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Mortality in malnourished older adults diagnosed by ESPEN and GLIM criteria in the SarcoPhAge study

BACKGROUND: The Global Leadership Initiative on Malnutrition (GLIM) criteria have been recently launched by consensus of the major nutrition societies. GLIM criteria are partly constructed on the previous definition of malnutrition developed by the European Society of Clinical Nutrition and Metaboli...

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Autores principales: Sanchez‐Rodriguez, Dolores, Locquet, Médéa, Reginster, Jean‐Yves, Cavalier, Etienne, Bruyère, Olivier, Beaudart, Charlotte
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7567139/
https://www.ncbi.nlm.nih.gov/pubmed/32657045
http://dx.doi.org/10.1002/jcsm.12574
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author Sanchez‐Rodriguez, Dolores
Locquet, Médéa
Reginster, Jean‐Yves
Cavalier, Etienne
Bruyère, Olivier
Beaudart, Charlotte
author_facet Sanchez‐Rodriguez, Dolores
Locquet, Médéa
Reginster, Jean‐Yves
Cavalier, Etienne
Bruyère, Olivier
Beaudart, Charlotte
author_sort Sanchez‐Rodriguez, Dolores
collection PubMed
description BACKGROUND: The Global Leadership Initiative on Malnutrition (GLIM) criteria have been recently launched by consensus of the major nutrition societies. GLIM criteria are partly constructed on the previous definition of malnutrition developed by the European Society of Clinical Nutrition and Metabolism (ESPEN). We aimed to assess malnutrition according to the ESPEN and GLIM criteria at baseline and to determine the corresponding risk of mortality during a 4‐year follow‐up in community‐dwelling older adults from the SarcoPhAge (Sarcopenia and Physical Impairment with advancing Age) study. The relationship between malnutrition and incidence of 4‐year adverse health consequences (institutionalization, hospitalization, falls, and fractures) was assessed. METHODS: This prospective population‐based cohort was part of SarcoPhAge, which included 534 older adults in Belgium, followed up from 2013 to 2019. Community‐dwelling healthy volunteers ≥65 years old were recruited. Mortality and adverse health consequences were collected annually by interview or phone call. Baseline malnutrition was defined according to the GLIM and ESPEN criteria. Agreement between the two definitions was reported by Cohen's kappa coefficient. Adjusted Cox regression and Kaplan–Meier survival curves were performed for malnutrition. Logistic regression was used for the other outcomes. RESULTS: From 534 subjects in SarcoPhAge, the records for 411 participants (73.2 ± 6.05 years old; 55.7% women) had all the variables needed to apply the GLIM criteria. Prevalence of baseline malnutrition was 23.4% for GLIM and 7% for ESPEN criteria (k = 0.30, low agreement). The adjusted Cox regression showed a significant increased mortality risk according to malnutrition status as defined by the GLIM [adjusted hazard ratio = 4.41 (95% confidence interval: 2.17–8.97)] and ESPEN [adjusted hazard ratio = 2.76 (95% confidence interval: 1.16–6.58)] criteria. Survival curves differed significantly between malnourished and non‐malnourished groups, regardless of the definition used (log rank P < 0.001 for both). No association was found between baseline malnutrition according to these two criteria and 4‐year risk of institutionalization, hospitalization, falls, or fractures (all P > 0.05). CONCLUSIONS: Malnutrition according to the GLIM criteria was associated with a 4.4‐fold higher mortality risk, double that of the ESPEN criteria, during a 4‐year follow‐up. No association was found between malnutrition according to these two criteria and incidence of other health adverse consequences. GLIM criteria anticipate mortality and might guide interventions, with important implications for clinical practice and research.
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spelling pubmed-75671392020-10-21 Mortality in malnourished older adults diagnosed by ESPEN and GLIM criteria in the SarcoPhAge study Sanchez‐Rodriguez, Dolores Locquet, Médéa Reginster, Jean‐Yves Cavalier, Etienne Bruyère, Olivier Beaudart, Charlotte J Cachexia Sarcopenia Muscle Original Articles BACKGROUND: The Global Leadership Initiative on Malnutrition (GLIM) criteria have been recently launched by consensus of the major nutrition societies. GLIM criteria are partly constructed on the previous definition of malnutrition developed by the European Society of Clinical Nutrition and Metabolism (ESPEN). We aimed to assess malnutrition according to the ESPEN and GLIM criteria at baseline and to determine the corresponding risk of mortality during a 4‐year follow‐up in community‐dwelling older adults from the SarcoPhAge (Sarcopenia and Physical Impairment with advancing Age) study. The relationship between malnutrition and incidence of 4‐year adverse health consequences (institutionalization, hospitalization, falls, and fractures) was assessed. METHODS: This prospective population‐based cohort was part of SarcoPhAge, which included 534 older adults in Belgium, followed up from 2013 to 2019. Community‐dwelling healthy volunteers ≥65 years old were recruited. Mortality and adverse health consequences were collected annually by interview or phone call. Baseline malnutrition was defined according to the GLIM and ESPEN criteria. Agreement between the two definitions was reported by Cohen's kappa coefficient. Adjusted Cox regression and Kaplan–Meier survival curves were performed for malnutrition. Logistic regression was used for the other outcomes. RESULTS: From 534 subjects in SarcoPhAge, the records for 411 participants (73.2 ± 6.05 years old; 55.7% women) had all the variables needed to apply the GLIM criteria. Prevalence of baseline malnutrition was 23.4% for GLIM and 7% for ESPEN criteria (k = 0.30, low agreement). The adjusted Cox regression showed a significant increased mortality risk according to malnutrition status as defined by the GLIM [adjusted hazard ratio = 4.41 (95% confidence interval: 2.17–8.97)] and ESPEN [adjusted hazard ratio = 2.76 (95% confidence interval: 1.16–6.58)] criteria. Survival curves differed significantly between malnourished and non‐malnourished groups, regardless of the definition used (log rank P < 0.001 for both). No association was found between baseline malnutrition according to these two criteria and 4‐year risk of institutionalization, hospitalization, falls, or fractures (all P > 0.05). CONCLUSIONS: Malnutrition according to the GLIM criteria was associated with a 4.4‐fold higher mortality risk, double that of the ESPEN criteria, during a 4‐year follow‐up. No association was found between malnutrition according to these two criteria and incidence of other health adverse consequences. GLIM criteria anticipate mortality and might guide interventions, with important implications for clinical practice and research. John Wiley and Sons Inc. 2020-07-13 2020-10 /pmc/articles/PMC7567139/ /pubmed/32657045 http://dx.doi.org/10.1002/jcsm.12574 Text en © 2020 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Sanchez‐Rodriguez, Dolores
Locquet, Médéa
Reginster, Jean‐Yves
Cavalier, Etienne
Bruyère, Olivier
Beaudart, Charlotte
Mortality in malnourished older adults diagnosed by ESPEN and GLIM criteria in the SarcoPhAge study
title Mortality in malnourished older adults diagnosed by ESPEN and GLIM criteria in the SarcoPhAge study
title_full Mortality in malnourished older adults diagnosed by ESPEN and GLIM criteria in the SarcoPhAge study
title_fullStr Mortality in malnourished older adults diagnosed by ESPEN and GLIM criteria in the SarcoPhAge study
title_full_unstemmed Mortality in malnourished older adults diagnosed by ESPEN and GLIM criteria in the SarcoPhAge study
title_short Mortality in malnourished older adults diagnosed by ESPEN and GLIM criteria in the SarcoPhAge study
title_sort mortality in malnourished older adults diagnosed by espen and glim criteria in the sarcophage study
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7567139/
https://www.ncbi.nlm.nih.gov/pubmed/32657045
http://dx.doi.org/10.1002/jcsm.12574
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