E Paillaud1, E Liuu2, M Laurent3, A Le Thuaut4, H Vincent5, A Raynaud-Simon6, S Bastuji-Garin7, C Tournigand8, P Caillet3, F Canoui-Poitrine7. 1. Department of Internal Medicine and Geriatrics, AP-HP, Henri-Mondor Hospital, Onco-Geriatric Clinic, F-94010 Créteil, France; LIC EA 4393, Université Paris Est Créteil (UPEC), F-94010 Créteil, France. Electronic address: Elena.paillaud@ach.aphp.fr. 2. Department of Internal Medicine and Geriatrics, AP-HP, Henri-Mondor Hospital, Onco-Geriatric Clinic, F-94010 Créteil, France. 3. Department of Internal Medicine and Geriatrics, AP-HP, Henri-Mondor Hospital, Onco-Geriatric Clinic, F-94010 Créteil, France; LIC EA 4393, Université Paris Est Créteil (UPEC), F-94010 Créteil, France. 4. LIC EA 4393, Université Paris Est Créteil (UPEC), F-94010 Créteil, France; Clinical Research Unit (URC-Mondor), AP-HP, Henri-Mondor Hospital, F 94010 Créteil, France. 5. Department of Geriatrics, AP-HP, Paul-Brousse Hospital, F-94804 Villejuif, France. 6. Department of Geriatrics, AP-HP, Bichat Hospital, F-75018 Paris, France. 7. LIC EA 4393, Université Paris Est Créteil (UPEC), F-94010 Créteil, France; Department of Public Health, AP-HP, Henri-Mondor Hospital, F-94010 Créteil, France. 8. Department of Oncology, AP-HP, Henri-Mondor Hospital, F-94010 Créteil, France.
Abstract
BACKGROUND & AIMS: We assessed the prevalence and risk factors of malnutrition in elderly cancer patients. METHODS: We studied a prospective cohort of solid cancer patients aged ≥70 years at referral to two geriatric oncology clinics between 2007 and 2010. Nutrition was evaluated using the Mini-Nutritional Assessment (MNA) using validated cut-offs (<17: malnutrition, 17-23.5: at-risk for malnutrition). Patients with non-digestive tumours (breast, prostate, urinary tract) and with digestive (colorectal, upper digestive tract and liver) were analysed separately using multinomial logistic regression. RESULTS: Of 643 consecutive patients, 519 had available data (median age, 80; men, 48.2%; metastases, 46.3%; digestive cancer 47.8%). In non-digestive group, 13.3% had malnutrition versus 28.6% in digestive group. The link between metastasis and malnutrition was significantly higher in non-digestive group (adjusted odds ratio [ORa ], 25.25; 95%CI: 5.97-106.8) than in digestive group (ORa, 2.59; 1.08-6.24; p for heterogeneity = 0.04). Other factors independently associated with malnutrition were cognitive impairment (ORa MMMSE ≤ 24 versus > 24 in non-digestive group: 16.68; 4.89-56.90 and in digestive group: 3.93; 1.34-11.50), and depressed mood (ORa MiniGDS ≥1 versus <1 in non-digestive group: 11.11; 3.32-37.17 and in digestive group: 3.25; 1.29-8.15) and fall risk (ORa fall risk versus no fall risk in non-digestive group: 4.68; 1.77-12.37; in digestive group: 100% of malnourished patients were faller's). CONCLUSION: We highlighted, in elderly cancer patients, the high prevalence of malnutrition and that geriatrics syndromes (i.e. cognitive impairment, depressed mood and fall risk) were independent risk factors for malnutrition. Moreover, metastatic status was significantly much more strongly associated with malnutrition in non-digestive than digestive tumours.
BACKGROUND & AIMS: We assessed the prevalence and risk factors of malnutrition in elderly cancerpatients. METHODS: We studied a prospective cohort of solid cancerpatients aged ≥70 years at referral to two geriatric oncology clinics between 2007 and 2010. Nutrition was evaluated using the Mini-Nutritional Assessment (MNA) using validated cut-offs (<17: malnutrition, 17-23.5: at-risk for malnutrition). Patients with non-digestive tumours (breast, prostate, urinary tract) and with digestive (colorectal, upper digestive tract and liver) were analysed separately using multinomial logistic regression. RESULTS: Of 643 consecutive patients, 519 had available data (median age, 80; men, 48.2%; metastases, 46.3%; digestive cancer 47.8%). In non-digestive group, 13.3% had malnutrition versus 28.6% in digestive group. The link between metastasis and malnutrition was significantly higher in non-digestive group (adjusted odds ratio [ORa ], 25.25; 95%CI: 5.97-106.8) than in digestive group (ORa, 2.59; 1.08-6.24; p for heterogeneity = 0.04). Other factors independently associated with malnutrition were cognitive impairment (ORa MMMSE ≤ 24 versus > 24 in non-digestive group: 16.68; 4.89-56.90 and in digestive group: 3.93; 1.34-11.50), and depressed mood (ORa MiniGDS ≥1 versus <1 in non-digestive group: 11.11; 3.32-37.17 and in digestive group: 3.25; 1.29-8.15) and fall risk (ORa fall risk versus no fall risk in non-digestive group: 4.68; 1.77-12.37; in digestive group: 100% of malnourished patients were faller's). CONCLUSION: We highlighted, in elderly cancerpatients, the high prevalence of malnutrition and that geriatrics syndromes (i.e. cognitive impairment, depressed mood and fall risk) were independent risk factors for malnutrition. Moreover, metastatic status was significantly much more strongly associated with malnutrition in non-digestive than digestive tumours.
Authors: Lydia Brugel; Marie Laurent; Philippe Caillet; Anne Radenne; Isabelle Durand-Zaleski; Michel Martin; Melany Baron; Héloïse de Kermadec; Sylvie Bastuji-Garin; Florence Canouï-Poitrine; Elena Paillaud Journal: BMC Cancer Date: 2014-06-13 Impact factor: 4.430
Authors: Semaw Ferede Abera; Rafael T Mikolajczyk; Eva Johanna Kantelhardt; Ljupcho Efremov; Ahmed Bedir; Christian Ostheimer; André Glowka; Dirk Vordermark; Daniel Medenwald Journal: Front Oncol Date: 2021-02-25 Impact factor: 6.244