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Coltman A, Ojeda T, Ashafa M, Pertel D, McCauley S. The Global Malnutrition Composite Score: Impacting malnutrition care. Nutr Clin Pract 2024. [PMID: 38824274 DOI: 10.1002/ncp.11162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/03/2024] [Accepted: 05/10/2024] [Indexed: 06/03/2024] Open
Abstract
The presence and impact of malnutrition in adult hospitalized patients has been well documented by a significant body of literature. However, current malnutrition care practices often vary widely and frequently lack standardization. The Global Malnutrition Composite Score (GMCS), the first nutrition-related electronic clinical quality measure, is intended to evaluate the quality of malnutrition care provided to inpatient adults. This measure aims to aid in standardizing malnutrition care through performance measurement. The four components of the measure (nutrition screening, nutrition assessment, malnutrition diagnosis, and nutrition care plans) follow the well-established Nutrition Care Process and encourage the use of standardized terminology. Facilities with high-performance scores on the GMCS are likely to experience improved outcomes associated with high-quality malnutrition care.
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Affiliation(s)
- Anne Coltman
- Commission on Dietetic Registration, Chicago, Illinois, USA
| | - Tamaire Ojeda
- Commission on Dietetic Registration, Chicago, Illinois, USA
| | | | - Donna Pertel
- Commission on Dietetic Registration, Chicago, Illinois, USA
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Bužančić I, Držaić M, Kummer I, Ortner Hadžiabdić M, Brkić J, Fialová D. Deprescribing potential of commonly used medications among community-dwelling older adults: insights from a pharmacist's geriatric assessment. Sci Rep 2024; 14:6235. [PMID: 38485992 PMCID: PMC10940601 DOI: 10.1038/s41598-024-56780-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 03/11/2024] [Indexed: 03/18/2024] Open
Abstract
Pharmacist's geriatric assessment can provide valuable insights into potential deprescribing targets, while including important information on various health-related domains. Data collected from a geriatric assessment questionnaire, for 388 patients, from the Croatian cohort of the EuroAgeism H2020 ESR 7 international project, along with guideline-based deprescribing criteria, were used to analyse potentially inappropriate prescribing of four medication groups (benzodiazepines (BZN), proton pump inhibitors (PPI), opioids, and non-steroidal anti-inflammatory drugs (NSAID)), and to assess the deprescribing potential. Binary logistic regression was used to explore the effects of age, gender, number of medicines and diagnoses, self-reported health, frailty score, and healthcare utilization on the likelihood of needing deprescribing. More than half of participants (n = 216, 55.2%) are candidates for deprescribing, with 31.1% of PPI, 74.8% of NSAID, 75% of opioid, and 96.1% of BZN users meeting at least one criterion. Most common criteria for deprescribing were inappropriately long use and safety concerns. Women (aOR = 2.58; p < 0.001), those reporting poor self-reported health (aOR = 5.14; p < 0.001), and those exposed to polypharmacy (aOR = 1.29; p < 0.001) had higher odds of needing to have medicines deprescribed. The high rate of deprescribing potential warrants prompt action to increase patient safety and decrease polypharmacy. Pharmacist's geriatric assessment and deprescribing-focused medication review could be used to lead a personalised approach.
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Affiliation(s)
- Iva Bužančić
- City Pharmacies Zagreb, Kralja Držislava 6, Zagreb, Croatia
- Faculty of Pharmacy and Biochemistry, Center for Applied Pharmacy, University of Zagreb, Ante Kovačića 1, 10 000, Zagreb, Croatia
| | - Margita Držaić
- City Pharmacies Zagreb, Kralja Držislava 6, Zagreb, Croatia
- Faculty of Pharmacy and Biochemistry, Center for Applied Pharmacy, University of Zagreb, Ante Kovačića 1, 10 000, Zagreb, Croatia
| | - Ingrid Kummer
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203/8, Hradec Králové, Prague, Czech Republic
| | - Maja Ortner Hadžiabdić
- Faculty of Pharmacy and Biochemistry, Center for Applied Pharmacy, University of Zagreb, Ante Kovačića 1, 10 000, Zagreb, Croatia.
| | - Jovana Brkić
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203/8, Hradec Králové, Prague, Czech Republic
- Department of Social Pharmacy and Pharmaceutical Legislation, Faculty of Pharmacy, University of Belgrade, 450 Vojvode Stepe Street, Belgrade, Serbia
| | - Daniela Fialová
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203/8, Hradec Králové, Prague, Czech Republic
- Department of Geriatrics and Gerontology, 1st Faculty of Medicine in Prague, Charles University, Kateřinská 32, Prague, Czech Republic
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Engelheart S, Andrén D, Repsilber D, Bertéus Forslund H, Brummer RJ. Nutritional status in older people - An explorative analysis. Clin Nutr ESPEN 2021; 46:424-433. [PMID: 34857230 DOI: 10.1016/j.clnesp.2021.08.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/23/2021] [Accepted: 08/30/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND & AIMS The nutritional status is seldom defined in general, but is considered to be important throughout life span, especially in times of diseases and disabilities. We previously proposed a theoretical model of the nutritional status from a functional perspective [1], however without proposing a definition of the nutritional status. The model comprises four domains that might affect the nutritional and functional status in a bidirectional way. These four domains are: Food and nutrition; Health and somatic disorders; Physical function and capacity; and Cognitive, affective, and sensory function. This study contributes to the existing literature and knowledge by empirically analysing patterns and relationships of possible nutritional status indicators within and between the four domains. METHODS This study is based on a sample of 69 men and women; older than 65 years, receiving home health care. They were followed up for three years. A broad set of nutritional status indicators in the participants were assessed in their home yearly. Given the small sample size and large number of variables, we used both correlation and factor analysis to explore patterns of nutritional status indicators within the four domains and relationships between the four domains suggested by the theoretical model of nutritional status which we proposed earlier. RESULTS At baseline, between 4 and 18 components were extracted from the four domains, separately, using factor analysis. The first three components of each domain (called main components) were correlated (p < 0.05) with at least one of the main components of each of the other three domains (r = -0.34-0.79 at baseline, 0.38-0.74 at year 1, 0.40-0.77 at year 2 and 0.47-0.71 at year 3). At baseline, these main components explained, respectively, 31%, 52%, 57% and 63% of the sample variation in the four domains. This remained stable throughout all three years of follow up. In all four domains, there were statistically significant differences in prevalence of malnutrition, frailty, sarcopenia, and dehydration (all different inadequate nutritional status) between individuals' individual component scores. CONCLUSIONS This study provides empirical evidence for the relationship between nutritional status indicators within and between the four domains suggested by our theoretical model of nutritional status. Components in all four domains were associated with inadequate nutritional status, highlighting that a wide perspective of the nutritional status assessment is necessary to be applied in clinical practice.
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Affiliation(s)
| | | | - Dirk Repsilber
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Heléne Bertéus Forslund
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Wolfe WA. Loneliness: An Overlooked Contributing Factor in Anorexia of Older Patients With End-Stage Renal Disease and Focal Point for Interventions to Enhance Nutritional Status-An Overview of Evidence and Areas of Suggested Research. J Ren Nutr 2021; 32:498-502. [PMID: 34772602 DOI: 10.1053/j.jrn.2021.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 09/20/2021] [Accepted: 10/03/2021] [Indexed: 11/11/2022] Open
Abstract
Although research has shown that loneliness can contribute to anorexia in older non-ESRD (end-stage renal disease) populations, and the benefits of its mitigation with improving appetite, nutrient, and caloric intake, its implications for older patients with ESRD have been overlooked. This article provides an overview of evidence on the potential contributing role of loneliness in anorexia of older patients with ESRD, and loneliness as a focal point for interventions to help improve nutritional status. Areas of needed research are suggested in the course of the analysis. With a 41%-83% projected rise in the prevalence of patients in the United States with ESRD by 2030, and demographic population trends showing that an ever-increasing number will be living alone, there is a long overdue need to better understand the implications of loneliness for this nutritionally vulnerable population. KEYWORDS: Chronic kidney disease; loneliness; anorexia; malnutrition; protein energy wasting.
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Affiliation(s)
- William A Wolfe
- Women's Institute for Family Health of Philadelphia, Consultant & University of Pennsylvania, School of Social Policy & Practice, Graduate Student Mentoring.
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Hoseinzadeh-Chahkandak F, Rahimlou M, Salmani F, Ansarifar E, Moodi M, Sharifi F, Zeinali T. Nutrition assessment and geriatric associated conditions among free living elderly people in Birjand, East of Iran: a cross-sectional study. BMC Geriatr 2021; 21:612. [PMID: 34717587 PMCID: PMC8557026 DOI: 10.1186/s12877-021-02518-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/04/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Few data are available on the nutritional status of Iranian geriatric population. The present study aimed to determine the nutritional status of older adults' population in Birjand, East of Iran. METHODS The community-based cohort study was performed on older adults population (60 years and older) living in urban and rural areas of Birjand. The mini nutritional assessment (MNA) questionnaire was used to assess nutritional status. Anthropometric and biochemical evaluation were also performed for all of the participants. RESULTS A total of 1417 geriatric person were enrolled in this study, which, most of them were female (51.9 %). According to MNA tool, most of the participants (73.3 %) had normal nutrition (MNA score ≥ 24). Malnourished (MNA score < 17) and at high risk of malnutrition (MNA score: 17- 23.5) were constituted 0.9 % and 25.8 % of the participants, respectively. Marital status, occupation, period of education and family member were associated with nutritional status. Multiple logistic regression showed that with increase of body mass index (BMI) (OR = 0.96), education years (OR = 0.95), hemoglobin (OR = 0.86) and lymphocyte (OR = 0.98), the odds of malnutrition decreased, but with increase of age the odds (1.03) of malnutrition is also elevated. CONCLUSIONS MNA could successfully forecast the risk of malnutrition and malnourished people. Sociodemographic factors are associated with the nutritional status.
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Affiliation(s)
- Fatemeh Hoseinzadeh-Chahkandak
- Social Determinants of Health Research Center, Department of Public health, School of Health, Birjand University of Medical sciences, Birjand, Iran
| | - Mehran Rahimlou
- Department of Nutrition, School of Medicine, Zanjan University of Medical sciences, Zanjan, Iran
| | - Fatemeh Salmani
- Social Determinants of Health Research Center, Department of Epidemiology and Biostatistics, School of Health, Birjand University of Medical Sciences, Birjand, Iran
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Elham Ansarifar
- Social Determinants of Health Research Center, Department of Public health, School of Health, Birjand University of Medical sciences, Birjand, Iran
| | - Mitra Moodi
- Social Determinants of Health Research Center, Department of Public health, School of Health, Birjand University of Medical sciences, Birjand, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Tayebeh Zeinali
- Social Determinants of Health Research Center, Department of Public health, School of Health, Birjand University of Medical sciences, Birjand, Iran.
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Mundi MS, Mohamed Elfadil O, Bonnes SL, Salonen BR, Hurt RT. Use of telehealth in home nutrition support: Challenges and advantages. Nutr Clin Pract 2021; 36:775-784. [PMID: 34245465 DOI: 10.1002/ncp.10736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), after initially being detected in Wuhan, China in late 2019, quickly spread to most regions of the world, meeting World Health Organization criteria for a pandemic. Social distancing along with other measures implemented to control spread had a drastic impact on the provision of healthcare including deferred elective procedures and surgeries as well as delayed care and evaluation for emergent diagnoses such as heart attacks and strokes. In the home nutrition practice, patients began to delay routine laboratory tests and were canceling or deferring annual visits. Our group soon began to rapidly deploy telehealth to meet the needs of the home nutrition patients. Telehealth is not a new concept with descriptions of healthcare being provided at a distance with the use of telephone in the 1870s. However, widespread adoption has been limited because of regulation (licensure, prescriptions, credentialing, and privileges), lack of reimbursement, as well as adoption and availability of technology needed to carry out telehealth visits. As regulations and limits on reimbursements were waived during COVID-19 pandemic, our home nutrition practice began to evaluate core components of the care we provide for our patients and assess which could be successfully transitioned to telehealth. In addition to the history and regulation of telehealth, the current manuscript provides details regarding successful implementation of telehealth visits such as change management, selection of telehealth platform, scheduling and logistics, as well as carrying out the virtual visit including history and physical exam.
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Affiliation(s)
- Manpreet S Mundi
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Osman Mohamed Elfadil
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Sara L Bonnes
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Bradley R Salonen
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Ryan T Hurt
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
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Dávalos-Yerovi V, Marco E, Sánchez-Rodríguez D, Duran X, Meza-Valderrama D, Rodríguez DA, Muñoz E, Tejero-Sánchez M, Muns MD, Guillén-Solà A, Duarte E. Malnutrition According to GLIM Criteria Is Associated with Mortality and Hospitalizations in Rehabilitation Patients with Stable Chronic Obstructive Pulmonary Disease. Nutrients 2021; 13:nu13020369. [PMID: 33530364 PMCID: PMC7911981 DOI: 10.3390/nu13020369] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/16/2021] [Accepted: 01/20/2021] [Indexed: 12/16/2022] Open
Abstract
Malnutrition has a negative impact on patients with chronic pulmonary obstructive disease (COPD). The purpose of this study was to assess the prevalence of malnutrition, defined by the Global Leadership Initiative for Malnutrition (GLIM), in stable COPD patients referred to pulmonary rehabilitation, and to explore potential associations of malnutrition according to GLIM, and its components, with increased risk of mortality and hospitalizations in 2 years. In a post-hoc analysis of a prospective cohort of 200 rehabilitation patients with stable COPD, main outcome variables were hospital admissions, length of stay, and mortality during a 2-year follow-up. Covariates were malnutrition according to GLIM and its phenotypic criteria: unintentional weight loss, low body mass index (BMI), and low fat-free mass (FFM). Univariate and multivariate analysis were performed using logistic and proportional hazard Cox regression. Malnutrition according to GLIM showed 45% prevalence and was associated with increased mortality risk. Low age-related BMI and FFM were independently associated with mortality, which persisted after adjustment for age and lung function. Malnutrition and low BMI were also associated with increased risk of hospitalization. Malnutrition according to GLIM criteria was highly prevalent in rehabilitation patients with COPD and was associated with nearly 3 times greater mortality and hospitalization risk.
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Affiliation(s)
- Vanesa Dávalos-Yerovi
- Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar Hospital de l’Esperança), Passeig Maritim de la Barceloneta 25-29, 08003 Barcelona, Spain; (V.D.-Y.); (M.T.-S.); (A.G.-S.); (E.D.)
- Rehabilitation Research Group, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Carrer del Doctor Aiguader 88, 08003 Barcelona, Spain; (D.S.-R.); (D.M.-V.); (E.M.); (M.D.M.)
| | - Ester Marco
- Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar Hospital de l’Esperança), Passeig Maritim de la Barceloneta 25-29, 08003 Barcelona, Spain; (V.D.-Y.); (M.T.-S.); (A.G.-S.); (E.D.)
- Rehabilitation Research Group, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Carrer del Doctor Aiguader 88, 08003 Barcelona, Spain; (D.S.-R.); (D.M.-V.); (E.M.); (M.D.M.)
- School of Medicine, Universitat Autònoma de Barcelona (UAB), Campus Universitari Mar, Carrer del Doctor Aiguader 80, 08003 Barcelona, Spain;
- School of Medicine, Universitat Internacional de Catalunya, Carrer Josep Trueta s/n, Sant Cugat del Vallès, 08195 Barcelona, Spain
- Correspondence: ; Tel.: +34-603-622-596
| | - Dolores Sánchez-Rodríguez
- Rehabilitation Research Group, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Carrer del Doctor Aiguader 88, 08003 Barcelona, Spain; (D.S.-R.); (D.M.-V.); (E.M.); (M.D.M.)
- Geriatrics Department, Centre Fòrum-Hospital del Mar, Carrer Llull 410, 08019 Barcelona, Spain
- Department of Health Sciences (CEXS), Universitat Pompeu i Fabra, Carrer del Doctor Aiguader 80, 08003 Barcelona, Spain
| | - Xavier Duran
- Methodology and Biostatistics Support Unit, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Carrer del Doctor Aiguader 88, 08003 Barcelona, Spain;
| | - Delky Meza-Valderrama
- Rehabilitation Research Group, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Carrer del Doctor Aiguader 88, 08003 Barcelona, Spain; (D.S.-R.); (D.M.-V.); (E.M.); (M.D.M.)
- Physical Medicine and Rehabilitation Department, National Institute of Physical Medicine and Rehabilitation (INMFER), Panama City 0819, Panama
- Physical Medicine and Rehabilitation Department, Caja de Seguro Social (C.S.S.), Panama City 0824, Panama
| | - Diego A. Rodríguez
- School of Medicine, Universitat Autònoma de Barcelona (UAB), Campus Universitari Mar, Carrer del Doctor Aiguader 80, 08003 Barcelona, Spain;
- Department of Health Sciences (CEXS), Universitat Pompeu i Fabra, Carrer del Doctor Aiguader 80, 08003 Barcelona, Spain
- Respiratory Medicine Department, Hospital del Mar, Passeig Maritim de la Barceloneta 25-29, 08003 Barcelona, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Avenida Monforte de Lemos 3-5, Pabellón 11, 28019 Madrid, Spain
| | - Elena Muñoz
- Rehabilitation Research Group, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Carrer del Doctor Aiguader 88, 08003 Barcelona, Spain; (D.S.-R.); (D.M.-V.); (E.M.); (M.D.M.)
| | - Marta Tejero-Sánchez
- Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar Hospital de l’Esperança), Passeig Maritim de la Barceloneta 25-29, 08003 Barcelona, Spain; (V.D.-Y.); (M.T.-S.); (A.G.-S.); (E.D.)
- Rehabilitation Research Group, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Carrer del Doctor Aiguader 88, 08003 Barcelona, Spain; (D.S.-R.); (D.M.-V.); (E.M.); (M.D.M.)
| | - Maria Dolors Muns
- Rehabilitation Research Group, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Carrer del Doctor Aiguader 88, 08003 Barcelona, Spain; (D.S.-R.); (D.M.-V.); (E.M.); (M.D.M.)
- Endocrinology and Nutrition Department, Hospital del Mar-Parc de Salut Mar. Passeig Marítim de la Barceloneta, 25, 29, 08003 Barcelona, Spain
| | - Anna Guillén-Solà
- Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar Hospital de l’Esperança), Passeig Maritim de la Barceloneta 25-29, 08003 Barcelona, Spain; (V.D.-Y.); (M.T.-S.); (A.G.-S.); (E.D.)
- Rehabilitation Research Group, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Carrer del Doctor Aiguader 88, 08003 Barcelona, Spain; (D.S.-R.); (D.M.-V.); (E.M.); (M.D.M.)
- School of Medicine, Universitat Autònoma de Barcelona (UAB), Campus Universitari Mar, Carrer del Doctor Aiguader 80, 08003 Barcelona, Spain;
| | - Esther Duarte
- Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar Hospital de l’Esperança), Passeig Maritim de la Barceloneta 25-29, 08003 Barcelona, Spain; (V.D.-Y.); (M.T.-S.); (A.G.-S.); (E.D.)
- Rehabilitation Research Group, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Carrer del Doctor Aiguader 88, 08003 Barcelona, Spain; (D.S.-R.); (D.M.-V.); (E.M.); (M.D.M.)
- School of Medicine, Universitat Autònoma de Barcelona (UAB), Campus Universitari Mar, Carrer del Doctor Aiguader 80, 08003 Barcelona, Spain;
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Sanchez-Rodriguez D, Annweiler C, Marco E, Hope S, Piotrowicz K, Surquin M, Ranhoff A, Van Den Noortgate N, Andersen-Ranberg K, Bonin-Guillaume S, Conroy S, Gordon A, Grodziki T, Landi F, Martínez-Velilla N, Münzer T, Ranhoff AH, Roller-Wirnsberger R, Singler K, Van Den Noortgate N, Al Hamad HK, Annweiler C, Beuscart JB, Blanc F, Ciurea A, Cobbaert K, Dallmeier D, Dinan P, Engvig A, Højmann AH, Hosia H, Hope S, Kerminen HM, Knapskog AB, Koutsouri A, Laurent M, Lilamand M, Marien S, Mellingsaeter M, Mendes A, Nguyen S, Ogugua C, Ommundsen N, Périvier S, Piotrowicz K, Rapo-Pylkkö S, Roitto HM, Roubaud-Baudron C, Saka B, Sanchez-Rodriguez D, Surquin M, Tarazona F, Toscano-Rico M, Tschurr G, Vande Walle N, Vetrano D, Yavuz BB. European Academy for medicine of ageing session participants' report on malnutrition assessment and diagnostic methods; an international survey. Clin Nutr ESPEN 2020; 35:75-80. [DOI: 10.1016/j.clnesp.2019.11.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 11/26/2019] [Indexed: 12/15/2022]
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Comprehensive Geriatric Assessment and Nutrition-Related Assessment: A Cross-Sectional Survey for Health Professionals. Geriatrics (Basel) 2019; 4:geriatrics4010023. [PMID: 31023991 PMCID: PMC6473726 DOI: 10.3390/geriatrics4010023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 02/09/2019] [Accepted: 02/12/2019] [Indexed: 01/06/2023] Open
Abstract
(1) Background: It is important to assess physical and nutritional status using the Comprehensive Geriatric Assessment (CGA). However, the correlation between the CGA usage and nutritional-related assessments remain unclear. This study aims to clarify the correlation between the CGA usage and other nutritional-related assessments. (2) Methods: We conducted a questionnaire survey on clinical use of CGA, assessment of sarcopenia/sarcopenic dysphagia/cachexia, and defining nutritional goals/the Nutrition Care Process/the International Classification of Functioning, Disability, and Health (ICF)/the Kuchi–Kara Taberu Index. (3) Results: The number of respondents was 652 (response rate, 12.0%), including 77 who used the CGA in the general practice. The univariate analyses revealed that participants using the CGA tended to assess sarcopenia (P = 0.029), sarcopenic dysphagia (P = 0.001), and define nutritional goals (P < 0.001). Multivariate logistic regression analyses for the CGA usage revealed that using ICF (P < 0.001), assessing sarcopenia (P = 0.001), sarcopenic dysphagia (P = 0.022), and cachexia (P = 0.039), and defining nutritional goals (P = 0.001) were statistically significant after adjusting for confounders. (4) Conclusions: There are correlations between the use of CGA and evaluation of sarcopenia, sarcopenic dysphagia, and cachexia and nutritional goals.
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Sánchez-Rodríguez D, Marco E, Schott AM, Rolland Y, Blain H, Vázquez-Ibar O, Escalada F, Duran X, Muniesa JM, Annweiler C. Malnutrition according to ESPEN definition predicts long-term mortality in general older population: Findings from the EPIDOS study-Toulouse cohort. Clin Nutr 2018; 38:2652-2658. [PMID: 30551898 DOI: 10.1016/j.clnu.2018.11.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 10/23/2018] [Accepted: 11/26/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND The European Society of Clinical Nutrition and Metabolism (ESPEN) has developed a consensus definition of malnutrition. This study aimed to determine the prevalence of malnutrition according to the ESPEN definition in otherwise healthy community-dwelling older women and to explore its value for predicting long-term mortality in this population. METHODS This prospective population-based cohort study included 181 women (age ≥75 years) from a subsample of the EPIDémiologie de l'OStéoporose (EPIDOS) study participants from Toulouse. Inclusion criteria were the availability of the data on variables required to apply the ESPEN definition and survival after 7 years of follow-up. Primary outcome was mortality at 12-year follow-up; main covariates were malnutrition assessment according to the ESPEN consensus and its components (unintentional weight loss, BMI, and FFMI). Body composition was assessed by dual-energy X-ray absorptiometry at baseline and at 7-year follow-up. Kaplan-Meier survival curves and adjusted Cox regressions were performed. Analysis was adjusted for age, hypertension, diabetes mellitus, and coronary heart disease as potential confounders. RESULTS Complete data were available for 179 of the 181 women in the EPIDOS-Toulouse cohort (83.1 ± 2.2 years) and 13 (7.3%) fulfilled the ESPEN definition for malnutrition at 7-year follow-up. Malnutrition was associated with increased risk of mortality (adjusted HR = 4.4 [95%CI: 1.7-11.3]). Among the ESPEN components, only BMI was associated with increased mortality (adjusted HR=0.6 [95%CI: 0.4-0.9]). CONCLUSIONS Although malnutrition prevalence according to the ESPEN definition was relatively low (7.3%) in this sample of otherwise healthy community-dwelling older French women, malnutrition was associated with 4.4-fold higher mortality risk at 12-year follow-up.
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Affiliation(s)
- Dolores Sánchez-Rodríguez
- Geriatrics Department, Parc de Salut Mar (Centre Fòrum - Hospital del Mar), Barcelona, Spain; Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain; School of Medicine, Universitat Pompeu Fabra, Barcelona, Spain.
| | - Ester Marco
- Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain; Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar - Hospital de l'Esperança), Barcelona, Spain; Universitat Internacional de Catalunya, Barcelona, Spain
| | - Anne-Marie Schott
- Department IMER, Lyon University Hospital, EA 4129, RECIF, University of Lyon, Inserm, U831, Lyon, France.
| | - Yves Rolland
- Department of Geriatrics, Toulouse University Hospital, Gerontopole of Toulouse, INSERM U1027, University of Toulouse III, Toulouse, France.
| | - Hubert Blain
- Department of Internal Medicine and Geriatrics, Montpellier University Hospital, University of Montpellier 1, Montpellier, France
| | - Olga Vázquez-Ibar
- Geriatrics Department, Parc de Salut Mar (Centre Fòrum - Hospital del Mar), Barcelona, Spain; School of Medicine, Universitat Pompeu Fabra, Barcelona, Spain
| | - Ferran Escalada
- Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain; Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar - Hospital de l'Esperança), Barcelona, Spain
| | - Xavier Duran
- Methodology and Biostatistics Support Unit, Institut Hospital del Mar d'Investigacions Mèdiques, (IMIM), Barcelona, Spain
| | - Josep M Muniesa
- Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain; Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar - Hospital de l'Esperança), Barcelona, Spain
| | - Cédric Annweiler
- Department of Neurosciences and Aging, Division of Geriatric Medicine, Angers University Hospital, Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, University of Angers, UNAM, Angers, France; Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
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11
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Marco E, Sánchez-Rodríguez D, Dávalos-Yerovi VN, Duran X, Pascual EM, Muniesa JM, Rodríguez DA, Aguilera-Zubizarreta A, Escalada F, Duarte E. Malnutrition according to ESPEN consensus predicts hospitalizations and long-term mortality in rehabilitation patients with stable chronic obstructive pulmonary disease. Clin Nutr 2018; 38:2180-2186. [PMID: 30342931 DOI: 10.1016/j.clnu.2018.09.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 08/09/2018] [Accepted: 09/13/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Nutritional disorders are frequent in patients with chronic pulmonary obstructive disease (COPD) and have negative health impacts. This study aimed to explore the value of the European Society of Clinical Nutrition and Metabolism (ESPEN) definition of malnutrition (and/or its individual components) to predict hospitalizations and mortality at 2 years, and to determine the prevalence of malnutrition in COPD patients referred to pulmonary rehabilitation. METHODS The study was a prospective analysis of 118 patients with COPD free of exacerbations and/or hospital admissions in the previous two months. Main outcome variables were mortality, hospital admissions, and length of stay at 2-year follow-up; main covariates were malnutrition assessment according to the ESPEN definition and its components: unintentional weight loss, body mass index, and fat-free mass index (FFMI). Body composition was assessed by bioimpedance analysis. Kaplan-Meier survival curves and linear regression analyses were performed, adjusting for age and airflow obstruction as potential confounders. RESULTS The observed prevalence of malnutrition was 24.6%. Malnutrition was associated with increased mortality risk (HR = 3.9 [95% CI: 1.4-10.62]). FFMI was independently associated with increased mortality (HR = 17.0 [95% CI: 2.24-129.8]), which persisted after adjustment for age and lung function (adjusted HR = 13.0 [95% CI: 1.67-101.7]). Low age-related body mass index was associated with increased risk of hospital admissions. CONCLUSIONS Malnutrition according to ESPEN criteria, highly prevalent in patients with stable COPD referred to pulmonary rehabilitation, was associated with 4 times greater mortality risk after 2 years. Low FFMI was associated with a 17-fold increase in mortality risk, suggesting independent predictive value.
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Affiliation(s)
- Ester Marco
- Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar - Hospital de l'Esperança), Barcelona, Catalonia, Spain; Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Catalonia, Spain; School of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; School of Medicine, Universitat Internacional de Catalunya, Barcelona, Catalonia, Spain.
| | - Dolores Sánchez-Rodríguez
- Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Catalonia, Spain; School of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Geriatrics Department, Parc de Salut Mar (Centre Fòrum - Hospital del Mar), Barcelona, Catalonia, Spain; Department of Health Sciences (CEXS), Universitat Pompeu i Fabra, Barcelona, Catalonia, Spain
| | - Vanesa N Dávalos-Yerovi
- Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar - Hospital de l'Esperança), Barcelona, Catalonia, Spain
| | - Xavier Duran
- Methodology & Biostatistics Support Unit, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Catalonia, Spain
| | - Eva M Pascual
- Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar - Hospital de l'Esperança), Barcelona, Catalonia, Spain
| | - Josep M Muniesa
- Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar - Hospital de l'Esperança), Barcelona, Catalonia, Spain; Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Catalonia, Spain; School of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain
| | - Diego A Rodríguez
- School of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Department of Health Sciences (CEXS), Universitat Pompeu i Fabra, Barcelona, Catalonia, Spain; Respiratory Medicine Department, Parc Salut Mar (Hospital del Mar - Centre Fòrum del Hospital del Mar), Barcelona, Catalonia, Spain; Muscle and Respiratory System Research Unit (URMAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Catalonia, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Ana Aguilera-Zubizarreta
- Hospital Home-care Unit, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - Ferran Escalada
- Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar - Hospital de l'Esperança), Barcelona, Catalonia, Spain; Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Catalonia, Spain; School of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain
| | - Esther Duarte
- Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar - Hospital de l'Esperança), Barcelona, Catalonia, Spain; Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Catalonia, Spain; School of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain
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12
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Sánchez-Rodríguez D, Annweiler C, Ronquillo-Moreno N, Vázquez-Ibar O, Escalada F, Duran X, Muniesa JM, Marco E. Prognostic Value of the ESPEN Consensus and Guidelines for Malnutrition: Prediction of Post-Discharge Clinical Outcomes in Older Inpatients. Nutr Clin Pract 2018; 34:304-312. [DOI: 10.1002/ncp.10088] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 02/20/2018] [Indexed: 12/21/2022] Open
Affiliation(s)
- Dolores Sánchez-Rodríguez
- Geriatrics Department; Hospital del Mar Medical Research Institute (IMIM); Barcelona Spain
- Rehabilitation Research Group; Hospital del Mar Medical Research Institute (IMIM); Barcelona Spain
- School of Medicine; Autònoma University of Barcelona; Barcelona Spain
- School of Medicine; Pompeu Fabra University; Barcelona Spain
| | - Cédric Annweiler
- Department of Neurosciences and Aging; Division of Geriatric Medicine; Angers University Hospital; Angers University Memory Clinic; Research Center on Autonomy and Longevity; UPRES EA 4638; University of Angers; UNAM Angers France
- Robarts Research Institute; Schulich School of Medicine and Dentistry; University of Western Ontario; London Ontario Canada
| | | | - Olga Vázquez-Ibar
- Geriatrics Department; Hospital del Mar Medical Research Institute (IMIM); Barcelona Spain
- School of Medicine; Pompeu Fabra University; Barcelona Spain
| | - Ferran Escalada
- Rehabilitation Research Group; Hospital del Mar Medical Research Institute (IMIM); Barcelona Spain
- School of Medicine; Autònoma University of Barcelona; Barcelona Spain
- Physical Medicine and Rehabilitation Department; Hospital del Mar Medical Research Institute (IMIM); Barcelona Spain
| | - Xavier Duran
- Methodology and Biostatistics Support Unit; Hospital del Mar Medical Research Institute (IMIM); Barcelona Spain
| | - Josep M. Muniesa
- Rehabilitation Research Group; Hospital del Mar Medical Research Institute (IMIM); Barcelona Spain
- School of Medicine; Autònoma University of Barcelona; Barcelona Spain
- Physical Medicine and Rehabilitation Department; Hospital del Mar Medical Research Institute (IMIM); Barcelona Spain
| | - Ester Marco
- Rehabilitation Research Group; Hospital del Mar Medical Research Institute (IMIM); Barcelona Spain
- School of Medicine; Autònoma University of Barcelona; Barcelona Spain
- Physical Medicine and Rehabilitation Department; Hospital del Mar Medical Research Institute (IMIM); Barcelona Spain
- International University of Catalunya; Barcelona Spain
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Koyama T, Shamoto H, Anzai H, Koganei Y, Maeda K, Wakabayashi H. Multidisciplinary Comprehensive Care for Early Recommencement of Oral Intake in Older Adults With Severe Pneumonia. J Gerontol Nurs 2018; 42:21-9. [PMID: 27668440 DOI: 10.3928/00989134-20160913-05] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 07/17/2016] [Indexed: 11/20/2022]
Abstract
HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Multidisciplinary Comprehensive Care for Early Recommencement of Oral Intake in Older Adults With Severe Pneumonia" found on pages 21-29, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until September 30, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Describe the effect of multidisciplinary comprehensive care (MDCC) on oral intake in older adults with severe pneumonia at the time of discharge. 2. Explore the impact of MDCC on the length of stay for hospitalized older adults with severe pneumonia. DISCLOSURE STATEMENT Neither the planners nor the authors have any conflicts of interest to disclose. The current study was designed to assess the effect of multidisciplinary comprehensive care (MDCC) on (a) oral intake at discharge and (b) hospital stay duration in older adult patients with severe pneumonia. Participants were divided into two groups: receiving and not receiving MDCC. MDCC comprises regular assessment of swallowing ability, aspiration risk management, improvement of oral hygiene, serving of nutritious texture-modified foods, and encouragement of early mobilization. The MDCC group (164 women, 206 men; mean age = 82.7, SD = 8.4 years) had severe pneumonia as well as high proportions of poor premorbid physical function and consciousness disturbance compared to the non-MDCC group (45 women, 56 men; mean age = 81.1, SD = 8.6 years). Nevertheless, MDCC was an independent determinant of hospital stay duration and oral intake (Functional Oral Intake Scale score ≥4) at discharge with Cox regression analysis (hazard ratio = 1.42, 95% confidence interval [1.09, 1.85]). MDCC may promote early oral intake and hospital discharge in older adults with severe pneumonia. [Journal of Gerontological Nursing, 42(10), 21-29.].
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Abd Aziz NAS, Teng NIMF, Abdul Hamid MR, Ismail NH. Assessing the nutritional status of hospitalized elderly. Clin Interv Aging 2017; 12:1615-1625. [PMID: 29042762 PMCID: PMC5634387 DOI: 10.2147/cia.s140859] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose The increasing number of elderly people worldwide throughout the years is concerning due to the health problems often faced by this population. This review aims to summarize the nutritional status among hospitalized elderly and the role of the nutritional assessment tools in this issue. Methods A literature search was performed on six databases using the terms “malnutrition”, “hospitalised elderly”, “nutritional assessment”, “Mini Nutritional Assessment (MNA)”, “Geriatric Nutrition Risk Index (GNRI)”, and “Subjective Global Assessment (SGA)”. Results According to the previous studies, the prevalence of malnutrition among hospitalized elderly shows an increasing trend not only locally but also across the world. Under-recognition of malnutrition causes the number of malnourished hospitalized elderly to remain high throughout the years. Thus, the development of nutritional screening and assessment tools has been widely studied, and these tools are readily available nowadays. SGA, MNA, and GNRI are the nutritional assessment tools developed specifically for the elderly and are well validated in most countries. However, to date, there is no single tool that can be considered as the universal gold standard for the diagnosis of nutritional status in hospitalized patients. Conclusion It is important to identify which nutritional assessment tool is suitable to be used in this group to ensure that a structured assessment and documentation of nutritional status can be established. An early and accurate identification of the appropriate treatment of malnutrition can be done as soon as possible, and thus, the malnutrition rate among this group can be minimized in the future.
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Affiliation(s)
- Nur Adilah Shuhada Abd Aziz
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Malaysia
| | - Nur Islami Mohd Fahmi Teng
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Malaysia
| | - Mohd Ramadan Abdul Hamid
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Malaysia
| | - Nazrul Hadi Ismail
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Malaysia
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