Malnutrition according to ESPEN definition predicts long-term mortality in general older population: Findings from the EPIDOS study-Toulouse cohort.


Journal

Clinical nutrition (Edinburgh, Scotland)
ISSN: 1532-1983
Titre abrégé: Clin Nutr
Pays: England
ID NLM: 8309603

Informations de publication

Date de publication:
12 2019
Historique:
received: 26 03 2018
revised: 23 10 2018
accepted: 26 11 2018
pubmed: 16 12 2018
medline: 22 9 2020
entrez: 16 12 2018
Statut: ppublish

Résumé

The European Society of Clinical Nutrition and Metabolism (ESPEN) has developed a consensus definition of malnutrition. This study aimed to determine the prevalence of malnutrition according to the ESPEN definition in otherwise healthy community-dwelling older women and to explore its value for predicting long-term mortality in this population. This prospective population-based cohort study included 181 women (age ≥75 years) from a subsample of the EPIDémiologie de l'OStéoporose (EPIDOS) study participants from Toulouse. Inclusion criteria were the availability of the data on variables required to apply the ESPEN definition and survival after 7 years of follow-up. Primary outcome was mortality at 12-year follow-up; main covariates were malnutrition assessment according to the ESPEN consensus and its components (unintentional weight loss, BMI, and FFMI). Body composition was assessed by dual-energy X-ray absorptiometry at baseline and at 7-year follow-up. Kaplan-Meier survival curves and adjusted Cox regressions were performed. Analysis was adjusted for age, hypertension, diabetes mellitus, and coronary heart disease as potential confounders. Complete data were available for 179 of the 181 women in the EPIDOS-Toulouse cohort (83.1 ± 2.2 years) and 13 (7.3%) fulfilled the ESPEN definition for malnutrition at 7-year follow-up. Malnutrition was associated with increased risk of mortality (adjusted HR = 4.4 [95%CI: 1.7-11.3]). Among the ESPEN components, only BMI was associated with increased mortality (adjusted HR=0.6 [95%CI: 0.4-0.9]). Although malnutrition prevalence according to the ESPEN definition was relatively low (7.3%) in this sample of otherwise healthy community-dwelling older French women, malnutrition was associated with 4.4-fold higher mortality risk at 12-year follow-up.

Sections du résumé

BACKGROUND
The European Society of Clinical Nutrition and Metabolism (ESPEN) has developed a consensus definition of malnutrition. This study aimed to determine the prevalence of malnutrition according to the ESPEN definition in otherwise healthy community-dwelling older women and to explore its value for predicting long-term mortality in this population.
METHODS
This prospective population-based cohort study included 181 women (age ≥75 years) from a subsample of the EPIDémiologie de l'OStéoporose (EPIDOS) study participants from Toulouse. Inclusion criteria were the availability of the data on variables required to apply the ESPEN definition and survival after 7 years of follow-up. Primary outcome was mortality at 12-year follow-up; main covariates were malnutrition assessment according to the ESPEN consensus and its components (unintentional weight loss, BMI, and FFMI). Body composition was assessed by dual-energy X-ray absorptiometry at baseline and at 7-year follow-up. Kaplan-Meier survival curves and adjusted Cox regressions were performed. Analysis was adjusted for age, hypertension, diabetes mellitus, and coronary heart disease as potential confounders.
RESULTS
Complete data were available for 179 of the 181 women in the EPIDOS-Toulouse cohort (83.1 ± 2.2 years) and 13 (7.3%) fulfilled the ESPEN definition for malnutrition at 7-year follow-up. Malnutrition was associated with increased risk of mortality (adjusted HR = 4.4 [95%CI: 1.7-11.3]). Among the ESPEN components, only BMI was associated with increased mortality (adjusted HR=0.6 [95%CI: 0.4-0.9]).
CONCLUSIONS
Although malnutrition prevalence according to the ESPEN definition was relatively low (7.3%) in this sample of otherwise healthy community-dwelling older French women, malnutrition was associated with 4.4-fold higher mortality risk at 12-year follow-up.

Identifiants

pubmed: 30551898
pii: S0261-5614(18)32549-4
doi: 10.1016/j.clnu.2018.11.016
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2652-2658

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Auteurs

Dolores Sánchez-Rodríguez (D)

Geriatrics Department, Parc de Salut Mar (Centre Fòrum - Hospital del Mar), Barcelona, Spain; Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain; School of Medicine, Universitat Pompeu Fabra, Barcelona, Spain. Electronic address: 97662@parcdesalutmar.cat.

Ester Marco (E)

Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain; Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar - Hospital de l'Esperança), Barcelona, Spain; Universitat Internacional de Catalunya, Barcelona, Spain.

Anne-Marie Schott (AM)

Department IMER, Lyon University Hospital, EA 4129, RECIF, University of Lyon, Inserm, U831, Lyon, France. Electronic address: anne-marie.schott-pethelaz@chu-lyon.fr.

Yves Rolland (Y)

Department of Geriatrics, Toulouse University Hospital, Gerontopole of Toulouse, INSERM U1027, University of Toulouse III, Toulouse, France. Electronic address: rolland.y@chu-toulouse.fr.

Hubert Blain (H)

Department of Internal Medicine and Geriatrics, Montpellier University Hospital, University of Montpellier 1, Montpellier, France.

Olga Vázquez-Ibar (O)

Geriatrics Department, Parc de Salut Mar (Centre Fòrum - Hospital del Mar), Barcelona, Spain; School of Medicine, Universitat Pompeu Fabra, Barcelona, Spain.

Ferran Escalada (F)

Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain; Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar - Hospital de l'Esperança), Barcelona, Spain.

Xavier Duran (X)

Methodology and Biostatistics Support Unit, Institut Hospital del Mar d'Investigacions Mèdiques, (IMIM), Barcelona, Spain.

Josep M Muniesa (JM)

Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain; Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar - Hospital de l'Esperança), Barcelona, Spain.

Cédric Annweiler (C)

Department of Neurosciences and Aging, Division of Geriatric Medicine, Angers University Hospital, Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, University of Angers, UNAM, Angers, France; Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.

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