Nutritional Assessment Score Research Articles

Impact of nutritional assessment scores in CVA patients – A pilot approach study in prediction of mortality and mortality

Impact of nutritional assessment scores in CVA patients – A pilot approach study in prediction of mortality and mortality

Anthropometric and Nutritional status of Chronic Obstructive Pulmonary Disease presenting in Acute Exacerbation in Tertiary care Hospital in Eastern Nepal

Background: There is scarcity of data regarding the nutritional status of COPD patients presenting in exacerbation in our setup, thus this observational study was conducted. Methods: We performed an observational study of patients with acute exacerbation of COPD, who were admitted in the Department of Pulmonary, Critical care and Sleep Medicine in tertiary hospital in eastern Nepal from April 2023 to June 2023. Results: During the study period, a total of 154 patients of COPD with exacerbations were admitted in our department. The baseline anthropometric parameters, lab parameters as well as the malnutrition scores were determined. The mean BMI was 21.82 ± 3.92 kg/m2 and only 29% had BMI < 18.5 kg/m2.The mean hemoglobin, mean cell volume, serum protein, serum albumin, serum calcium, phosphorus and vitamin D level were 12.43 ± 2.32 g/dL, 84.4 ± 9.41 fL, 6.42 ± 1.74 g/ dL, 3.32 ± 0.34 g/dL, 8.98 ± 0.63 mg/dL, 3.02 ± 0.42 mg/dL, 18.48 ± 8.22 pg/mL and 40%, 12%, 28%, 41%, 31%, 42% and 49% of these values were below the lower normal limit respectively. The nutritional status tool used NRS-2002, MUST and MNAS-F screened malnutrition in about 68%, 51% and 54% respectively. There shows a discrepancy between the evaluation of the malnutrition assessed by BMI with that of nutritional assessment score. Conclusion: COPD who present in exacerbations are malnourished, but use of sole BMI to rule out malnutrition in such group of patients can cause false negative result.

Self-reported exhaustion and a 4-item physical frailty index to predict the incidence of major complications after onco-geriatric surgery

BackgroundThe aim of this study was to analyze four pre-operative physical frailty indicators from a geriatric assessment (GA) independently and combined in a physical frailty index, in their ability to predict postoperative 30 d-complications. Materials and methodsIn this secondary analysis of data from the published PERATECS study (ClinicalTrials.gov: NCT01278537), the predictive value of four physical frailty indicators from a defined GA battery was examined with univariable and multivariate logistic regression models in a sample of 493 onco-geriatric surgical patients. The primary endpoint was incidence of major (Clavien–Dindo ≥ grade 2 [CD ≥ 2]) complications within 30 postoperative days.Predictors of the first model included self-reported exhaustion (SRE), body mass index (BMI), Timed Up-and-Go (TUG) and handgrip strength (HGS) independently, and a second model combined these four items as a Physical Frailty Index (4i-PFI). Both regression models were adjusted for age, gender, American Society of Anesthesiologists (ASA) status, tumor sites, duration of surgery time and Mini Nutritional Assessment (MNA) score. ResultsA total of 233 patients (47 %) developed CD ≥ 2 complications. In addition to ASA score, length of surgery, and gynecological and upper gastrointestinal tumor sites, the first model showed that SRE (OR 1.866) predicted CD ≥ 2 complications, but not TUG, BMI and HGS. In the second model, the 4i-PFI predicted CD ≥ 2 complications (OR pre-frail = 1.808, frail = 3.787). ConclusionsPhysical frailty indicators as SRE revealed a better ability to predict CD ≥ 2 complications than BMI, TUG and HGS. However, prediction of CD ≥ 2 complications was enhanced when these parameters were combined in a novel 4i-PFI.

ADMA, neutrophil to lymphocyte, platelet to lymphocyte ratios and phase angle: effects on inflammation and nutrition in hemodialysis patients

Objectives: Neutrophil/lymphocyte ration (NLR) and platelet/lymphocyte ratio (PLR) levels can be used as systemic infallamotory parameters. Asymmetric dimethyl arginine (ADMA) inhibits endothelial nitric oxide synthase. Phase Angle (PhA) is a potential paremeter to screen for inflammatory abnormalities. In present study we aimed to determine the relations between NLR, PLR, ADMA, and PhA in terms of early markers for nutritonal status in addition to their well-known role in inflammation. Methods: A total of 89 patients undergoing maintenance hemodialysis 3 days a week at least 6 months were enrolled. To assess nutritional status, we performed the dietary questionnaire and mini nutritional assessment score (MNAS). ADMA was measured by ELISA. NLR and PLR are calculated from monthly complete blood count tests. Patients were divided into 2 groups accordng to NLR levels as group 1 (NLR≥4.6; n=48) ve and group 2 (NLR<4.6, n=41). Results: The mean ADMA level was 0.03±0.01 µmol/L, the mean PhA was 7.2±1.1º. In subgroup analysis, MNAS, albumin levels and phase angle of patients in group 1 were lower and CRP, PLR, ADMA levels were higher when compared to group 2. In correlation analysis, NLO was positively correlated with PLR, CRP and ADMA however negatively correlated with albumin and PhA levels. In regression analysis, NLR, PLR and ADMA were detected as independent predictors of MNAS. Conclusion: In conclusion our study suggests that NLR, PLR and ADMA are independent predictors for nutritional status and inflammation in patients ongoing hemodialysis.

Relationship of Biochemical Parameters and Echocardiogram Findings with Appetite in Patients having Reduced Ejection Fraction Heart Failure

Objective: To determine the relationship of biochemical parameters and echocardiogram findings with appetite and nutritional status in patients with heart failure with reduced ejection fraction. Study Design: Cross-sectional study.Place and Duration of Study: This study was conducted at the Department of Medicine, Combined Military Hospital (CMH), Peshawar, Pakistan, from February 2022 to August 2022.Methods: The study was conducted on adult patients with heart failure for at least three months. Indoor patients, those with hospitalization within the last four weeks, and unwilling patients were excluded. The Council on Nutrition Appetite Questionnaire and Mini Nutritional Assessment questionnaire were administered in direct face-to-face interviews. A transthoracic echocardiogram was done to document the left ventricular ejection fraction. Different hematological and biochemical parameters were also analyzed.Results: There were 76 patients aged 55.92± 15.22 years. Mean mini nutritional assessment and Council on Nutrition appetite questionnaire scores were 17.89± 5.23 and 20.74± 8.19, respectively. Based on mini nutritional assessment scores, 36 were malnourished, 27 were at risk of malnutrition, and 13 had normal nutritional status. Using Council on Nutrition appetite questionnaire scores, 57 were at risk of malnutrition, while 19 had no risk. Left ventricular ejection fraction and hemoglobin were lower in malnourished patients. However, there were no differences in other biochemical parameters amongst patients with good or poor nutritional status.Conclusion: Patients with heart failure had poor appetite and nutritional status proportionate to the degree of left ventricular systolic dysfunction. How to cite this: Saeed B, Arshad AR, Hussain M. Relationship of Biochemical Parameters and Echocardiogram Findings with Appetite and Nutritional Status in Patients with Heart Failure with Reduced Ejection Fraction. Life and Science. 2024; 5(2): 144-150. doi: http://doi.org/10.37185/LnS.1.1.359

The Relationship Between Controlling Nutritional Assessment Score and Mortality in Patients with Chronic Coronary Syndrome: A Retrospective Study from Türkiye.

Controlling Nutritional Assessment (CONUT) score has been shown to have a higher predictive value compared to other nutritional scores in acute coronary syndrome. To determine the relationship between CONUT score and long-term mortality in patients with chronic coronary syndrome (CCS). Between 2017 and 2020, 585 consecutive patients newly diagnosed and proven to have CCS by coronary angiography were included in the study. CONUT score and demographic and laboratory data of all patients were evaluated. The relationship between results and mortality was evaluated. The mean age of the patients was 64 years and 75% were male. Mortality was observed in 56 (9.6%) patients after a median follow-up period of 3.5 years. The median CONUT score was significantly higher in patients with mortality (P < 0.001). In multivariate regression analysis, the CONUT score was associated with mortality (Hazard ratio (HR): 1.63 (95% confidence interval (CI): 1.34-1.98 P < 0.001)). The area under curve (AUC) for long-term mortality estimation for the CONUT score was 0.75 (95% CI 0.67-0.82 P < 0.001). When the CONUT score value was accepted as 0.5, the sensitivity was 78% and the specificity was 60. CONUT score was found to be predictive of mortality in long-term follow-up of patients with CCS.

An investigation into the potential association between nutrition and Alzheimer's disease.

Malnutrition is the most common nutritional issue in Alzheimer's disease (AD) patients, but there is still a lack of a comprehensive evaluation of the nutritional status in AD patients. This study aimed to determine the potential association of various nutritional indices with AD at different stages. Subjects, including individuals with normal cognition (NC) and patients diagnosed with AD, were consecutively enrolled in this cross-sectional study. Demographics, body composition, dietary patterns, nutritional assessment scales and nutrition-related laboratory variables were collected. Binary logistics regression analyses and receiver operating characteristic (ROC) curves were used to indicate the association between nutrition-related variables and AD at different stages. Totals of 266 subjects, including 73 subjects with NC, 72 subjects with mild cognitive impairment due to AD (AD-MCI) and 121 subjects with dementia due to AD (AD-D) were included. There was no significant difference in dietary patterns, including Mediterranean diet and Mediterranean-DASH diet intervention for neurodegenerative delay (MIND) diet between the three groups. Lower BMI value, smaller hip and calf circumferences, lower Mini Nutritional Assessment (MNA) and Geriatric Nutritional Risk Index (GNRI) scores, and lower levels of total protein, albumin, globulin, and apolipoprotein A1 were associated with AD (all p < 0.05). Total protein and albumin levels had the greatest ability to distinguish AD from non-AD (AUC 0.80, 95% CI 0.74-0.84, p < 0.001), increased by combining calf circumference, MNA score and albumin level (AUC 0.83, 95% CI 0.77-0.88, p < 0.001). Albumin level had the greatest ability to distinguish NC from AD-MCI (AUC 0.75, 95% CI 0.67-0.82, p < 0.001), and MNA score greatest ability to distinguish AD-MCI from AD-D (AUC 0.72, 95% CI 0.65-0.78, p < 0.001). Nutritional status of AD patients is significantly compromised compared with normal controls, and tends to be worsened with AD progresses. Early identification and intervention of individuals with nutritional risk or malnutrition may be significantly beneficial for reducing the risk, development, and progression of AD.

Do nutritional assessment scores have a relationship with transthyretin levels?

nutritional screening tools assess factors like weight loss, BMI, food intake, and disease severity to determine a patient's nutritional risk and needed care. Plasma transthyretin is a practical measurement used to assess nutritional evolution due to its rapid response to food intake. This study examines the relationship between nutritional scores, transthyretin protein levels, and the possibility of death. the sample consisted of 302 patients hospitalized in the wards or intensive care unit of a public teaching hospital, using parenteral nutrition as the primary source of nutrition. Five nutritional screening tools were applied, and patient charts were verified for transthyretin levels. from the sample, 260 were adults, and 42 were children, with a mean age of 48.3 years. When evaluating the patient's outcome in relation to the scores, the Malnutrition Universal Screening Tool proved to be better at predicting death (p-value = 0.02). None of the scores were related to transthyretin levels, showing that lower transthyretin values did not influence nutritional risk. we believe early identification of nutritional risk through nutritional scores is necessary for better nutritional monitoring to minimize unfavorable outcomes. This study corroborates the more recent concept that transthyretin is not useful for determining unfavorable outcomes in hospitalized patients with a severe inflammatory process. In clinical practice, identifying a patient at nutritional risk according to the Malnutrition Universal Screening Tool and promoting adequate nutritional monitoring may reduce mortality.

Sarcopenia, but not malnutrition, is associated with fear of falling in older patients with dementia.

Fear of falling (FoF) is common in patients with cognitive impairment. However, the role of sarcopenia and malnutrition, which are two important factors that cause falls, on FoF is unknown. The aim of this study was to explore the association between FoF and malnutrition and sarcopenia in older patients with dementia. Two hundred and sixty-six dementia patients underwent comprehensive geriatric assessment. The Falls Efficacy Scale-International (FES-I) was applied to assign and classify FoF. Scores for the FES-I scale were categorized as ≥28, 20-27, or 16-19, representing high concern, moderate, and no or low concern about FoF, respectively. Mini Nutritional Assessment (MNA) scores <17, 17-23.5, or >23.5 were categorized as malnutrition, malnutrition risk, and well-nourished, respectively. Sarcopenia was defined using the SARC-F tool. SARC-F score ≥4 was categorized as sarcopenia. Serum folate, Vitamin B12, and Vitamin D deficiencies were also evaluated. The relationship between FoF groups and nutritional status, presence of sarcopenia, and micronutrient status was evaluated. The mean age was 80.83±6.61 years. The prevalence of moderate and high FoF in dementia patients was 51%. There was a significant difference in terms of cerebrovascular events, the history of falling, instrumental and basic activities of daily living (IADL and BADL), MNA, and SARC-F scores between the FoF groups (p<0.05). The association between sarcopenia and FoF persisted in multivariable analysis adjusted for MNA scores, cerebrovascular events, falls history, BADL, and IADL (OR=2.67, 95% CI: 1.50-4.50), but there was no significant association between malnutrition/micronutrient deficiencies and FoF (p>0.05). Sarcopenia is associated with the severity of FoF, but malnutrition or micronutrient deficiencies are not associated with the severity of FoF in older patients with dementia.

Underweight, overweight, and weight change in older family caregivers and their care recipients: longitudinal evidence from a randomized controlled trial.

This study aimed to identify differences among body mass index (BMI) categories of older family caregivers (≥60years) and their care recipients (≥65years). Secondly, this study aimed to examine group differences and factors associated with weight change during a nutrition and oral health intervention. This secondary analysis of a randomized controlled trial (ClinicalTrial.gov (NCT04003493)) involved individually tailored nutritional guidance from a clinical nutritionist and oral health guidance from a dental hygienist. Baseline BMI differences were analyzed, followed by further analyses of group differences and associated factors of weight change over a 6-month period using generalized estimating equations. Among the participants (113 family caregivers and 107 care recipients), 36.3% and 35.1% were overweight (BMI >29kg/m2), while 18.6% and 21.6% were underweight (BMI <24kg/m2) at baseline, respectively. For family caregivers differences in BMI categories included age, mid-arm and calf circumferences, and plasma prealbumin concentration. For care recipients differences were observed in medication use, mid-arm and calf circumferences, Mini Nutritional Assessment scores, physical function, and number of teeth. During the 6-month intervention, there were no differences in weight change between intervention and control groups for both caregivers and care recipients. Factors significantly associated (p < 0.05) with weight loss included female sex for both caregivers and care recipients, and frailty for caregivers. Family caregivers' characteristics were not significantly associated with weight change in their care recipients. In conclusion, being overweight is a prevalent among older family caregivers and care recipients. Factors such as age, medication use, physical function, number of teeth, and Mini Nutritional Assessment scores varied across BMI categories. Female sex was associated with weight loss in both older family caregivers and care recipients, and frailty was associated with weight loss in caregivers. However, the characteristics of family caregivers did not explain the weight loss of their care recipients. Clinical Trial Registration: [https://www.ClinicalTrial.gov/], identifier [NCT04003493].

Development and Validation of a Risk Prediction Model for Frailty in Patients with Chronic Diseases.

The occurrence rate of frailty is high among patients with chronic diseases. However, the assessment of frailty among these patients is still far from being a routine part of clinical practice. The aim of this study is to develop a validated predictive model for assessing frailty risk in patients with chronic illnesses. This study recruited 543 patients with chronic diseases, and 237 were included in the development and validation of the predictive model. A total of 57 frailty related indicators were analyzed, encompassing sociodemographic variables, health status, physical measurements, nutritional assessment, physical activity levels, and blood biomarkers. There were 100 cases (42.2%) presenting frailty symptoms. Multivariate logistic regression analysis revealed that gender, age, chronic diseases, Mini Nutritional Assessment score, and Clinical Frailty Scale score were predictive factors for frailty in chronic disease patients. Utilizing these factors, a nomogram model demonstrated good consistency and accuracy. The AUC values for the predictive model and validation set were 0.946 and 0.945, respectively. Calibration curves, ROC, and DCA indicated the nomogram had favorable predictive performance. Altogether, the comprehensive nomogram developed here is a promising and convenient tool for assessing frailty risk in patients with chronic diseases, aiding clinical practitioners in screening high-risk populations.

An Investigation of the Role of Phase Angle in Malnutrition Risk Evaluation and Clinical Outcomes in Patients with Head and Neck or Brain Tumors Undergoing Radiotherapy

This cross-sectional study aimed to investigate the role of bioelectrical impedance analysis (BIA) and phase angle measurement in assessing malnutrition in head and neck (n = 37) and brain (n = 63) tumor patients received radiotherapy. Common nutritional screening and assessment tests were used to identify malnutrition in the patients. Each patient underwent these tests once, along with phase angle measurement. Additionally, inflammation parameters, including neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and systemic inflammatory index (SII), were calculated. All study results were correlated with the phase angle cutoff point of 5.72°. The phase angle demonstrated significant correlations with subjective global assessment (SGA), mini nutritional assessment (MNA) scores, BIA parameters, nutritional index, NLR, and SII (p < 0.05). Moreover, in head and neck tumor patients, those with higher standardized phase angle values exhibited significantly better two-year overall survival (32.1% vs. 87.5%, p = 0.006). The phase angle measurement is a convenient, noninvasive, and reproducible method that can complement existing tools for assessing malnutrition risk in radiotherapy patients. The significant correlations observed between the phase angle and various nutritional, inflammation markers and prognosis highlight its potential utility. Further studies incorporating a larger patient cohort will be beneficial in establishing a standard phase angle reference value for cancer patients.

Development and validation of a nutrition-related genetic-clinical-radiological nomogram associated with behavioral and psychological symptoms in Alzheimer's disease.

Few evidence is available in the early prediction models of behavioral and psychological symptoms of dementia (BPSD) in Alzheimer's disease (AD). This study aimed to develop and validate a novel genetic-clinical-radiological nomogram for evaluating BPSD in patients with AD and explore its underlying nutritional mechanism. This retrospective study included 165 patients with AD from the Chinese Imaging, Biomarkers, and Lifestyle (CIBL) cohort between June 1, 2021, and March 31, 2022. Data on demoimagedatas, neuropsychological assessments, single-nucleotide polymorphisms of AD risk genes, and regional brain volumes were collected. A multivariate logistic regression model identified BPSD-associated factors, for subsequently constructing a diagnostic nomogram. This nomogram was internally validated through 1000-bootstrap resampling and externally validated using a time-series split based on the CIBL cohort data between June 1, 2022, and February 1, 2023. Area under receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were used to assess the discrimination, calibration, and clinical applicability of the nomogram. Factors independently associated with BPSD were: CETP rs1800775 (odds ratio [OR] = 4.137, 95% confidence interval [CI]: 1.276-13.415, P = 0.018), decreased Mini Nutritional Assessment score (OR = 0.187, 95% CI: 0.086-0.405, P <0.001), increased caregiver burden inventory score (OR = 8.993, 95% CI: 3.830-21.119, P <0.001), and decreased brain stem volume (OR = 0.006, 95% CI: 0.001-0.191, P = 0.004). These variables were incorporated into the nomogram. The area under the ROC curve was 0.925 (95% CI: 0.884-0.967, P <0.001) in the internal validation and 0.791 (95% CI: 0.686-0.895, P <0.001) in the external validation. The calibration plots showed favorable consistency between the prediction of nomogram and actual observations, and the DCA showed that the model was clinically useful in both validations. A novel nomogram was established and validated based on lipid metabolism-related genes, nutritional status, and brain stem volumes, which may allow patients with AD to benefit from early triage and more intensive monitoring of BPSD. Chictr.org.cn, ChiCTR2100049131.

The phase 2 LYSA study of prednisone, vinblastine, doxorubicin, and bendamustine for untreated Hodgkin lymphoma in older patients

AbstractOlder patients with classical Hodgkin lymphoma (cHL) require more effective and less toxic therapies than younger patients. In this multicenter, prospective, phase 2 study, we investigated a new firstline therapy regimen comprising 6 cycles of prednisone (40 mg/m2, days 1-5), vinblastine (6 mg/m2, day 1), doxorubicin (40 mg/m2, day 1), and bendamustine (120 mg/m2, day 1) (PVAB regimen) every 21 days for patients with newly diagnosed cHL aged ≥61 years with an advanced Ann Arbor stage. A Mini Nutritional Assessment score ≥17 was the cutoff value for patients aged ≥70 years. The primary end point was the complete metabolic response (CMR) rate after 6 cycles. The median age of the 89 included patients was 68 years (range, 61-88 years), with 35 patients (39%) aged ≥70 years. Seventy-eight patients (88%) completed the 6 cycles. The toxicity rate was acceptable, with a 20% rate of related serious adverse events. CMR was achieved by 69 patients (77.5%; 95% confidence interval [CI], 67-86). After a median follow-up of 42 months, 31 patients progressed or relapsed (35%), and 24 died (27%) from HL (n = 11), toxicity during treatment (n = 4), secondary cancers (n = 6), or other causes (n = 3). The 4-year progression-free survival (PFS) and overall survival rates were 50% and 69%, respectively. Multivariate analysis showed that liver involvement (P = .001), lymphopenia (P = .001), CRP (P = .0005), and comedications (P = .003) were independently associated with PFS. The PVAB regimen yielded a high CMR rate with acceptable toxicity. Over long-term follow-up, survival end points were influenced by unrelated lymphoma events. This trial was registered at www.clinicaltrials.gov as #NCT02414568 and at EudraCT as 2014-001002-17.

Longitudinal Associations Between ATPase Inhibitory Factor 1, Growth Differentiation Factor-15, and Nutritional Status in Older Adults From the MAPT Study.

Weight and appetite regulation have been associated with the expression and secretion of ATPase inhibitory factor 1 (IF1) and growth differentiation factor-15 (GDF-15), 2 potential biomarkers for age-related mitochondrial dysfunction. The aim was to explore the associations between these biomarkers and nutritional variables in the Multidomain Alzheimer Preventive Trial study. IF1 and GDF-15 plasma levels were quantified at 1-year follow-up. The nutritional status was measured using the Mini Nutritional Assessment (MNA) score variation between baseline and 1- and 2-year visits; appetite loss was extracted from the MNA. Bodyweight was measured every 6 months until the third year and then yearly until the fifth year of follow-up, and weight loss was established if the loss was greater than 5% or 10% within the past 6 or 12 months, respectively. Bidirectional associations of IF1 and GDF-15 levels with malnutrition, appetite, and weight loss were examined. The interactions between individual IF1 and GDF-15 with sex were explored. Four hundred and forty-eight participants had MNA data and 1 045 had weight loss data. All the associations between IF1 levels and the MNA score, appetite loss, and weight loss were nonsignificant. Higher GDF-15 levels were cross-sectionally associated with appetite loss at the first year of follow-up, and the GDF-15 highest quartile was associated with nearly 80% higher risks of weight loss over 4 years. Interactions between IF1 and GDF-15 levels, and between these 2 markers and sex were not significantly associated with the outcomes. GDF-15 plasma levels were related to key malnutrition criteria.

Prevalence of Malnutrition and the Value of Predicting Pancreatic Fistula in Patients with Laparoscopic Pancreatoduodenectomy.

Background: Pancreatoduodenectomy is a standard surgical procedure for periampullary tumors. With recent improvements in perioperative management, postoperative mortality has decreased significantly in recent years; however, postoperative pancreatic fistula (POPF) is still one of the most prevalent and dangerous complications. The purpose of this study was to analyze the prevalence of malnutrition and the value of predicting POPF in patients with laparoscopic pancreatoduodenectomy (LPD). Methods: We retrospectively analyzed the perioperative data of 747 patients undergoing LPD in the Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, China. Simultaneously, we analyzed the prevalence rate of malnutrition with three different nutritional assessment scores and explored the independent risk variables for POPF to identify potential predictive value. Results: Malnutrition was observed in 20.1% of patients with the prognostic nutritional index (PNI), 85.0% of patients with the controlling nutritional status (CONUT) score, and 73.1% of patients with the NRI score. Univariate and multivariate analyses all showed that the risk factors for POPF were pancreatic texture, pancreatic duct diameter, abdominal infection, body mass index (BMI), nomogram-revised risk index (NRI), and PNI. The receiver operating characteristic curve indicated that the BMI/PNI ratio was capable of predicting the occurrence of clinical POPF following LPD, with an area under the curve of 0.708. Conclusions: Compared with no malnourished patients, malnutrition is associated with a higher risk of POPF among patients with LPD. In addition, the BMI/PNI ratio has some predictive value in the development of POPF following LPD.

Poor sleep quality is an overlooked risk for geriatric syndromes in older adults with type 2 diabetes mellitus

ABSTRACT Background Aging and type 2 diabetes mellitus (DM) are two different conditions that impair sleep quality. The primary objective of this study was to investigate the impact of sleep quality on geriatric syndromes in older diabetic adults. Methods Comprehensive geriatric assessment was performed on 236 patients. The assessment included the Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), European Quality of Life Questionnaire (EQ-5D), Mini Mental Statement Examination (MMSE), Pittsburgh Sleep Quality Index (PSQI), Mini Nutritional Assessment, and measurement of handgrip strength (HGS). Results Of the participants, 55% had DM, and 61.4% had poor sleep quality. Poor sleep prevalence was higher in diabetic patients (68.5%) than in non-diabetics (52.8%). Diabetic patients with poor sleep quality had higher frequencies of chronic pain, recurrent urinary tract infections, confirmed sarcopenia, and frailty (p = 0.015, p < 0.001, p = 0.027, and p < 0.001, respectively), a higher number of comorbidities and higher GDS and BAI scores (p = 0.046, p < 0.001 and p < 0.001, respectively), and lower scores of activities of daily living, HGS, and EQ-5D index (p = 0.023, p = 0.004, and p < 0.001, respectively) compared to diabetic patients with good sleep quality. According to the correlation analysis results, PSQI score had a positive correlation with GDS score (r = 0.461, p < 0.001) and a negative correlation with Mini Nutritional Assessment score (r = –0.317, p < 0.001), skeletal muscle mass index (r = –0.283, p = 0.002) and HGS (r = –0.307, p < 0.001) scores in diabetic older adults. Conclusion Poor sleep quality in older diabetic patients has a negative impact on several geriatric syndromes. Our findings suggest that poor sleep quality is an independent risk factor for depression, malnutrition, and lower muscle mass in older diabetic adults. Improving sleep quality may play a crucial role in preventing and managing geriatric syndromes in this population.

The risk of malnutrition and its clinical implications in older patients with cancer.

Malnutrition is a common geriatric syndrome with multiple negative outcomes including mortality. However, there is a scarcity of literature that focuses on the relationship between malnutrition risk and its clinical implications on geriatric syndromes and mortality among cancer patients. The aim of this study is to determine the clinical importance of malnutrition risk in geriatric oncology practice. 180 patients with cancer who were ≥ 65years were included in the study. All patients were questioned in terms of geriatric syndromes, including polypharmacy, frailty, probable sarcopenia, fall risk, dynapenia, depression, cognitive impairment, insomnia, and excessive daytime sleepiness. Mini Nutritional Assessment scores > 23.5 and 17-23.5 were categorized as well-nourished and malnutrition risk, respectively. Of the 180 patients (mean age 73.0 ± 5.6years, female: 50%), the prevalence of malnutrition risk was 28.9%. There was no statistically significant difference between the groups in terms of age, gender, education, marital status, body mass index, and comorbidities except for chronic obstructive pulmonary disease (p > 0.05). After adjustment for age, sex, and body mass index; polypharmacy (odds ratio [OR]: 3.17; 95% confidence interval [CI], 1.48-6.81), reduced calf circumference (OR: 3.72; 95% CI, 1.22-11.38), fall risk (OR: 2.72; 95% CI, 1.03-7.23), depression (OR: 6.24; 95% CI, 2.75-14.18), insomnia (OR: 4.89; 95% CI, 2.16-11.05), and frailty (OR: 2.44; 95% CI, 1.75-3.40) were associated with malnutrition risk compared to well-nourished patients (p < 0.05). Median survival in patients with malnutrition risk was 21.3months (range 14.1-28.4 95% CI) and median survival in patients who were defined as well nourished was not reached (p < 0.001). The risk of malnutrition was associated with a higher risk for all-cause mortality in older patients with cancer, and was associated with many geriatric syndromes, including polypharmacy, fall risk, frailty, insomnia, and depression.

Nutritional assessment and nutritional status of centenarians (based on the materials of the study “Centenary citizen” in Moscow)

BACKGROUND: Malnutrition and micro- and macronutrient deficiencies are common in people aged 95 years and older. For timely detection of nutritional disorders, it is crucial to regularly examine centenarians and, if necessary, correct an individual patient management plan. A well-balanced diet is one of the fundamental factors for the normal functioning of the human body throughout its life. With age, for various reasons, the risk of malnutrition increases, however, the nutritional status of centenarians is currently not fully understood due to the difficulties of diagnosis.&#x0D; AIM: To evaluate nutritional status and its impact on life expectancy in patients aged 95 years and older, to identify the main determinants that affect the development of malnutrition, and to assess their impact on three-year survival of centenarians.&#x0D; MATERIALS AND METHODS: Analyzed the results of a Mini Nutritional Assessment, general and biochemical blood tests (including such parameters as hemoglobin levels, iron levels, total protein, albumin, vitamin B12, vitamin D, folic acid) in non-institutionalized people aged 95 and older living in Moscow. All studies were conducted at home in the presence of relatives and/or social workers after signing a voluntary informed consent.&#x0D; RESULTS: The study included 82 people, mean age (98.31.89) years; 87.8% were women. Of all the study participants, 56.1% (n=46) were at risk of developing malnutrition, and 11% (n=9) had malnutrition syndrome. Among the 64 participants who took the blood test, anemia was diagnosed in 71.9% (n=46), with macrocytic in 10.9% (n=5), normocytic in 84.8% (n=39), and microcytic in 4.3% (n=2) of patients. Hypoalbuminemia was identified in 16.9% (n=11 of 65) of participants. Of the 50 people who were screened for vitamin D levels, vitamin D deficiency was found in 98% (n=49 out of 50). The following factors influenced survival: a Mini Nutritional Assessment score of more than 24 reduces the risk of 3-year death by 72% (odds ratio (OR) 0.28, confidence interval (CI) 0.10.8), anemia increases the adverse risk by 3 times (OR=3.1, CI 1.18.9). The main clinical conditions associated with a higher risk of developing malnutrition were anemia (OR=3.1, CI 1.18.9) and chewing problems (OR=2.8, CI 0.97.8).&#x0D; CONCLUSIONS: Conducting a nutrition assessment and drawing up a program for the prevention of malnutrition syndrome in centenarians will improve the quality of life and increase life expectancy.

A Potential Screening Tool for Nutritional Preparedness in Collegiate Level Female Athletes: A Pilot study

Background: Diet monitoring is part of an athlete’s health and performance assessment, and adequate nutrition is known to be a method that can positively influence the reduction in exercise-induced injury. However, the concept of nutritional preparedness as a screening tool to identify low energy availability for the competitive season is not mainstream practise. Objectives: Our pilot study investigated three aims: 1) changes to nutritional status from the pre-competition phase to the competition phase, 2) living status impact on athlete’s food accessibility, and 3) whether nutritional preparedness in the pre-competition phase influenced the potential for low energy availability during the competition phase. Methods: Female volleyball athletes (N=21, 19-22 yrs., 80% lived off campus) were recruited from 3 universities (Ambrose, Calgary, New Brunswick- Saint John) through social media sites, and word of mouth. Two cross-sectional questionnaires (questions derived from the Short Food Frequency-Q, LEAF-Q, and RED-S screening tool-Q) were administered prior to and during the competitive season. Results: The nutritional assessment score significantly decreased from the pre-competition to competition phase, respectively (n=20, 26.11 ± 4.25; n=12, 20.64 ± 4.74; p=0.022). Many athletes (6/12) reported an injury during the competitive season with an average time loss from sport of 8-14 days. Conclusions: These findings suggest that collegiate female volleyball athletes have a potential for low energy availability, regardless of living status. Future research should build on the nutritional preparedness concept as a method of screening for low energy availability and the influence on injuries sustained during the competition phase.