30 January 2012

Elderly patients more likely to be malnourished

Cancer patients age 65 and older are more likely than younger cancer patients to suffer from malnutrition, said researchers from Spain.


Cancer patients age 65 and older are more likely than younger cancer patients to suffer from malnutrition, said researchers from Spain this week at the annual meeting of the American Society for Parenteral and Enteral Nutrition in Orlando, Florida.

"Elderly cancer patients need an integrated geriatric assessment which must include nutritional status. Attending to not only nourishment but also symptoms that impact nutrition could be very important to get an improvement in survival, quality of life and function," said Dr Pilar Matía, from the Hospital Clínico San Carlos in Madrid.

In a presentation 22 January 2012, the researchers reported that out of 1 608 patients studied, 62% of those age 65 and older were moderately or severely malnourished, compared to 45% of patients younger than 65 (p<0.001).

After adjusting for gender, tumour site and stage, use of chemotherapy, and diabetes status, the age-related odds ratio for malnutrition was 1.75.

Nearly half of the patients studied (46%) were at least 65 years old. In the younger group, the mean age was 51.

Differences in age groups

Among the nutrition-related symptom and behaviour differences between the two age groups; the older group was more likely to eat less food than usual (55% vs. 45%), to have a global fat deficit (56% vs. 44%) and to have existing oedema (58% vs. 42%).

The older patients apparently ate less for different reasons than the younger patients: 51% said they had no appetite, compared to 33% of the younger patients; and 19% had dental problems, compared to 8% of the younger patients.

Other symptoms were similar between the two groups, including constipation (about 20%), diarrhoea (11-14%), lacking the ability to taste (about 10%), and nausea (10-13%).

Dr Paul Palalay of the University of Hawaii, who was not involved in the study, said that elderly patients may be more prone to malnutrition, but the new data don't seem to account for differences in types of cancer or for normal physiological changes of age.

Dr Palalay, who was Oncology Medical Director at the Hawaii Medical Centre until it closed its Oahu branches in December 2011, also said, "I think it does underscore the importance of other variables that contribute to malnutrition, and in this study, these included the presence of treatment, stage of disease, and diabetes. It remains a complex issue, and the study does raise the importance of nutritional status, especially in patients above the age of 65 years."

Dr Matía and her team are continuing their research and plan to have more results soon, she says.

(Reuters Health, Rob Goodier, January 2012)

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