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      Association between the risk of malnutrition and sarcopenia at 4.2 years of follow-up in community-dwelling older adults

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          Abstract

          Introduction

          Currently, there is only scarce evidence of a causal association between risk of malnutrition (RM) by the mini-nutritional assessment (MNA) and the incidence of sarcopenia. This study was designed to assess such an association at 4.2 years of follow-up in community-dwelling subjects over 60 years old.

          Methods

          The data used were from the FraDySMex cohort study. The exposition variables were RM diagnosed by the long forma of the MNA (MNA-LF) and short form (MNA-SF). The last one included the body mass index and calf circumference at baseline, while sarcopenia was diagnosed by the EWGSOP2 at follow-up and taken as the response variable. Several covariates involved in the association were also considered. A multiple logistic regression analysis was performed to test the association.

          Results

          At baseline, 27.0 and 37.9% of subjects had RM by the MNA-LF and MNA-SF, respectively. The incidence of sarcopenia was 13.7%. The fat mass variable significantly modified the association, so it was tested in each stratum. Two independent models showed that subjects with RM by the MNA-LF in the normal fat mass stratum were at a higher risk for developing sarcopenia at follow-up than those without RM (OR 9.28; IC 95% 1.57–54.76) after adjusting for age, sex, and waist circumference. No association was found for the excess fat mass stratum subjects. Subjects with RM by the MNA-SF in the excess fat mass stratum were more likely to develop sarcopenia at follow-up than those without RM by the MNA-SF (OR 3.67; IC 95% 1.29–10.43). This association was not found in the subjects in the normal fat mass stratum.

          Conclusion

          The association was dependent on the variable fat mass. The two forms of the MNA should not be applied indistinctly with older adults. Based on these results, it is clear that the risk of malnutrition precedes the onset of sarcopenia.

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          Most cited references79

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            A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation

            Mary Charlson, Peter Pompei, Kathy Ales … (1987)
            The objective of this study was to develop a prospectively applicable method for classifying comorbid conditions which might alter the risk of mortality for use in longitudinal studies. A weighted index that takes into account the number and the seriousness of comorbid disease was developed in a cohort of 559 medical patients. The 1-yr mortality rates for the different scores were: "0", 12% (181); "1-2", 26% (225); "3-4", 52% (71); and "greater than or equal to 5", 85% (82). The index was tested for its ability to predict risk of death from comorbid disease in the second cohort of 685 patients during a 10-yr follow-up. The percent of patients who died of comorbid disease for the different scores were: "0", 8% (588); "1", 25% (54); "2", 48% (25); "greater than or equal to 3", 59% (18). With each increased level of the comorbidity index, there were stepwise increases in the cumulative mortality attributable to comorbid disease (log rank chi 2 = 165; p less than 0.0001). In this longer follow-up, age was also a predictor of mortality (p less than 0.001). The new index performed similarly to a previous system devised by Kaplan and Feinstein. The method of classifying comorbidity provides a simple, readily applicable and valid method of estimating risk of death from comorbid disease for use in longitudinal studies. Further work in larger populations is still required to refine the approach because the number of patients with any given condition in this study was relatively small.
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              "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician.

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                Author and article information

                Contributors
                Helen J. Vidaña-Espinoza: URI : https://loop.frontiersin.org/people/2622536/overviewRole: Role: Role:
                Miriam T. López-Teros: URI : https://loop.frontiersin.org/people/1114147/overviewRole: Role: Role: Role: Role: Role:
                Julián Esparza-Romero: URI : https://loop.frontiersin.org/people/581809/overviewRole: Role:
                Oscar Rosas-Carrasco: URI : https://loop.frontiersin.org/people/174255/overviewRole: Role: Role: Role:
                Armando Luna-López: URI : https://loop.frontiersin.org/people/501268/overviewRole:
                Heliodoro Alemán Mateo: URI : https://loop.frontiersin.org/people/1906985/overviewRole: Role: Role: Role:
                Journal
                Journal ID (nlm-ta): Front Med (Lausanne)
                Journal ID (iso-abbrev): Front Med (Lausanne)
                Journal ID (publisher-id): Front. Med.
                Title: Frontiers in Medicine
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2296-858X
                Publication date (Electronic): 26 February 2024
                Publication date Collection: 2024
                Volume: 11
                Electronic Location Identifier: 1363977
                Affiliations
                [1] 1Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo (CIAD), A.C. , Hermosillo, Sonora, Mexico
                [2] 2Centro de Evaluación del Adulto Mayor, Departamento de Salud, Universidad Iberoamericana Ciudad de México , Ciudad de México, Mexico
                [3] 3Dirección de Investigación, Instituto Nacional de Geriatría , Ciudad de México, Mexico
                Author notes

                Edited by: Paolo Gallo, Campus Bio-Medico University Hospital, Italy

                Reviewed by: Paolo Fabbietti, National Institute of Science and Health for Aging (IRCCS), Italy

                Andrea Falcomatà, Campus Bio-Medico University Hospital, Italy

                *Correspondence: Heliodoro Alemán Mateo, helio@ 123456ciad.mx

                †These authors share first authorship

                ‡ORCID: Helen J. Vidaña-Espinoza, orcid.org/0009-0004-8458-2139

                Julián Esparza-Romero, orcid.org/0000-0001-9748-2031

                Heliodoro Alemán-Mateo, orcid.org/0000-0002-1582-2475

                Miriam T. López-Teros, orcid.org/0000-0001-9486-005X

                Oscar Rosas-Carrasco, orcid.org/0000-0002-0564-5882

                Armando Luna-López, orcid.org/0000-0001-7941-5695

                Article
                DOI: 10.3389/fmed.2024.1363977
                PMC ID: 10929268
                PubMed ID: 38476442
                SO-VID: 140cd4f8-ce31-4342-8501-dade946d1dae
                Copyright © Copyright © 2024 Vidaña-Espinoza, López-Teros, Esparza-Romero, Rosas-Carrasco, Luna-López and Alemán Mateo.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 31 December 2023
                Date accepted : 13 February 2024
                Page count
                Figures: 1, Tables: 6, Equations: 0, References: 79, Pages: 13, Words: 11106
                Funding
                The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the “Programa presupuestario con erogación para la igualdad entre mujeres y hombres de la Secretaría de Salud (2014–2015)”, and by the “Red colaborativa de la investigación traslacional para el envejecimiento saludable, (RECITES-2019) con sede en el Instituto Nacional de Geriatría, Mexico City”.
                Categories
                Subject: Medicine
                Subject: Original Research
                Custom metadata
                section-at-acceptance Geriatric Medicine

                Keywords: nutritional status,risk of malnutrition,mini-nutritional assessment,sarcopenia,fat mass,older adults
                Data availability:
                Keywords: nutritional status, risk of malnutrition, mini-nutritional assessment, sarcopenia, fat mass, older adults

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