Easy-to-use clinical criteria for screening malnutrition in older patients with type 2 diabetes mellitus.
(2014) Journées d’Automne - Société belge de gériatrie et gérontologie (SBGG) — Location: Liège, BE
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- Introduction. Malnutrition is associated with a high mortality risk in older patients with type 2 diabetes mellitus, and can be diagnosed with the mini-nutritional assessment short form (MNA-SF). Nevertheless, in the daily practice, MNASF is not systematically performed in geriatric inpatients, partly due to lack of time and/or missing data. This study aimed at identifying some easy-to-use, easily gathered and effective clinical criteria for screening malnutrition in older patients with diabetes. Methods. Cross-sectional study in older diabetic patients admitted to medical or surgical wards in a Belgian academic hospital (2012-2013). The four inclusion criteria were met by 172 patients (83+/- 4 years old; sex ratio 1:1), i.e. older age (≥75 years), type 2 diabetes mellitus, risk of decline (ISAR ≥2) and comprehensive geriatric assessment (CGA) performed by the internal liaison team. Searching clinical criteria for screening malnutrition, we compared the patients with malnutrition (MNA-SF ≤ 7/14) to those without malnutrition in terms of mid-arm circumference (MAC) and MNA-SF items (scores for mobility and neuropsychological problems, body mass index; history over the past 3 months of weight loss, psychological stress/acute disease or food intake decline). Appropriate statistics were used (χ2 and t-tests) to test the observed differences. Results. Older diabetic patients with malnutrition (n=44, MNA-SF 5.8 +/-1.6), as compared to those without malnutrition (n=128, MNA-SF 10.7+/-1.7), were similar in age and gender but presented with smaller MAC (25.2 +/-3.3 vs. 28.6 +/- 3.9 cm, n=151, p<0.001). MACvs. 32%, ORatio=4.5, χ2 1df 13.7, p<0.001), and offered fair screening characteristics (sensitivity 68%, specificity 67%) at this cut-off value. Comparing the MNA-SF items in patients with and without malnutrition, we observed differences in mobility problems (scores: 0.84 vs. 1.25; Δ=0.41), neuropsychological troubles (1.02 vs. 1.48; Δ=0.46), body mass index (1.41 vs. 2.68; Δ=1.27, n=121) as well as in reports of weight loss (0.82 vs. 2.13; Δ=1.31), of psychological stress/acute disease (1.09 vs. 1.69; Δ=0.60) and of food intake decline (0.59 vs. 1.46; Δ=0.87) over the past 3 months.
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Christiaens, A., Beeckmans, M., Hermans, M., & Boland, B. (2014). Easy-to-use clinical criteria for screening malnutrition in older patients with type 2 diabetes mellitus. Geriatrie et Psychologie Neuropsychiatrie du Vieillissement, 12(Suppl. 3), 16-17. https://hdl.handle.net/2078.5/124917 (Original work published 2014)