depression and nutritional status

1
MORIIAY,OCTOBER 22 POSTER SESSION:PROFESSIONAL PRACTICE/COMMUNITY NUTRITIONAND PUBLICHEALTH TITLE: NUTRITION FOR OLDER ADULTS' HEALTH: A WEB- BASED RESOURCE OF NUTRITION EDUCATION MATERIALS FOR ELDERLY NUTRITION PROGRAMS. AUTHORS: SM Elbon, PhD. MEd, RD, LD, Self-Employed, Consultant, Athens, GA; MA Johnson, PhD, Professor of Foods and Nutrition and Faculty of Gerontology; JG Fischer, PhD, RD, LD, Associate Professor; The University of Georgia. LEARNING OUTCOME: To describe the process used to create a web- based resource of nutrition education materials for use by health professionals working with participants in elderly nutrition programs. ABSTRACT TEXT: The objective of NOAHnet (Nutrition for Older Adults" Health) was to create a web-based resource that provides nutrition education lesson plans targeted toward elders with low income and low literacy skills. Content experts, Registered Dietitians and an Instructional Designer reviewed and revised 15 existing paper-based nutrition lesson plans for the target audience and reformatted them to achieve a consistent layout. A website was developed to serve as a portal for access. The lesson plans were uploaded and made available in PDF and Word formats so they can be viewed with universally available software (Adobe Acrobat Reader) or customized (Microsoft Word). Additional content on NOAHnet includes a library of existing Internet resources. Formative evaluations were conducted pre- and postproduction. Senior Center Directors, Registered Dietitians and Instructional Designers were observed using the site to improve navigation and usability. Participants rated design by Likert scales and open-ended suggestions. Revisions were made to optimize usability based on the observations and results of the evaluations. NOAHnet will be registered with Interact search engines and promoted at professional meetings. (Funding provided by: University of Georgia Gerontology Center and The Georgia Department of Human Resources Contract #427-93-11903.) CONFLICT OF INTEREST: None. TITLE: DEPRESSION AND NUTRITIONAL STATUS AUTHORS: C L Stein Arnold MS RD LD, B Karchmar, and J M Moreschi MS RD LD, Benedictine University, Lisle, IL. LEARNING OUTCOME: To describe the relationship between the Beck Depression Inventory and Mini- Nutritional Assessment in participants of the Home Delivered Meals program. ABSTRACT TEXT: Poor nutrition is a risk factor for depression. Depression affects 20-40% of Older Americans, and is cited as a common cause of appetite and weight loss. Participants of the Home Delivered Meals (HDM) program were interviewed November 2000, using the Beck Depression Inventory (BDI) and the Mini- Nutritional Assessment (MNA). The mean + SD for the age of the participants (n=50) were 78.74 + 9.55 years. The mean + SD of the BDI total score were 9.94 _+8.06 indicating mild to moderate depression. The mean + SD of the MNA were 24.92 + 3.49, above the "at risk" category. However, 6.7% of the participants had scores of"malnourished", while 30% of the participants were "at risk for malnutrition" according to the MNA. The BDI total score is significantly negatively correlated (P<.01) with the total MNA score (-.561); thus, HDM participants with greater levels of depression were more likely to be "at risk" or "malnourished" according to the MNA. Additional data analyses revealed numerous statistically significant correlations. A decline in food intake (MNA) was related to (BDI) anorexia (.705, P<.01), insomnia (.487, P<.01), weight loss (.475, P<.01), and fatigue (341, P<.05). Anorexia (BDI) was also correlated with weight loss (.503, P<.01), insomnia (.432, P<.01), fatigue (.378, P<.01), eating less full meals per day (.325, P<.05), a poorer self view of nutritional status (.308, P<.05), and total MNA score (.525, P<.01). Those scoring lower on the MNA (more at nutritional risk) expressed stress or psychological concerns (.642, P<.01), a loss of mobility (.391, P<.01), decline in food intake (.517, P<.01), weight loss ( 489, P< 01), lower BMI (.403, P<.01), and lower number of full meals consumed daily (.441, P<.01). The data suggests that significant relationships exists between symptoms of depression and nutritional status in participants of the HDM program. Nutrition professionals need to recognize that symptoms of depression (in particular anorexia, weight loss, insomnia, and fatigue) may be related to declines in nutritional status. An early referral/intervention for depression may eliminate invasive and expensive nutrition therapy while improving the HDM participant's quality of life. CONFLICT OF INTEREST: none TITLE: BREAKFAST GROCERY BAG DELIVERY PROGRAM TARGETS ELDERLY MEALS ON WHEELS RECIPIENTS AUTHOR~): M.L.Tyrrell, MPH, RD, CDN, Meals on Wheels of Buffalo & Erie County, Inc., Buffalo, NY LEARNING OUTCOME: To evaluate a grocery delivery program as part of a home-delivered meal program service. ABSTRACT TEXT: In January 2001, Sunshine Nutrition, a four-month pilot grocery bag delivery program was initiated by four non-profit community agency partners. Twenty- eight Meals on Wheels recipients received a weekly early morning delivery of cereal, juice, fresh fruits, and bread products, planned to complement the hot lunch and cold supper meals already normally received. The local Food Bank provided the food; Goodwill Industries assembled the bags; and the Meals on Wheels Foundation funded the project. Based upon a pre- service assessment, recipients reported that they were not eating an adequate breakfast or were having difficulty purchasing extra groceries due to limited help or financial hardship. A one-month follow-up indicated most recipients were using the foods for breakfast and snacks and were satisfied with the amount and variety of foods sent. Suggestions for additional food items included fresh milk and eggs. Monthly follow-up continued through the pilot. Agency partners evaluated the efficacy of continuation and expansion to additional Meals on Wheels recipients in a wider geographical area. TITLE: PREPARING NEW IMMIGRANTS TO MEET THE HOME HEALTH CARE CHALLENGE OF NUTRITION FOR OLDER ADULTS WITH STROKE AUTHOR(S): S. E. Belle, MA, RD, CDN, Westchester County Department of Senior Programs and Services, Mount Vernon, NY. LEARNING OUTCOME: To increase the awareness of stroke and factors that affect the care of the stroke client at home. ABSTRACT TEXT: Every year about 500,000 Americans suffer a stroke. It is the third leading cause of death in the United States. National trends show that older adults 85 years and over are the fastest growing segment of the elderly population and that most seniors prefer to live at home instead of in an assisted living facility. Surveys show that older persons between the ages of 75 years to 85 years may experience chronic conditions like hypertension and stroke. The severity of these health conditions often makes it difficult for the seniors to live at home independently without the help of home care workers. The estimated number of persons served by home health care agencies rose from 1.2 million in 1992 to 24 million in 1996. Shopping for food is the most common activity that the aides perform for the elderly clients, followed by meal preparation. On March 21, 2001 the senior health and wellness coalition collaborated with a home care agency to provide a free in service entitled, Stroke-Awareness, Warning Signs and Treatment. The sessions were presented by a registered dietitian, registered nurses and a physical therapist. Home health care aides from eleven different agencies participated. More than 90% of these aides were immigrants. The pre and post-test showed that the aides were able to recognize stroke symptoms, repeat the dietary/ nutritional challenges, and increase their awareness of rehabilitation and support services available to stroke survivors and their families. Seniors in this area are aging in place and need services that will help them function as vital, productive citizens of the community. It is evident that many new immigrants are taking these entry-level jobs as home care workers. Investing in the education and training of these immigrants not only provides them with jobs and income but also contributes to the health and quality of life of many seniors in this community. A-80 / September 2001 Supplement Volume 101 Number 9

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Page 1: Depression and nutritional status

MORIIAY, OCTOBER 22

POSTER SESSION: PROFESSIONAL PRACTICE/COMMUNITY NUTRITION AND PUBLIC HEALTH TITLE: NUTRITION FOR OLDER ADULTS' HEALTH: A WEB- BASED RESOURCE OF NUTRITION EDUCATION MATERIALS FOR ELDERLY NUTRITION PROGRAMS. AUTHORS: SM Elbon, PhD. MEd, RD, LD, Self-Employed, Consultant, Athens, GA; MA Johnson, PhD, Professor o f Foods and Nutrition and Faculty o f Gerontology; JG Fischer, PhD, RD, LD, Associate Professor; The University of Georgia. L E A R N I N G O U T C O M E : To describe the process used to create a web- based resource of nutrition education materials for use by health professionals working with participants in elderly nutrition programs. ABSTRACT TEXT: The objective o f NOAHnet (Nutrition for Older Adults" Health) was to create a web-based resource that provides nutrition education lesson plans targeted toward elders with low income and low literacy skills. Content experts, Registered Dietitians and an Instructional Designer reviewed and revised 15 existing paper-based nutrition lesson plans for the target audience and reformatted them to achieve a consistent layout. A website was developed to serve as a portal for access. The lesson plans were uploaded and made available in PDF and Word formats so they can be viewed with universally available software (Adobe Acrobat Reader) or customized (Microsoft Word). Additional content on NOAHnet includes a library o f existing Internet resources. Formative evaluations were conducted pre- and postproduction. Senior Center Directors, Registered Dietitians and Instructional Designers were observed using the site to improve navigation and usability. Participants rated design by Likert scales and open-ended suggestions. Revisions were made to optimize usability based on the observations and results o f the evaluations. NOAHnet will be registered with Interact search engines and promoted at professional meetings. (Funding provided by: University o f Georgia Gerontology Center and The Georgia Department o f Human Resources Contract #427-93-11903.) C O N F L I C T OF INTEREST: None.

TITLE: DEPRESSION AND NUTRITIONAL STATUS AUTHORS: C L Stein Arnold MS RD LD, B Karchmar, and J M Moreschi MS RD LD, Benedictine University, Lisle, IL. LEARNING OUTCOME: To describe the relationship between the Beck Depression Inventory and Mini- Nutritional Assessment in participants of the Home Delivered Meals program. ABSTRACT TEXT: Poor nutrition is a risk factor for depression. Depression affects 20-40% of Older Americans, and is cited as a common cause of appetite and weight loss. Participants of the Home Delivered Meals (HDM) program were interviewed November 2000, using the Beck Depression Inventory (BDI) and the Mini- Nutritional Assessment (MNA). The mean + SD for the age of the participants (n=50) were 78.74 + 9.55 years. The mean + SD of the BDI total score were 9.94 _+ 8.06 indicating mild to moderate depression. The mean + SD of the MNA were 24.92 + 3.49, above the "at risk" category. However, 6.7% of the participants had scores of"malnourished", while 30% of the participants were "at risk for malnutrition" according to the MNA. The BDI total score is significantly negatively correlated (P<.01) with the total MNA score (-.561); thus, HDM participants with greater levels of depression were more likely to be "at risk" or "malnourished" according to the MNA. Additional data analyses revealed numerous statistically significant correlations. A decline in food intake (MNA) was related to (BDI) anorexia (.705, P<.01), insomnia (.487, P<.01), weight loss (.475, P<.01), and fatigue (341, P<.05). Anorexia (BDI) was also correlated with weight loss (.503, P<.01), insomnia (.432, P<.01), fatigue (.378, P<.01), eating less full meals per day (.325, P<.05), a poorer self view of nutritional status (.308, P<.05), and total MNA score (.525, P<.01). Those scoring lower on the MNA (more at nutritional risk) expressed stress or psychological concerns (.642, P<.01), a loss of mobility (.391, P<.01), decline in food intake (.517, P<.01), weight loss ( 489, P< 01), lower BMI (.403, P<.01), and lower number of full meals consumed daily (.441, P<.01). The data suggests that significant relationships exists between symptoms of depression and nutritional status in participants of the HDM program. Nutrition professionals need to recognize that symptoms of depression (in particular anorexia, weight loss, insomnia, and fatigue) may be related to declines in nutritional status. An early referral/intervention for depression may eliminate invasive and expensive nutrition therapy while improving the HDM participant's quality of life. CONFLICT OF INTEREST: none

TITLE: BREAKFAST GROCERY BAG DELIVERY PROGRAM TARGETS ELDERLY MEALS ON WHEELS RECIPIENTS

AUTHOR~):

M.L.Tyrrell, MPH, RD, CDN, Meals on Wheels of Buffalo & Erie County, Inc., Buffalo, NY

LEARNING OUTCOME:

To evaluate a grocery delivery program as part of a home-delivered meal program service.

ABSTRACT TEXT:

In January 2001, Sunshine Nutrition, a four-month pilot grocery bag delivery program was initiated by four non-profit community agency partners. Twenty- eight Meals on Wheels recipients received a weekly early morning delivery of cereal, juice, fresh fruits, and bread products, planned to complement the hot lunch and cold supper meals already normally received. The local Food Bank provided the food; Goodwill Industries assembled the bags; and the Meals on Wheels Foundation funded the project. Based upon a pre- service assessment, recipients reported that they were not eating an adequate breakfast or were having difficulty purchasing extra groceries due to limited help or financial hardship. A one-month follow-up indicated most recipients were using the foods for breakfast and snacks and were satisfied with the amount and variety of foods sent. Suggestions for additional food items included fresh milk and eggs. Monthly follow-up continued through the pilot. Agency partners evaluated the efficacy of continuation and expansion to additional Meals on Wheels recipients in a wider geographical area.

TITLE: PREPARING NEW IMMIGRANTS TO MEET THE HOME HEALTH CARE CHALLENGE OF NUTRITION FOR OLDER ADULTS WITH STROKE

AUTHOR(S):

S. E. Belle, MA, RD, CDN, Westchester County Department of Senior Programs and Services, Mount Vernon, NY.

LEARNING OUTCOME: To increase the awareness of stroke and factors that affect the care of the stroke client at home.

ABSTRACT TEXT: Every year about 500,000 Americans suffer a stroke. It is the third leading cause of death in the United States. National trends show that older adults 85 years and over are the fastest growing segment of the elderly population and that most seniors prefer to live at home instead of in an assisted living facility. Surveys show that older persons between the ages of 75 years to 85 years may experience chronic conditions like hypertension and stroke. The severity of these health conditions often makes it difficult for the seniors to live at home independently without the help of home care workers. The estimated number of persons served by home health care agencies rose from 1.2 million in 1992 to 24 million in 1996. Shopping for food is the most common activity that the aides perform for the elderly clients, followed by meal preparation. On March 21, 2001 the senior health and wellness coalition collaborated with a home care agency to provide a free in service entitled, Stroke-Awareness, Warning Signs and Treatment. The sessions were presented by a registered dietitian, registered nurses and a physical therapist. Home health care aides from eleven different agencies participated. More than 90% of these aides were immigrants. The pre and post-test showed that the aides were able to recognize stroke symptoms, repeat the dietary/ nutritional challenges, and increase their awareness of rehabilitation and support services available to stroke survivors and their families. Seniors in this area are aging in place and need services that will help them function as vital, productive citizens of the community. It is evident that many new immigrants are taking these entry-level jobs as home care workers. Investing in the education and training of these immigrants not only provides them with jobs and income but also contributes to the health and quality of life of many seniors in this community.

A-80 / Sep tember 2001 Supp lemen t Volume 101 Number 9