Rationale Quality of Life (QoL) is impaired in cancer, and the elderly are particularly vulnerable to malnutrition. A diagnosis of cancer in elderly patients further exacerbates risks of negative health outcomes. Here we investigated associations between QoL and nutritional status in a sample population of mostly socially deprived elderly cancer patients. Method 432 cancer patients were recruited for this cross-sectional study at point of admission to a tertiary referral hospital for cancer treatment. Patient-generated subjective global assessment (PG-SGA) assessed nutritional status. Functional assessment of cancer therapy- general (FACT-G) quantified QoL. Relationship between PG-SGA and QoL was assessed by Spearman correlation. PG-SGA outcomes were compared against FACT-G scores employing Mann–Whitney test. Bivariate Linear Regression Model was employed to investigate influences of sociodemographic, clinical and nutritional status upon QoL. Results 37.5% of participants were malnourished or at risk. 39% were illiterate and 54.6% had family income lower than minimum wage. Malnourished patients showed lower FACT-G scores (76.8 vs. 84.7; p = 0.000). Poor nutritional diagnosis was inversely correlated with all QoL domains. Bivariate regression analysis showed that lower PG-SGA scores (βo =  − 1.00; p = 0.000) contributed to FACT-G score deterioration, the male gender showed better QoL scores, and other clinical and sociodemographic variables did not show relationship. Conclusion Poorer nutritional status was significantly associated with worsened physical, social, emotional and functional well-being QoL domains in elderly cancer patients. Poorer nutritional status is an independent risk factor for worsened QoL. Future policies aimed at particularly vulnerable populations may improve QoL and health outcomes.

Introdução: O estado nutricional e a localização do tumor são essenciais na avaliação do idoso com câncer, pois relacionam-se com morbimortalidade e impactam diretamente na sobrevida. Objetivo: Avaliar o estado nutricional segundo a mini avaliação nutricional, índice de massa corporal e circunferência da panturrilha, identificar o grau de concordância entre esses parâmetros e verificar a associação entre o estado nutricional e os diferentes tipos de câncer. Método: Estudo transversal, com pacientes idosos oncológicos internados em um hospital de referência em Salvador, Bahia. Na coleta dos dados, utilizou-se a mini avaliação nutricional (versão reduzida), questionário estruturado para coleta de dados clínicos e perfil sociodemográfico, e antropométricos. Realizaram-se análise descritiva, teste de qui--quadrado (x²) e teste Kappa. Resultados: Observou-se que 41%, 54,3% e 74,3% dos pacientes apresentavam estado nutricional adequado segundo a mini avaliação nutricional, índice de massa corporal e circunferência da panturrilha, respectivamente, com uma concordância moderada (Kappa=0,59) entre índice de massa corporal e mini avaliação nutricional. Os maiores comprometimentos do estado nutricional foram observados nos pacientes com diagnóstico de câncer de cabeça e pescoço. Conclusão: Neste estudo, a mini avaliação nutricional foi mais sensível para identificar inadequação no estado nutricional quando comparada com o índice de massa corporal e circunferência da panturrilha; observou-se ainda associação entre o estado nutricional e a localização do tumor. Provavelmente, os parâmetros subjetivos da mini avaliação nutricional justificam o diagnóstico de desnutrição mais precoce, favorecendo a intervenção nutricional.

Rationale: Quality of Life (QoL) is impaired in cancer, and the elderly are particularly vulnerable to malnutrition. A diagnosis of cancer in elderly patients further exacerbate risks of negative health outcomes. Here we investigated associations between QoL and nutritional status in a sample population of mostly socially deprived elderly cancer patients.Method: 432 patients with diagnosed cancer were recruited for this cross-sectional study at point of admission to a tertiary referral charitable hospital for cancer treatment. Patient-Generated Subjective Global Assessment (PG-SGA) assessed nutritional status. Functional Assessment of Cancer Therapy- General (FACT-G) quantified QoL. PG-SGA outcomes were compared against FACT-G scores employing Mann-Whitney test. Relationship between PG-SGA and QoL scores was assessed by Spearman correlation. Bivariate Linear Regression Model was employed to investigate the influence of sociodemographic, clinical and nutritional status upon QoL.Results: 37.5% of participants were malnourished or at risk. 39% were illiterate and 54.6% had a family income lower than minimum wage. Malnourished patients showed lower FACT-G scores (78.0 vs. 86.0; p=0.000). Poor nutritional diagnosis was inversely correlated with all QoL domains. Bivariate regression analysis showed that worsened PG-SGA scores (βo = -1.00; p = 0.000) contributed to FACT-G score deterioration; the male gender showed less pronounced effects in QoL, whereas literacy and family income did not show relationship.Conclusion: We found that poorer nutritional status was significantly associated with worsened physical, social, emotional and functional well-being domains of QoL in elderly cancer patients. Future policies aimed at this particularly vulnerable population may improve QoL and health outcomes.

O objetivo da presente Norma Técnica é garantir as melhores condições de saúde dos pacientes e minimizar os riscos de infecção dos profissionais, pacientes e familiares.

Introduction Malnutrition is strongly associated with negative outcomes in aged populations with cancer. Several studies have compared the outcomes of nutritional-screening tools, but knowledge specifically covering older adult patients with cancer remains limited. The aim of this study was to compare the outcomes of two tools, the Patient-Generated Subjective Global Assessment (PG-SGA) versus the Mini Nutritional Assessment (MNA) for this population. Method Cross-sectional study with 432 participants who consented to participate and were enrolled at admission to medical and surgical wards of a tertiary referral hospital. The participants’ nutritional statuses were simultaneously assessed using the PG-SGA and the MNA, and the outcomes compared using the kappa statistical test. The Receiver Operating Characteristic Curve (ROC) was employed to calculate the MNA sensitivity, specificity, positive and negative predictive values, and was compared with PG-SGA. Results Prevalence of good nourishment was observed in 62.5% and 61.1% of the participants, as detected by PG-SGA and MNA, respectively. Both tools concurred moderately (kappa = 0.453). Importantly, there were significant differences in the diagnosis of malnutrition (7.6% vs. 4.6%, p = 0.000). The MNA showed sensitivity of 72.2% and specificity of 75.9% in detecting good nourishment for the population investigated. Conclusion The MNA may not present greater sensitivity, possibly due to a lack of coverage of gastrointestinal symptoms. It is a quick and efficient tool for nutritional assessment of older adult patients with cancer, but as it is more specific than sensitive, caution is recommended when identifying borderline or early malnourished individuals of this population.