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.

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.

Predictors of Early Death Risk in Older Patients Treated With First-Line Chemotherapy for Cancer

2012 ◽  
Vol 30 (15) ◽  
pp. 1829-1834 ◽  
Author(s):  
Pierre Soubeyran ◽  
Marianne Fonck ◽  
Christèle Blanc-Bisson ◽  
Jean-Frédéric Blanc ◽  
Joël Ceccaldi ◽  
...  
Keyword(s):  
Daily Living ◽  
Rating Scale ◽  
Nutritional Assessment ◽  
Advanced Disease ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Mini Nutritional Assessment ◽  
Early Death ◽  
First Line ◽  
Line Chemotherapy

Purpose Objective factors for making choices about the treatment of elderly patients with cancer are lacking. This investigation aimed to help physicians select appropriate treatments through the identification of factors that predict early death (< 6 months) after initiation of chemotherapy treatment. Patients and Methods Previously untreated patients greater than 70 years of age who were scheduled for first-line chemotherapy for various types of cancer were included. Baseline abbreviated comprehensive geriatric assessment (aCGA), including the Mini-Mental State Exam, Timed Get Up and Go (GUG), Activities of Daily Living (ADL), Instrumental Activities in Daily Living (IADL), Mini Nutritional Assessment (MNA), Geriatric Depression Scale (GDS15), and comorbidities index (Cumulative Index Rating Scale-Geriatric), was carried out. Prognostic factors of early death were sought from aCGA results and traditional oncology measures. Results A total of 348 patients were included across 12 centers in Southwest France (median age, 77.45 years; ratio of men to women, 1.47; advanced disease, 65%). Abnormal aCGA scores were observed for 18.1% of patients on the ADL, 73.0% of patients on the IADL, 24.1% of patients on the GUG, 19.0% of patients on the MMS, 44.0% of patients on the GDS15, and 64.9% of patients on the MNA. Advanced disease (odds ratio [OR], 3.9; 95% CI, [1.58 to 9.73]), a low MNA score (OR 2.77; 95% CI, [1.24 to 6.18]), male sex (OR, 2.40; 95% CI, [1.2 to 4.82]), and long GUG (OR, 2.55; 95% CI, [1.32 to 4.94] were associated with higher risk of early death. Conclusion In patients greater than 70 years of age with cancer, advanced disease, a low MNA score, and poor mobility predicted early death. We recommend that the MNA and GUG, performed by a trained nurse, be maintained as part of routine pretreatment workup in these patients to identify at-risk patients and to inform the decision-making process for chemotherapy.

scholarly journals Pengaruh Status Nutrisi terhadap Kesintasan 30 Hari Pasien Geriatri yang Dirawat di Rumah Sakit

2017 ◽  
Vol 2 (3) ◽  
pp. 160
Author(s):  
Nata Pratama Hardjo Lugito ◽  
Czeresna Heriawan Soejono ◽  
Edy Rizal Wahyudi ◽  
Esthika Dewiasty
Keyword(s):  
Regression Model ◽  
Nutritional Assessment ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Mini Nutritional Assessment ◽  
Proportional Hazard ◽  
Geriatric Depression ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Cox Proportional Hazard Regression

Pendahuluan. Dengan meningkatnya jumlah populasi usia lanjut, masalah kesehatan yang dialami juga semakin banyak, salah satunya malnutrisi. Studi di luar negeri menunjukkan malnutrisi pada pasien geriatri yang dirawat di rumah sakit menurunkan kesintasan. Pasien usia lanjut di Indonesia mempunyai karakteristik yang berbeda dengan pasien usia lanjut di luar negeri. Di Indonesia belum ada studi tentang status nutrisi pasien usia lanjut yang dirawat di rumah sakit dan pengaruhnya terhadap kesintasan. Penelitian ini bertujuan mengetahui pengaruh status nutrisi terhadap kesintasan 30 hari pasien usia lanjut yang dirawat di ruang rawat akut geriatri dan ruang rawat penyakit dalam rumah sakit.Metode. Penelitian kohort retrospektif, dengan pendekatan analisis kesintasan, dilakukan terhadap 177 pasien geriatri yang dirawat di ruang rawat akut geriatri dan ruang rawat penyakit dalam Rumah Sakit Cipto Mangunkusumo selama bulan April–September 2011. Data demografis, diagnosis medis, kadar albumin, indeks ADL Barthel, geriatric depression scale, status nutrisi dengan mini nutritional assessment (MNA) dikumpulkan, dan diamati selama 30 hari sejak mulai dirawat untuk melihat ada tidaknya mortalitas. Perbedaan kesintasan kelompok pasien dengan status nutrisi baik, berisiko malnutrisi dan malnutrisi ditampilkan dalam kurva Kaplan-Meier, diuji dengan uji Log-rank, serta analisis multivariat dengan Cox proportional hazard regression model untuk menghitung adjusted Hazard Ratio dan interval kepercayaan 95% terjadinya mortalitas 30 hari dengan memasukkan variabel-variabel perancu sebagai kovariat.Hasil. Kesintasan antara subyek yang status nutrisinya baik, berisiko malnutrisi dan malnutrisi ialah 94,7% dengan 89,0% dan 80,7%, namun perbedaan kesintasan 30 hari tak bermakna dengan uji Log-rank (p=0,106). Pada analisis multivariat didapatkan adjusted HR setelah penambahan variabel perancu sebesar 1,49 (IK 95% 0,29 – 7,77) untuk kelompok berisiko malnutrisi dan 2,65 (IK 95% 0,47 – 14,99) untuk kelompok malnutrisi dibandingkan dengan pasien nutrisi baikSimpulan. Perbedaan kesintasan 30 hari pasien geriatri yang dirawat di rumah sakit yang menderita malnutrisi dan berisiko malnutrisi dibandingkan dengan status nutrisi baik pada awal perawatan belum dapat dibuktikan.

scholarly journals The Desire to Better Understand Older Adults with Solid Tumors to Improve Management: Assessment and Guided Interventions—The French PACA EST Cohort Experience

Cancers ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 192 ◽  
Author(s):  
Rabia Boulahssass ◽  
Sebastien Gonfrier ◽  
Noémie Champigny ◽  
Sandra Lassalle ◽  
Eric François ◽  
...  
Keyword(s):  
Solid Tumors ◽  
Nutritional Assessment ◽  
Geriatric Depression Scale ◽  
Geriatric Oncology ◽  
Depression Scale ◽  
Mini Nutritional Assessment ◽  
Factors Associated ◽  
Independent Risk Factors ◽  
State Examination

Todays challenge in geriatric oncology is to screen patients who need geriatric follow-up. The main goal of this study was to analyze factors that identify patients, in a large cohort of patients with solid tumors, who need more geriatric interventions and therefore specific follow-up. Between April 2012 and May 2018, 3530 consecutive patients were enrolled in the PACA EST cohort (France). A total of 3140 patients were finally enrolled in the study. A Comprehensive Geriatric Assessment (CGA) was performed at baseline. We analyzed the associations between factors at baseline (geriatric and oncologic factors) and the need to perform more than three geriatric interventions. The mean age of the population was 82 years old with 59% of patients aged older than 80 years old. A total of 8819 geriatric interventions were implemented for the 3140 patients. The percentage of patients with three or more geriatric interventions represented 31.8% (n = 999) of the population. In multivariate analyses, a Mini Nutritional assessment (MNA) <17, an MNA ≤23·5 and ≥17, a performans status (PS) >2, a dependence on Instrumental Activities of Daily Living (IADL), a Geriatric Depression Scale (GDS) ≥5, a Mini Mental State Examination (MMSE) <24, and a Screening tool G8 ≤14 were independent risk factors associated with more geriatric interventions. Factors associated with more geriatric interventions could assist practitioners in selecting patients for specific geriatric follow-up.

scholarly journals Comparison of mood disorder screening scales in geriatric oncology: THYMOG study results

2019 ◽  
Author(s):  
Guillaume Boudin ◽  
Heidi Solem Laviec ◽  
Lauriane Ghewy ◽  
Jean Luc Machavoine ◽  
Julie Denhaerynck ◽  
...  
Keyword(s):  
Mood Disorder ◽  
Older Patients ◽  
Geriatric Depression Scale ◽  
Geriatric Oncology ◽  
Depression Scale ◽  
Care Physician ◽  
Initial Assessment ◽  
Multicentric Study ◽  
Patients With Cancer ◽  
Study Results

Abstract Background: Early and systematic depression screening is recommended for older patients with cancer. The objective of this study is to evaluate the performance of three different mood disorder screening scales for detection of Major Depressive Disorder (MDD) in older patients with cancer. Methods: A prospective multicentric study was conducted in patients with cancer over 70 years of age, comparing three self-administered questionnaires: the 15-item Geriatric Depression Scale (GDS-15), the Hospital Anxiety and Depression Scale - Depression (HADS-D) and the Distress Thermometer (DT). Three weeks after initial assessment, in case of score above the standard cut-off, a reassessment of the patient’s mood was performed by the primary care physician, using the DSM-V MDD diagnostic criteria and the DT. Potential differences between an abnormal mood screening test and a confirmed MDD was assessed using variance analysis for each screening scale. Results: 93 patients with an average age of 81 years [70 - 95 years] were included. 66 patients had at least one abnormal score on one of the screening scales. A MDD was confirmed for 10 of the 36 reassessed patients (28%). Abnormal screening by the GDS-15 (p=0.021), the HADS-D (p=0.018) and the DT (p=0.045) was significantly associated with MDD diagnosis. Conclusions: The three screening scales enabled detection of MDD in older patients with cancer. Among the tested scales, the HADS-D could perform best in detecting MDD. However, these screening scales may not be sufficiently reliable for MDD screening in this population. Further studies are needed to confirm the results.

scholarly journals Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Chemotherapy: ASCO Guideline for Geriatric Oncology

2018 ◽  
Vol 36 (22) ◽  
pp. 2326-2347 ◽  
Author(s):  
Supriya G. Mohile ◽  
William Dale ◽  
Mark R. Somerfield ◽  
Mara A. Schonberg ◽  
Cynthia M. Boyd ◽  
...  
Keyword(s):  
Older Patients ◽  
Geriatric Depression Scale ◽  
Geriatric Oncology ◽  
Depression Scale ◽  
Treatment Decision ◽  
Eligibility Criteria ◽  
Aging Research ◽  
Additional Information ◽  
Treatment Decision Making ◽  
Cancer Management

Purpose To provide guidance regarding the practical assessment and management of vulnerabilities in older patients undergoing chemotherapy. Methods An Expert Panel was convened to develop clinical practice guideline recommendations based on a systematic review of the medical literature. Results A total of 68 studies met eligibility criteria and form the evidentiary basis for the recommendations. Recommendations In patients ≥ 65 years receiving chemotherapy, geriatric assessment (GA) should be used to identify vulnerabilities that are not routinely captured in oncology assessments. Evidence supports, at a minimum, assessment of function, comorbidity, falls, depression, cognition, and nutrition. The Panel recommends instrumental activities of daily living to assess for function, a thorough history or validated tool to assess comorbidity, a single question for falls, the Geriatric Depression Scale to screen for depression, the Mini-Cog or the Blessed Orientation-Memory-Concentration test to screen for cognitive impairment, and an assessment of unintentional weight loss to evaluate nutrition. Either the CARG (Cancer and Aging Research Group) or CRASH (Chemotherapy Risk Assessment Scale for High-Age Patients) tools are recommended to obtain estimates of chemotherapy toxicity risk; the Geriatric-8 or Vulnerable Elders Survey-13 can help to predict mortality. Clinicians should use a validated tool listed at ePrognosis to estimate noncancer-based life expectancy ≥ 4 years. GA results should be applied to develop an integrated and individualized plan that informs cancer management and to identify nononcologic problems amenable to intervention. Collaborating with caregivers is essential to implementing GA-guided interventions. The Panel suggests that clinicians take into account GA results when recommending chemotherapy and that the information be provided to patients and caregivers to guide treatment decision making. Clinicians should implement targeted, GA-guided interventions to manage nononcologic problems. Additional information is available at www.asco.org/supportive-care-guidelines .

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.

Depression among the oldest old: the Umeå 85+ study

2005 ◽  
Vol 17 (4) ◽  
pp. 557-575 ◽  
Author(s):  
Ellinor Bergdahl ◽  
Janna M. C. Gustavsson ◽  
Kristina Kallin ◽  
Petra von Heideken Wågert ◽  
Berit Lundman ◽  
...  
Keyword(s):  
Rating Scale ◽  
Nutritional Assessment ◽  
Oldest Old ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Mini Nutritional Assessment ◽  
Well Being ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Prevalence Of Depression

Objectives: To investigate the prevalence of depression among the oldest old and to analyze factors associated with depression.Methods:A cross-sectional, population-based study was undertaken in Umeå, Sweden. Out of 319 eligible participants aged 85, 90 and 95 years and older, it was possible to evaluate 242 people (75.9%) for depression. Data were collected from structured interviews and assessments in the participants’ homes, and from medical charts, relatives and caregivers. Depression was screened for using the Geriatric Depression Scale-15 and further assessed with the Montgomery–Åsberg Depression Rating Scale. Cognition was assessed using the Mini-mental State Examination, activities of daily living (ADL) using the Barthel ADL Index, nutrition using the Mini Nutritional Assessment and well-being using the Philadelphia Geriatric Center Morale Scale.Results:The 85-year-olds had a significantly lower prevalence of depression than the 90- and 95-year-olds (16.8% vs. 34.1% and 32.3%). No sex differences were found. One-third of those with depression had no treatment and among those with ongoing treatment 59% were still depressed. Persons diagnosed with depression had a poorer well-being and a higher 1-year mortality. Logistic regression analyses showed that depression was independently associated with living in institutions and number of medications.Conclusion:Depression among the oldest old is common, underdiagnosed and inadequately treated, and causes poor well-being and increased mortality. More knowledge about depression is essential to improve the assessment and treatment of depression among the oldest old.

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 and Depressive Symptoms in Elderly Palliative Care Patients

2021 ◽  
pp. 082585972110455
Author(s):  
Eyyup M. Efendioglu ◽  
Ahmet Cigiloglu ◽  
Ibrahim H. Turkbeyler
Keyword(s):  
Palliative Care ◽  
Depressive Symptoms ◽  
Nutritional Assessment ◽  
Short Form ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Mini Nutritional Assessment ◽  
Nutrition Status ◽  
Strong Negative Correlation ◽  
State Examination

Objective: The aim of this study is to determine the prevalence of and relationship between malnutrition and depressive symptoms in older palliative care inpatients. Methods: One hundred and thirty-six older adults were included in the study. The Geriatric Depression Scale, Mini Nutritional Assessment Short Form, Mini Mental State Examination, Barthel index, and Lawton & Brody index were used to evaluate the mood, nutrition status, mental status, and activities of daily living of the patients. Results: The mean age of the patients was 74.88 ± 8.82 years, and 63.2% of the patients were female. According to the nutritional assessment, 39.7% of the patients suffered from malnutrition, while 47.1% were at risk for it, and depressive symptoms were detected in 79.4% of the patients. A strong negative correlation was found between the scores for nutritional and depressive symptoms (r = −.750, 95% CI = −.834 to −.668). Conclusion: Malnutrition, risk of malnutrition, and depressive symptoms were found to occur often among the patients, and the relationship between them was statistically significant. Our results highlight that the quality of life of palliative care patients could be improved by providing adequate nutrition and psychological support.

Sign in / Sign up

Export Citation Format

Share Document