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Aging of the Guinean population is a public health concern for the coming years, and the nutritional status of older people is virtually unknown. We also know that this population is growing and that undernutrition and obesity can affect the health of older adults. This study aimed to assess the nutritional status of older people in the general population of Guinea and its associated factors. A representative cross-sectional survey was conducted using sociodemographic, clinical, and anthropometric data (weight and height). Oral status was assessed by using the University of Nebraska Oral Status Scale. Visual acuity was assessed using the Monoyer scale. The standardized prevalence ratio (SPR) of the nutritional status was calculated for each region. The sample included 1698 subjects with a mean BMI of 22.6 ± 4.3 kg/m 2 . A total of 50.3% had impaired oral status and 20.3% had moderately to severely impaired visual acuity. The prevalence of undernutrition was 14.4% and of obesity 5.7%. Differences in the prevalence of nutritional status were found between regions, with an SPR > 1 for undernutrition in the Labé region (SPR 1.9, 95% CI = 1.5-2.5) and for obesity in the Conakry and Kindia regions (SPR of 2.90, 95% CI = 2.0-4.05 and 2.32, 95% CI = 1.5-3.3, respectively). In Guinea, The prevalence of nutritional disorders was approximately 20%. Screening and management of the health and nutritional status of older adults should be a national priority, and management should be adapted to each region of the country., (© 2023. Springer Nature Limited.)

Background and Aims: Although the ageing of the Cameroonian population is a public health issue in the coming years, the nutritional status of the elderly is unknown. The aim of the study was to assess the nutritional status, health status and associated socio-demographic factors among elderly in Cameroon., Methods: A cross-sectional study of 599 elderly (aged ≥ 60) was conducted in urban and rural areas. Several socio-demographic, sanitary, and anthropometric (weight, height, body mass index (BMI), Waist Circumference (WC), Mid-Upper Arm Circumference (MUAC)) data were collected. Nutritional status was defined according to WHO. Multinomial analysis was performed to identify factors associated with nutritional status. The threshold of statistical significance was 5%., Results: The population, representative of the elderly, was aged 68.9 ± 7.2 years, with sex ratio M/F = 0.93, weight 68.5 ± 14.7 kg, BMI 24.7 ± 5.3, WC 90.1 ± 12.8 cm and MUAC 28.2 ± 5.0 cm. According to BMI, undernutrition was 19.7%, normal status 37.9%, overweight 24.9%, obesity 17.5%. The concordance for undernutrition between BMI and MUAC was weak (kappa = 0.3). In multinomial analysis, only no medication was negatively associated with undernutrition (OR = 0.3). Obesity was positively associated with the urban environment (OR = 4.8) and inactivity (OR = 2.9) and negatively associated with male gender (OR = 0.4), widowed (OR = 0.2), head of household (OR = 0.4), no income (OR = 0.3), one pathology (OR = 0.4), no medication (OR = 0.2), having normal diastolic pressure (OR = 0.2)., Conclusions: Undernutrition and obesity (more frequent in women, and in urban area) affect 37.2% of the elderly. These nutritional disorders are a public health problem that cannot be ignored., Competing Interests: Declaration of competing interest The authors have no conflicts to declare., (Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Introduction: Dysphagia and undernourishment are common in cerebrovascular accident (stroke) patients in developed countries. Despite the dietary transition, there is little information available in Africa on this topic. This study aims to assess the prevalence of undernourishment and dysphagia in stroke patients in two Burkina Faso teaching hospitals at a starting point (D0), on the eighth day, and on the 14th (D14) and to specify factors related to undernourishment at day 14., Methodology: The nutritional state of the patients was assessed using body mass index, triceps skinfold thickness, and mid-upper arm circumference. Dysphagia was identified using the Practical Aspiration Screening Schema., Results: A total of 222 patients were included in the study. From D0 to D14, the prevalence of undernourishment increased from 25.2% to 31.0% and the prevalence of dysphagia decreased from 37.4% to 15.8%. All nutritional criteria worsened. In a multivariate analysis, undernourishment was more present at D14 for women (odds ratio [OR] = 7.01; 95% confidence interval [CI]: 1.51-32.56, P = 0.01) and was less present if weight (OR = 0.69; 95% CI: 0.60-0.79, P = 0.0001) or triceps skinfold thickness (OR = 0.85; 95% CI: 0.74-0.99, P = 0.03) were high at D0., Conclusion: The prevalence of undernourishment was high at D0 and increased during the monitoring period. It would be advisable to monitor patients' weight and triceps skinfold thickness, to optimize care for women and patients with low weight or triceps skinfold thickness at D0, to monitor dysphagia, and to inform patients, families, and relevant staff of nutritional concerns after a cerebrovascular accident., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Food and malnutrition in the elderly. Malnutrition affects 4-10% of elderly at home, but 15-40% of them in institutions. Its consequences are multiple and sometimes severe. Knowing the risk factors often helps to prevent the onset of malnutrition. The simplest and most readily usable criteria are the body mass index (BMI) inferior 21 and weight loss (at least 5% in one month or 10% in six months). The treatment is primarily through enriched intakes by mouth and/or oral nutritional supplements, but in case of severe malnutrition with very limited intakes by mouth, enteral nutrition must be offered at the outset, if the digestive tract is usable. Parenteral nutrition is the last resort because of its dangerousness., Competing Interests: J.-C. Desport déclare des liens ponctuels (conférences, congrès, expertises) avec Nutricia, Baxter, Fresenius Kabi, Nestlé, NHC, Nutrisens. P. Jésus déclare des liens ponctuels avec Nutricia et avoir été pris en charge lors de congrès par Nutricia, Fresenius Kabi, Nestlé et Lactalis. P. Fayemendy déclare des liens ponctuels avec Nutricia, B. Braun, Baxter, Fresenius Kabi, K’noé, et Shire, et avoir été pris en charge lors de congrès par NHC, Nutricia, B.Braun, Fresenius Kabi et Lactalis.

Objectives: To determine the nutritional status of elderly African people and to investigate the association between undernutrition and dementia., Design: Door-to-door cross-sectional surveys in the general population., Setting: Representative districts of Bangui (Central African Republic) and Brazzaville (Republic of Congo)., Participants: Population aged over 65 years., Measurement: Undernutrition was defined as a body mass index <18.5. Anthropometric parameters (arm circumference, waist circumference and triceps skinfold thickness) were measured, and information was gathered on nutritional habits. PARTICIPANTS underwent cognitive screening using the Community Screening Interview for Dementia (CSI-D) and the Five-Word Test. After further neuropsychological testing and neurological examination, the diagnosis of dementia was confirmed according to DSM-IV criteria. Multivariate logistic regression models were applied in order to identify factors associated with undernutrition in populations with or without dementia., Results: 1016 people were included. In the general population, the prevalence of undernutrition was 19.2%. Dementia was found in 7.4% of elderly people. Compared with healthy people, patients with dementia had an increased prevalence of undernutrition (32.0% vs. 17.7%; p = 0.002), lower weight (49.3 ± 10.5 kg vs. 58.4 ± 13.5 kg ; p < 0.001), and lower BMI (20.8 ± 4.1 vs. 22.9 ± 4.8 ; p < 0.001); they were less likely to eat their fill (38.9% vs. 45.9% ; p = 0.001), had more dietary restrictions (36.1% vs. 24.3% ; p = 0.03) and ate less often with their family (66.7% vs. 90.6% ; p < 0.0001). Eating only one meal per day was the sole factor associated with undernutrition in dementia (OR: 7.23 [CI: 1.65-31.7]; p = 0.03)., Conclusion: The prevalence of undernutrition is high in the older population. The nutritional status of patients with dementia is more impaired than that of healthy patients. However, they are less often malnourished than in French home care settings. This study is the first to look at the nutritional status of at-home patients with dementia in Africa. These comparative data will eventually be used in the development of new nutritional intervention strategies.

Background: Aging is accompanied by a drop in the level of health and autonomy, within Western countries more and more people being cared for in nursing homes (NH). The nutritional data in NH in France remain poor, not exhaustive and not representative. The objective of the study was to assess the nutritional status, dementia and mobility patterns among residents of NH in the Limousin territory of France. Methods: The study was cross-sectional, descriptive and exhaustive, conducted with the residents of 13 voluntary NH. Undernutrition was identified using French High Authority for Health criteria, and obesity if Body Mass Index >30, in the absence undernutrition criterion. The Mini Mental State examination scores was used for dementia assessment at the threshold of 24. The Mini Nutritional AssessmentTM was used for mobilitity assessment. The statistics were significant at the 5% threshold. Results: 866 residents (70.6% women) included with an average age of 85.3 ± 9.3 years. Undernutrition was 27.5%, obesity 22.9%, dementia 45.7% and very low mobility 68.9%. Women were older than men, more often undernourished, more often demented and more often had very low mobility (p<0.01). Undernutrition (p<0.0001) and low mobility (p<0.0001) were significantly higher among those with dementia versus those without dementia. Very low mobility was higher among undernourished (p<0.05). Conclusions: Undernutrition and obesity are important problems in NH in France. Being a woman, having dementia and having a very low mobility may induce undernutrition. [ABSTRACT FROM AUTHOR]

Several studies in Western countries have shown an association between cognitive disorders and low BMI or weight loss in elderly people. However, few data are available in Africa. We analysed the association between cognitive disorders and undernutrition among elderly people in Central Africa. A cross-sectional, multicentre, population-based study using a two-phase design was carried out in subjects aged 65 years and above in the Central African Republic (CAR) and the Republic of Congo (ROC). All subjects were interviewed using the Community Screening Interview for Dementia, and those with low performance were clinically assessed by a neurologist and underwent further psychometrical tests. Diagnostic and Statistical Manual-IV and Petersen's criteria were required for the diagnoses of dementia and mild cognitive impairment (MCI), respectively. Undernutrition was evaluated using mid-upper arm circumference (MUAC) < 24 cm, BMI < 18·5 kg/m2 and arm muscular circumference (AMC) < 5th percentile. Multivariate binary logistic regression models were used to estimate the associations. In CAR, MCI was associated with MUAC < 24 cm (OR 0·7, 95 % CI 0·4, 1·0) and dementia with BMI < 18·5 kg/m2 (OR 2·3, 95 % CI 1·6, 3·1), AMC < 5th percentile (OR 2·3, 95 % CI 1·1, 4·6) and MUAC < 24 cm (OR 1·8, 95 % CI 1·4, 2·4). In ROC, both MCI and dementia were associated with all markers of undernutrition, but only AMC < 5th percentile was significantly associated with MCI (OR 3·1, 95 % CI 1·9, 4·8). In conclusion, cognitive disorders were associated with undernutrition. However, further studies are needed to elucidate the relationship between MCI and undernutrition in CAR. [ABSTRACT FROM AUTHOR]

Résumé Introduction et objectifs Les données sur nutrition et sclérose en plaque sont discordantes et peu précises. L’objectif de cet article était de faire un point sur les facteurs nutritionnels impliqués dans la sclérose en plaque, de la prévention de la maladie à la prise en charge spécifique des patients. Résultats Parmi les paramètres environnementaux nutritionnels suspectés de participer à la pathogenèse de la sclérose en plaque, l’obésité du jeune adulte et l’insuffisance en vitamine D sont des facteurs de risque reconnus. Les données sont insuffisantes pour préciser la prévalence ou l’incidence des altérations du statut nutritionnel des patients, mais la sclérose en plaque peut exposer au risque de dénutrition, le surpoids pourrait concerner une part importante des patients, et l’obésité être moins fréquente qu’en population générale. Les causes de dénutrition lors de la sclérose en plaque sont multiples. La prévalence élevée des troubles de la déglutition impose un dépistage de ces anomalies. La prise en charge nutritionnelle doit être pluridisciplinaire et graduée, incluant des conseils d’adaptation de textures et de positionnement, des conseils diététiques, la supplémentation orale voire la nutrition entérale. L’alimentation pourrait jouer un rôle dans l’évolution de la sclérose en plaque. Les données de la littérature sont insuffisantes pour établir des recommandations quant à la prise en charge diététique spécifique lors de la sclérose en plaque. Cependant, la limitation de consommation des acides gras polyinsaturés et des acides gras trans, la réduction de l’apport sodé, l’augmentation de l’apport en acides gras polyinsaturés ou en vitamine D sont les éléments les plus fréquemment cités comme facteurs d’amélioration potentiels. Introduction and objectives Nutritional data on multiple sclerosis are discordant and have a low accuracy. The objective of this article was to focus on the nutritional factors involved in multiple sclerosis, from the prevention of disease to the specific management of patients. Results Among the many nutritional environmental parameters suspected of participating in the pathogenesis of multiple sclerosis, obesity in young adults and vitamin D deficiency are well recognized as risk factors. The literature is insufficient to specify the prevalence or incidence of nutritional alterations during pathogenesis of multiple sclerosis, but the disease may conduct to undernutrition, an excess of weight probably concerns an important proportion of patients and obesity might be less frequent than in the general population. Multiple causes of undernutrition are identified in multiple sclerosis. The high prevalence of swallowing disorders requires early detection. Nutritional management must be multidisciplinary and progressive: advice for adjusting textures and positioning, dietary advices, oral enriched supplementation and even enteral nutrition. The literature is insufficient to establish clear recommendations for specific dietary management in multiple sclerosis. Nevertheless, diet might play a role in the course of multiple sclerosis: a limited consumption of polyunsaturated fatty acids, trans fatty acids and sodium, an increased intake of polyunsaturated fatty acids or vitamin D are the most frequently cited factors which may contribute to the improvement of the disease. [ABSTRACT FROM AUTHOR]

Résumé L’acidurie mévalonique et le syndrome d’hyperimmunoglobulinémie D (HIDS) sont les deux expressions cliniques du déficit en mévalonate kinase. Peu de cas sont décrits dans le monde et l’état nutritionnel n’a jamais été précisé. Un patient qui avait souffert durant l’enfance de colite néonatale et d’épisodes fébriles récurrents avec rash, sans diagnostic étiologique, était diagnostiqué HIDS à l’âge de 28 ans, suite à un bilan pour arthrite récidivante. Il était adressé en nutrition après un suivi en endocrinologie pour retard staturo-pondéral. Il pesait 41,2 kg pour 1 m49 (indice de masse corporelle [IMC] normal à 18,6) et sa circonférence musculaire brachiale était dans une zone de dénutrition. En impédancemétrie, le volume extracelullaire (VEC) était élevé par rapport au volume intracelullaire (VIC) et l’angle de phase était abaissé, ce qui suggérait une altération cellulaire. Diverses carences vitaminiques et une hypophosphorémie étaient présentes. Des compléments nutritionnels oraux et une supplémentation vitaminique étaient introduits. Un an plus tard, la phosphorémie était améliorée, de même que certaines concentrations sanguines en vitamines mais il nécessitait toujours une supplémentation. On constatait une prise pondérale de 2,7 %, le rapport VEC/VIC et l’angle de phase étaient normalisés. Le déficit en mévalonate kinase est une maladie rare, probablement sous-diagnostiquée, à laquelle il faut savoir penser devant des épisodes fébriles récurrents dans l’enfance. Le cas décrit montre qu’une dénutrition et plusieurs carences sont possibles à l’âge adulte dans cette maladie. Mevalonic aciduria and hyperimmunoglobulin D syndrome (HIDS) are both clinical expressions of mevalonate kinase deficiency. Few cases are described in the world and nutritional status has never been clarified. A patient who previously suffered from neonatal colitis and recurrent fever with rash, without etiological diagnosis, was diagnosed with HIDS at the age of 28, following a record for recurrent arthritis. He was addressed in nutrition after endocrinological following for deficit of growth. He weighed 41.2 kg for 1 m49 height (normal body mass index [BMI] at 18.6), but midarm muscle circumference showed an undernutriution. In bioimpedance analysis, the extra-celullar volume (ECV) was high in relation to intra-celullar volume (ICV) and phase angle was low, suggesting a cellular alteration. Several vitamin deficiencies and hypophosphatemia were present. Oral nutritional supplements and vitamin supplementation were introduced. One year later, serum phosphorus and some vitamins were improved, but the patient still required supplementation. One noted a 2.7 % weight gain, and a normalization of ECV/ICV ratio and phase angle. Mevalonate kinase deficiency is a rare disease probably underdiagnosed, that can be evoked in front of recurrent episodes of fever in childhood. The case described shows that undernutrition and several deficiencies are possible in this disease, even in adults. [ABSTRACT FROM AUTHOR]

Résumé En institution comme à domicile, certains patients peuvent avoir des difficultés à se mobiliser et à se déshabiller ou refuser de se mettre en sous-vêtements. Il est donc probable que peser les patients habillés est une pratique fréquente. La surestimation du poids corporel ainsi obtenue pourrait induire une erreur d'évaluation du statut nutritionnel. L'objectif de l'étude était de déterminer dans quelle mesure peser les patients adultes habillés versus en sous-vêtements pouvait modifier leur statut nutritionnel. Cinquante et un patients étaient inclus. La pesée habillée surestimait le poids réel de 1,6 ± 0,6 kg et induisait une surestimation de classification du statut nutritionnel dans près de 14 % des cas. De plus, le poids des vêtements était différent selon le sexe et selon les conditions de température extérieure. Ces résultats suggèrent qu'il est souhaitable autant que possible de peser tous les patients adultes en sous-vêtements. Abstract In institutions and at home, some patients may have difficulty mobilizing and undressing, or refusing to put on their underwear. It is therefore likely that weighing dressed patients is a common practice. The overestimation of the body weight thus obtained could lead to an error in the evaluation of the nutritional status. The aim of the study was to determine the extent to which adult patients dressed versus underwear could alter their nutritional status. Fifty-one patients were included. Dressed weighing overestimated the actual weight of 1.6 ± 0.6 kg and induced an overestimation of nutritional status classification in almost 14% of cases. In addition, the weight of the clothes was different according to the sex and the conditions of outside temperature. These results suggest that it is desirable as much as possible to weigh all adult patients in underwear. [ABSTRACT FROM AUTHOR]