Malnutrition common among older patients with cancer
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Hospitalized older patients with cancer demonstrated higher risk for malnutrition compared with their younger counterparts, according to results of a prospective Brazilian study published in Cancer.
Nutritional screening and assessments should be conducted immediately after hospitalization to allow for prompt diagnosis and interventions, researchers noted.
“With these findings, we can indicate to professionals that intensive nutritional counseling from the age of 50 years and older is needed to prevent and treat symptoms of nutritional impact,” Nivaldo B. de Pinho, PhD, MSc, researcher at NCI, said in a press release. “This can improve caloric and protein intake and prevent malnutrition and weight loss so common to these patients.”
Malnutrition can worsen clinical outcomes for patients with cancer and can develop if patients experience nutrition impact symptoms, which can result from the tumor or anticancer treatment. These symptoms include lack of appetite, nausea, dry mouth and vomiting, among others.
De Pinho and colleagues investigated the prevalence of malnutrition and nutrition impact symptoms among 4,783 adults with cancer across 45 public hospitals in Brazil. The study included 1,606 patients aged 50 years or younger (64.1% women), 1,686 patients aged 51 to 64 years (50.5% men), and 1,491 patients aged 65 years or older (57.1% men).
The prevalence of malnutrition among all patients was 45.3%.
Malnutrition appeared more common among patients aged 65 years or older (55%) than among patients aged 50 years or younger (36.1%) and patients aged 54 to 64 years (48.4%; P < .001). Patients whose scores on a nourishment assessment indicated a critical need for better nutrition had higher rates of nutrition impact symptoms, including lack of appetite (58.1%), nausea (38.3%), dry mouth (37.1%) and vomiting (26%).
Nutrition impact symptoms most likely to occur among patients aged 65 years or older included lack of appetite (OR = 1.9; 95% CI, 1.62-2.22) and dry mouth (OR = 1.4; 95% CI, 1.1-1.67). Among patients aged 51 to 64 years, compared with younger patients, symptoms with a higher risk for occurrence included lack of appetite (OR = 1.45; 95% CI, 1.23-1.69), dry mouth (OR = 1.22; 95% CI, 1.02-1.45) and problems swallowing (OR = 1.56; 95% CI, 1.25-1.96).
Prevalence of lack of appetite ranged from 21.8% to 44.6% and was highest among patients with lung cancer (OR = 2.88; 95% CI, 2.06-4.04). Nausea, which ranged from 11.6% to 27.6% in prevalence, was more common among patients with gynecological cancer (OR = 2.13; 95% CI, 1.63-2.79).
Patients with upper digestive cancer had higher risk for vomiting (OR = 3.07; 95% CI, 2.18-4.33) and dry mouth (OR = 1.69; 95% CI, 1.25-2.28), whereas problems swallowing were especially common among patients with head and neck cancer (OR = 11.59; 95% CI, 7.81-17.8).
A lack of data on disease stage, type of treatment, and a change in symptoms over time served as the study’s primary limitations.
“These results highlight the need for nutritional screening and assessment both for characteristics of malnutrition and for underlying risk factors soon after hospitalization to enable early and multidisciplinary or interdisciplinary interventions,” De Pinho and colleagues wrote. – by John DeRosier
Disclosures: De Pinho reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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