ABSTRACT
OBJECTIVES: To analyze if body mass index (BMI) and waist circumference (WC) as measures of nutritional status, and the Mini Nutritional Assessment Short Form (MNA-SF) as a nutritional risk measure are associated with increased risk of incident disability in basic activities of daily living (BADL) in a population based cohort of Spanish older adults. DESIGN: Concurrent cohort study. SETTING: Albacete City, Spain. PARTICIPANTS: 678 subjects over age 70 from the FRADEA Study (Frailty and Dependence in Albacete). MEASUREMENTS: BMI, WC and MNA-SF were recorded at the basal visit of the FRADEA Study. Incident disability in BADL was defined as loss of the ability to perform bathing, grooming, dressing, toilet use, or feeding from basal to follow-up visit, using the Barthel index. The association between nutritional status and nutritional risk with incident BADL disability was determined by Kaplan-Meier analysis and logistic regression adjusted for age, sex, basal function, comorbidity, cognitive decline, depression risk and frailty status. RESULTS: Each point less of MNA-SF (OR 1.17, 95%CI 1.04-1.31) and MNA-SF<14 (OR 2.33, 95%CI 1.39-3.89), but not MNA-SF<12 (OR 1.47, 95%CI 0.89-2.42) had a greater adjusted risk of incident disability in BADL. Neither BMI (OR 1.02, 95%CI 0.97-1.06) nor WC (OR 1.01, 95%CI 0.99-1.03) were associated. Weight loss (OR 1.75, 95%CI 1.08-2.83) and mobility impairment (OR 3.35, 95%CI 1.67-6.73) remained as adjusted predictors of incident BADL disability, while anorexia almost reached the significance (OR 1.65, 95%CI 0.94-2.87). CONCLUSION: Nutritional risk measured with the MNA-SF is associated with incident disability in BADL in older adults, while nutritional status measured with BMI or WC is not.
Subject(s)
Disabled Persons/statistics & numerical data , Nutritional Status , Activities of Daily Living , Aged , Aged, 80 and over , Anorexia/epidemiology , Body Mass Index , Cohort Studies , Female , Geriatric Assessment , Humans , Kaplan-Meier Estimate , Logistic Models , Male , Nutrition Assessment , Risk , Spain/epidemiology , Waist Circumference , Weight LossABSTRACT
Se presenta el caso de un enfermos LL de 68 años de edad, intensamente positivo dianosticado hace 2 meses, que ingresa con un cuadro con lesiones úlcero-necróticas que afetan un 50% del tegumento, mal estado general y anemia. No obstante el tratamiento específico, corticoterapia y hemoterapia fallece a los 20 días.
