Severe Weight Loss and Its Association with Fatigue in Old Patients at Discharge from a Geriatric Hospital

Abstract

Although malnutrition is frequent in the old, little is known about its association with fatigue. We evaluated the relation of self-reported severe weight loss with fatigue and the predictors for fatigue in old patients at hospital discharge. Severe weight loss was defined according to involuntary weight loss ≥5% in the last three months. We determined fatigue with the validated Brief Fatigue Inventory questionnaire. The regression analyses were adjusted for age, sex, number of comorbidities, medications/day, and BMI. Of 424 patients aged between 61 and 98 y, 34.1% had severe weight loss. Fatigue was higher in patients with severe weight loss (3.7 ± 2.3 vs. 3.2 ± 2.3 points, p = 0.021). In a multinomial regression model, weight loss was independently associated with higher risk for moderate fatigue (OR:1.172, CI:1.026–1.338, p = 0.019) and with increased risk for severe fatigue (OR:1.209, CI:1.047–1.395, p = 0.010) together with the number of medications/day (OR:1.220, CI:1.023-1.455, p = 0.027). In a binary regression model, severe weight loss predicted moderate-to-severe fatigue in the study population (OR:1.651, CI:1.052-2.590, p = 0.029). In summary, patients with self-reported severe weight loss at hospital discharge exhibited higher fatigue levels and severe weight loss was an independent predictor of moderate and severe fatigue, placing these patients at risk for impaired outcome in the post-hospital period.

Is the natural feed the better nutritional therapy in patients with severe acquired brain injury? A retrospective study

“…One of the main aspects of hospital malnutrition is represented by excessive thinness [32]. Such a condition, demonstrated by a low BMI, was also observed in our sample.…”

Malnutrition in Older Adults—Recent Advances and Remaining Challenges

“…Fatigue has been described as a relentless exhaustion affecting the ability to carry out physical and mental activities [ 43 ] and has been linked to age-related mitochondrial dysfunction [ 44 , 45 ]. Old patients with severe involuntary weight loss at discharge from hospital had a significantly higher risk for severe fatigue which in turn compromises post hospital recovery [ 46 ]. Nutritional status including both malnutrition and obesity, has moreover been identified as an important modulator of fatigue [ 47 ], and more evidence is warranted on the role of dietary approaches, including anti-inflammatory diets, in the treatment of fatigue [ 48 ].…”

Lack of energy is associated with malnutrition in nursing home residents: Results from the INCUR study

“…More recently, Kushkestani et al 22 reported a positive association (r = 0.410, P < 0.001) between malnutrition, defined according to the MNA, and fatigue (assessed using the Functional Assessment of Chronic Illness Therapy Fatigue questionnaire) in NH residents. Another recent study 23 documented that severe weight loss was an independent predictor of moderate (OR = 1.17, 95% CI = 1.03-1.34, P = 0.019) to severe fatigue (OR = 1.21, 95% CI = 1.05-1.39, P = 0.01) in older patients at hospital discharge. Tsutsumimoto et al 24 reported that anorexia of aging was independently associated with exhaustion (OR = 1.39, 95% CI = 1.11-1.74, P = 0.004).…”