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Saijo T, Mori D, Okamoto T, Matsumoto K, Sate H, Fujino K, Takeuchi H, Sakai S, Ando R, Momoki C, Habu D, Ryomoto K. Malnutrition defined by global leadership initiative on malnutrition criteria impedes home discharge in acute care hospital admissions. Clin Nutr 2024; 43:112-119. [PMID: 39361983 DOI: 10.1016/j.clnu.2024.09.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2024] [Revised: 09/13/2024] [Accepted: 09/24/2024] [Indexed: 10/05/2024]
Abstract
BACKGROUND & AIMS Limited evidence exists on the association between malnutrition diagnosis using the Global Leadership Initiative on Malnutrition (GLIM) criteria in hospitalized acute care patients and their outcomes; several aspects still require clarification. This study aimed to evaluate the relationship between malnutrition, as defined by the GLIM criteria, at the time of acute hospital admission and discharge to home. METHODS This retrospective observational study was conducted at a hospital that provides acute care in Japan. Adult patients admitted between July 2023 and April 2024 were included in this study. The primary outcome was the number of patients discharged to home, with in-hospital mortality as the secondary outcome. To ensure the reliability of the cohort-wide results, background factors were adjusted using propensity score matching. The two groups were compared based on the presence or absence of malnutrition, as defined by the GLIM criteria at admission. Furthermore, multiple logistic regression analysis was conducted, with the outcome as the dependent variable and malnutrition, diagnosed using the GLIM criteria, as the explanatory variable, adjusting for covariates. RESULTS A total of 1007 patients were included in the final analysis, of whom 492 (49 %) were diagnosed without malnutrition, while 515 (51 %) were diagnosed with malnutrition according to the GLIM criteria. In the multivariate logistic regression analysis after matching, malnutrition defined by the GLIM criteria emerged as an independent factor associated with discharge to home (odds ratio [OR] = 0.37, 95 % confidence interval = 0.25-0.56, P < 0.001) when adjusting for age, sex, and various comorbidities. Among the GLIM sub-criteria, reduced muscle mass, reduced food intake or assimilation, and disease burden or inflammation were independently associated with discharge to home. Notably, disease burden/inflammation exhibited the lowest OR among the GLIM sub-criteria for discharge. CONCLUSION Malnutrition diagnosed using the GLIM criteria upon admission in patients admitted to a regional hospital providing acute care was associated with decreased rates of discharge to home and increased in-hospital mortality. Specifically, attention should be paid to the criteria for reduced muscle mass and disease burden or inflammation within the GLIM framework.
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Affiliation(s)
- Takeshi Saijo
- Department of Nutrition Management, Osaka Rosai Hospital, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka 591-8025, Japan.
| | - Daisuke Mori
- Department of Nephrology, Osaka Rosai Hospital, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka 591-8025, Japan.
| | - Tomomi Okamoto
- Department of Nutrition Management, Osaka Rosai Hospital, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Kiyomi Matsumoto
- Department of Nutrition Management, Osaka Rosai Hospital, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Hiromi Sate
- Department of Nutrition Management, Osaka Rosai Hospital, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Kohei Fujino
- Department of Nutrition Management, Osaka Rosai Hospital, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Hiroki Takeuchi
- Department of Nutrition Management, Osaka Rosai Hospital, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Shiho Sakai
- Department of Nutrition Management, Osaka Rosai Hospital, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Ryo Ando
- Department of Nutrition Management, Osaka Rosai Hospital, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Chika Momoki
- Department of Food Science and Human Nutrition, Faculty of Agriculture, Setsunan University, 45-1, Nagaotoge-cho, Hirakata, Osaka 573-0101, Japan.
| | - Daiki Habu
- Department of Nutritional Medicine, Graduate School of Human Life and Ecology, Osaka Metropolitan University, 3-3-138, Sugimoto, Sumiyoshi-ku, Osaka, Osaka 558-8585, Japan.
| | - Kayoko Ryomoto
- Department of Nutrition Management, Osaka Rosai Hospital, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka 591-8025, Japan; Department of Diabetes, Osaka Rosai Hospital, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka 591-8025, Japan.
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Kokura Y. Association between quadriceps muscle thickness or echo intensity, malnutrition, and activities of daily living in an integrated medical and long-term care facility: A cross-sectional study. Clin Nutr ESPEN 2024; 63:929-935. [PMID: 39159830 DOI: 10.1016/j.clnesp.2024.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 07/15/2024] [Accepted: 08/12/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND &AIMS Malnutrition and physical function impairment are prevalent concerns in long-term care facilities. This study investigated the relationship between quadriceps muscle thickness (QMT) or echo intensity (QEI), nutritional status, and activities of daily living (ADL) in residents of an Integrated Facility for Medical and Long-term Care (IFMLC) in Japan. METHODS Using a cross-sectional design, 126 residents (86 women, median age 89 years) at an IFMLC were assessed. Malnutrition was diagnosed using the Global Leadership Initiative on Malnutrition (GLIM) criteria including disease burden/inflammation, while ADL status was evaluated using the Barthel Index (BI). QMT and QEI, indicative of muscle mass and intramuscular adipose tissue, were measured by ultrasound. Multivariate logistic and linear regression analyses were conducted to explore the association of QMT or QEI with malnutrition and ADL. RESULTS 62 residents (49%) were in the lower QMT group and 63 residents (50%) were in the upper QEI group. The prevalence of severe malnutrition in the lower QMT group was significantly higher than that in the upper QMT group. Moreover, the lower QMT group had significantly lower BI points than the upper QMT group. The upper QEI group had significantly lower BI points than the lower QEI group. lower QMT was associated with severe malnutrition (odds ratio 3.170; 95% CI 1.238 to 8.725; P = 0.016). Furthermore, both lower QMT (B = -12.520; 95% CI -17.069 to -7.973; P < 0.001) and upper QEI (B = -7.598; 95% CI -12.565 to -2.631; P = 0.003) showed an independent correlation with lower BI scores. CONCLUSION This study found a relationship between lower QMT correlated with severe malnutrition and poor ADL, while higher QEI is associated with poor ADL.
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Affiliation(s)
- Yoji Kokura
- Department of Nutritional Management, Keiju Hatogaoka Integrated Facility for Medical and Long-term Care, Anamizu, Japan.
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Verstraeten LMG, Kreeftmeijer J, van Wijngaarden JP, Meskers CGM, Maier AB. Geriatric Syndromes Frequently (Co)-Occur in Geriatric Rehabilitation Inpatients: Restoring Health of Acutely Unwell Adults (RESORT) and Enhancing Muscle Power in Geriatric Rehabilitation (EMPOWER-GR). Arch Phys Med Rehabil 2024; 105:1854-1861. [PMID: 38851557 DOI: 10.1016/j.apmr.2024.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 05/14/2024] [Accepted: 05/14/2024] [Indexed: 06/10/2024]
Abstract
OBJECTIVE To determine the prevalence and co-occurrence of common geriatric syndromes in geriatric rehabilitation inpatients. DESIGN Restoring Health of Acutely Unwell Adults (RESORT) and Enhancing Muscle Power in Geriatric Rehabilitation (EMPOWER-GR) are observational, longitudinal cohorts. SETTING Geriatric rehabilitation. PARTICIPANTS Geriatric rehabilitation inpatients (N=1890 and N=200). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Geriatric syndromes included polypharmacy, multimorbidity (Cumulative Illness Rating Scale), cognitive impairment, depression (Hospital Anxiety and Depression Scale/Geriatric Depression Scale), malnutrition (Global Leadership Initiative on Malnutrition), functional limitation (Katz index), falls, physical frailty (Fried), and sarcopenia (European Working Group on Sarcopenia in Older People 2). RESULTS Inpatients in RESORT (R) (N=1890, 56% females) had a median age of 83.4 years (interquartile range [IQR], 77.6-88.4) and in EMPOWER-GR (E) (N=200, 57% females) of 79.8 years (IQR, 75.0-85.9). Polypharmacy (R, 82.2%; E, 84.0%), multimorbidity (R, 90.4%; E, 85.5%), functional limitation (R, 96.0%; E, 76.5%), and frailty (R, 91.8%; E, 92.2%) were most prevalent. Most inpatients had ≥5 geriatric syndromes at admission in both cohorts (R, 70.0%; E, 72.4%); few inpatients had only 1 (R, 0.4%; E, 1.5%) or no geriatric syndrome (R, 0.2%; E, 0.0%). Geriatric syndromes did not occur in isolation (without other syndromes), except for multimorbidity (R, 1%; E, 5%), functional limitation (R, 3%; E, 2%), falls (R, 0%; E, 4%), and frailty (R, 2%; E, 5%), which occurred in isolation in some inpatients; sarcopenia did not. CONCLUSIONS Geriatric syndromes are highly prevalent at admission to geriatric rehabilitation, with a median of 5 co-occurring syndromes. Implications for diagnosis and intervention potential should be further addressed.
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Affiliation(s)
- Laure M G Verstraeten
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Jos Kreeftmeijer
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | | | - Carel G M Meskers
- Department of Rehabilitation Medicine, Amsterdam University Medical Centre, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Andrea B Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands; Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia; Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore.
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Keller K, Schmitt VH, Brochhausen C, Hahad O, Engelhardt M, Espinola-Klein C, Münzel T, Lurz P, Konstantinides S, Hobohm L. Sarcopenia influences usage of reperfusion treatment in patients with pulmonary embolism aged 75 years and older. IJC HEART & VASCULATURE 2024; 53:101470. [PMID: 39132305 PMCID: PMC11314863 DOI: 10.1016/j.ijcha.2024.101470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 08/13/2024]
Abstract
Background Although pulmonary embolism (PE) and sarcopenia are common diseases, only a few studies have assessed the impact of sarcopenia in PE on usage of reperfusion treatments in PE. Methods All hospitalizations of PE patients aged ≥75 years 2005-2020 in Germany were included in this study and stratified for sarcopenia. Impact of sarcopenia on treatment procedures and adverse in-hospital events were investigated. Results Overall, 576,364 hospitalizations of PE patients aged ≥75 years (median age 81.0 [78.0-85.0] years; 63.3 % females) were diagnosed in Germany during the observational period 2005-2020. Among these, 2357 (0.4 %) were coded with sarcopenia. PE patients with sarcopenia were in median 2 years older (83.0 [79.0-87.0] vs. 81.0 [78.0-85.0] years, P<0.001) and showed an aggravated comorbidity-profile (Charlson Comorbidity Index 7.00 [5.00-9.00] vs. 6.00 [4.00-7.00], P<0.001). Although signs of hemodynamic compromise such as shock (5.2 % vs. 4.1 %, P=0.005) and tachycardia (4.1 % vs. 2.8 %, P<0.001) were more prevalent in sarcopenic PE patients, systemic thrombolysis (1.9 % vs. 3.5 %, P<0.001) was less often used in these patients. Sarcopenia was independently related to an underuse of systemic thrombolysis (OR 0.537 [95 %CI 0.398-0.725], P<0.001). This underuse might driven by higher rates of bleeding events (gastro-intestinal bleeding: 3.1 % vs. 1.9 %, P<0.001, necessity of transfusion of blood constituents: 18.9 % vs. 11.3 %, P<0.001), but also stroke (5.6 % vs. 3.3 %, P<0.001). Conclusions Sarcopenia represents a widely overlooked condition in PE patients. Although sarcopenic PE patients were more often afflicted by hemodynamic compromise, systemic thrombolysis was less often administered. This underuse might be caused by contraindications like bleeding events and stroke.
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Affiliation(s)
- Karsten Keller
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Medical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Volker H. Schmitt
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Christoph Brochhausen
- Institute of Pathology, University Medical Center Mannheim, Heidelberg University, Germany
| | - Omar Hahad
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Martin Engelhardt
- Department for Orthopedics, Trauma surgery and Hand surgery, Klinikum Osnabrück, Osnabrück, Germany
- Institute for Applied Training Science Leipzig, Germany
| | - Christine Espinola-Klein
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Philipp Lurz
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Stavros Konstantinides
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Department of Cardiology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Lukas Hobohm
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Miura K, Matsushita T, Nishioka S, Nakashima R, Onizuka S. Association between sarcopenia at discharge and functional outcomes 1 month and 6 months after discharge in patients in convalescent rehabilitation wards. Geriatr Gerontol Int 2024; 24:715-721. [PMID: 38860531 DOI: 10.1111/ggi.14921] [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: 01/12/2024] [Revised: 05/15/2024] [Accepted: 05/24/2024] [Indexed: 06/12/2024]
Abstract
AIM This retrospective cohort study investigated the relationship between sarcopenia and Activities of Daily Living capacity after discharge from convalescent rehabilitation wards. METHODS We included consecutive patients discharged from three convalescent rehabilitation wards in a hospital in Japan between December 2018 and October 2020. Sarcopenia was diagnosed based on the criteria of the 2019 Asian Working Group for Sarcopenia, utilizing skeletal muscle mass index and handgrip strength. Statistical analyses were carried out separately for men and women. The primary outcome was a higher motor domain (motor Functional Independence Measure [mFIM]) and a higher cognitive domain (cognitive Functional Independence Measure [cFIM]) of the FIM score 1 month after discharge. The secondary outcomes were higher mFIM and cFIM scores 6 months after discharge, analyzed using binary logistic regression. RESULTS Among 305 participants (mean age 70.0 years, 148 men), 93 were identified as having sarcopenia. The prevalence of sarcopenia was 16% for outpatient rehabilitation services, 59% for home-visit rehabilitation services and 50% for older adult day care. Logistic regression analyses showed that sarcopenia at discharge was not an independent variable for mFIM at 1 month (odds ratio [OR] 20, 95% confidence interval [CI] 0.31-1300 for men, OR 0.51, 95% CI 0.11-2.4 for women) and cFIM (OR 0.63, 95% CI 0.10-3.8 for men, OR 5.3, 95% CI 0.81-34 for women). At 6 months, sarcopenia at discharge was not an independent variable for mFIM (OR 0.30, 95% CI 0.02-3.6 for men, OR 0.40, 95% CI 0.06-2.5 for women) and cFIM (OR 0.16, 95% CI 0.01-2.4 for men, OR 0.00, 95% CI 0.00-1.1 for women). CONCLUSIONS Sarcopenia at the time of discharge from convalescent rehabilitation wards does not independently predict FIM 1 month or 6 months after discharge. Geriatr Gerontol Int 2024; 24: 715-721.
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Affiliation(s)
- Kyohei Miura
- Department of Clinical Service, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Tatsuya Matsushita
- Department of Clinical Service, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Shinta Nishioka
- Department of Clinical Nutrition and Food Services, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Ryusei Nakashima
- Department of Clinical Service, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Shinya Onizuka
- Department of Rehabilitation Medicine, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
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Nishioka S, Kokura Y, Momosaki R, Taketani Y. Measures for Identifying Malnutrition in Geriatric Rehabilitation: A Scoping Review. Nutrients 2024; 16:223. [PMID: 38257116 PMCID: PMC10820477 DOI: 10.3390/nu16020223] [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: 12/18/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Malnutrition is a common condition in geriatric rehabilitation settings; however, the accuracy and predictive validity of the measures to identify malnutrition have not been established. The current scoping review followed the Joanna Briggs Institute's evidence synthesis manual and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews checklist. Literature published through September 2023 was searched using MEDLINE and CINAHL. The inclusion criteria selected studies reporting malnutrition measures, which include static body weight and weight loss. Identified tools were classified as nutritional screening tools, nutritional assessment tools, or diagnostic criteria. The domains of each tool/criterion and their accuracy and predictive validity were extracted. Fifty-six articles fulfilled the inclusion criteria, and six nutritional screening tools, three nutritional assessment tools, and three diagnostic criteria for malnutrition were identified. These measures consisted of various phenotypes, e.g., weight loss, causes such as inflammation/disease, and risk factors of malnutrition, e.g., functional impairment. The predictive validity of nutritional screening tools (n = 6) and malnutrition diagnostic criteria (n = 5) were inconsistently reported, whereas those for nutritional assessment tools were scarce (n = 1). These findings highlight the need to distinguish the functional impairment of nutritional origin from that of non-nutritional origin in nutritional assessment procedures, and the need to study the accuracy and the predictive validity of these measures in geriatric rehabilitation patients.
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Affiliation(s)
- Shinta Nishioka
- Department of Clinical Nutrition and Food Service, Nagasaki Rehabilitation Hospital, 4-11, Gin-yamachi, Nagasaki 850-0854, Japan
- Department of Clinical Nutrition and Food Management, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15, Kuramoto-cho, Tokushima 770-8503, Japan;
| | - Yoji Kokura
- Department of Nutrition Management, Keiju Hatogaoka Integrated Facility for Medical and Long-Term Care, 15-39-8, Mugigaura, Anamizu, Hosu-gun 927-0023, Japan;
| | - Ryo Momosaki
- Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu 514-8507, Mie, Japan;
| | - Yutaka Taketani
- Department of Clinical Nutrition and Food Management, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15, Kuramoto-cho, Tokushima 770-8503, Japan;
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Moynihan P, Teo JL. Exploring Oral Function, Protein Intake, and Risk of Sarcopenia: A Scoping Review. JDR Clin Trans Res 2024; 9:4-20. [PMID: 36883673 PMCID: PMC10725128 DOI: 10.1177/23800844231157259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
INTRODUCTION Sarcopenia is loss of both muscle mass and function with age and is associated with inadequate protein intake. However, evidence to suggest an association with oral health is less clear. OBJECTIVE To scope peer-reviewed published evidence (2000-2022) pertaining to oral function in relation to sarcopenia and/or protein intake in older people. METHODS CINAHL, Embase, PubMed, and Scopus were searched. Included were peer-reviewed studies measuring oral function (e.g., tooth loss, salivary flow masticatory function, strength of muscles of mastication, and tongue pressure) and a measure of protein intake and/or a measure of sarcopenia (appendicular muscle mass and function). Full article screening was conducted by 1 reviewer with a random 10% screened in duplicate by a second reviewer. Relevant content pertaining to study type, country of origin, measures of exposure, and outcomes and key findings was mapped and the balance of data showing a positive versus null association of oral health with outcomes charted. RESULTS Of 376 studies identified, 126 were screened in full, yielding 32 included texts, of which 29 were original articles. Seven reported intake of protein and 22 reported measures of sarcopenia. Nine distinct oral health exposures were identified, with ≤4 studies relating to any one of these measures. Most data were cross-sectional in nature (27 studies) and from Japan (20 studies). The balance of data showed associations between tooth loss and measures of sarcopenia and protein intake. However, the balance of data pertaining to any association between chewing function, tongue pressure, or indices of oral hypofunction and sarcopenia was mixed. CONCLUSION A broad range of oral health measures have been studied in relation to sarcopenia. The balance of data suggests that tooth loss is associated with risk, but data pertaining to the oral musculature and indices of oral hypofunction are mixed. KNOWLEDGE TRANSFER STATEMENT The findings of this research will increase awareness among clinicians of the amount and nature of evidence pertaining to the relationship between oral health and risk of compromised muscle mass and function, including data showing that loss of teeth is associated with increased risk of sarcopenia in older people. The findings highlight to researchers the gaps in the evidence and where further research and clarification of the relationship between oral health and risk of sarcopenia is warranted.
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Affiliation(s)
- P.J. Moynihan
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - J-L. Teo
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
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Bando N, Nakayama N, Kashiwa K, Horike R, Fujimoto A, Egawa M, Adachi M, Saji H, Kira B, Nakayama K, Okayama A, Katayama S. Co-existence of malnutrition and sarcopenia and its related factors in a long-term nursing care facility: A cross-sectional study. Heliyon 2023; 9:e22245. [PMID: 38045137 PMCID: PMC10692913 DOI: 10.1016/j.heliyon.2023.e22245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 12/05/2023] Open
Abstract
Objectives Malnutrition and sarcopenia often co-exist in older patients. This condition, called co-MS, shows a worse prognosis than either condition alone but is often overlooked and undertreated. We aimed to clarify the prevalence of co-MS and its associated factors with a focus on prescription in a long-term nursing care facility in Japan. Methods Patients aged >65 years who resided in a long-term nursing care facility in Hyogo, Japan, were recruited for this cross-sectional study, which was conducted from July 1 to July 30, 2022. Sarcopenia and malnutrition were diagnosed using the Asian Working Group for Sarcopenia and Global Leadership Initiative on Malnutrition criteria, respectively. Patients who met both criteria were classified as having co-MS. Potentially associated factors, including age, sex, length of stay, activities of daily living, comorbidity, oral function and hygiene, swallowing ability, and the number and type of prescriptions, were assessed. Results The prevalence of sarcopenia was 92 % (72/78). All malnourished patients were sarcopenic (40.3 %) and were classified as having co-MS. Oral function and hygiene, swallowing ability, comorbidity, and the presence of potentially inappropriate medications showed significant associations in univariate analyses. Of particular note, potentially inappropriate medication was an independent factor in the multivariate analysis. Conclusions Co-MS is prevalent in long-term nursing care facilities; thus, healthcare workers should pay attention to relevant factors to identify patients at risk of co-MS and to provide appropriate care and intervention.
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Affiliation(s)
- Noriko Bando
- Hyogo Medical University, School of Medicine, Sasayama Medical Center, Department of General Medicine and Community Health Science, Tanbasasayama 669-2321, Japan
- Hyogo Medical University, School of Medicine, Sasayama Medical Center, Department of Clinical Nutrition, Tanbasasayama 669-2321, Japan
| | - Naomi Nakayama
- Hyogo Medical University, School of Medicine, Sasayama Medical Center, Department of General Medicine and Community Health Science, Tanbasasayama 669-2321, Japan
| | - Kaori Kashiwa
- Hyogo Medical University, School of Medicine, Center for Medical Education, Nishinomiya 663-8501, Japan
| | - Rena Horike
- Hyogo Medical University, School of Medicine, Sasayama Medical Center, Nursing Care Service Division, Tanbasasayama 669-2321, Japan
| | - Asaka Fujimoto
- Hyogo Medical University, School of Medicine, Sasayama Medical Center, Nursing Care Service Division, Tanbasasayama 669-2321, Japan
| | - Mitsuharu Egawa
- Hyogo Medical University, School of Medicine, Sasayama Medical Center, Nursing Care Service Division, Tanbasasayama 669-2321, Japan
| | - Munehiro Adachi
- Hyogo Medical University, School of Medicine, Sasayama Medical Center, Nursing Care Service Division, Tanbasasayama 669-2321, Japan
| | - Hisae Saji
- Hyogo Medical University, School of Medicine, Sasayama Medical Center, Department of Rehabilitation, Tanbasasayama 669-2321, Japan
| | - Beni Kira
- Hyogo Medical University, School of Medicine, Sasayama Medical Center, Department of General Medicine and Community Health Science, Tanbasasayama 669-2321, Japan
- Hyogo Medical University, School of Medicine, Sasayama Medical Center, Department of Clinical Nutrition, Tanbasasayama 669-2321, Japan
| | - Kentaro Nakayama
- Nagoya City University, School of Medicine, Department of Obstetrics and Gynecology 467-8602, Nagoya, Japan
| | - Akira Okayama
- Japan Community Health Care Organization Kobe Central Hospital, Department of Orthopedics, Kobe, Japan
| | - Satoru Katayama
- Hyogo Medical University, School of Medicine, Sasayama Medical Center, Department of General Medicine and Community Health Science, Tanbasasayama 669-2321, Japan
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Wang H, Wang S, Li C, Yang W, Guo G, Hui Y, Wang X, Cui B, Fan X, Jiao H, Sun C. Coexistent GLIM-Defined Malnutrition and Sarcopenia Increase the Long-Term Mortality Risk in Hospitalized Patients with Decompensated Cirrhosis. ANNALS OF NUTRITION & METABOLISM 2023; 79:423-433. [PMID: 37725950 DOI: 10.1159/000534152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 09/07/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION The synergistic impact of coexistent malnutrition and sarcopenia on morality in hospitalized patients with decompensated cirrhosis remains elusive. This prospective cohort study aimed to delineate the prevalence concerning coexistence of malnutrition and sarcopenia and the prognosticating role on long-term mortality among cirrhosis. METHODS Adult cirrhotic patients with decompensated episodes between 2019 and 2021 were consecutively enrolled. Malnutrition and sarcopenia were diagnosed according to the Global Leadership Initiative on Malnutrition (GLIM) criteria and the European Working Group on Sarcopenia in Older People (EWGSOP2) algorithm, respectively. The entire cohort was divided into three groups: non-malnutrition and non-sarcopenia (NN), malnutrition or sarcopenia, and coexistent malnutrition and sarcopenia (MS). Log-rank test and multivariate Cox regression model were utilized to evaluate survival status and independent risk factors for mortality, respectively. RESULTS Our findings indicated that malnutrition manifested in 44.6% of inpatients with decompensated cirrhosis, while sarcopenia presented in 16.4% of the entire cohort, indicative of a prevalence of 14.7% regarding coexistent malnutrition and sarcopenia. The Kaplan-Meier graphic demonstrated a significant difference regarding survival curves among the three groups, referring to the MS group presented with the lowest survival rate (log-rank test: p < 0.001). Moreover, coexistent malnutrition and sarcopenia were associated with nearly 4 times higher mortality risk (model 1: hazard ratio [HR] = 3.31, 95% confidence interval [CI]: 1.20-9.13, p = 0.020; model 2: HR = 4.34, 95% CI: 1.52-12.4, p = 0.006) in comparison with patients without any condition (NN group). CONCLUSIONS Malnutrition and sarcopenia had superimposed negative impacts on inpatients with decompensated cirrhosis. It is imperative to identify this vulnerable subset to provide prompt therapeutic intervention for better prognosis.
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Affiliation(s)
- Han Wang
- Department of Health Management, Tianjin Hospital, Tianjin, China
| | - Sipu Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Chaoqun Li
- Department of Internal Medicine, Tianjin Hexi Hospital, Tianjin, China
| | - Wanting Yang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Gaoyue Guo
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yangyang Hui
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiaoyu Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Binxin Cui
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, Tianjin, China
| | - Xiaofei Fan
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Huanli Jiao
- Department of Health Management, Tianjin Hospital, Tianjin, China
| | - Chao Sun
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, Tianjin, China
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10
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Stanciu LE, Iliescu MG, Oprea C, Ionescu EV, Petcu A, Ciortea VM, Petcu LC, Apostol S, Nedelcu AD, Motoașcă I, Irsay L. The Impact of Complex Rehabilitation Treatment on Sarcopenia-Pathology with an Endocrine Morphological Substrate and Musculoskeletal Implications. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1238. [PMID: 37512050 PMCID: PMC10383638 DOI: 10.3390/medicina59071238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/17/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023]
Abstract
The pathogenesis of sarcopenia is multifactorial, including changes in the endocrine system. Easy-to-perform screening tests can guide the diagnosis of sarcopenia and the rehabilitation therapeutic conduct, which can act on many physiopathological links. This study was conducted over a period of 5 months, from April to August 2022, and included 84 patients hospitalized for a period of 10 days in the Balneal and Rehabilitation Sanatorium Techirghiol for complex physiotherapy, which included balneotherapy. In dynamics, both at admission and discharge, specific screening tests for sarcopenia (SARC-F questionnaire, grip strength, testing muscle strength at the level of the quadriceps, sit-to-stand tests (the time required for five consecutive rises and the number of rises performed in 30 s)) and the Visual Analogue Scale (VAS) for pain were performed. The study was conducted according to the norms of deontology and medical ethics. Results: A significant proportion of patients had a positive result in at least one of the tests for the screening of sarcopenia syndrome. The most eloquent results were obtained from the statistical analysis of the following parameters evaluated at admission: the SARC-F questionnaire and the sit-to-stand test-the number of rises in 30 s. In terms of dynamics, after performing the complex rehabilitation treatment, the patients recorded improvements in the established screening tests and improvements in pain symptoms evaluated with the help of the VAS. Conclusions: Sarcopenia, a pathology developed with aging, is frequently encountered among adults. In the future, it is important to perform screening for sarcopenia in both endocrinology and medical rehabilitation clinics. Good management of sarcopenia can influence therapeutic conduct and can prevent complications, improving the functional capacity and the quality of life of the patients.
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Affiliation(s)
- Liliana-Elena Stanciu
- Balneal and Rehabilitation Sanatorium of Techirghiol, 34-40 Dr. Victor Climescu Street, 906100 Techirghiol, Romania
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, "Ovidius" University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Mădălina-Gabriela Iliescu
- Balneal and Rehabilitation Sanatorium of Techirghiol, 34-40 Dr. Victor Climescu Street, 906100 Techirghiol, Romania
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, "Ovidius" University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Carmen Oprea
- Balneal and Rehabilitation Sanatorium of Techirghiol, 34-40 Dr. Victor Climescu Street, 906100 Techirghiol, Romania
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, "Ovidius" University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Elena-Valentina Ionescu
- Balneal and Rehabilitation Sanatorium of Techirghiol, 34-40 Dr. Victor Climescu Street, 906100 Techirghiol, Romania
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, "Ovidius" University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Adina Petcu
- Faculty of Pharmacy, "Ovidius" University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Viorela Mihaela Ciortea
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Lucian Cristian Petcu
- Faculty of Dental Medicine, "Ovidius" University of Constanta, 7 Ilarie Voronca Street, 900178 Constanta, Romania
| | - Sterian Apostol
- Balneal and Rehabilitation Sanatorium of Techirghiol, 34-40 Dr. Victor Climescu Street, 906100 Techirghiol, Romania
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, "Ovidius" University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Andreea-Dalila Nedelcu
- Balneal and Rehabilitation Sanatorium of Techirghiol, 34-40 Dr. Victor Climescu Street, 906100 Techirghiol, Romania
| | - Irina Motoașcă
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Laszlo Irsay
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
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11
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Everink IHJ, Grund S, Benzinger P, de Vries A, Gordon AL, van Wijngaarden JP, Bauer JM, Schols JMGA. Nutritional Care Practices in Geriatric Rehabilitation Facilities across Europe: A Cross-Sectional Study. J Clin Med 2023; 12:jcm12082918. [PMID: 37109255 PMCID: PMC10142565 DOI: 10.3390/jcm12082918] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/06/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
Many patients in geriatric rehabilitation (GR) are physically frail at the time of admission and suffer from malnutrition and sarcopenia, which may worsen rehabilitation outcomes. This study aims to obtain insight into the current nutritional care practices in GR facilities across Europe. METHODS In this cross-sectional study, a questionnaire focused on nutritional care practices in GR was distributed across experts in EUGMS member countries. Data were analyzed by using descriptive statistics. RESULTS In total, 109 respondents working in 25 European countries participated, and the results showed that not all GR patients were screened and treated for malnutrition, and not all participants used (inter)national guidelines when performing nutritional care. The results also showed variations across European geographical areas related to screening and treatment of malnutrition, sarcopenia, and frailty. Even though the participants underlined the importance of dedicating time to nutritional care, they experienced barriers in its implementation, which were mostly due to a lack of resources. CONCLUSION As malnutrition, sarcopenia, and frailty are often present in patients admitted to GR, in addition to being interrelated, it is recommended to develop an integrated approach to screening and treatment of all three clinical problems.
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Affiliation(s)
- Irma H J Everink
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Stefan Grund
- Center for Geriatric Medicine, Agaplesion Bethanien Hospital Heidelberg, Geriatric Center at the Heidelberg University, 69126 Heidelberg, Germany
| | - Petra Benzinger
- Center for Geriatric Medicine, Agaplesion Bethanien Hospital Heidelberg, Geriatric Center at the Heidelberg University, 69126 Heidelberg, Germany
- Institute for Health and Generations, University of Applied Sciences Kempten, 87435 Kempten, Germany
| | - Anne de Vries
- Danone Trading Medical B.V., 2132 LS Hoofddorp, The Netherlands
| | - Adam L Gordon
- Academic Unit of Injury, Recovery and Inflammation Sciences (IRIS), School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
- NIHR Applied Research Collaboration-East Midlands (ARC-EM), Nottingham DE22 3NE, UK
| | | | - Jürgen M Bauer
- Center for Geriatric Medicine, Agaplesion Bethanien Hospital Heidelberg, Geriatric Center at the Heidelberg University, 69126 Heidelberg, Germany
| | - Jos M G A Schols
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6200 MD Maastricht, The Netherlands
- Department of Family Medicine and Care and Public Health Research Institute (CAPHRI), Maastricht University, 6200 MD Maastricht, The Netherlands
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12
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Nozawa Y, Nishitani-Yokoyama M, Shimada K, Kasuya H, Kunimoto M, Fujiwara K, Doi M, Sato Y, Nishimura J, Xu J, Abulimiti A, Tabata M, Minamino T. Nutritional Status in Patients Undergoing Phase II Cardiac Rehabilitation by Mini Nutritional Assessment. Cardiol Res 2023; 14:133-141. [PMID: 37091881 PMCID: PMC10116935 DOI: 10.14740/cr1479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/01/2023] [Indexed: 04/25/2023] Open
Abstract
Background Malnutrition impairs quality of life and prognosis of patients with cardiovascular disease. The Mini Nutritional Assessment (MNA) is a screening tool developed for the nutritional assessment of older adults. However, usefulness of MNA for patients undergoing cardiac rehabilitation (CR) has not been fully investigated. Methods From March 2017 to September 2019, the MNA-short form (MNA-SF) and the MNA total score in patients undergoing phase II CR at the Juntendo University Hospital were evaluated. Results A total of 336 patients (mean age 70.1 ± 11.4 years; males: 209) were analyzed. In the MNA-SF, 157 patients (47%) were found to be malnourished or at risk of malnutrition. In MNA total score, 168 patients (50%) were found to be malnourished or at risk of malnutrition. The MNA-SF < 12 group had significantly lower body mass index (BMI), hemoglobin level, low MNA scores for protein/water intake, self-evaluation of nutrition and health, and upper arm and calf circumferences compared to the MNA-SF ≥ 12 group. Assuming BMI < 18.5 as malnutrition, the sensitivity and specificity for malnutrition were 100% and 58.9% for MNA-SF, and 96.9% and 54.9% for MNA total score, respectively. Conclusions MNA is useful in screening for malnutrition in patients undergoing CR. Approximately 50% of them were determined to be malnourished or at risk of malnutrition, suggesting the need for detailed evaluation regarding their food intake and dietary intervention.
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Affiliation(s)
- Yosuke Nozawa
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Medical Affairs, Pfizer Japan Inc., Tokyo, Japan
| | - Miho Nishitani-Yokoyama
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Cardiovascular Rehabilitation and Fitness, Juntendo University Hospital, Tokyo, Japan
- Corresponding Author: Miho Nishitani-Yokoyama, Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo 113-8421, Japan.
| | - Kazunori Shimada
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hiroki Kasuya
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mitsuhiro Kunimoto
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kei Fujiwara
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mayumi Doi
- Cardiovascular Rehabilitation and Fitness, Juntendo University Hospital, Tokyo, Japan
| | - Yusei Sato
- Cardiovascular Rehabilitation and Fitness, Juntendo University Hospital, Tokyo, Japan
| | - Junya Nishimura
- Cardiovascular Rehabilitation and Fitness, Juntendo University Hospital, Tokyo, Japan
| | - Jianying Xu
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Abidan Abulimiti
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Minoru Tabata
- Department of Cardiovascular Surgery, Juntendo University Graduate School of Juntendo Medicine, Tokyo, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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13
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Nishioka S. Current Understanding of Sarcopenia and Malnutrition in Geriatric Rehabilitation. Nutrients 2023; 15:nu15061426. [PMID: 36986156 PMCID: PMC10056038 DOI: 10.3390/nu15061426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023] Open
Abstract
Malnutrition and sarcopenia are different but common conditions in older adults that share some underlying causes, including age-related physiological changes, decreased food intake, acute or chronic inflammation [...]
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Affiliation(s)
- Shinta Nishioka
- Department of Clinical Nutrition and Food Management, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan; ; Tel.: +81-88-633-7095
- Department of Clinical Nutrition and Food Services, Nagasaki Rehabilitation Hospital, Tokushima 770-8503, Japan
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14
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Cederholm T, Barazzoni R. Validity and feasibility of the global leadership initiative on malnutrition diagnostic concept in older people: a literature review from August 2021 to August 2022. Curr Opin Clin Nutr Metab Care 2023; 26:23-31. [PMID: 36485034 DOI: 10.1097/mco.0000000000000886] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW Early 2019, the Global Leadership Initiative on Malnutrition (GLIM) concept offered a clinically applicable and objective procedure for diagnosing malnutrition. This review summarizes 40 publications from August 2021 to August 2022 that applied the GLIM criteria in older populations from various clinical settings for criterion and predictive validation. RECENT FINDINGS Criterion validity studies, by comparing the GLIM construct with various semi-gold standards such as SGA, PG-SGA, MNA-FF/SF and ESPEN criteria, indicate by sensitivity, specificity and agreement that GLIM performs at least as well as the other tools to capture malnutrition. One meta-analysis of 20 studies with various comparators reports high accuracy for distinguishing malnutrition. GLIM-malnutrition prevalence figures vary with screening tool. Predictive validity of GLIM for mortality, and other outcomes, is good in all settings reported. Sarcopenia and GLIM show some expected overlapping. SUMMARY In populations more than 60 years old, the GLIM construct appears to have well acceptable criterion validity as well as predictive validity. The continuous implementation of the GLIM concept is justified.
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Affiliation(s)
- Tommy Cederholm
- Department of Public Health and Caring Sciences, Uppsala University. Theme Ageing, Karolinska University Hospital, Stockholm, Sweden
| | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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15
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A scoping review on the GLIM criteria for malnutrition diagnosis: Understanding how and for which purpose it has been applied in studies on hospital settings. Clin Nutr 2023; 42:29-44. [PMID: 36473426 DOI: 10.1016/j.clnu.2022.10.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 10/16/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022]
Abstract
AIMS This scoping review aimed to identify and map the literature on malnutrition diagnosis made using the GLIM criteria in hospitalized patients. METHODS The scoping review was conducted using the Joanna Briggs Institute's methodology. We searched PubMed, Embase, Scopus, and Web of Science (until 16 April 2022) to identify studies based on the 'population' (adults or elderly patients), 'concept' (malnutrition diagnosis by the GLIM criteria), and 'context' (hospital settings) framework. Titles/abstracts were screened, and two independent reviewers extracted data from eligible studies. RESULTS Ninety-six studies were eligible (35.4% from China, 30.2% involving oncological patients, and 30.5% with prospective data collection), 32 followed the two-step GLIM approach, and 50 applied all the criteria. All the studies evaluated body mass index (BMI), while 92.7% evaluated weight loss; 77.1%, muscle mass; 93.8%, inflammation; and 70.8%, energy intake. A lack of details on the methods adopted for criterion evaluation was observed in five (muscle mass evaluation) to 40 studies (energy intake evaluation). The frequency of the use of the GLIM criteria ranged from 22.2% (frequency of low BMI) to 84.7% (frequency of inflammation), and the malnutrition prevalence ranged from 0.96% to 87.9%. Less than 30% of studies aimed to assess the GLIM criterion validity, eight studies cited the guidance on validation of the GLIM criteria, and a minority implemented it. CONCLUSIONS This map of studies on the GLIM criteria in hospital settings demonstrated that they are applied in a heterogeneous manner, with a wide range of malnutrition prevalence. Almost 50% of the studies applied all the criteria, while one-third followed the straightforward two-step approach. The recommendations of the guidance on validation of the criteria were scarcely adhered to. The gaps that need to be explored in future studies have been highlighted.
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16
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Prevalence of Malnutrition Assessed by the GLIM Criteria and Association with Activities of Daily Living in Older Residents in an Integrated Facility for Medical and Long-Term Care. Nutrients 2022; 14:nu14173656. [PMID: 36079911 PMCID: PMC9460923 DOI: 10.3390/nu14173656] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 11/18/2022] Open
Abstract
Malnutrition is associated with poor functional outcomes in residents in long-term care facilities. The integrated facility for medical and long-term care (IFMLC) is a new Japanese long-term care facility where medical services can be provided. This study aimed to investigate the prevalence of malnutrition diagnosed based on the Global Leadership Initiative on Malnutrition (GLIM) criteria and its association with activities of daily living (ADL) in older residents in IFMLC. In this cross-sectional study of older residents, we diagnosed mild and severe malnutrition using the GLIM criteria and assessed ADLs using the Barthel index (BI). Multivariate regression analysis was used to investigate the relationship between BI score and GLIM-defined malnutrition. A total of 117 older residents (84 women; median age, 88 years) were analyzed in this study. The prevalence values of mild and severe malnutrition were 29% and 18%, respectively. Multivariate analyses for the BI score after adjusting for potential confounders showed that mild and severe malnutrition were independently associated with BI score (B = −6.113, p < 0.046; B = −8.411, p = 0.015, respectively). GLIM-defined malnutrition is negatively associated with ADLs in older residents in IFMLC.
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Frontera WR. Rehabilitation of Older Adults with Sarcopenia: From Cell to Functioning. Prog Rehabil Med 2022; 7:20220044. [PMID: 36118146 PMCID: PMC9437741 DOI: 10.2490/prm.20220044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 08/16/2022] [Indexed: 11/11/2022] Open
Abstract
The 20th and 21st centuries have witnessed a substantial increase in human life expectancy and in the number of men and women aged 60 years and older. Aging is associated with a large number of health conditions, including sarcopenia, which has been the subject of important research in the past 30 years. Sarcopenia is characterized by an age-related loss of muscle mass, weakness, and impaired physical performance. The condition can be diagnosed with a combination of measurements of these three elements. The precise definition of sarcopenia and the selection of optimal assessment methods have changed significantly in the past 20 years; nonetheless, the prevalence of sarcopenia in the general older population is in the range of 5-15%. Molecular and cellular events at the muscle cell level impact the size and quality of muscles (force adjusted for size). The active and passive mechanical properties of single muscle fibers are altered by changes in the structure and function of various cellular elements. Systemic factors such as inflammation, loss of hormonal influence, and deleterious lifestyle choices also contribute to sarcopenia. The consequences of sarcopenia include many adverse effects such as impairments in activities of daily living, falls, loss of independence, and increased mortality. Several rehabilitative interventions have been tested, and the safest and most effective is the use of progressive resistance exercise. An increase in dietary protein intake has synergistic effects. Future research should focus on a consensus definition of sarcopenia, identification of the best assessment methods, understanding of biological mechanisms, and testing of innovative interventions.
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Affiliation(s)
- Walter R. Frontera
- Department of Physical Medicine, Rehabilitation, and Sports
Medicine/Department of Physiology, University of Puerto Rico School of Medicine, San Juan,
Puerto Rico, USA
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