Skip to main content
SpringerLink
Log in

Caregivers’ male gender is associated with poor nutrient intake in AD families (NuAD-trial)

  • Published:
The journal of nutrition, health & aging

Abstract

Objective

Alzheimer patients (AD) are known to be at risk for malnutrition and their older spouses may also have nutritional problems. The aim of our study was to clarify the association of caregivers' sex on the nutrient intake of AD couples.

Setting

Our study uses the baseline data of a randomized nutritional trial exploring the effectiveness of nutrition intervention among home-dwelling AD patients.

Participants

The central AD register in Finland was used to recruit AD patients living with a spousal caregiver, 99 couples participated in our study.

Measurements

Nutritional status was assessed using the Mini-Nutritional Assessment (MNA). Nutrient intakes for both AD patients and their spouses were calculated from 3-day food diaries.

Results

The mean age of caregivers and AD spouses was 75.2 (SD 7.0) and 77.4 years (SD 5.6), respectively. According to the MNA, 40% of male and 52% of female AD spouses were at risk for malnutrition. Among male caregivers, the mean energy and protein intakes were 1605 kcal (SD 458) and 0.93g/body kg (SD 0.30), whereas the respective figures for their female AD spouses were 1313 kcal (SD 340) and 0.86 g/body kg (SD 0.32), respectively. Among female caregivers, the mean energy and protein intakes were 1536 kcal (SD 402) and 1.00 g/body kg (SD 0.30), whereas the respective figures for their male AD spouses were 1897 kcal (SD 416) and 1.04 g/body kg (SD 0.30). The interaction between male caregiver sex and lower energy (p<0.001) and lower protein intake (p=0.0048) (adjusted for age and MMSE) was significant. Similar differences between caregiver sexes were observed with the intake of various nutrients.

Conclusions

A gender difference exists in the ability to cope with caregiver responsibilities related to nutrition. A need exists for tailored nutritional guidance among older individuals and especially among male caregivers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Guigoz Y. The Mini Nutritional assessment (MNA®) review of the literature — what does it tell us? J Nutr Health Aging 2006;10:466–485.

    CAS  PubMed  Google Scholar 

  2. Gillette Guyonnet S, Abellan Van Kan G, Alix E, Andrieu S, Belmin J, Berrut G. International Academy on Nutrition and Aging (IANA) Expert Group: weight loss and Alzheimer’s disease. J Nutr Health Aging 2007;11:38–48.

    Google Scholar 

  3. Shatenstein B, Kergoat MJ, Reid I. Poor nutrient intakes during 1-year follow-up with community-dwelling older adults with early-stage Alzheimer dementia compared to cognitively intact matched controls. J Am Diet Assoc 2007;107:2091–2099.

    Article  CAS  PubMed  Google Scholar 

  4. Rogue M, Salva A, Vellas B. Malnutrition in community-dwelling adults with dementia (Nutrialz trial). J Nutr Health Aging 2013;4:295–299.

    Article  Google Scholar 

  5. Lesourd B. Nutritional factors and immunological ageing. Proc Nutr Soc 2006;65:319–325.

    Article  CAS  PubMed  Google Scholar 

  6. Wardwell L, Chapman-Novakofski K, Herrel S, Woods J. Nutrient intakes and immune function of elderly subjects. J Am Diet Assoc 2008;108:2005–2012.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. Morley JE, Argiles JM, Evans JW et al. Nutritional recommendations for the management of sarcopenia. J Am Med Dir Assoc 2010;11:391–396.

    Article  PubMed  Google Scholar 

  8. Silva P, Kergoat MJ, Shatenstein B. Challenges in managing the diet of older adults with early-stage Alzheimer dementia: a caregiver perspective. J Nutr Health Aging; 2013;17:142–147.

    Article  CAS  PubMed  Google Scholar 

  9. Rivière S, Gillette-Guyonnet S, Voisin T, Reynish E, Andrieu S, Lauque S, Salva A, Frisoni G, Nourhashemi F, Micas M, Vellas B. A nutritional education program could prevent weight loss and slow cognitive decline in Alzheimer’s disease. J Nutr Health Aging 2001;5:295–299.

    PubMed  Google Scholar 

  10. Lauque S, Arnaud-Battandier F, Gillette S, Plaze JM, Andrieu S, Cantet C, Vellas B. Improvement of Weight and Fat-Free Mass with Oral Nutritional Supplementation in Patients with Alzheimer’s Disease at Risk of Malnutrition: A Prospective Randomized Study. J Am Geriatr Soc 2004;52:1702–1707.

    Article  PubMed  Google Scholar 

  11. Milne A, Avenell A, Potter J. Meta-Analysis: Protein and energy supplementation in older people. Ann Intern Med 2006;144:37–48.

    Article  CAS  PubMed  Google Scholar 

  12. Shatenstein B, Kergoat MJ, Reid I, Chicoine ME. Dietary intervention on older adults with early-stage Alzheimer dementia: early lessons learned. J Nutr Health Aging 2008;12:461–469.

    Article  CAS  PubMed  Google Scholar 

  13. Raivio M, Eloniemi-Sulkava U, Laakkonen ML, Saarenheimo M, Pietila M, Tilvis R, Pitkala K. How do offically organized services meet the needs of elderly caregivers and their spouses with Alzheimer’s disease? Am J Alzheimer’s Dis Other Demen 2007;22:360–368.

    Article  Google Scholar 

  14. Johansson L, Sibenvall B, Malmberg L, Christensson L. Who will become malnourished? A prospective study of factors associated with malnutrition in older persons living at home. J Nutr Health Aging 2009;13:855–861.

    Article  CAS  PubMed  Google Scholar 

  15. Torres SJ, McCabe M, Nowson CA. Depression, nutritional risk and eating behaviour in older caregivers. J Nutr Health & Aging 2010;14:442–448.

    Article  CAS  Google Scholar 

  16. Foote JA, Giuliano AR, Harris RB. Older adults need guidance to meet Nutritional Recommendations. J Am Coll Nutr 2000;19:628–640.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  17. Volkert D, Kreuel K, Heseker H, Stehle P. Energy and nutrient intake of young-old, old-old and very-old elderly in Germany. Eur J Clin Nutr 2004;58:1190–1200.

    Article  CAS  PubMed  Google Scholar 

  18. Marshall TA, Stumbo PJ, Warren JJ, Xie XJ. Inadequate nutrient intakes are common and associated with low diet variety in rural, community-dwelling elderly. J Nutr 2001;131:2192–2196.

    CAS  PubMed  Google Scholar 

  19. Toffanello ED, Inelmen EM, Minicuci N, Campigotto F, Sergi G, Coin A, Miotto F, Enzi E, Manzato E. Ten-year trends in vitamin intake in free-living healthy elderly people: the risk of subclinical malnutrition. J Nutr Health Aging 2011;2:99–103.

    Article  Google Scholar 

  20. Soini H, Suominen MH, Muurinen S, Strandberg TE, Pitkälä KH. Malnutrition according to the mini nutritional assessment in older adults in different settings. J Am Geriatr Soc 2011;59:765–766.

    Article  PubMed  Google Scholar 

  21. Vikstedt T, Suominen MH, Joki A, Muurinen S, Soini H, Pitkälä KH. Nutritional status, energy, protein, and micronutrient intake of older service house residents. J Am Med Dir Assoc 2011;12:302–307.

    Article  PubMed  Google Scholar 

  22. Bates CJ, Prentice A, Finch S. Gender differences in food and nutrient intakes and status indicates from the National Diet and Nutrition Survey of people aged 65 years and over. Eur J Clin Nutr 1999;53:694–699.

    Article  CAS  PubMed  Google Scholar 

  23. Baker & Wardle. Sex differences in fruit and vegetable intake in older adults. Appetite 2003;40:269–275.

    Article  PubMed  Google Scholar 

  24. Paturi M, Tapanainen H, Reinivuo H, Pietinen P. The national FINDIET 2007 Survey. Kansanterveyslaitoksen julkaisuja B 23/2008.

  25. Hughes G, Bennet KM, Hetherington MM. Old and alone: barriers to healthy eating in older men living on their own. Appetite 2004;43:269–276.

    Article  PubMed  Google Scholar 

  26. Fjellström C, Starkenberg Å, Wesslen A, Licentiate MS, Tysen Bäckström AC, Faxen-Irving G, The OmegAD study group. To be a good provider: An Exploratory study among spouses of persons with Alzheimer’s disease. Am J Alzeimers Dis Other Demen. 2010;25:521–526.

    Article  Google Scholar 

  27. Jyvakorpi S, Puranen T, Pitkala KH, Suominen MH. Nutritional treatment of aged individuals with alzheimer disease living at home with their spouses — a randomized controlled intervention trial. Trials. 22012;4:13:66.

    Article  Google Scholar 

  28. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984;34:939–944.

    Article  CAS  PubMed  Google Scholar 

  29. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987;40:373–83.

    Article  CAS  PubMed  Google Scholar 

  30. Folstein MF, Folstein SE, Mchugh PR. ”Mini-mental-state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.

    Article  CAS  PubMed  Google Scholar 

  31. Guigoz Y, Launque S, Vellas BJ. Identifying the elderly at risk for malnutrition the Mini Nutritional Assessment. Clin Geriatr 2002;18:737–757.

    Article  Google Scholar 

  32. Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist 1980;20 649–655.

    Article  CAS  PubMed  Google Scholar 

  33. Lawton MP and Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9:179–186.

    Article  CAS  PubMed  Google Scholar 

  34. Rastas M, Seppänen R, Knuts LR et al. Ruokien ravintoainesisältö [Nutrient Composition of Foods]. Kansaneläkelaitos, Turku, 1997.

    Google Scholar 

  35. Baker KL & Robertson N. Coping with caring for someone with dementia: reviewing the literature about men. Aging and Mental Health 2008;12:413–422.

    Article  PubMed  Google Scholar 

  36. Pöysti MM, Laakkonen ML, Strandberg T, Savikko N, Tilvis RS, Eloniemi-Sulkava U, Pitkälä KH. Gender Differences in Dementia spousal caregiving. Int J Alz Dis. 2012;162960.

    Google Scholar 

  37. Gariballa SE & Forster SJ. Dietary intake o folder patients in hospital and at home: The validity of patients kept food diaries. J Nutr Health Aging 2008;12:102–106.

    Article  CAS  PubMed  Google Scholar 

  38. Bilotta C, Bergamaschini L, Arienti R, Spreafico S, Vergani C. Caregiver burden as a short time predictor of weight loss in older outpatients suffering from mild to moderate Alzheimer’s disease: A thee months follow-up study. Aging and mental health 2010;14:481–488

    Article  PubMed  Google Scholar 

  39. Nordic Council of Ministers. Nordic Nutrition Recommendations. Integrating nutrition and physical activity. Copenhagen, 2004.

    Google Scholar 

  40. Bauer J, Biolo G, Cederholm T, Cesari M, Cruz-Jentoft AJ, Morley JE, Phillips S, Sieber C, Stehle P, Teta D, Visvanathan R, Volpi E, Boirie Y. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Diet Assoc 2013;14:542–559.

    Article  Google Scholar 

  41. Iuliano S, Woods J, Robbins J. Consuming two additional serves of dairy food a day significantly improves energy and nutrient intakes in ambulatory aged care residents: A feasibility study. J Nutr Health Aging 2013;6:509–513.

    Article  Google Scholar 

  42. Roos G, Prättälä R, Koski K. Men, masculinity and food: interviews with Finnish carpentres and engineers. Appetite 2001;27:45–56.

    Google Scholar 

  43. Calasanti T & Bowen E. Spousal caregiving and crossing gender boundaries: Maintaining gendered identities. J Aging Studies 2006;20:253–263.

    Article  Google Scholar 

  44. Raivio M, Eloniemi-Sulkava U, Laakkonen ML, Saarenheimo M, Pietilä M, Tilvis R, Pitkälä K. How do officially organized services meet the needs of elderly caregivers and their spouses with Alzheimer’s disease? Am J Alzheimers Dis Other Demen 2007;22:360–368.

    Article  PubMed  Google Scholar 

  45. Keller HH, Gibbs A, Wong S, Wanderkooy P, Hedley M. Men can cook! J Nutr Elderly 2004;24:71–84.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Unit of Primary Health Care, Helsinki University Central Hospital and Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland

    T. M. Puranen, K. H. Pitkala, H. Kautiainen, M. Raivio, S. K. Jyvakorpi & Merja Suominen

  2. Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland

    S. E. Pietila

  3. Palmenia Centre for Continuing Education, University of Helsinki, Helsinki, Finland

    U. Eloniemi-Sulkava

Authors
  1. T. M. Puranen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. E. Pietila
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. H. Pitkala
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H. Kautiainen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Raivio
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. U. Eloniemi-Sulkava
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S. K. Jyvakorpi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Merja Suominen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Merja Suominen.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Puranen, T.M., Pietila, S.E., Pitkala, K.H. et al. Caregivers’ male gender is associated with poor nutrient intake in AD families (NuAD-trial). J Nutr Health Aging 18, 672–676 (2014). https://doi.org/10.1007/s12603-014-0499-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-014-0499-z

Key words

Search

Navigation