Depressive symptoms, low-grade inflammation, and poor oral health prevents the success of nutritional guidance in older caregivers

Sohvi Koponen; Irma Nykänen; Roosa-Maria Savela; Tarja Välimäki; Anna Liisa Suominen; Ursula Schwab

doi:10.1016/j.clnesp.2023.06.018

Depressive symptoms, low-grade inflammation, and poor oral health prevents the success of nutritional guidance in older caregivers

Clin Nutr ESPEN. 2023 Oct:57:39-47. doi: 10.1016/j.clnesp.2023.06.018. Epub 2023 Jun 22.

Authors

Sohvi Koponen¹, Irma Nykänen², Roosa-Maria Savela³, Tarja Välimäki³, Anna Liisa Suominen⁴, Ursula Schwab⁵

Affiliations

¹ Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland. Electronic address: sohvi.koponen@uef.fi.
² Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland.
³ Department of Nursing Science, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland.
⁴ Institute of Dentistry, School of Medicine, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland; Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, P.O. Box 1711, FI-70211 Kuopio, Finland.
⁵ Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland; Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS, Finland.

PMID: 37739684
DOI: 10.1016/j.clnesp.2023.06.018

Abstract

Purpose: The present study aimed to determine which factors prevents the success of nutritional interventions for older family caregivers (FCs), in the form of individually tailored nutritional guidance.

Methods: The present study focuses on the intervention group of FCs (n = 63) of a randomized controlled trial. Older FCs (≥60 years of age) receiving a care allowance for a home-living care recipient (≥65 years of age) were included in the present study, which focused on nutritional interventions via individually tailored nutritional guidance provided by a clinical nutritionist. The associations between changes in protein intake (3-day food record), Mini Nutritional Assessment (MNA) scores, and plasma albumin and prealbumin concentrations, as well as associated factors, for the 6-month intervention period were analyzed using generalized estimating equations.

Results: Intervention time, female sex, older age, higher net income, better hand grip strength, more teeth, and removable denture use were positively associated with an increase in protein intake. Fewer depressive symptoms were associated with a positive change in the MNA scores. Younger age, lower education level, lower body mass index (BMI), higher depressive symptoms, and fewer teeth were associated with an increase in plasma albumin concentration. Younger age, lower education, lower plasma concentration of high-sensitivity C-reactive protein at 6 months, lower Sense of Coherence (SOC) -13 score, fewer teeth, and absence of removable dentures were associated with an increase in plasma prealbumin concentration.

Conclusion: Older female FCs with a higher income, better hand grip strength, lower education, and lower SOC benefited most from individually tailored nutritional guidance. Depressive symptoms, oral health, and low-grade inflammation should be considered when providing nutritional guidance to older FCs.

Clinical trial registration number: ClinicalTrials.gov NCT04003493 (July 1, 2019).

Keywords: Dietary intake; Family caregiver; Nutritional guidance; Nutritional status; Older people.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Caregivers*
Depression / prevention & control
Female
Hand Strength
Humans
Infant
Inflammation / prevention & control
Oral Health
Prealbumin*

Substances

Prealbumin

Associated data

ClinicalTrials.gov/NCT04003493