Osteosarcopenic Adiposity and Nutritional Status in Older Nursing Home Residents during the COVID-19 Pandemic

The aim was to evaluate body composition and prevalence of osteosarcopenic adiposity (OSA) in nursing home residents (NHR) and to assess their nutritional status. This research builds on our pilot study (conducted prior COVID-19 pandemic) that revealed high OSA prevalence and poor nutritional status in NHR. The current study included newly recruited n = 365 NHR; 296 women, 69 men, aged 84.3 ± 5.6 and 83.1 ± 7.3 years, respectively. Body composition was measured by bioelectrical impedance BIA-ACC®, yielding total bone mass along with all components of lean and adipose tissues. The Mini Nutritional Assessment-Short Form (MNA-SF) was used to assess nutritional status. Participants reported about their present/past diseases, including COVID-19. Mean duration of stay in nursing homes was 46.3 ± 47.0 months. Approximately 30% of participants had COVID-19 prior (median 6.7 months) to entering the study. OSA was diagnosed in 70.8% women and 47.8% men (p < 0.001). Malnourishment was detected in 5.8% women and 6.2% men while the risk of malnourishment was found in 30.8% women and 30.0% men. No significant differences in age, body composition parameters, prevalence of OSA, malnutrition/risk for malnutrition were found in participants who had COVID-19 compared to those who did not. Regression analysis showed that intramuscular adipose tissue (%) was significantly positively, while bone mass was significantly negatively associated with OSA. In this population, the high prevalence of OSA coincided with the high prevalence of malnutrition/risk of malnutrition. Such unfavorable body composition status is more likely a consequence of potentially poor diet quality in nursing homes, rather than of health hazards caused by COVID-19.

[1]  J. Llorca,et al.  Sarcopenic osteoporosis, sarcopenic obesity, and sarcopenic osteoporotic obesity in the Camargo cohort (Cantabria, Spain) , 2022, Archives of Osteoporosis.

[2]  D. Dengel,et al.  No Changes in Body Composition in NCAA Division I Collegiate Football Players because of COVID-19 Restrictions , 2022, Journal of strength and conditioning research.

[3]  Inyoul Y. Lee,et al.  Multiple early factors anticipate post-acute COVID-19 sequelae , 2022, Cell.

[4]  Sunghoon Shin,et al.  Association of Sarcopenia with Osteopenia and Osteoporosis in Community-Dwelling Older Korean Adults: A Cross-Sectional Study , 2021, Journal of clinical medicine.

[5]  T. Kusakabe,et al.  Phase angle from bioelectrical impedance analysis is a useful indicator of muscle quality , 2021, Journal of cachexia, sarcopenia and muscle.

[6]  V. Fuchs-Tarlovsky,et al.  Body composition in recovered covid-19 patients , 2021, Clinical Nutrition ESPEN.

[7]  O. D. Del Brutto,et al.  Body Composition in Community-Dwelling Older Adults Before and After SARS-CoV-2 Infection: A Longitudinal Prospective Study in a Rural Village Struck by the Pandemic , 2021, Journal of primary care & community health.

[8]  Mark M. Davis,et al.  Integrated analysis of plasma and single immune cells uncovers metabolic changes in individuals with COVID-19 , 2021, Nature Biotechnology.

[9]  M. Muscaritoli,et al.  The link between nutritional status and outcomes in COVID-19 patients in ICU: Is obesity or sarcopenia the real problem? , 2021, European Journal of Internal Medicine.

[10]  Liliana González-Espinoza,et al.  Functional, cognitive, and nutritional decline in 435 elderly nursing home residents after the first wave of the COVID-19 Pandemic , 2021, European Geriatric Medicine.

[11]  Ana Ilić,et al.  Assessment of Body Composition and Dietary Intake in Nursing-Home Residents: Could Lessons Learned from the COVID-19 Pandemic Be Used to Prevent Future Casualties in Older Individuals? , 2021, Nutrients.

[12]  J. Ilich Osteosarcopenic adiposity syndrome update and the role of associated minerals and vitamins , 2021, Proceedings of the Nutrition Society.

[13]  L. B. Briongos Figuero,et al.  The nutritional status of the elderly patient infected with COVID-19: the forgotten risk factor? , 2021, Current medical research and opinion.

[14]  K. Park,et al.  The relationship between extracellular water-to-body water ratio and sarcopenia according to the newly revised Asian Working Group for Sarcopenia: 2019 Consensus Update , 2021, Aging Clinical and Experimental Research.

[15]  M. Lim,et al.  Dreadful Consequences of Sarcopenia and Osteoporosis due to COVID-19 Containment , 2021, Geriatric orthopaedic surgery & rehabilitation.

[16]  R. Fisberg,et al.  Obesity Associated with Low Lean Mass and Low Bone Density Has Higher Impact on General Health in Middle-Aged and Older Adults , 2020 .

[17]  J. Ilich Nutritional and Behavioral Approaches to Body Composition and Low-Grade Chronic Inflammation Management for Older Adults in the Ordinary and COVID-19 Times , 2020, Nutrients.

[18]  Thomas A. Jackson,et al.  COVID-19 and Acute Sarcopenia , 2020, Aging and disease.

[19]  R. Baier,et al.  Front-line Nursing Home Staff Experiences During the COVID-19 Pandemic , 2020, Journal of the American Medical Directors Association.

[20]  Mark M. Davis,et al.  Multi-Omics Resolves a Sharp Disease-State Shift between Mild and Moderate COVID-19 , 2020, Cell.

[21]  E. Kolbaşı,et al.  Prevalence of osteosarcopenic obesity in community-dwelling older adults: a cross-sectional retrospective study , 2020, Archives of Osteoporosis.

[22]  P. Ebeling,et al.  Adiposity Without Obesity: Associations with Osteoporosis, Sarcopenia, and Falls in the Healthy Ageing Initiative Cohort Study , 2020, Obesity.

[23]  L. Lera,et al.  Osteosarcopenia Predicts Falls, Fractures, and Mortality in Chilean Community-Dwelling Older Adults. , 2020, Journal of the American Medical Directors Association.

[24]  M. Kohzuki,et al.  Osteosarcopenic Obesity Associated with Poor Physical Performance in the Elderly Chinese Community , 2020, Clinical interventions in aging.

[25]  Anna Stachel,et al.  Obesity in patients younger than 60 years is a risk factor for Covid-19 hospital admission , 2020, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[26]  S. Cvijetić,et al.  Chronic Stress Contributes to Osteosarcopenic Adiposity via Inflammation and Immune Modulation: The Case for More Precise Nutritional Investigation , 2020, Nutrients.

[27]  N. Ishiguro,et al.  Higher extracellular water-to-total body water ratio more strongly reflects the locomotive syndrome risk and frailty than sarcopenia. , 2020, Archives of gerontology and geriatrics.

[28]  J. Ilich,et al.  Osteosarcopenic Obesity: Current Knowledge, Revised Identification Criteria and Treatment Principles , 2019, Nutrients.

[29]  T. Madeira,et al.  Malnutrition among older adults living in Portuguese nursing homes: the PEN-3S study , 2018, Public Health Nutrition.

[30]  S. Perna,et al.  Osteosarcopenic Visceral Obesity and Osteosarcopenic Subcutaneous Obesity, Two New Phenotypes of Sarcopenia: Prevalence, Metabolic Profile, and Risk Factors , 2018, Journal of aging research.

[31]  C. Pinho,et al.  Phase Angle as a Sarcopenia Marker in Hospitalized Elderly Patients , 2018, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition.

[32]  V. Domislovic,et al.  Nutritional Issues and Nutrition Support in Older Home Care Patients in the City of Zagreb. , 2017, Acta clinica Croatica.

[33]  C. Szlejf,et al.  Osteosarcopenic Obesity: Prevalence and Relation With Frailty and Physical Performance in Middle-Aged and Older Women. , 2017, Journal of the American Medical Directors Association.

[34]  Ai-lin Bian,et al.  A study on relationship between elderly sarcopenia and inflammatory factors IL-6 and TNF-α , 2017, European Journal of Medical Research.

[35]  A. Parrish The impact of aging on epithelial barriers , 2017, Tissue barriers.

[36]  J. Ilich,et al.  Aging human body: changes in bone, muscle and body fat with consequent changes in nutrient intake. , 2017, The Journal of endocrinology.

[37]  George P Chrousos,et al.  Bioimpedance analysis vs. DEXA as a screening tool for osteosarcopenia in lean, overweight and obese Caucasian postmenopausal females , 2017, Hormones.

[38]  Arya M. Sharma,et al.  The use of magnetic resonance imaging to characterize abnormal body composition phenotypes in youth with Prader-Willi syndrome. , 2017, Metabolism: Clinical and Experimental.

[39]  R. Straub,et al.  Increased extracellular water measured by bioimpedance and by increased serum levels of atrial natriuretic peptide in RA patients—signs of volume overload , 2017, Clinical Rheumatology.

[40]  A. Brunt,et al.  The High Price of Obesity in Nursing Homes , 2015, Care Management Journals.

[41]  C. Tsigos,et al.  Stress and inflammatory biomarkers and symptoms are associated with bioimpedance measures , 2015, European journal of clinical investigation.

[42]  O. Kwon,et al.  Use of Bioelectrical Impedance Analysis for the Assessment of Nutritional Status in Critically Ill Patients , 2015, Clinical nutrition research.

[43]  M. Lapeyre-Mestre,et al.  OBESITY IN NURSING HOME RESIDENTS: A CROSS-SECTIONAL STUDY , 2015, The Journal of Nursing Home Research Sciences.

[44]  R. Nasser,et al.  Nutritional and health status among nursing home residents in Lebanon: comparison across gender in a national cross sectional study , 2014, BMC Public Health.

[45]  L. Panton,et al.  Interrelationship among muscle, fat, and bone: Connecting the dots on cellular, hormonal, and whole body levels , 2014, Ageing Research Reviews.

[46]  J. Schulzke,et al.  Determinants of bioelectrical phase angle in disease , 2011, British Journal of Nutrition.

[47]  B. Vellas,et al.  Validation of the Mini Nutritional Assessment short-form (MNA®-SF): A practical tool for identification of nutritional status , 2009, The journal of nutrition, health & aging.

[48]  D. Volkert,et al.  Nutritional situation of elderly nursing home residents , 2007, Zeitschrift für Gerontologie und Geriatrie.

[49]  B. Vellas,et al.  Overview of the MNA--Its history and challenges. , 2006, The journal of nutrition, health & aging.

[50]  J. Eisman,et al.  Incidence of Hip and Other Osteoporotic Fractures in Elderly Men and Women: Dubbo Osteoporosis Epidemiology Study , 2004, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[51]  P J Garry,et al.  The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. , 1999, Nutrition.

[52]  M. Schroll,et al.  Evaluating the DETERMINE Your Nutritional Health Checklist and the Mini Nutritional Assessment as tools to identify nutritional problems in elderly Europeans , 1998, European Journal of Clinical Nutrition.