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The risk of malnutrition and its clinical implications in older patients with cancer

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Abstract

Aim

Malnutrition is a common geriatric syndrome with multiple negative outcomes including mortality. However, there is a scarcity of literature that focuses on the relationship between malnutrition risk and its clinical implications on geriatric syndromes and mortality among cancer patients. The aim of this study is to determine the clinical importance of malnutrition risk in geriatric oncology practice.

Method

180 patients with cancer who were ≥ 65 years were included in the study. All patients were questioned in terms of geriatric syndromes, including polypharmacy, frailty, probable sarcopenia, fall risk, dynapenia, depression, cognitive impairment, insomnia, and excessive daytime sleepiness. Mini Nutritional Assessment scores > 23.5 and 17–23.5 were categorized as well-nourished and malnutrition risk, respectively.

Results

Of the 180 patients (mean age 73.0 ± 5.6 years, female: 50%), the prevalence of malnutrition risk was 28.9%. There was no statistically significant difference between the groups in terms of age, gender, education, marital status, body mass index, and comorbidities except for chronic obstructive pulmonary disease (p > 0.05). After adjustment for age, sex, and body mass index; polypharmacy (odds ratio [OR]: 3.17; 95% confidence interval [CI], 1.48–6.81), reduced calf circumference (OR: 3.72; 95% CI, 1.22–11.38), fall risk (OR: 2.72; 95% CI, 1.03–7.23), depression (OR: 6.24; 95% CI, 2.75–14.18), insomnia (OR: 4.89; 95% CI, 2.16–11.05), and frailty (OR: 2.44; 95% CI, 1.75–3.40) were associated with malnutrition risk compared to well-nourished patients (p < 0.05). Median survival in patients with malnutrition risk was 21.3 months (range 14.1–28.4 95% CI) and median survival in patients who were defined as well nourished was not reached (p < 0.001).

Conclusion

The risk of malnutrition was associated with a higher risk for all-cause mortality in older patients with cancer, and was associated with many geriatric syndromes, including polypharmacy, fall risk, frailty, insomnia, and depression.

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Authors and Affiliations

  1. Department of Medical Oncology, Bezmialem Vakif University, Istanbul, Turkey

    Zehra Sucuoglu Isleyen, Mehmet Besiroglu, Ayse Irem Yasin, Melih Simsek, Atakan Topcu & Haci Mehmet Turk

  2. Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK

    Lee Smith

  3. Department of Medical Oncology, Erzincan Binali Yildirim University Medical School, Erzincan, Turkey

    Baran Akagunduz

  4. Department of Geriatric Medicine, Bezmialem Vakif University, Istanbul, Turkey

    Pinar Soysal

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  1. Zehra Sucuoglu Isleyen
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  2. Mehmet Besiroglu
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Correspondence to Pinar Soysal.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the local ethics committee (identifier: 02/32).

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All the procedures performed in this study involving human participants were in accord ance with the ethical standards of the institutional and national research committee and with the 1964 Declaration of Helsinki and its later amendments.

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Sucuoglu Isleyen, Z., Besiroglu, M., Yasin, A.I. et al. The risk of malnutrition and its clinical implications in older patients with cancer. Aging Clin Exp Res 35, 2675–2683 (2023). https://doi.org/10.1007/s40520-023-02538-0

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