The validity of three malnutrition screening markers among older patients with cancer

2019 ◽  
Vol 10 (3) ◽  
pp. 363-368 ◽  
Author(s):  
Xiaotao Zhang ◽  
Linda Pang ◽  
Shreela V Sharma ◽  
Ruosha Li ◽  
Alan G Nyitray ◽  
...  
Keyword(s):  
Weight Loss ◽  
Older Patients ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Cancer Center ◽  
Patients With Cancer ◽  
Standard Assessment ◽  
Diagnosis Of Cancer ◽  
Md Anderson ◽  
Sensitivity Specificity

BackgroundMalnutrition is common in older adults with cancer and is associated with adverse clinical outcomes. We assessed and compared the validity of three tools commonly used to screen for malnutrition: The Mini Nutritional Assessment (MNA), weight loss and body mass index (BMI).MethodsIn this retrospective study, we reviewed patients over age 65 with a diagnosis of cancer who were treated at the MD Anderson Cancer Center between 1 January 2013 and 31 March 2017. All patients in this study were evaluated by a trained geriatrician as part of a comprehensive geriatric assessment (CGA). Malnutrition was diagnosed by both CGA and clinical examination. The sensitivity, specificity and Cohen’s κ of each tool was also compared with the clinical diagnosis.ResultsA total of 454 older patients with cancer who had malnutrition information available were included in the analyses. The median age was 78%, and 42% (n=190) were clinically diagnosed with malnutrition at baseline. When the MNA was performed, 105 out of 352 patients (30%) were malnourished, and 122 (35%) at risk of malnutrition. Weight loss >3 kg was seen in 183 out of 359 (51%) patients, and BMI <20 kg/m2 was found in 30 of the 454 (7%) patients. MNA had the highest validity (area under curve (AUC)=0.83) and reliability (κ=0.67), weight loss had moderate validity (AUC=0.73) and reliability (κ=0.46), while BMI had the lowest validity (AUC=0.55) and reliability (κ=0.55).ConclusionsFor clinical practice, MNA should be incorporated for standard assessment/screening for these older patients with cancer.

Malnutrition in older patients with cancer: Appraisal of the Mini Nutritional Assessment, weight loss, and body mass index

2018 ◽  
Vol 9 (1) ◽  
pp. 81-83 ◽  
Author(s):  
Xiaotao Zhang ◽  
Ming Sun ◽  
June M. McKoy ◽  
Nizar Noor Ali Bhulani ◽  
Vicente Valero ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Body Mass ◽  
Older Patients ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Patients With Cancer

A comparison of anticholinergic burden in older patients with and without cancer

2021 ◽  
Author(s):  
Ayse Irem Yasin ◽  
Atakan Topcu ◽  
Meysere Nur Akuc ◽  
Hacı Mehmet Türk ◽  
Pinar Soysal
Keyword(s):  
Older Patients ◽  
Nutritional Assessment ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Mini Nutritional Assessment ◽  
Patients With Cancer ◽  
Cancer Management ◽  
Rational Drug ◽  
Geriatric Clinic ◽  
Anticholinergic Burden

Aim: To compare anticholinergic burden (ACB) in older patients with and without cancer and evaluate the effects of ACB on geriatric syndromes. Methods: A total of 291 patients from the geriatric clinic and 301 patients from the oncology clinic were evaluated. ACB <2 was categorized as low ACB and ACB ≥2 was categorized as high ACB. A comprehensive geriatric assessment was performed on patients from the geriatric clinic. Results: ACB scores were significantly higher in patients without cancer compared with those with cancer (p < 0.005). Number of falls and Geriatric Depression Scale 15 scores were higher and Mini-Nutritional Assessment and Barthel/Lawton activities of daily living scores were lower in geriatric patients with high ACB scores compared with those with low ACB scores (p < 0.005). Conclusion: It is crucial to understand the potential effects of ACB for rational drug use and optimum cancer management in older patients with cancer.

Nutritional Status and Its Contributing Factors among Older Adults with Cancer Receiving Chemotherapy

2020 ◽  
Vol 29 (8) ◽  
pp. 650-658
Author(s):  
Eman Shokry Abd Allah ◽  
Hanan Mohammed Mohammed Gad ◽  
Hassanat Ramadan Abdel-Aziz
Keyword(s):  
Older Adults ◽  
Nutritional Status ◽  
Older Patients ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
University Hospitals ◽  
Contributing Factors ◽  
Patients With Cancer ◽  
Study Results ◽  
Relationship Of

The study aimed to assess nutritional status and its contributing factors among older adults with cancer receiving chemotherapy so, a descriptive study design was used. The study was conducted at Zagazig University Hospitals, Egypt. The study’s sample was selected purposively which composed of 194 older adults. Nutritional status was measured by the Arabic version of the Mini-Nutritional Assessment (MNA). Contributing factors were identified by examining the relationship of nutritional status with demographic and clinical variables. Study results revealed that 33% of the older patients were malnourished and 51.5% were at risk for malnutrition. Statistically significant relations were found between nutritional status and advanced age, illiteracy, insufficient monthly income, comorbidities, cancer stage four at diagnosis, and receiving ≥4 chemotherapy cycles. High prevalence of malnutrition and many contributing factors were identified among older patients with cancer receiving chemotherapy. So, continuous malnutrition screening along chemotherapy courses with special concern for contributing factors assessed in this study is recommended.

Association of GDF15 With Inflammation and Physical Function During Aging and Recovery After Acute Hospitalization: A Longitudinal Study of Older Patients and Age-Matched Controls

2021 ◽  
Author(s):  
Juliette Tavenier ◽  
Line Jee Hartmann Rasmussen ◽  
Aino Leegaard Andersen ◽  
Morten Baltzer Houlind ◽  
Anne Langkilde ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Physical Function ◽  
Plasma Levels ◽  
Older Patients ◽  
Nutritional Assessment ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
Acute Illness ◽  
Urokinase Plasminogen Activator Receptor

Abstract Growth differentiation factor 15 (GDF15) is a stress-induced cytokine. Its plasma levels increase during aging and acute illness. In older Patients and age-matched Controls, we evaluated whether GDF15 levels (i) were associated with recovery after acute illness, and (ii) reflected different trajectories of aging and longitudinal changes in health measures. Fifty-two older Patients (≥65 years) were included upon admission to the emergency department (ED). At 30 days after discharge (time of matching), Patients were matched 1:1 on age and sex with Controls who had not been hospitalized within 2 years of inclusion. Both groups were followed up after 1 year. We assessed plasma levels of GDF15 and inflammatory biomarkers, frailty, nutritional status (mini nutritional assessment short-form), physical and cognitive function, and metabolic biomarkers. In Patients, elevated GDF15 levels at ED admission were associated with poorer resolution of inflammation (soluble urokinase plasminogen activator receptor [suPAR]), slowing of gait speed, and declining nutritional status between admission and 30-day follow-up. At time of matching, Patients were frailer and overall less healthy than age-matched Controls. GDF15 levels were significantly associated with participant group, on average Patients had almost 60% higher GDF15 than age-matched Controls, and this difference was partly mediated by reduced physical function. Increases in GDF15 levels between time of matching and 1-year follow-up were associated with increases in levels of interleukin-6 in Patients, and tumor necrosis factor-α and suPAR in age-matched Controls. In older adults, elevated GDF15 levels were associated with signs of accelerated aging and with poorer recovery after acute illness.

Cancer Cachexia in the Age of Obesity: Skeletal Muscle Depletion Is a Powerful Prognostic Factor, Independent of Body Mass Index

2013 ◽  
Vol 31 (12) ◽  
pp. 1539-1547 ◽  
Author(s):  
Lisa Martin ◽  
Laura Birdsell ◽  
Neil MacDonald ◽  
Tony Reiman ◽  
M. Thomas Clandinin ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Body Mass Index ◽  
Weight Loss ◽  
Body Mass ◽  
Normal Weight ◽  
Cancer Center ◽  
Skeletal Muscle Index ◽  
Patients With Cancer ◽  
C Statistic ◽  
Muscle Attenuation

Purpose Emerging evidence suggests muscle depletion predicts survival of patients with cancer. Patients and Methods At a cancer center in Alberta, Canada, consecutive patients with cancer (lung or GI; N = 1,473) were assessed at presentation for weight loss history, lumbar skeletal muscle index, and mean muscle attenuation (Hounsfield units) by computed tomography (CT). Univariate and multivariate analyses were conducted. Concordance (c) statistics were used to test predictive accuracy of survival models. Results Body mass index (BMI) distribution was 17% obese, 35% overweight, 36% normal weight, and 12% underweight. Patients in all BMI categories varied widely in weight loss, muscle index, and muscle attenuation. Thresholds defining associations between these three variables and survival were determined using optimal stratification. High weight loss, low muscle index, and low muscle attenuation were independently prognostic of survival. A survival model containing conventional covariates (cancer diagnosis, stage, age, performance status) gave a c statistic of 0.73 (95% CI, 0.67 to 0.79), whereas a model ignoring conventional variables and including only BMI, weight loss, muscle index, and muscle attenuation gave a c statistic of 0.92 (95% CI, 0.88 to 0.95; P < .001). Patients who possessed all three of these poor prognostic variables survived 8.4 months (95% CI, 6.5 to 10.3), regardless of whether they presented as obese, overweight, normal weight, or underweight, in contrast to patients who had none of these features, who survived 28.4 months (95% CI, 24.2 to 32.6; P < .001). Conclusion CT images reveal otherwise occult muscle depletion. Patients with cancer who are cachexic by the conventional criterion (involuntary weight loss) and by two additional criteria (muscle depletion and low muscle attenuation) share a poor prognosis, regardless of overall body weight.

scholarly journals How We Care for an Older Patient With Cancer

2017 ◽  
Vol 13 (2) ◽  
pp. 95-102 ◽  
Author(s):  
Armin Shahrokni ◽  
Soo Jung Kim ◽  
George J. Bosl ◽  
Beatriz Korc-Grodzicki
Keyword(s):  
Predictive Models ◽  
Older Patients ◽  
Process Development ◽  
Adverse Outcomes ◽  
Added Value ◽  
Cancer Center ◽  
Multiple Chronic Conditions ◽  
Older Patient ◽  
Improve Patient Survival ◽  
Patients With Cancer

As the number of older patients with cancer is increasing, oncology disciplines are faced with the challenge of managing patients with multiple chronic conditions who have difficulty maintaining independence, who may have cognitive impairment, and who also may be more vulnerable to adverse outcomes. National and international societies have recommended that all older patients with cancer undergo geriatric assessment (GA) to detect unaddressed problems and introduce interventions to augment functional status to possibly improve patient survival. Several predictive models have been developed, and evidence has shown correlation between information obtained through GA and treatment-related complications. Comprehensive geriatric evaluations and effective interventions on the basis of GA may prove to be challenging for the oncologist because of the lack of the necessary skills, time constraints, and/or limited available resources. In this article, we describe how the Geriatrics Service at Memorial Sloan Kettering Cancer Center approaches an older patient with colon cancer from presentation to the end of life, show the importance of GA at the various stages of cancer treatment, and how predictive models are used to tailor the treatment. The patient’s needs and preferences are at the core of the decision-making process. Development of a plan of care should always include the patient’s preferences, but it is particularly important in the older patient with cancer because a disease-centered approach may neglect noncancer considerations. We will elaborate on the added value of co-management between the oncologist and a geriatric nurse practitioner and on the feasibility of adapting elements of this model into busy oncology practices.

scholarly journals Factors associated with nutritional risk and appetite loss in long-aged older people

2021 ◽  
Vol 34 ◽  
Author(s):  
Mariana de Paula SANTANA ◽  
Nadine Motta FIGUEIREDO ◽  
Sergio CHOCIAY JUNIOR ◽  
Tainá Aparecida SILVA ◽  
Rosimeire Aparecida Manoel SEIXAS ◽  
...  
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Depressive Symptoms ◽  
Older People ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Perceived Health ◽  
Nutritional Risk ◽  
Calf Circumference ◽  
Appetite Loss

ABSTRACT Objective To analyze the factors that are associated with the nutritional risk and appetite loss of long-aged older people with two assessment instruments. Methods A cross-sectional and quantitative study was developed in Três Lagoas, a city in the Brazilian state of Mato Grosso do Sul. The household data collection was conducted with 87 long-aged older adults (≥90 years) living in the community. The risk of malnutrition, malnutrition, and the risk of weight loss were the dependent variables, assessed by the Simplified Nutritional Appetite Questionnaire and by the Mini-Nutritional Assessment - Short Form. The association with independent sociodemographic, general health, psychological, cognitive, and physical variables was analyzed using logistic regressions. Results Most of the older adults were female (55.2%), with an average age of 93.3 years, and 1.4 years of schooling. According to the Simplified Nutritional Appetite Questionnaire, 34.5% of the older individuals were at risk of losing weight. As for the results of the Mini-Nutritional Assessment, 19.5% were classified as malnourished, and 39.1% at risk of malnutrition. A greater nutritional risk in both instruments was associated with the individual's poorer self-perceived health, lower calf circumference, and presence of depressive symptoms. The greater the number of medications used, the lower the chance of weight loss. The agreement between the two instruments was low. Conclusion There was an association connecting malnutrition and appetite/weight loss with lower calf circumference, worse self-perceived health status, and presence of depressive symptoms. These results can assist in interventions planning to reduce the nutritional risk and improve the life quality of older adults.

scholarly journals 307 A Survey of Nutritional Status of Older Patients Attending Medicine for Older Person Clinics

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Keneilwe Malomo ◽  
Josephine Soh ◽  
Eamon Dolan ◽  
Marie O'Connor
Keyword(s):  
Weight Loss ◽  
Nutritional Status ◽  
Older Patients ◽  
Healthcare Professionals ◽  
Nutritional Assessment ◽  
Clinical Information ◽  
Nutritional Supplement ◽  
Community Dwelling ◽  
Factors Affecting ◽  
Clinical Complications

Abstract Background Nutritional assessment is an important but frequently overlooked aspect of comprehensive geriatric assessment. Malnutrition is common and associated with clinical complications. Our study aimed to assess older patients’ perceptions of their nutritional status and to investigate clinical factors affecting it. Methods All patients attending our clinics over a 2 week period were invited to complete a self-administered questionnaire. Further clinical information including diagnosis and weight collected by review of medical notes. Results A total of 43 patients completed the questionnaire; median age 82.5 years (67-102). Of these, 69.8%(n=30) were female and 27.9% (n=12) lived alone. Majority reported good appetite (83.7%, n=36) and eating 3 meals a day (79.1%,n=34). 25.6%(n=11) prepared meals themselves and 34.9%(n=15) had received nutritional advise from healthcare professionals. 17 patients (39.5%) self-reported weight loss over the past year, and of these 76.5% (n=13) had objective weight loss documented. Only 2.3% (n=1) were concerned and seek advice from healthcare professionals. 50% (n=12) of the remaining 24 patients who self-reported no weight loss had objective weight loss in clinic. 26 (60.5%) patients had objective weight loss. A higher proportion of the weight loss cohort lived alone (30.8% vs 23.5%), had no home care packages(HCP) (65.4% vs 47.1%), did not take nutritional supplement (76.9% vs 58.8%), had no dentures ( 42.5% vs 23.5%) and had no diagnosis of dementia (57.7% vs 47.1%). Of those who lost weight, 34.6% (n=9) lost significant amount (>5%) of weight, including 4 (15.4%) who lost >10%. Conclusion 2 out of 3 of our community dwelling, older patients lost weight, with one third having lost significant amount. Awareness is poor with 50% not recognising their weight loss and only one third ever sought nutritional advice. Patients who lost weight were more likely to be living alone with no formal community supports.

scholarly journals The Impact of Diet Type on Weight Loss in Patients with Alzheimer’s Disease

2021 ◽  
Vol 36 ◽  
pp. 153331752110448
Author(s):  
Tomiyo Nakamura
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Weight Loss ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Care Hospital ◽  
Term Care ◽  
Significant Difference ◽  
The Impact ◽  
Diet Type

Objectives: To compare differences in weight loss in patients with Alzheimer’s disease on normal, diabetic, or texture-modified diets. Methods: This prospective interventional study examined the data of patients with Alzheimer’s disease who were admitted to a long-term care hospital in Japan from February to April 2013. Dietary elements and weight loss over a 3-month period were examined. Results: Of the 75 patients examined, 6 were on a normal diet, 10 were on a diabetic diet, and 59 were on a texture-modified diet. Weight loss was significantly associated with body weight, Mini Nutritional Assessment®, and diet type. In the non-malnourished patients, there was a significant difference between the three types of diets in terms of eating rate and weight loss. Conclusion: Diet type was independently associated with weight loss in patients with Alzheimer’s disease. Research using larger sample sizes is necessary to eliminate the differences between these diet types.

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