Validation of the G8 in older patients with a haematological malignancy

Abstract

Introduction.– The aim of the study was to assess the correlates of poor nutritional status of elderly subjects. Methods.– Comprehensive geriatric assessment (Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Mini Nutritional Assessment (MNA), Katz’s Index, Lawton scale) was performed in 89 subjects aged 60 years and older. Physical performance was assessed using 6-Minute Walk Test (6MWT), walking speed (V) and handgrip strength. Markers of inflammation: hsCRP, TNFalfa-soluble receptor2 (STNFR2), IL-6, IL-8, IL-18, pentraxin (PTX) and osteoprotegerin (OPG) were measured. Using dual energy Xray absorptiometry (DXA) lean body mass total (LBM) and appendicular (aLM)weremeasured, aLM indexwas calculated: aLMIx= aLM(kg)/height(m2). Results.– Out of 89 patients (mean age 72.8±7,6) MNA<24 had 30.3%. Subjects in good nutritional status and at risk of malnutrition did not differ in age, but had lower MMSE (P=0.025), handgrip strength (14.0±7.9 vs 22.79±10.97kg, P=0.0019), lower hemoglobin (12.82±1.5 vs 14.07±1.5 g/dl, P=0.0006), and albumin level (41.82±3.6 vs 43.48±2.7, P=0.026). Patients with lower MNA had lower LBM (41.51±7.71 vs 48.67±7.24kg, P=0.001), aLM (16.85±3.5 vs 20.68±3.4 kg; P=0.0003) and aLMIx (6.64±0.99vs7.52±0.86kg/m2, P=0.001), and performed worse physical tests: had shorter 6-MWT distance (308.89±7682 vs 362.55±107.5m; P=0.03), lowerV (0.761±0.23 vs 0.935±0.3m/s; P=0.03). MNA<24 was associated with higher OPG (9.851±3.45 vs 8.094±2.5, P=0.013), and STNFR2 (P=0.039). MNA correlated positively with 6MWT (r=0.3, P=0.04), V (r=0.44, P=0.002), handgrip strength (r=0.42, P=0.003), LBM (r=0.29, P=0.04), aLM (r=0.32,P=0.03), aLMIx (r=0.20, P=0.047) and negatively with age (r=–0.33,P=0.02). In multiple regression analysis MNAwas influenced by MMSE positively and negatively by hsCRP, IL-8 and number of diseases. Conclusions.– Risk of malnutrition in elderly was associated with worse physical performance, cognitive impairment, comorbidity, higher osteoprotegerin and inflammatory markers.