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Novel Assessment of Nutrition and Ageing

Introduction

Current figures suggest that 1 in 4 older people are likely to be malnourished.

Malnutrition in older people is closely linked to physical frailty, which is a major factor in the development of disability and dependency in old age.

Malnutrition may be due to a range of factors including impaired physical function, such as problems with chewing and swallowing or reduced mobility; mental health factors such as depression or social isolation; and cognitive factors such as dementia or other neurological illnesses.

It is difficult to examine the links between diet, physical health, mental health and cognitive factors due to inadequacies and unsuitability of currently available methods of measurement.

Sensitively designed technology can improve data collection and integrate information on nutrition, physical function, cognitive function and mental health to identify individuals at risk of malnourishment and improve targeting of interventions.

Aims

  • The first aim is to improve the methods available for collecting nutritional information from older people using advanced technology to overcome the limitations of current pen and paper methods.
  • The second aim is to develop a comprehensive assessment package that integrates nutritional information with information on health status; function in activities of daily living; cognition; and mental health to improve the targeting of interventions.

The assessment package must be suitable to monitor events over time so that changes and rates of decline or improvement can be detected.

These two aims reflect the underlying principle of the NANA project to improve recognition of poor nutritional status in older people alongside improved identification and understanding of the factors that contribute to this.

Methods

This is a multi-disciplinary programme involving Psychology, Nutrition, Engineering and Software Engineering. The programme of work and methods is as follows:

Phase 1: User Needs Analysis. The first phase will involve consulting with a broad cross-section of older people, and caregivers and health professionals who work with older people, to establish what technical approaches would be useful and acceptable to all groups.

Phase 2: Development of an Integrated Measurement Toolkit. This phase contains three inter-related subsections:

  1. The first is an iterative programme to develop the assessment technology. This will be lead by Engineering and Software Development, closely liaising with Psychology and Nutrition.
  2. The second subsection focuses on techniques for dietary assessment in older people and is lead by Nutrition, working closely with the other three disciplines to facilitate integration into the assessment toolkit.
  3. The third subsection is a parallel investigation of measures of cognition and mental health in older people, lead by Psychology but working closely with Nutrition, Engineering and Software Engineering to ensure integration between the three subsections.

Phase 3: Full Validation of the Assessment Toolkit. This phase will comprise a comparison of the new integrated assessment with traditional 'pen and paper' methods with volunteers having the equipment installed in their homes.

Outcomes

This research will not only improve measurement of nutrition, physical health, mental health and cognitive function but will also improve our understanding of the interactions between these factors. This will be useful for informing strategies to prevent physical and mental decline in ageing, and improvements in the medical treatment and social provision for older people.

The toolkit has potential for commercial development primarily for use with older people but also for potential usage with other groups in the population that would benefit from comprehensive integrated assessment.