An operationalized version of the Mini-Nutritional Assessment Short Form using comprehensive geriatric assessment

2018 ◽  
Vol 27 ◽  
pp. 100-104 ◽  
Author(s):  
Maryam Pourhassan ◽  
Rainer Wirth
Keyword(s):  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Nutritional Assessment ◽  
Short Form ◽  
Mini Nutritional Assessment

Screening tools for targeted comprehensive geriatric assessment in HIV-infected patients 50 years and older

2019 ◽  
Vol 30 (10) ◽  
pp. 1009-1017
Author(s):  
Aroonsiri Sangarlangkarn ◽  
Tanakorn Apornpong ◽  
Amy C Justice ◽  
Anchalee Avihingsanon
Keyword(s):  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Nutritional Assessment ◽  
Depression Scale ◽  
Mini Nutritional Assessment ◽  
Screening Tools ◽  
People Living With Hiv ◽  
Timed Up And Go ◽  
Symptom Index ◽  
Cross Sectional

Many people living with HIV (PLWH) are aging with geriatric syndromes, but few undergo comprehensive geriatric assessment (CGA) due to limited resources. Our study evaluates tools to identify aging PLWH who may forego CGA. We conducted a cross-sectional study on 357 PLWH ≥50 years old at the Red Cross, Thailand. Tools evaluated were the Veterans Aging Cohort Study Index (VACSI) and G-8, which is predictive among older cancer patients. CGA consists of eight tests: history of fall within 12 months, timed-up-and-go test (TUG), activities of daily living (ADL), instrumental ADL (IADL), Montreal cognitive assessment (MoCA), Thai depression scale (TDS), mini nutritional assessment (MNA), and HIV symptom index (HSI). We considered ≥2 impaired domains on CGA to be abnormal results. Forty-nine percent (n = 175) had ≥2 impaired domains on CGA. Few participants had experienced a fall (11%) or abnormal TUG/ADL/IADL (<2%), and only MoCA/TDS/MNA/HSI were analyzed. A VACSI < 17 produces 85% sensitivity (Se) and 30% specificity (Sp) (area under the ROC curve [AUC] = 63, 95%CI 58–69) and G-8 > 15.5 produces 90%Se and 33%Sp (AUC = 74, 95%CI 69–79) in identifying patients with <2 impaired domains. A G-8 > 13.5 produces 91%Se and 77%Sp (AUC = 89, 95%CI 86–92) in ruling out abnormal nutrition. Patients with VACSI < 17 and G-8 > 15.5 may forego CGA due to low likelihood of abnormal cognition, mood, nutrition, or symptom burden.

scholarly journals Comprehensive geriatric assessment is correlated to overall survival among gynaecologic oncology patients

2019 ◽  
Vol 50 (3) ◽  
pp. 276-281
Author(s):  
Nadav Michaan ◽  
Sang Yoon Park ◽  
Myong Cheol Lim
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Activities Of Daily Living ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Daily Living ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Cancer Type ◽  
Oncology Patients

Abstract Objective To investigate the correlation of comprehensive geriatric assessment to overall survival among older gynaecologic oncology patients. Methods Between 2011 and 2017, patients &gt;70 years had geriatric assessment before treatment. Geriatric assessment included the following tests: Old American resource and services, instrumental activities of daily living, modified Barthels index, mini-mental state examination, geriatric depression scale, mini-nutritional assessment, risk of falling and medication use. Overall survival was calculated for patients’ groups below and above median tests scores. Univariate as well as multivariate analysis was done to evaluate the association between each variable and survival. Results About 120 patients had geriatric assessment. Mean patients’ age was 76.4 ± 5. A total of 78 Patients had ovarian cancer, 16 uterine cancer, 17 cervical cancer and 9 had other gynaecologic malignancies. No correlation was found between age, BMI (body mass index) and cancer type to overall survival. Patients with scores below cut-off values of modified Barthels index, instrumental activities of daily living, mini-nutritional assessment and mini-nutritional assessment had significantly shorter overall survival (P = 0.004, 0.031, 0.046 and 0.004, respectively). This remained significant in both univariate and multivariate analysis. Conclusions Gynaecologic oncology patients with lower geriatric assessment scores have significantly lower overall survival, irrespective of cancer type. Geriatric assessment tests allow objective assessment of older patients with worst prognosis before treatment planning.

scholarly journals Evaluation of pro-inflammatory cytokines in frail Tunisian older adults

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242152
Author(s):  
Sonia Hammami ◽  
Imen Ghzaiel ◽  
Souha Hammouda ◽  
Nabil Sakly ◽  
Mohamed Hammami ◽  
...  
Keyword(s):  
Older Adults ◽  
Inflammatory Cytokines ◽  
Geriatric Assessment ◽  
Nutritional Assessment ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
Serum Levels ◽  
Enzyme Linked Immunosorbent Assay ◽  
Tnf Α ◽  
Pro Inflammatory Cytokines

The present study was undertaken to evaluate serum levels of pro-inflammatory cytokines in Tunisian older adults and to examine the relationships between inflammatory marker levels, geriatric, and biochemical parameters. A cross-sectional study was conducted in a population of Tunisian older adults (N = 141, aged 65 and over). Patients were recruited from the Department of Internal Medicine, Fattouma Bourguiba University Hospital (Monastir, Tunisia) and from a nursing home (Sousse, Tunisia). Comprehensive geriatric assessment, history taking and examination including functional and nutritional assessment were done for each participant. Enzyme-linked immunosorbent assay (ELISA) test was used to measure serum cytokine (TNF-α, IL-8, IL-6) levels. The modified Short Emergency Geriatric Assessment score (SEGAm) were used to classify patients as 51 very-frail, 40 frail, and 50 non-frail. The age of the participants (80 men, 61 women) ranged from 65 to 97 years. Serum levels of TNF-α, IL-8 and C-reactive protein (CRP) were significantly higher in very-frail participants compared to frail and non-frail ones. However, no significant differences in IL-6 levels were detected among frailty groups. After adjustment for age, CRP and IL-8 levels remained significantly associated with frailty. Analysis of the receiver operating characteristic (ROC) curve corresponding to IL-8 showed an area under the curve of 0.7 (p = 0.003; 95% CI [0.58–0.81]) and a predictive threshold of 5.27 pg/ml. Positive correlations were found between frailty score, IL-6, and IL-8 levels. In addition, a significant positive correlation was observed between IL-8 levels and Timed Up and Go test results. However, a negative correlation was observed between Mini Nutritional Assessment Short-Form score, IL-6 and CRP levels, as well as between Activities of Daily Living score and serum levels of TNF-α, IL-6, and CRP. In conclusion, the key findings of this study collectively support a role of pro-inflammatory cytokines, TNF-α, CRP, and especially IL-8 in the development of frailty in older adults.

New conditions identified through a comprehensive geriatric assessment in cancer patients.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 133-133 ◽  
Author(s):  
Beatrice Jara-Almonte Edwards ◽  
Holly Michelle Holmes ◽  
Heather Valladarez ◽  
Ming Sun ◽  
Peter Khalil ◽  
...  
Keyword(s):  
Older Adults ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Healthy Aging ◽  
Nutritional Assessment ◽  
Cohort Analysis ◽  
Mini Nutritional Assessment ◽  
Hematologic Malignancies ◽  
Cancer Center ◽  
Co Morbidity

133 Background: Chronologic age cannot be used to predict the degree of comorbidity and of functional deterioration of older adults. Assessment of older adults includes health, functional status, nutrition, cognition, socio-economic and mood disorders evaluations. This multidisciplinary assessment is referred to as comprehensive geriatric assessment (CGA). The risk of comorbid conditions increases with age and may result in under diagnosis: in older patients, new symptoms may not be clearly recognized by the patient and may be dismissed by practitioners as manifestations of preexisting conditions. Methods: We conducted a retrospective cohort analysis, of older adult patients (aged 70 years of age and older) evaluated at the Program for Healthy Aging at MD Anderson from January 1, 2013 through December 31, 2014. Assessment was conducted using Katz’ ADLs, Lawton’s IADLs, PHQ-9, the short physical performance battery, the Montreal cognitive assessment, mini nutritional assessment and Charlson co-morbidity index. Medication review and social assessment were also included. Analysis: cross tabulations were performed in SAS 9.4 (SAS Institute INC, Cary, NC) Results: We evaluated 198 patients, (n = 99, 51.6% females). Most common malignancies evaluated included hematologic malignancies (n = 62, 33%), breast cancer (n = 32, 13.2 %), prostate cancer (n = 19, 10 %) and other solid malignancies (n = 85, 43%). The comprehensive geriatric assessment identified a mean of 3 new conditions (range 1-10). The most commonly identified conditions included cognitive impairment and dementia (n = 148, 77%), low bone mass and osteoporosis (n = 67, 34%), malnutrition (n = 65, 34%), frailty (n = 58, 30.2%), and polypharmacy (n = 64, 33%). These conditions are relevant in the management of such patients and could lead to recurring admissions if left unaddressed. Conclusions: A CGA program in a cancer center allows for the identification of medical conditions that directly contribute to clinical outcomes. A CGA allows for the development of a comprehensive plan of care that addresses such issues preventing adverse consequences.

scholarly journals Evaluation of The Comprehensive Geriatric Assessment (CGA) Tool As A Predictor of Postoperative Complications Following Major Oncological Abdominal Surgery in Older Patients

2021 ◽  
Author(s):  
Yoon Penning ◽  
Antoine El Asmar ◽  
Michel Moreau ◽  
Julie Raspé ◽  
Lissandra Dal Lago ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Nutritional Status ◽  
Abdominal Surgery ◽  
Geriatric Assessment ◽  
Nutritional Assessment ◽  
Short Form ◽  
Univariate Analysis ◽  
Mini Nutritional Assessment ◽  
Postoperative Mortality ◽  
Geriatric Screening

Abstract Purpose: The concept of frailty extends beyond chronological age. Identifying frailty using a two-step approach, starting with the use of a screening tool (G8) followed by complete geriatric assessment (CGA), may be useful for guiding treatment decisions and follow-up.This study evaluated the association between geriatric screening and individual components of the tCGA with the risk of 90-day postoperative complications in oncogeriatric patients.Methods: Data on patients with major oncological abdominal surgery were retrospectively collected from hospital records (2016-2019). Patients with G8 and CGA geriatric screening in those identified by an altered G8 screening score were included. Postoperative complications were classified by Clavien-Dindo grade and the Comprehensive Complication Index (CCI).Results: One hundred and twelve patients aged ≥ 70 years surgically treated with curative intent for cancer were included. Seventy-six (67.9%) presented with an altered G8. Of these, sixty-six (58.9%) had a CGA. In univariate analysis, only altered nutritional status assessed by the Mini-Nutritional Assessment-Short Form was associated with higher total complication rate (p = 0.01). Patients with impaired G8 had significantly more complications and higher 1-year mortality rates than patients with normal G8. Fifteen patients (13.4%) had grade III-IVb complications. A CCI > 50 was recorded in 16 patients (14.3%). All-cause 90-day postoperative mortality was 10.7%.Conclusions: Identifying altered preoperative nutritional status as part of the CGA in patients screening positive for frailty is a potentially modifiable risk factor that can influence preoperative management and treatment decision making. G8 may be a predictive factor for postoperative complications.

scholarly journals Comprehensive geriatric assessment in elderly outpatients with dementia

2007 ◽  
Vol 1 (3) ◽  
pp. 303-310 ◽  
Author(s):  
Márlon Juliano Romero Aliberti ◽  
Elina Lika Kikuchi ◽  
Regina Miksian Magaldi ◽  
Sérgio Márcio Pacheco Paschoal ◽  
Wilson Jacob Filho
Keyword(s):  
Activities Of Daily Living ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Daily Living ◽  
Nutritional Assessment ◽  
Clinical Status ◽  
Mini Nutritional Assessment ◽  
Clinical Dementia Rating ◽  
Severe Dementia ◽  
Elderly Outpatients

Abstract Dementia is a common disabling disease in the elderly. In such patients, general health conditions may worsen the functional decline and loss of autonomy. The Comprehensive Geriatric Assessment (CGA) is a validated and recommended instrument for multidimensional evaluation of the aged. Nonetheless, it has yet to be assessed in demented patients. Objectives: To analyze the functional, emotional and clinical status in elderly with dementia measured by the CGA. We also compared the results obtained in the same patients stratified for severity of dementia. Methods: Transversal study with demented elderly outpatients. Subjects were evaluated by the CGA consisting of clinical data, Clinical Dementia Rating, performance-oriented mobility assessment of gait and balance (POMA), Cornell scale for depression, activities of daily living, Mini Mental Status Examination (MMSE), Mini Nutritional Assessment, Whispered and Snellen Test. Results: Fifty-two patients with mean age of 77 years were evaluated. Majority of patients had Alzheimer disease (77%). Depression was the most prevalent comorbidity. The POMA score was related to the number of falls in the previous year. Also, there was correlation between complaints of visual and hearing impairment and the results on the Snellen and Whispered Tests. Regarding severity, 56% presented mild, 33% moderate and 11% severe condition. Patients with moderate/severe dementia had less leisure activities, greater risk of falls, along with worse performance on the MMSE, POMA and activities of daily living. Conclusions: The CGA was applied in demented elderly with the help of their caregivers, and was able to better characterize patient state of health. Subjects with moderate/severe dementia obtained poor results in several assessed criteria.

scholarly journals Evaluation of Malnutrition and Depression in Elderly People: An Epidemiological Study in Turkey

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Aydoğan ◽  
A Ünsal ◽  
D Arslantaş
Keyword(s):  
Health Care Providers ◽  
Nutritional Assessment ◽  
Short Form ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Cluster Sampling ◽  
Care Providers ◽  
Cross Sectional

Abstract Background Malnutrition is an important cause of morbidity and mortality. Malnutrition increases the number of hospitalizations and prolongs the length of hospitalization by disrupting organ functions, increasing the number and severity of infections and delaying wound healing. The aim of this study was to determine the frequency of suspected malnutrition in the elderly, to examine some related variables and to evaluate the depression. Methods The study is a cross-sectional study conducted between March-April 2019 in individuals aged 60 years and older living in Sivrihisar. Sample size was calculated as 579. Cluster sampling method used. Data was collected by door to door in 4 neighborhoods determined by randomly. Mini Nutritional Assessment Test-Short Form (for malnutrition), Katz Daily Living Activities Scale (for dependency) and Geriatric Depression Scale-Short Form (for depression) were used. Chi-square test, Mann Whitney U test and logistic regression analysis were used for the analyzes. Results The study group consisted of 220 (38%) women and 359 (62%) men. The mean age was 68.9±6.4 (ranged 60-93). Frequency of suspected malnutrition was 25% (n = 145). Being 80 years of age or older (OR:3.24, CI:1.53-6.85), having a primary and lower education level (OR:2.54, CI:1.32-4.90), history of chronic illness (OR:2.34, CI:1.33-4.03), using dentures (OR:1.62, CI:1.03-2.55) and suspected depression (OR:4.97, CI:3.17-7.78) are important risk factors for malnutrition. Those with suspicion of malnutrition had lower scores on DLA (z = 8.982;p=0.001). Conclusions Malnutrition was found to be an important health problem for the elderly. The frequency of suspected malnutrition is higher in individuals with depression. Those with suspected malnutrition have higher level of dependency. In order to reduce the frequency of malnutrition, it may be beneficial to increase the awareness of the elderly and caregivers and to give importance to the elderly nutrition of primary health care providers. Key messages Depression is an important risk factor for malnutrition. Malnutrition increases the dependence of the individual on daily activities.

scholarly journals Diagnostic Performance and Accuracy of the MNA-SF against GLIM Criteria in Community-Dwelling Older Adults from Poland

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2183
Author(s):  
Aleksandra Kaluźniak-Szymanowska ◽  
Roma Krzymińska-Siemaszko ◽  
Marta Lewandowicz ◽  
Ewa Deskur-Śmielecka ◽  
Katarzyna Stachnik ◽  
...  
Keyword(s):  
At Risk ◽  
Diagnostic Performance ◽  
Nutritional Assessment ◽  
Short Form ◽  
Area Under The Curve ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Study Results ◽  
Community Dwelling Older Adults ◽  
Test Result

Up to 28% of elderly residents in Europe are at risk of malnutrition. As uniform diagnostic criteria for malnutrition have not been formulated, in autumn 2018, the Global Leadership Initiative on Malnutrition (GLIM) presented a consensus on its diagnosis. According to the consensus, the diagnosis of malnutrition requires a positive screening test result for the risk of malnutrition, and the presence of at least one etiologic and one phenotypic criterion. This study aimed to assess the diagnostic performance and accuracy of the Mini Nutritional Assessment—Short Form (MNA-SF) against GLIM criteria. The analysis involved 273 community-dwelling volunteers aged ≥ 60 years. All participants were screened for malnutrition with the MNA-SF questionnaire. Next, the GLIM phenotypic and etiologic criteria were assessed in all subjects. Based on the presence of at least one phenotypic and one etiologic criterion, malnutrition was diagnosed in more than one-third of participants (n = 103, 37.7%). According to the MNA-SF, only 7.3% of subjects had malnutrition, and 28.2% were at risk of malnutrition. The agreement between the MNA-SF score and the GLIM criteria were observed in only 22.3% of the population. The sensitivity and specificity of MNA-SF against the GLIM criteria were fair (59.2% and 78.8%, respectively). The area under the curve (AUC) was 0.77, indicating the fair ability of MNA-SF to diagnose malnutrition. Based on the present study results, the best solution may be an optional replacement of the screening tool in the first step of the GLIM algorithm with clinical suspicion of malnutrition.

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