MNA-SF as a screening tool for malnutrition diagnosed with the glim criteria in older persons with cancer.

PURPOSE: We aimed to evaluate and compare the Short Form of the Mini Nutritional Assessment (MNA-SF) as a nutritional screening tool with the new Global Leadership Initiative on Malnutrition (GLIM) diagnostic criteria for malnutrition (the most current reference standard) among older patients with cancer. METHODS: Patients ≥ 70 years old, with a G8 screening tool ≤ 14, referred to an oncogeriatric clinic. MNA-SF and GLIM criteria were obtained. RESULTS: 40 patients were included (mean age 84.8 ± 5.5, 60% male). According to the GLIM diagnostic criteria, 57.5% were malnourished. The MNA-SF classified 80% as being malnourished or at risk of malnutrition. MNA-SF showed a high sensitivity (100%) and a low specificity (50%) to detect GLIM-defined malnutrition. The AUC of the ROC curve was 0.75. CONCLUSION: The MNA-SF scale is useful as a screening tool to detect malnutrition in older cancer outpatients.

Mejorando la prescripción de medicamentos en las personas mayores: una nueva edición de los criterios STOPP-START / Improving drug prescribing in the elderly: A new edition of STOPP/START criteria

La utilización inapropiada de los medicamentos en los pacientes mayores tiene graves consecuencias en su salud —aumento del riesgo de sufrir reacciones adversas o síndromes geriátricos, mayor morbimortalidad— y en el sistema sanitario —aumento de costes, estancias hospitalarias excesivas. Para detectar y prevenir la utilización inadecuada de fármacos se está imponiendo progresivamente el uso de criterios explícitos, que pueden usarse dentro de la evaluación geriátrica exhaustiva o como parte de la actuación de diversos equipos multidisciplinares geriátricos. Los criterios STOPP-START, publicados por vez primera en 2008 (y en español en 2009), se están imponiendo como criterios de referencia en el ámbito europeo. Se presenta aquí la versión en español de la nueva edición (2014) de estos criterios, recientemente publicados en inglés. Además, se revisan en este artículo las publicaciones que han usado la versión inicial de los criterios STOPP-START en España desde su aparición, con la intención de fomentar su utilización e investigación en los distintos niveles asistenciales (AU)

Inappropriate use of drugs in older patients may have an adverse impact on several individual health outcomes, such as increasing the prevalence of adverse drug reactions, morbidity and mortality, and geriatric syndromes, as well as on health care systems, such as increased costs and longer hospital stays. Explicit criteria of drug appropriateness are increasingly used to detect and prevent inappropriate use of drugs, either within a comprehensive geriatric assessment or as tool used by different multidisciplinary geriatric teams. STOPP-START criteria, first published in 2008 (in Spanish in 2009), are being adopted as reference criteria throughout Europe. The Spanish version of the new 2014 edition (recently published in English) of the STOPP-START criteria is presented here. A review of all the papers published in Spain using the former version of these criteria is also presented, with the intention of promoting their use and for research in different health care levels (AU)

[Improving drug prescribing in the elderly: a new edition of STOPP/START criteria]. / Mejorando la prescripción de medicamentos en las personas mayores: una nueva edición de los criterios STOPP-START.

Inappropriate use of drugs in older patients may have an adverse impact on several individual health outcomes, such as increasing the prevalence of adverse drug reactions, morbidity and mortality, and geriatric syndromes, as well as on health care systems, such as increased costs and longer hospital stays. Explicit criteria of drug appropriateness are increasingly used to detect and prevent inappropriate use of drugs, either within a comprehensive geriatric assessment or as tool used by different multidisciplinary geriatric teams. STOPP-START criteria, first published in 2008 (in Spanish in 2009), are being adopted as reference criteria throughout Europe. The Spanish version of the new 2014 edition (recently published in English) of the STOPP-START criteria is presented here. A review of all the papers published in Spain using the former version of these criteria is also presented, with the intention of promoting their use and for research in different health care levels.

Importance of nutritional support in older people.

Proper nutrition is an essential part of successful aging and may delay the onset of diseases. Nutrition-related problems in older subjects have been long-time ignored; good nutritional status is an essential component of health and a relevant part of therapeutic plans of most chronic diseases. Moreover, food and nutrition are a relevant aspect of most cultures and are strongly linked with individual lifestyles. Research has proved that nutritional intervention can improve outcomes in many clinical scenarios. This is especially true for older individuals with different acute and chronic conditions and diseases, or with malnutrition. Nutritional intervention can provide sufficient energy, protein and micronutrients, maintain or improve nutritional status, reduce morbidity and increase survival. Evidence is still lacking on the impact of nutritional intervention on physical and mental function, and on quality of life, very relevant outcomes for older individuals. Nutritional screening and assessment should become part of health care of both healthy and sick older people. Nutritional counseling and intervention should be embedded in a general care plan that takes into account all aspects of an aging person. Nutritional programs that aim for high compliance should be individualized, and would have to consider every aspect of old age: beliefs, attitudes, preferences, expectations, and aspirations.

Utilidad de la estación unipodal en la valoración del riesgo de caídas / Utility of one-leg balance in evaluation of the risk of falls

Objetivo: comparar los resultados obtenidos en la estación unipodal con el análisis del equilibrio estático mediante posturografía. Métodos: 59 sujetos mayores de 64 años. Se evaluó la estación unipodal y el Modified Clinical Test for the Sensory Interaction on Balance mediante el posturógrafo Balance Master (Neurocom®). Grupo A: sujetos que no realizaron la estación unipodal, y grupo B: los que sí pudieron realizarla. Resultados: grupo A: 37,2% (22). Grupo B: 62,6% (37). Sobre una superficie dura y con los ojos abiertos, el centro de gravedad del grupo A se desplazó 0,4 grados/s (0,28-0,6) y el del grupo B 0,2 grados/s (0,1-0,3) (p = 0,01). Sobre una superficie firme y con los ojos cerrados, el centro de gravedad del grupo A se desplazó 0,5 grados/s (0,3-0,8) y el del grupo B 0,3 grados/s (0,1-0,4) (p = 0,002). Sobre una superficie almohadillada y con los ojos abiertos, el centro de gravedad del grupo A se desplazó 1,1 grados/s (0,90-1,60) y el del grupo B 0,9 grados/s (0,73-1,3) (p = 0,045). Sobre una superficie almohadillada y con los ojos cerrados, el centro de gravedad del grupo A se desplazó 6 grados/ s (4-6) y el del grupo B 2,3 grados/s (1,63-3,08) (p < 0,001). Conclusiones: los sujetos de edad avanzada capaces de mantener la estación unipodal durante al menos 5 s muestran un menor desplazamiento de su centro de gravedad que los que no lo consiguen. Los resultados se mantienen cuando se suprimen las aferencias visual y propioceptiva (AU)

Aims: to compare posturographic test with One-Leg Balance test in the elderly. Methods: we studied 59 healthy men and women living in the community who were at least 65 years of age. All of them were evaluated with One–Leg Balance (defined as the ability to stand on one leg unsupported for 5 seconds) and Modifies Clinical Test for the Sensory Interaction on Balance by the Balance Master (Neurocom®). We distributed the patients in two groups. Group A included those who couldn’t perform one-leg balance and group B those who could perform it. Results: 62.6% of subjects could perform one-leg balance and 37.2% could not perform it. On a firm surface with opened eyes, the A group made a variation of 0.4 deg/s (0.28-0.6) in the gravity center position and the B group 0,2 deg/s (0.1-0.3) (p = 0.010). On a firm surface with closed eyes, the A group made a variation of 0.5 deg/s (0.3-0.8) and the B group 0.3 deg/s (0.1- 0.4) (p = 0.002). On a foam surface with open eyes, the A group made a variation of their gravity center position of 1.10 deg/s (0.90-1.60) and the B group 0.9 deg/s (0.73-1.30) (p = 0.045). On a foam surface with closed eyes the A group made a variation of their gravity center position of 6 deg/s (4-6) and the B group 2.3 deg/s (1.63-3.08) (p < 0.001). Conclusions: elderly patients who can perform one-leg balance, make less variations of their gravity centre. The results are the same when visual and propioceptive afferences are suppressed (AU)