Identifying and Managing Malnutrition, Frailty and Sarcopenia in the Community: A Narrative Review

Roberts, Shelley; Collins, Peter; Rattray, Megan

doi:10.3390/nu13072316

Cited by 48 publications

(28 citation statements)

References 166 publications

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“…To date, several barriers have been identified in routine clinical screening of sarcopenia, including the lack of confidence in health care workers in the screening tools, the underestimation of the disease, the lack of specific services to manage sarcopenic patients, or limitations to access these specific services [ 169 , 170 , 171 ]. As a result, sarcopenic dysphagia screening has not been fully introduced in routine clinical practice, albeit recent studies [ 172 , 173 , 174 , 175 ] have emphasized the need for a specific therapeutic intervention including rehabilitation in this condition.…”

Section: Sarcopenic Dysphagia: An Old and New Conceptmentioning

confidence: 99%

Sarcopenic Dysphagia, Malnutrition, and Oral Frailty in Elderly: A Comprehensive Review

et al. 2022

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Frailty is a highly prevalent condition in the elderly that has been increasingly considered as a crucial public health issue, due to the strict correlation with a higher risk of fragility fractures, hospitalization, and mortality. Among the age-related diseases, sarcopenia and dysphagia are two common pathological conditions in frail older people and could coexist leading to dehydration and malnutrition in these subjects. “Sarcopenic dysphagia” is a complex condition characterized by deglutition impairment due to the loss of mass and strength of swallowing muscles and might be also related to poor oral health status. Moreover, the aging process is strictly related to poor oral health status due to direct impairment of the immune system and wound healing and physical and cognitive impairment might indirectly influence older people’s ability to carry out adequate oral hygiene. Therefore, poor oral health might affect nutrient intake, leading to malnutrition and, consequently, to frailty. In this scenario, sarcopenia, dysphagia, and oral health are closely linked sharing common pathophysiological pathways, disabling sequelae, and frailty. Thus, the aim of the present comprehensive review is to describe the correlation among sarcopenic dysphagia, malnutrition, and oral frailty, characterizing their phenotypically overlapping features, to propose a comprehensive and effective management of elderly frail subjects.

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Section: Sarcopenic Dysphagia: An Old and New Conceptmentioning

confidence: 99%

Sarcopenic Dysphagia, Malnutrition, and Oral Frailty in Elderly: A Comprehensive Review

et al. 2022

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“…Both ESPEN and ASPEN identified similar criteria for the diagnosis of malnutrition but with different clinical indicators [16,17]. Following the ESPEN recommendations, subjects at risk of malnutrition should be recognized by validated screening tool criteria, further assessed, and treated accordingly (Table 1).…”

Section: Definition Of Malnutritionmentioning

confidence: 99%

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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“…Sarcopenia, defined as an age-related generalized loss of skeletal muscle mass, has been related to frailty, overall functional impairment, and poor survival in geriatric population [ 8 – 10 ]. Although the universal measurements for sarcopenia remain to be established [ 11 ], sarcopenia has been proposed as a predictor of poor prognosis in patients of various chronic diseases, such as cancer [ 12 ], coronary artery disease [ 13 ], and chronic kidney disease [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Sarcopenia and Mortality Risk of Patients with Sepsis: A Meta-Analysis

Liu

Zhao

2022

International Journal of Clinical Practice

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Background. The association between sarcopenia at admission and mortality in patients with sepsis has not been comprehensively evaluated. We performed a meta-analysis to systematically evaluate the above association. Methods. This meta-analysis included relevant observational studies from Medline, Embase, and Web of Science databases. A random-effect model after incorporation of the intrastudy heterogeneity was selected to pool the results. Subgroup analyses were applied to evaluate the influences of study characteristics on relationship. Results. Ten cohort studies including 2396 patients with sepsis were included, and 1496 (62.4%) of them had sarcopenia at presentation. Pooled results showed that compared to those without sarcopenia, septic patients with sarcopenia had a significantly increased early (in-hospital or 1-month) mortality risk (risk ration (RR): 2.14, 95% confidence interval (CI): 1.60–2.87, P < 0.001; I2 = 46%). Subgroup analyses showed consistent association between sarcopenia and increased acute mortality risk in septic patients which were not affected by study characteristics such as study design, country of the study, clinical settings, diagnostic criteria for sepsis, age, gender of the patients, and methods for diagnosis of sarcopenia ( P for all subgroup analyses >0.05). Further meta-analyses showed that sarcopenia was also associated with increased mortality risk in septic patients at 3–6 months (RR: 2.13, 95% CI: 1.58–2.89, P < 0.001; I2 = 0%) and at 1 year (RR: 1.57, 95% CI: 1.09–2.24, P = 0.01; I2 = 29%). Conclusions. Current evidence suggests that sarcopenia may be a predictor of mortality in patients with sepsis.

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Identifying and Managing Malnutrition, Frailty and Sarcopenia in the Community: A Narrative Review

Cited by 48 publications

References 166 publications

Sarcopenic Dysphagia, Malnutrition, and Oral Frailty in Elderly: A Comprehensive Review

Sarcopenic Dysphagia, Malnutrition, and Oral Frailty in Elderly: A Comprehensive Review

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

Sarcopenia and Mortality Risk of Patients with Sepsis: A Meta-Analysis

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