anamnesis of elderly patients].

Malnutrition is frequent in the elderly, especially if frail or hospitalized. Nutritional evaluation tools allow the early detection of malnutrition and should be incorporated into the standard gerontological work-up as a basis for preventive action or rapid appropriate intervention. We review the various nutritional evaluation tools available, in particular the Mini Nutritional Assessment (MNA) which both evaluates nutritional status and guides nutritional intervention.

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PubMed1999

The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients.

The Mini Nutritional Assessment (MNA) has recently been designed and validated to provide a single, rapid assessment of nutritional status in elderly patients in outpatient clinics, hospitals, and nursing homes. It has been translated into several languages and validated in many clinics around the world. The MNA test is composed of simple measurements and brief questions that can be completed in about 10 min. Discriminant analysis was used to compare the findings of the MNA with the nutritional status determined by physicians, using the standard extensive nutritional assessment including complete anthropometric, clinical biochemistry, and dietary parameters. The sum of the MNA score distinguishes between elderly patients with: 1) adequate nutritional status, MNA > or = 24; 2) protein-calorie malnutrition, MNA < 17; 3) at risk of malnutrition, MNA between 17 and 23.5. With this scoring, sensitivity was found to be 96%, specificity 98%, and predictive value 97%. The MNA scale was also found to be predictive of mortality and hospital cost. Most important it is possible to identify people at risk for malnutrition, scores between 17 and 23.5, before severe changes in weight or albumin levels occur. These individuals are more likely to have a decrease in caloric intake that can be easily corrected by nutritional intervention.

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PubMed1999

Nutritional support and aging in preoperative nutrition.

In the past 20 years, an increased interest geriatric nutrition has induced researchers to document the distribution and magnitude of nutritional problems in the elderly population. It has been observed that the prevalence of malnutrition is greatly affected by the general health status and autonomy of the elderly. Among free-living healthy elderly persons, the prevalence of protein-caloric undernutrition is low. As health and functional capacities deteriorate with age, however, the prevalence increases dramatically to 30-65% of those in home care, nursing homes or in hospital. Formal nutritional assessment has typically been absent from most published programmes of geriatric evaluation and comprehensive geriatric assessment. This is frequently because of the lack of a specific validated tool to assess nutritional status in older persons and, at least partly, to explain this phenomenon. The Mini Nutritional Assessment was developed and validated on large representative samples of elderly persons to address these specific issues. Recent experimental studies have shown that advanced malnutrition is much more difficult to treat in the elderly than in younger adults. Trials of nutritional support using oral supplements or enteral tube feeding have shown improved outcome in those identified as malnourished on admission to hospital.

Administration, Oral↗
PubMed1999

Nutrition and Alzheimer's disease.

Alzheimer's disease begins with cognitive deficiencies that gradually become worse with the extension of cerebral lesions. Other troubles arise such as loss of independence, orientation impairments, disordered eating behavior, and weight loss. This weight loss increases the risk of infections, skin ulcers, and falls and consequently decreases quality of life in Alzheimer's patients. Various hypotheses (increased energy expenditure, mesial temporal cortex atrophy) were suggested to explain weight loss. We set up a Health Promotion Program that aims to prevent weight loss in patients with Alzheimer's disease. This program uses various tools (nutrition calendar, Mini Nutritional Assessment, nutrition education sessions) described in this article.

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PubMed1999

[Alzheimer's disease and nutrition].

Weight loss is a nutritional problem commonly associated with Alzheimer disease. Two types of weight loss have been described. A severe weight loss correlated with a decrease in daily caloric intake and with increased difficulties in performing the activities of daily living. A slowly progressive but clinically significant loss, not associated with either a decrease in caloric intake or an inflammatory syndrome. It is difficult to explain this type of weight loss as subjects have adequate caloric intakes. Several hypothesis are however considered as increased energy requirements (which can result from increased energy expenditure, from increased metabolic disorder, or from increased growth hormone secretion), or mesial temporal cortex atrophy. But, at the present time, no study can give a proper explanation. Vitamin deficiencies, specially vitamin B6, B12 and folates, high homocysteine level, antioxidants deficiencies (especially, vitamin E deficiency), iron, counter, and phenol derived could also influence the memory capacities and have an effect upon cognitive impairment, as reported in epidemiological studies. The prevention of nutritional deficiencies in patients with Alzheimer's disease, could be one of the strategies to improve the caregiver and the patients quality of life.

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PubMed1998

Relation between HLA DRB1 alleles and corticosteroid resistance in giant cell arteritis.

OBJECTIVE: To evaluate the clinical usefulness of genomic HLA typing during the first two years of established giant cell arteritis (GCA). METHODS: HLA typing was performed by PCR-SSO in 41 selected white patients with GCA confirmed by biopsy. Patient data were compared with those of a control group of 384 bone marrow donors (relative risk, p value and chi 2 test for each allele). Clinical features at onset and response to treatment over a two year period were evaluated in relation to the genetic pattern. RESULTS: DRB1*04 was significantly increased in the GCA group (frequency of 48.78% compared with 19.79% in controls, p < 0.001). The distribution of the DRB1*04 subtypes in the GCA group was similar to that in controls. No clinical or biological differences were found in association with HLA at the time of diagnosis. Over the two year follow up, nine patients presented resistance to corticosteroid treatment and eight of these (88.88%) had DRB1*04 (p < 0.001). CONCLUSIONS: GCA seems to be associated with HLA DRB1*04 (regardless of the subtype) and this association appears to be accompanied by corticosteroid resistance, suggesting that genomic typing may be useful to identify patients eligible for early alternative treatment to corticosteroid drugs.

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PubMed1998

Assessment of the effectiveness of drug therapies on nutritional status in the elderly: "concerning a randomised, double-blind clinical study of the activity of pancreatic extracts and a placebo during the renutrition of elderly subjects suffering from protein caloric undernutrition".

AIMS: to study, versus placebo, the value of administering pancreatic extracts in elderly subjects suffering from denutrition. METHODS: 52 subjects over 70 years of age, living in the Toulouse region of France, were included in this study. Each subject was required to present with an impaired nutritional status of their food intake, anthropometric and laboratory markers. RESULTS: among the 52 patients included in the study, 26 received the placebo and 26 received a pancreatic extract (Créon 12,000). 88% of these patients were women and 12% were men, the mean age of patients was 87+/-6 years. The groups were comparable at entry into the study. Nutritional intake increased in the two groups. There was a non-significant increase in body weight in the treated group when compared with the placebo group. DISCUSSION: we think that in the future, it would be preferable to conduct studies in convalescent subjects, reducing the frequency of nutritional assessments (food intake on D0 and D90, to reduce interference with the patient's habits.

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PubMed1997

[Weight loss in patients with Alzheimer-type dementia].

Epidemiologic studies show that weight loss is commonly associated with Alzheimer's disease. It would be a manifestation of the disease itself. It is not easy to explain weight loss as subjects with Alzheimer's disease have adequete caloric intakes. Several hypothesis are considered: increased energy expenditure, biologic disturbances, dysfunction in body weight regulation, mesial cortex temporal atrophy. However, at the present time, no study can give a proper explanation. The amelioration of nutritional problems, which lead to many complications (infections, bedsores, bedridden subjects, etc), could be one of the best strategies to lessen the burden of the disease.

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PubMedDate not supplied

One-leg standing balance and functional status in a population of 512 community-living elderly persons.

The objective of this cross-sectional study (whose baseline data were drawn from a longitudinal population study) was to determine if one-leg standing balance might be a useful marker of functional status in elderly persons independently living in an urban community (N = 512, mean age 73 +/- 7.0, 71.4% women). One-leg standing balance (ascertained by the Tinetti test) and functional status were obtained from a baseline gerontological assessment and follow-up questionnaires. Correlations were tested between one-leg balance and physical health and functional measurements. One-leg standing balance (OLSB) was abnormal in 24.7% of the population. At least one incapacity in instrumental activities of daily living (IADL) was found in 60.6% of those with OLSB abnormality, vs 45.5% in those with OLSB "adaptive" (borderline abnormal), and 33.3% in those with normal one-leg standing balance (p < 0.0001). Multivariate analysis showed 3 independent factors related to one-leg balance abnormality: age > 71 years (OR = 5.11, CI = 1.99-13.10); IADL deficit requiring help with transportation (OR = 3.61; CI = 1.15-11.40); and "poor" health status on the Iowa Self-Assessment Inventory (OR = 2.67, CI = 1.35-5.27). We conclude that one-leg standing balance may be a simple, predictive and inexpensive marker helpful in screening for low functional level and frailty in clinical practice.

Activities of Daily Living↗
PubMedDate not supplied

Body composition and osteoporosis in elderly women.

OBJECTIVES: To study body composition in elderly osteoporotic women to determine the relationship of body weight, body fat mass and lean mass to bone mineral density (BMD), and to investigate the association between one-leg balance, osteoporosis and sarcopenia. DESIGN AND SETTING: A cross-sectional study of a community-based population in Toulouse, France. METHODS: For each participant, whole body composition and BMD were estimated using a dual-energy x-ray absorptiometry scanner. We investigated balance using a one-leg balance test. PARTICIPANTS: 129 healthy women aged 75-89 years, volunteers, ambulatory and living at home. RESULTS: Total fat mass and appendicular skeletal muscle mass (ASM) were significantly lower in osteoporotic women than in the age- and sex-matched non-osteoporotic controls [18.7 +/- 4.6 vs. 22.2 +/- 6.6 for total fat mass (p < 0.01); 13.1 +/- 1.6 vs. 13.8 +/- 2.2 for ASM (p < 0. 05)]. We did not find a positive association between osteoporosis and sarcopenia (OR = 0.75, CI 0.3-1.84), osteoporosis and one-leg balance (OR = 1.27, CI 0.51-3.17), or sarcopenia and one-leg balance (OR = 1.31, CI 0.52-3.36). There were significant positive correlations between BMD in all areas and body measurements (weight, fat mass, lean tissue mass), but fat mass accounted for more of the variance in total body and femoral BMD than lean tissue mass. Total fat mass alone, in a multivariate model, was correlated with whole body BMD, whereas femoral BMD was associated with both fat mass and lean tissue mass. CONCLUSION: Higher values of fat mass and lean tissue mass may have a protective effect on femoral bone density. Sarcopenia and osteoporosis are not necessarily linked with balance.

Absorptiometry, Photon↗