Dolores Sánchez-Rodríguez1, Ester Marco2, Natalia Ronquillo-Moreno3, Ramón Miralles4, Olga Vázquez-Ibar5, Ferran Escalada6, Josep M Muniesa7. 1. Geriatrics Department, Parc de Salut Mar (Centre Fòrum-Hospital del Mar), Barcelona, Spain; Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain. Electronic address: 97662@parcdesalutmar.cat. 2. Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital del Mar, Hospital de l'Esperança), Barcelona, Spain; Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; School of Medicine, Universitat Internacional de Catalunya, Spain. Electronic address: emarco@parcdesalutmar.cat. 3. Geriatrics Department, Parc de Salut Mar (Centre Fòrum-Hospital del Mar), Barcelona, Spain. Electronic address: 61309@parcdesalutmar.cat. 4. Geriatrics Department, Parc de Salut Mar (Centre Fòrum-Hospital del Mar), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain. Electronic address: 36286@parcdesalutmar.cat. 5. Geriatrics Department, Parc de Salut Mar (Centre Fòrum-Hospital del Mar), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain. Electronic address: 92257@parcdesalutmar.cat. 6. Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital del Mar, Hospital de l'Esperança), Barcelona, Spain; Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain. Electronic address: 87637@parcdesalutmar.cat. 7. Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital del Mar, Hospital de l'Esperança), Barcelona, Spain; Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain. Electronic address: 87662@parcdesalutmar.cat.
Abstract
BACKGROUNDS & AIMS: The European Society of Clinical Nutrition and Metabolism (ESPEN) consensus definition of malnutrition has been applied in hospitalized older diabetics and middle-aged patients, geriatric outpatients, and healthy elderly and young individuals. In a post-acute care setting, our aim was to assess malnutrition (ESPEN definition) and determine its relationship with sarcopenia in older in-patients deconditioned due to an acute process. METHODS: Eighty-eight in-patients aged ≥70 years with body mass index (BMI) <30 kg/m2 were included (84.1 years old; 62% women) and screened for malnutrition risk using biochemical markers and Mini-Nutritional Assessment-Short Form (MNA-SF). The ESPEN definition was applied: 1) BMI <18.5 kg/m2 or 2) unintentional weight loss plus a) low BMI or b) low fat-free mass index (FFMI). European Working Group on Sarcopenia in Older People (EWGSOP) criteria were also applied. RESULTS: Unintentional weight loss occurred in 27 (30.7%) of 88 in-patients considered "at risk" by MNA-SF. Malnutrition prevalence was 4.5%, 7.9%, and 17% using ESPEN definitions 1, 2a, and 2b, respectively; 19.3% were malnourished. Prevalence of sarcopenia was 37.5%, of which 90.9% fulfilled ESPEN malnutrition criteria, a significant association (p = 0.02). No differences in biochemical markers were observed between patients with or without malnutrition or sarcopenia. CONCLUSIONS: ESPEN criteria constitute an appropriate tool to establish a malnutrition diagnosis in post-acute care. Sarcopenia, as defined by EWGSOP, was present in 37.5% of patients, of which 90.9% fulfilled ESPEN criteria; therefore, malnutrition was significantly related to sarcopenia. Additional work is needed to determine further implications of the ESPEN consensus definition.
BACKGROUNDS & AIMS: The European Society of Clinical Nutrition and Metabolism (ESPEN) consensus definition of malnutrition has been applied in hospitalized older diabetics and middle-aged patients, geriatric outpatients, and healthy elderly and young individuals. In a post-acute care setting, our aim was to assess malnutrition (ESPEN definition) and determine its relationship with sarcopenia in older in-patients deconditioned due to an acute process. METHODS: Eighty-eight in-patients aged ≥70 years with body mass index (BMI) <30 kg/m2 were included (84.1 years old; 62% women) and screened for malnutrition risk using biochemical markers and Mini-Nutritional Assessment-Short Form (MNA-SF). The ESPEN definition was applied: 1) BMI <18.5 kg/m2 or 2) unintentional weight loss plus a) low BMI or b) low fat-free mass index (FFMI). European Working Group on Sarcopenia in Older People (EWGSOP) criteria were also applied. RESULTS: Unintentional weight loss occurred in 27 (30.7%) of 88 in-patients considered "at risk" by MNA-SF. Malnutrition prevalence was 4.5%, 7.9%, and 17% using ESPEN definitions 1, 2a, and 2b, respectively; 19.3% were malnourished. Prevalence of sarcopenia was 37.5%, of which 90.9% fulfilled ESPEN malnutrition criteria, a significant association (p = 0.02). No differences in biochemical markers were observed between patients with or without malnutrition or sarcopenia. CONCLUSIONS: ESPEN criteria constitute an appropriate tool to establish a malnutrition diagnosis in post-acute care. Sarcopenia, as defined by EWGSOP, was present in 37.5% of patients, of which 90.9% fulfilled ESPEN criteria; therefore, malnutrition was significantly related to sarcopenia. Additional work is needed to determine further implications of the ESPEN consensus definition.
Authors: E Dent; J E Morley; A J Cruz-Jentoft; H Arai; S B Kritchevsky; J Guralnik; J M Bauer; M Pahor; B C Clark; M Cesari; J Ruiz; C C Sieber; M Aubertin-Leheudre; D L Waters; R Visvanathan; F Landi; D T Villareal; R Fielding; C W Won; O Theou; F C Martin; B Dong; J Woo; L Flicker; L Ferrucci; R A Merchant; L Cao; T Cederholm; S M L Ribeiro; L Rodríguez-Mañas; S D Anker; J Lundy; L M Gutiérrez Robledo; I Bautmans; I Aprahamian; J M G A Schols; M Izquierdo; B Vellas Journal: J Nutr Health Aging Date: 2018 Impact factor: 4.075