NASA - National Aeronautics and Space Administration

Some elderly people have trouble feeding themselves properly.

One result, according to the Consortium for Research in Elder Self-Neglect of Texas (CREST), is that they risk deficiencies of vitamins B12 and D, folate and antioxidants. The nutrients are related to cognitive and other critical functions.

Most blood samples for the study were analyzed at the NASA Nutritional Biochemistry Laboratory at Johnson Space Center.

Image to right: Scott M. Smith, NASA nutritionist at the Johnson Space Center, is one of the investigators on the CREST project. Credit: NASA

Initial findings of the study are in the October issue of the Journal of Nutrition. In contrast to extensively studied clinical phenomena such as depression and dementia, risk factors of self-neglect in community-dwelling elders are not well understood.

Previous studies have shown that depressive symptoms and cognitive impairment are independent predictors of self-neglect. This study shows that clinically defined self-neglectors are more likely than age-matched and gender-matched controls to have nutrient deficits and evidence for altered bone metabolism.

Forty self-neglect subjects were matched for age, gender, ethnicity and socioeconomic status to 40 nonself-neglecting control subjects. All lived in Houston. The study was conducted from April through October 2005.

The study looked at the self-neglecting elderly to document their nutritional status. The testing profile used was a modification of the assessment profile used to assess the nutritional status of International Space Station crewmembers before and after their long-duration missions.

"This study is an example of how NASA research and capabilities not only benefit astronauts, but can contribute to basic science and to public health," said Scott M. Smith, NASA nutritionist at the Johnson Space Center. Smith is one of the investigators on the CREST project and the lead author of the published paper.

Elder self-neglect is the most common form of elder mistreatment. It encompasses a wide range of social, health and housing issues. Individuals who cannot provide basic needs for themselves may develop social, functional and physical deficits.

Considerable evidence shows that certain nutrients are related to some of the cognitive effects associated with self-neglect. For example, in community-based elderly populations with good health, adequate folate status is associated with higher cognitive function scores and is inversely associated with dementia.

The research raises new questions. Two striking ones are: 1) Are nutritional deficiencies a cause of self-neglect or a consequence? And 2) Can these deficiencies be corrected and, if so, will that enable a return to self-reliance?

"Many nutrient deficiencies exist," said Smith. "I think that malnutrition may not just be an outcome but may actually be an initiating factor. Many nutrient deficiencies, including vitamin D, folate and vitamin B12, are related to neural and cognitive impairments."

Coincidentally, vitamin D and folate are two key nutritional concerns for astronauts. With a re-emergence of vitamin D deficiency in the general population in recent years, the fact that spacecraft are shielded from ultraviolet light puts astronauts at risk for vitamin D deficiency, similar to the elderly and other population groups.

As nutrition science continues to learn about nutrient impact on health and disease, advances help many people, including space travelers.

CREST is a Baylor College of Medicine and the Texas Elder Abuse Mistreatment Institute project funded by the National Institutes of Health.