Ageing and COPD affect different domains of nutritional status: the ECCE study

Abstract

Chronic obstructive pulmonary disease (COPD) and ageing may contribute to malnutrition. We aimed to explore whether COPD and ageing determine malnutrition in different manners.460 stable COPD outpatients (376 males and 84 females) from the Extrapulmonary Consequences of COPD in the Elderly (ECCE) study database were investigated (age 75.0¡5.9 yrs; forced expiratory volume in 1 s 54.7¡18.3% predicted). Nutritional status was evaluated using the Mini Nutritional Assessment1 (MNA) questionnaire. From the MNA, three scores exploring the domains of the nutritional status were calculated: body composition, energy intake and body functionality scores.Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages were negatively correlated with five MNA items exploring mobility, patient's perception of own nutrition and health status, and arm and calf circumferences (lowest Spearman's rho (rs)5 -0.011; highest p50.039). GOLD stages were independently correlated with body composition and body functionality scores (model r 2 50.073). Age was negatively correlated with four MNA items exploring loss of appetite, fluid intake, mobility and autonomy in daily life (lowest rs5 -0.013; highest p50.030). Age was independently correlated with body functionality score (model r 2 50.037). Severe COPD and ageing are independent and probably concurrent conditions leading to malnutrition. The MNA questionnaire allows a valuable insight into the complexity of components of nutritional status and may provide useful clues for treatment strategies.

Comparison of Geriatric Nutritional Risk Index scores on physical performance among elderly patients with chronic obstructive pulmonary disease

“…Several assessment tools of nutritional depletion for patients with COPD, such as questionnaire (mini-nutritional assessment, MNA 28 ; subjective global assessment, SGA 29 ) and body weight, have already been reported. The GNRI is easier to use than the MNA and is not based on subjective judgment as is the SGA.…”

Anaemia in chronic obstructive pulmonary disease: an insight into its prevalence and pathophysiology

“…Its aetiology is multifactorial; however, inadequate oral intake is one of the identified causes [125,126]. Obase et al [127] reported that daily iron intake among 13 COPD patients was about half of that of 27 age-matched controls; however, literature data on mineral intake among COPD patients are limited, so the frequency and severity of true iron deficiency as a cause of anaemia cannot be accurately estimated.…”

“…The cause of anaemia is multifactorial. Increased systemic inflammatory markers, such as TNF-α and IL-6 [132,133], decreased sensitivity of erythroid progenitor cells to EPO [134], lower ability of the aging kidney to produce adequate EPO quantities [131], malnutrition [126] and high burden of co-morbidities [130,131] all contribute to the establishment of anaemia in the elderly.…”

Practical management problems of stable chronic obstructive pulmonary disease in the elderly

“…Additionally, COPD and aging are independent and probably concurrent conditions leading to malnutrition. Recent evidence suggests that COPD influences aspects related to body composition, whereas both COPD and aging contribute to poor body functionality [30]. Finally, the combination of nutritional supplementation with low-intensity exercise training may help to increase weight and energy intake, as well as exercise capacity and health-related quality of life in elderly malnourished COPD patients [31].…”