scholarly journals Prevalence and Prognostic Value of Malnutrition Among Elderly Cancer Patients Using Three Scoring Systems

2021 ◽  
Vol 8 ◽  
Author(s):  
Qi Zhang ◽  
Liang Qian ◽  
Tong Liu ◽  
Jia-Shan Ding ◽  
Xi Zhang ◽  
...  

Background: Malnutrition is common in patients with cancer and is associated with adverse outcomes, but few data exist in elderly patients. The aim of this study was to report the prevalence of malnutrition using three different scoring systems and to examine the possible clinical relationship and prognostic consequence of malnutrition in elderly patients with cancer.Methods: Nutritional status was assessed by using controlling nutritional status (CONUT), the prognostic nutritional index (PNI), and the nutritional risk index (NRI). Quality-of-life (Qol) was assessed during admission by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30. Performance status (PS) was assessed by using the Eastern Cooperative Oncology Group (ECOG) classification. The relationship between nutritional status and overall survival and Qol were examined.Results: Data were available for 1,494 elderly patients with cancer (63.65% male), the mean age was 70.76 years. According to the CONUT, NRI, and PNI, 55.02, 58.70, and 11.65% patients were diagnosed with malnutrition, respectively. Worse nutritional status was related to older, lower BMI, lower hand grip strength, and more advanced tumor stage. All malnutrition indexes were correlated with each other (CONUT vs. PNI, r = −0.657; CONUT vs. NRI scores, r = −0.672; PNI vs. NRI scores, r = 0.716, all P < 0.001). During a median follow-up of 43.1 months, 692 (46.32%) patients died. For patients malnourished, the incidence rate (events-per-1,000person-years) was as follows: CONUT (254.18), PNI (429.91), and NRI (261.87). Malnutrition was associated with increased risk for all-cause mortality (adjust HR [95%CI] for CONUT: 1.09 [1.05–1.13], P < 0.001; PNI: 0.98[0.97–0.99], P < 0.001; NRI: 0.98 [0.98–0.99], P < 0.001). All malnutrition indexes improved the predictive ability of the TNM classification system for all-cause mortality. Deterioration of nutritional status was associated with deterioration in Qol parameters and immunotherapeutic response (P < 0.001).Conclusions: Malnutrition was prevalent in elderly patients with cancer, regardless of the assessment tools used, and associated with lower Qol and the immunotherapy response.

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 273-273
Author(s):  
Catherine Mercier ◽  
Kenza Drareni ◽  
Anestis Dougkas ◽  
Fadila Farsi ◽  
Pamela Funk-Debleds ◽  
...  

Abstract Objectives Monitoring psychosocial, emotional, and hedonic aspects of food behavior is important to understand cancer patients’ distress and help to reduce risks of malnutrition. However, to date, there is no specific tool to measure the impact of diet, eating behavior, and chemotherapy side effects on patients’ food-related quality of life during cancer and its treatments. The objective was to develop and validate a questionnaire that aims to assess the food-related quality of life in cancer patients undergoing chemotherapy. Methods Relevant items from the existing food-related quality of life assessment tools were selected to compose the present 46-item questionnaire. The validation of the questionnaire was conducted in 276 healthy volunteers and 173 cancer patients. Exploratory Factor Analysis (EFA) was performed in both groups, construct and discriminant validity, and test-retest reliability were calculated. Results The questionnaire was perceived as clear and required less than14 minutes for completion (93% complete responses) in a pre-test (n = 156). The EFA allowed the inclusion of 9 dimensions in the food-related quality of life questionnaire. Common patterns between patients and healthy volunteers (factor loadings ≥ 0.4 in both groups) were used to calculate scores by dimension. Scores in the dimensions of adapting diet and sensorial discomfort (taste/odor) were higher in cancer patients, whilst scores in the dimension of discomfort in satiety were higher in healthy volunteers. Among patients with cancer, the total scores in sensorial discomfort, digestive discomfort, and discomfort in satiety were higher under chemotherapy than no treatment. Reproducibility after one week was in increasing order; digestive discomfort 0.6, adapting diet 0.61, products’ quality 0.67, cooking 0.75, healthy diet 0.76, eating and pleasure 0.80, discomfort in satiety 0.82, and sensorial discomfort 0.85. Conclusions This 46-item questionnaire can discriminate cancer patients versus healthy volunteers, and patients receiving vs those not receiving chemotherapy. A good to very good reproducibility was found for the most important factors of food-related quality of life of patients with cancer, i.e, eating and pleasure, sensorial discomfort, and discomfort in satiety. Funding Sources This study is funded by La Région Auvergne Rhône-Aples and La Métropôle de Lyon.


BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e032889
Author(s):  
Solveigh Paola Lingens ◽  
Georgia Schilling ◽  
Julia Harms ◽  
Holger Schulz ◽  
Christiane Bleich

IntroductionIn recent years, medical treatment for cancer has improved, thereby increasing the life expectancy of patients with cancer. Hence, the focus in healthcare shifted towards analysing treatments that offer to decrease distress and improve the quality of life of patients with cancer. The psychological burden of patients with cancer originates from all kinds of psychosocial challenges related to diagnosis and treatment. Cancer counselling centres (CCounCs) try to address these concerns. However, the current literature lacks research on the effectiveness of CCounCs. This study aims to assess the effectiveness of CCounCs with regard to distress and other relevant psychosocial variables (quality of life, anxietyand so on).Methods and analysisThis prospective observational study with a non-randomised control group has three measurement points: before the first counselling session (baseline, t0) and at 2 weeks and 3 months after baseline (t1, t2). Patients and their relatives who seek counselling between December 2018 and November 2020 and have sufficient German language skills will be included. The control group will be recruited at clinics and oncological outpatient centres in Hamburg. Propensity scoring will be applied to adjust for differences between the control and intervention groups at baseline. Sociodemographic data, medical data and counselling concerns are measured at baseline. Distress (distress thermometer), quality of life (Short Form-8 Health Survey, European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire-Core 30), anxiety (Generalized AnxietyDisorder-7), depression (Patient HealthQuestionnaire-9) and further psychosocial variables are assessed at all time points. With a total of 787 participants, differences between the intervention and control groups of a small effect size (f=0.10) can be detected with a power of 80%.Ethics and disseminationThe study was registered prior to data collection with the German Registration of Clinical Trials in September 2018. Ethical approval was received by the local psychological ethical committee of the Center for Psychosocial Medicine at the University Medical Centre Hamburg-Eppendorf in August 2018. The results will be published in peer-reviewed journals.Trial registration numberDRKS00015516; Pre-results.


2020 ◽  
pp. bmjspcare-2020-002249
Author(s):  
Manuel Cobo Dols ◽  
Carmen Beato Zambrano ◽  
Luis Cabezón Gutiérrez ◽  
Rodolfo Chicas Sett ◽  
María Isabel Blancas López-Barajas ◽  
...  

ObjectivesOpioid-induced constipation (OIC) can affect up to 63% of all patients with cancer. The objectives of this study were to assess quality of life as well as efficacy and safety of naloxegol, in patients with cancer with OIC.MethodsAn observational study was made of a cohort of patients with cancer and with OIC exhibiting an inadequate response to laxatives and treated with naloxegol. The sample consisted of adult outpatients with a Karnofsky performance status score ≥50. The Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) and the Patient Assessment of Constipation Symptoms (PAC-SYM) were applied for 3 months.ResultsA total of 126 patients (58.2% males) with a mean age of 61.3 years (range 34–89) were included. Clinically relevant improvements (>0.5 points) were recorded in the PAC-QOL and PAC-SYM questionnaires (p<0.0001) from 15 days of treatment. The number of days a week with complete spontaneous bowel movements increased significantly (p<0.0001) from 2.4 to 4.6 on day 15, 4.7 after 1 month and 5 after 3 months. Pain control significantly improved (p<0.0001) during follow-up. A total of 13.5% of the patients (17/126) presented some gastrointestinal adverse reaction, mostly of mild (62.5%) or moderate intensity (25%).ConclusionsClinically relevant improvements in OIC-related quality of life, number of bowel movements and constipation-related symptoms were recorded as early as after 15 days of treatment with naloxegol in patients with cancer and OIC, with a good safety profile.


2020 ◽  
Vol 9 (9) ◽  
pp. e491997397
Author(s):  
Andréa Victória Oliveira Santos ◽  
Lorenna Emília Sena Lopes ◽  
Iani Miranda Pinto ◽  
Stefane dos Santos ◽  
Luiz Eduardo Oliveira de Almeida ◽  
...  

Introduction: Duchenne Muscular Dystrophy (DMD) is characterized by membrane dissociation, resulting in the breakdown of the musculoskeletal fiber. Objective:  to identify the assessment tools used to measure the quality of life in patients with DMD. Methodology: A systematic review of articles published from 2007 to 2017 on QOL assessment tools in patients with DMD was conducted in the SciELO, PubMED and LILACS databases. Results: 6 articles met the inclusion criteria, using the QOL assessment tools; Life Satisfaction Index for Adolescents; Quality of Life Evaluation Scale; Medical Outcomes Study 36; World Health Organization Quality of Life Instrument; Health Related Quality of Life Questionnaire for Children and Young People and their Parents e Pediatric Quality of Life Inventory. Conclusions: the tools for the evaluation of quality of life in patients with Duchenne Muscular Dystrophy (DMD) are essentials to determinate and to present an effective treatment focused on patient’s priorities and their main difficulties. However the lack of a validated scale specifically focused on this diagnostic interferes in the real score of those patients quality of life.


Author(s):  
Thị Hồng Chuyên Nguyễn

ASSESSING THE RELATIONSHIP OF NUTRITIONAL STATUS TO THE QUALITY OF LIFE OF CANCER PATIENTS RECEIVING CHEMOTHERAPY AT THE ONCOLOGY DEPARTMENT OF HUE COLLEGE OF MEDICINE AND PHARMACY Background: Cancer is the second leading cause of death globally as well as in Vietnam. Chemotherapy is a systemic treatment with chemical drugs. Chemotherapy often causes many problems related to physical, mental and toxicity, which have an effect on the quality of life and nutritional status of patients. While malnutrition has been shown to be common in cancer patients, its impacts on the patient's quality of life have not been adequately studied, especially in Vietnam. Objective: To evaluate the quality of life of cancer patients receiving chemotherapy. To determine the relationship of nutritional status to the quality of life in these patients. Methods: A cross-sectional study was conducted on 82 patients with cancer during a chemotherapytreatment at the Department of Oncology, Hue College of Medicine and Pharmacy from February 2018 to February 2019. Assessing the quality of life by the Quality of Life Questionnaire of the European Organizationfor Research and Treatment of Cancer (EORTC QLQ-C30). Descriptive statistics and test Chi-square and Fisher exact were performed to analyze the quality of life parameters and the relationship between nutritional status and quality of life. Results: A total of 82 subjects were included in this study, 51 subjects (62.20%) were males and 31 subjects (37.80%) were females, the mean age was 58.98 ± 12.52. The most common type of cancer is gastrointestinal cancer (37.80%), the highest stage of cancer is stage 4 (56.10%), symptomatic chemotherapy accounts for the highest rate with 53.70% and the average number of chemotherapy cycles is 4.00 ± 3.68. The study shows that the meanglobal health status is 50.00 ± 16.89, the best quality of life score is in the field of cognitive function with 83.33 points, the worst quality of life score is in the symptoms field of insomnia and in the financial difficulties with 66.67 points. Results from Chi-square and Fisher Exact analysis test revealed a statistically significant association between the risk of malnutrition according to SGA classification and the role functioning offunctional scales (p <0.05). Conclusions: The quality of life of cancer patients is generally good. The nutritional status affects the quality of life in the field of role function. Keywords: Quality of life, cancer, chemotherapy.


2021 ◽  
Vol 17 (1) ◽  
pp. 295-306
Author(s):  
Elena Massa ◽  
Clelia Donisi ◽  
Nicole Liscia ◽  
Clelia Madeddu ◽  
Valentino Impera ◽  
...  

Background: Depression is a common psychiatric problem in the elderly and oncology patients. In elderly people with cancer, depression has a peculiar phenomenology. It has a significant impact on the quality of life. Moreover, it is associated with poor adherence to treatments, increased risk of suicide, and mortality. Nevertheless, the topic of depression in elderly people with cancer remains unexplored. Objective: The main goal of this article is to review the literature from the past 20 years on the relationships between depression, cancer, and aging. Methods: The methods followed the Prisma model for eligibility of studies. The articles in which the keywords “depression”, “cancer”, “ elderly, aging, or geriatric” were present, either in the text or in the abstract, were selected. 8.056 articles, by matching the keywords “depression and elderly and cancer,” were identified. Only 532 papers met the eligibility criteria of search limits and selection process. Out of 532 papers, 467 were considered irrelevant, leaving 65 relevant studies. Out of 65 suitable studies, 39 (60.0%) met our quality criteria and were included. Results: The risk factors associated with depression in elderly people with cancer can be divided into 4 groups: 1) tumor-related; 2) anticancer treatment-related; 3) patients-related; 4) number and type of comorbidity. The main obstacles in diagnosing depression in elderly patients with cancer are the overlap of the symptoms of cancer and side effects of treatment with the symptoms of depression but also the different ways of reporting depressive symptoms of elderly people and the different clinical types of depression. There is a lack of data regarding validated scales to assess depression in geriatric patients with cancer. Any mental illness, specifically co-occurring anxiety and depression, increases the risk of diagnosis delay and anticancer treatment adherence. Cancer and the diagnosis of mental disorders prior to cancer diagnosis correlate with an increased risk for suicide. A non-pharmacological therapeutic approach, pharmacological treatment and/or a combination of both can be used to treat elderly patients with cancer, but a detailed analysis of comorbidities and the assessment of polypharmacy is mandatory in order to avoid potential side-effects and interactions between antidepressants and the other drugs taken by the patients. Conclusion: Future research should be conducted with the aim of developing a modified and adapted assessment method for the diagnosis and treatment of depression in elderly people with cancer in order to improve their clinical outcomes and quality of life.


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