N05 - The G8 screening as a tool for malnutrition risk

Abstract

Background: Incidence of cancer increases with age. In older cancer patients, important information may be missed without a Comprehensive Geriatric Assessment (CGA). A validated screening instrument is needed to identify patients for whom a CGA would be beneficial. G8 is a screening tool (8 questions) for older cancer patients in need of a CGA, it explores functional, cognitive, nutritional status and it takes 5 minutes; a score of ≤14 is considered abnormal.Objectives: To test the performance of the G8 ≤14 in older patients with solid cancer; to identify those who would benefit from a nutritional support when a reduced MNA in the Mini Nutritional Assessment in the CGA was found.Methods: Between January and April 2015, G8 was performed in 488 consecutive patients aged ≥70 years diagnosed with solid cancer at Vito Fazzi Hospital for a total of 963 G8. The G8 was administered 3 times in 78 patients and in 54 with G8 score <14, CGA (including MNA) were completed. MNA involves anthropometric measurements, global assessment, dietary questionnaire, a subjective assessment and it enables a subject to be categorized as normal (adequate nutrition), borderline (risk of malnutrition) or undernutrition. MNA is an 18-item questionnaire comprising anthropometric measurements (BMI, mid-arm/calf circumference, weight loss) combined with a questionnaire regarding dietary intake (number of meals consumed, food-fluid intake, feeding autonomy), a global assessment (lifestyle, medication, mobility, acute stress presence, presence of dementia/depression) and a self-assessment (self-perception of health and nutrition). Patients aged 70 years or older treated with chemotherapy for solid tumor and at risk of malnutrition (MNA) received Nutritional Advice.Results: 54 patients with 76 years median age were included; 31,4% (N = 17) had an abnormal MNA <24, risk factor of malnutrition (5 female, 12 male) for each of them Clinical Nutrition Unit adopted an individualized nutrition program with oral nutritional supplements (ready-made liquids) or in 2 patients parenteral nutrition. In these patients there was an improvement of the G8 due to the increase of the MNA to start the chemotherapy.Conclusion: G8 can be used in order to identify those patients who would benefit from a CGA and those who have a malnutrition risk. The results show that it is important to implement and develop strategies for individual nutritional care, in order to prevent and treat malnutrition in elderly people. Background: Incidence of cancer increases with age. In older cancer patients, important information may be missed without a Comprehensive Geriatric Assessment (CGA). A validated screening instrument is needed to identify patients for whom a CGA would be beneficial. G8 is a screening tool (8 questions) for older cancer patients in need of a CGA, it explores functional, cognitive, nutritional status and it takes 5 minutes; a score of ≤14 is considered abnormal. Objectives: To test the performance of the G8 ≤14 in older patients with solid cancer; to identify those who would benefit from a nutritional support when a reduced MNA in the Mini Nutritional Assessment in the CGA was found. Methods: Between January and April 2015, G8 was performed in 488 consecutive patients aged ≥70 years diagnosed with solid cancer at Vito Fazzi Hospital for a total of 963 G8. The G8 was administered 3 times in 78 patients and in 54 with G8 score <14, CGA (including MNA) were completed. MNA involves anthropometric measurements, global assessment, dietary questionnaire, a subjective assessment and it enables a subject to be categorized as normal (adequate nutrition), borderline (risk of malnutrition) or undernutrition. MNA is an 18-item questionnaire comprising anthropometric measurements (BMI, mid-arm/calf circumference, weight loss) combined with a questionnaire regarding dietary intake (number of meals consumed, food-fluid intake, feeding autonomy), a global assessment (lifestyle, medication, mobility, acute stress presence, presence of dementia/depression) and a self-assessment (self-perception of health and nutrition). Patients aged 70 years or older treated with chemotherapy for solid tumor and at risk of malnutrition (MNA) received Nutritional Advice. Results: 54 patients with 76 years median age were included; 31,4% (N = 17) had an abnormal MNA <24, risk factor of malnutrition (5 female, 12 male) for each of them Clinical Nutrition Unit adopted an individualized nutrition program with oral nutritional supplements (ready-made liquids) or in 2 patients parenteral nutrition. In these patients there was an improvement of the G8 due to the increase of the MNA to start the chemotherapy. Conclusion: G8 can be used in order to identify those patients who would benefit from a CGA and those who have a malnutrition risk. The results show that it is important to implement and develop strategies for individual nutritional care, in order to prevent and treat malnutrition in elderly people.