Malnutrition is associated with poor trajectories of activities of daily living in geriatric rehabilitation inpatients: RESORT

Hettiarachchi, Jeewanadee; Reijnierse, Esmee M.; Soh, Cheng Hwee; Agius, Bridget; Fetterplace, Kate; Lim, Wen Kwang; Maier, Andrea B.

doi:10.1016/j.mad.2021.111500

Cited by 24 publications

(20 citation statements)

References 44 publications

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“…However, these results were partly in contrast to the study done by Hettiarachchia et al [31] who found that malnutrition cases were associated with limitation of ADL but no limitation in IADL. Regarding GUGT in this study about 80.8% of normal nutrition, 75% of at risk and 21.4% of malnutrition groups were at risk of falls and physical limitations and these results were similar to the study done by Ramsey et al [32] who found that time up and go test was associated with physical limitation.…”

Section: Resultscontrasting

confidence: 98%

Study of Geriatric Nutritional Risk Index and Creatinine Index in Elderly Hemodialysis Patients for Nutritional Assessment

Gayar¹,

Ramadan²,

Tahon

2022

The Egyptian Journal of Hospital Medicine

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Background: Patients undergoing hemodialysis (HD) frequently experience malnutrition, and this condition has strong causal relationship with mortality risk. Patients on hemodialysis typically use both the Geriatric Nutritional Risk Index (GNRI) and the Creatinine Index (CI) for evaluation of their nutritional status. Objective: To compare CI and GNRI for evaluation of malnutrition in elderly hemodialysis patients. Methods: This study included 60 patients aged ≥65 years on maintained hemodialysis who attended Hemodialysis Unit of Alexandria Main University Hospital. Full clinical assessment and routine laboratory investigations were done. Anthropometric measurements were estimated. Nutritional assessment using CI, GNRI, and Short Form Mini Nutritional Assessment. Cognitive function was evaluated using MMSE (mini mental status examination), Get up and Go Test (GUGT), (ADL), and (IADL) were assessed. Results: 43.3% had normal nutrition, 33.3% at risk of malnutrition and 23.3% had malnutrition. BMI, hemoglobin and serum albumin were significantly lower in at risk and malnutrition groups but cholesterol, triglycerides and ESR were significantly higher in at risk and malnutrition groups. GNRI, CI and were significantly lower in at risk and malnutrition groups. All severe cognitive impairment cases (57.1%) were malnourished. 35.7% of mild cognitive impairment were malnourished and 7.1% of normal cognitive functions cases were malnourished. 38.3% had impaired instrumental activities of daily living (IADL), 26.7% had impaired activities of daily living (ADL) and 65% were at risk of falls. Conclusion: GNRI is easy screening scoring tool for identifying the risk of malnutrition and has higher sensitivity and specificity compared to CI in hemodialysis elderly patients.

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Section: Resultscontrasting

confidence: 98%

Study of Geriatric Nutritional Risk Index and Creatinine Index in Elderly Hemodialysis Patients for Nutritional Assessment

Gayar¹,

Ramadan²,

Tahon

2022

The Egyptian Journal of Hospital Medicine

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“…Similarly, an association between poor nutritional state and lower Barthel index was demonstrated in hospitalized old patients [74]. Of note, hospitalized patients with malnutrition or at risk of malnutrition showed a weak recovery function in ADL [75].…”

Section: Malnutrition Muscle and Functional Impairment And Quality Of...mentioning

confidence: 71%

Malnutrition in Hospitalized Old Patients: Screening and Diagnosis, Clinical Outcomes, and Management

et al. 2022

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Malnutrition in hospitalized patients heavily affects several clinical outcomes. The prevalence of malnutrition increases with age, comorbidities, and intensity of care in up to 90% of old populations. However, malnutrition frequently remains underdiagnosed and undertreated in the hospital. Thus, an accurate screening to identify patients at risk of malnutrition or malnourishment is determinant to elaborate a personal nutritional intervention. Several definitions of malnutrition were proposed in the last years, affecting the real frequency of nutritional disorders and the timing of intervention. Diagnosis of malnutrition needs a complete nutritional assessment, which is often challenging to perform during a hospital stay. For this purpose, various screening tools were proposed, allowing patients to be stratified according to the risk of malnutrition. The present review aims to summarize the actual evidence in terms of diagnosis, association with clinical outcomes, and management of malnutrition in a hospital setting.

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“…Liu et al observed that being dependent in ADL and a lower score of ADL were independent factors of malnutrition in older Chinese inpatients [ 41 ], which possibly related to the fact that impaired functional capacity usually causes a loss of appetite and reduced food intake. On the other hand, it has been reported that, in geriatric rehabilitation inpatients, malnutrition at admission was associated with “remained poor” and “deteriorated” ADL trajectories from two weeks pre-admission to three months post-discharge [ 42 ], which implied that decreased muscle mass caused by malnutrition could result in reduced physical function. Therefore, we believe that the relationship between decreased physical capacity and malnutrition is bidirectional.…”

Section: Discussionmentioning

confidence: 99%

The identification and prediction of frailty based on Bayesian network analysis in a community-dwelling older population

et al. 2022

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Background We have witnessed frailty, which characterized by a decline in physiological reserves, become a major public health issue in older adults. Understanding the influential factors associated with frailty may help prevent or if possible reverse frailty. The present study aimed to investigate factors associated with frailty status and frailty transition in a community-dwelling older population. Methods A prospective cohort study on community-dwelling subjects aged ≥ 60 years was conducted, which was registered beforehand (ChiCTR 2,000,032,949). Participants who had completed two visits during 2020–2021 were included. Frailty status was evaluated using the Fried frailty phenotype. The least absolute shrinkage and selection operator (LASSO) regression was applied for variable selection. Bayesian network analysis with the max-min hill-climbing (MMHC) algorithm was used to identify factors related to frailty status and frailty transition. Results Of 1,981 subjects at baseline, 1,040 (52.5%) and 165 (8.33%) were classified as prefrailty and frailty. After one year, improved, stable, and worsening frailty status was observed in 460 (35.6%), 526 (40.7%), and 306 (23.7%) subjects, respectively. Based on the variables screened by LASSO regression, the Bayesian network structure suggested that age, nutritional status, instrumental activities of daily living (IADL), balance capacity, and social support were directly related to frailty status. The probability of developing frailty is 14.4% in an individual aged ≥ 71 years, which increases to 20.2% and 53.2% if the individual has balance impairment alone, or combined with IADL disability and malnutrition. At a longitudinal level, ADL/IADL decline was a direct predictor of worsening in frailty state, which further increased the risk of hospitalization. Low high-density lipoprotein cholesterol (HDL-C) and diastolic blood pressure (DBP) levels were related to malnutrition, and further had impacts on ADL/IADL decline, and ultimately led to the worsening of the frailty state. Knowing the status of any one or more of these factors can be used to infer the risk of frailty based on conditional probabilities. Conclusion Older age, malnutrition, IADL disability, and balance impairment are important factors for identifying frailty. Malnutrition and ADL/IADL decline further predict worsening of the frailty state.

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Malnutrition is associated with poor trajectories of activities of daily living in geriatric rehabilitation inpatients: RESORT

Cited by 24 publications

References 44 publications

Study of Geriatric Nutritional Risk Index and Creatinine Index in Elderly Hemodialysis Patients for Nutritional Assessment

Study of Geriatric Nutritional Risk Index and Creatinine Index in Elderly Hemodialysis Patients for Nutritional Assessment

Malnutrition in Hospitalized Old Patients: Screening and Diagnosis, Clinical Outcomes, and Management

The identification and prediction of frailty based on Bayesian network analysis in a community-dwelling older population

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