Frailty and nutritional status in older people: the Mini Nutritional Assessment as a screening tool for the identification of frail subjects

Valentini, Alessia; Federici, Massimo; Cianfarani, Maria Assunta; Tarantino, Umberto; Bertoli, A

doi:10.2147/cia.s164174

Cited by 74 publications

(72 citation statements)

References 39 publications

(47 reference statements)

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“…In this connection, systemic inflammation was found not only to reduce albumin synthesis but also to increase its degradation and promote transcapillary leakage [47]. As in the present study, earlier research demonstrated that nutritional status was closely associated with the degree of frailty [48][49][50]. Hence, this association supports the presence of link between pro-inflammatory cytokines and nutritional status.…”

Section: Discussionsupporting

confidence: 86%

Evaluation of pro-inflammatory cytokines in frail Tunisian older adults

et al. 2020

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The present study was undertaken to evaluate serum levels of pro-inflammatory cytokines in Tunisian older adults and to examine the relationships between inflammatory marker levels, geriatric, and biochemical parameters. A cross-sectional study was conducted in a population of Tunisian older adults (N = 141, aged 65 and over). Patients were recruited from the Department of Internal Medicine, Fattouma Bourguiba University Hospital (Monastir, Tunisia) and from a nursing home (Sousse, Tunisia). Comprehensive geriatric assessment, history taking and examination including functional and nutritional assessment were done for each participant. Enzyme-linked immunosorbent assay (ELISA) test was used to measure serum cytokine (TNF-α, IL-8, IL-6) levels. The modified Short Emergency Geriatric Assessment score (SEGAm) were used to classify patients as 51 very-frail, 40 frail, and 50 non-frail. The age of the participants (80 men, 61 women) ranged from 65 to 97 years. Serum levels of TNF-α, IL-8 and C-reactive protein (CRP) were significantly higher in very-frail participants compared to frail and non-frail ones. However, no significant differences in IL-6 levels were detected among frailty groups. After adjustment for age, CRP and IL-8 levels remained significantly associated with frailty. Analysis of the receiver operating characteristic (ROC) curve corresponding to IL-8 showed an area under the curve of 0.7 (p = 0.003; 95% CI [0.58–0.81]) and a predictive threshold of 5.27 pg/ml. Positive correlations were found between frailty score, IL-6, and IL-8 levels. In addition, a significant positive correlation was observed between IL-8 levels and Timed Up and Go test results. However, a negative correlation was observed between Mini Nutritional Assessment Short-Form score, IL-6 and CRP levels, as well as between Activities of Daily Living score and serum levels of TNF-α, IL-6, and CRP. In conclusion, the key findings of this study collectively support a role of pro-inflammatory cytokines, TNF-α, CRP, and especially IL-8 in the development of frailty in older adults.

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Section: Discussionsupporting

confidence: 86%

Evaluation of pro-inflammatory cytokines in frail Tunisian older adults

et al. 2020

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“…Functional decline may be more important and it is associated with the G8 score in elderly patients and the reasons are as follows. The G8 screening tool puts weight on nutritional status and consists of mobility, neuropsychological problems, drugs prescribed, self-assessment health condition, and age, from the Mini-Nutritional Assessment questionnaire [22, 23]. We think that these items may be important factors for reflecting functional decline and predicting chemotherapy tolerance in elderly cancer patients.…”

Section: Discussionmentioning

confidence: 99%

Prospective evaluation of the G8 screening tool for prognostication of survival in elderly patients with lung cancer: A single-institution study

et al. 2019

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The G8 questionnaire is a quick and easy-to-use screening tool. Several studies reported that the G8 questionnaire had a high sensitivity for predicting abnormalities in the full comprehensive geriatric assessment and predicted functional decline and survival in elderly cancer patients. The present study aimed to evaluate the role of the G8 questionnaire for predicting clinical outcomes and overall survival (OS) in elderly patients with lung cancer, who received chemotherapy or chemoradiotherapy. The data of 101 lung cancer patients aged ≥70 years, who were hospitalized between September 2011 and August 2014, were analyzed. Of these patients (median age, 77 years), 83 (82%) had impaired G8 scores. The proportion of patients with an impaired G8 score was significantly higher in patients aged ≥80 years than those aged <80 years (p = 0.04). All 18 patients with a normal G8 score possessed an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 or 1, and none of the patients with a normal G8 score had an ECOG PS of ≥2 (p < 0.0001). An impaired G8 score tended to correlate with a relative dose intensity of <0.65 in patients who received chemotherapy or chemoradiotherapy (p = 0.05, odds ratio = 5.40). In the univariate analysis, an ECOG PS of ≥2 and an impaired G8 score were significantly associated with a poor OS (p = 0.009 and p = 0.003, respectively). Moreover, in the multivariate analysis, an ECOG PS of ≥2 (HR 2.55; 95% CI, 1.23–5.30; p = 0.01) and an impaired G8 score (HR 3.86; 95% CI, 1.44–13.36; p = 0.006) were remained independent prognostic factor for OS. G8 screening tool is useful for the prognostication of elderly lung cancer patients treated with chemotherapy. These finding suggest that the G8 questionnaire could be a useful tool in treatment decision-making to predict prognosis and prevent patients from receiving inappropriate anti-cancer treatment near the end of life.

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“…Frailty was more common in the hospitalized patients, while pre-frailty was more prevalent in the outpatient population. [27] We do not know for certain how the prevalence of these syndromes has changed or will change over time, but another study conducted in Swedish elders found the prevalence of geriatric syndromes to be stable over time. [28] Of note, our study found the overlap between frailty and sarcopenia risk to be quite high with 25.1% of older adults screening positive for both frailty and sarcopenia.…”

Section: Plos Onementioning

confidence: 99%

High prevalence of geriatric syndromes in older adults

et al. 2020

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Introduction The geriatric syndromes of frailty, sarcopenia, weight loss, and dementia are highly prevalent in elderly individuals across all care continuums. Despite their deleterious impact on quality of life, disability, and mortality in older adults, they are frequently under-recognized. At Saint Louis University, the Rapid Geriatric Assessment (RGA) was developed as a brief screening tool to identify these four geriatric syndromes. Materials and methods From 2015-2019, the RGA, comprised of the FRAIL, SARC-F, Simplified Nutritional Appetite Questionnaire (SNAQ), and Rapid Cognitive Screen (RCS) tools and a question on Advance Directives, was administered to 11,344 individuals � 65 years of age across Missouri in community, office-based, hospital, Programs of All-Inclusive Care for the Elderly (PACE), and nursing home care settings. Standard statistical methods were used to calculate the prevalence of frailty, sarcopenia, weight loss, and dementia across the sample. Results Among the 11,344 individuals screened by the RGA, 41.0% and 30.4% met the screening criteria for pre-frailty and frailty respectively, 42.9% met the screening criteria for sarcopenia, 29.3% were anorectic and at risk for weight loss, and 28.1% screened positive for dementia. The prevalence of frailty, risk for weight loss, sarcopenia, and dementia increased with age and decreased when hospitalized patients and those in the PACE program or nursing home were excluded. Conclusions Using the RGA as a valid screening tool, the prevalence of one or more of the geriatric syndromes of frailty, sarcopenia, weight loss, and dementia in older adults across all care

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Frailty and nutritional status in older people: the Mini Nutritional Assessment as a screening tool for the identification of frail subjects

Cited by 74 publications

References 39 publications

Evaluation of pro-inflammatory cytokines in frail Tunisian older adults

Evaluation of pro-inflammatory cytokines in frail Tunisian older adults

Prospective evaluation of the G8 screening tool for prognostication of survival in elderly patients with lung cancer: A single-institution study

High prevalence of geriatric syndromes in older adults

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