Diabetes mellitus, malnutrition, and sarcopenia: The bond is not explained by bioelectrical impedance analysis in older adults.

As people age, their risk of diabetes mellitus (DM) and sarcopenia increases due to the decline in muscle mass and strength. Bioelectrical impedance analysis (BIA) is a method used to detect changes in body composition. The primary aim of the study was to determine the distribution of BIA variables among a group of non-DM people and two groups of patients with controlled and uncontrolled DM. The secondary aim was to establish the independent association between BIA-derived data, lipidic assets, and the prevalence of metabolic syndromes with DM. This study included a total of 235 participants who were categorized into three groups based on the presence of diabetes mellitus (DM) and their glycated hemoglobin (HbA1c) levels: non-DM, controlled DM (HbA1c≤7.0%), and uncontrolled DM (HbA1c>7.0%). Waist circumference (p=0.005), bone (p<0.001), muscular (p<0.001), and appendicular skeletal mass (p<0.001) were lower in the non-DM group, while sarcopenic risk (p<0.001), total cholesterol (p<0.001), and LDL (p<0.001), were higher. Grip strength (p<0.001), visceral fat (p=0.01), and phase angle (p=0.04) were significantly lower in non-DM than uncontrolled DM patients, as well as the number of drugs taken (p=0.014). A multivariate analysis highlighted that LDL (coefficient -0.006, p=0.01) was negatively associated, while bone mass (coefficient 0.498, p=0.0042) was positively associated with DM uncontrol. Our study shows that BIA may not be the ideal tool for distinguishing between elderly individuals with and without DM, as it can be affected by numerous covariates, including potential differences in glucometabolic and cardiovascular control.

Comprehensive Geriatric Assessment: Application and correlations in a real-life cross-sectional study.

Background: The assessment process of elderly people considers all aspects of an individual's life, including physical, mental, and social aspects. Frailty refers to a decline in physiological functions or strengths leading to increased vulnerability to stressors and decreased ability to cope with them. Comprehensive Geriatric Assessment (CGA) is a validated and useful tool in this context to holistically study elderly people. The primary aim of this study was to determine the prevalence of impaired health status in a large geriatric population turning to outpatient service, based on the components of the CGA, and thus to describe its usefulness in real-life clinical practice. The secondary aim of this study was the evaluation of the association between nutritional status, assessed with Mini Nutritional Assessment (MNA)-within the CGA-and cognitive-affective and functional capacities, and multimorbidity. Materials and methods: This real-life, retrospective cross-sectional study included subjects consecutively evaluated from January 2009 to December 2020 at the Geriatric Outpatient Service, University Hospital of Monserrato, Cagliari, Italy. A sum of 3,260 patients were subjected to CGA. Results: Only a small proportion of the sample (2.24%) showed an absence of impairment in cognitive-affective, functional, and nutritional domains. Moderate correlations were found between MNA and several other CGA variables, namely, Geriatric Depression Scale (GDS; ϱ = -0.41, p < 0.0001), Barthel Index of Independence in Activities of Daily Living (ADL) (ϱ = 0.51, p < 0.0001), Instrumental Activities of Daily Living (IADL) (ϱ = 0.43, p < 0.0001), and Performance-Oriented Mobility Assessment (ϱ = 0.44, p < 0.0001). A multiple regression also highlighted these variables as significant regressors of MNA. Finally, malnutrition showed a significant association with depression (odds ratio [OR]: 4.97), dependence on ADL (OR: 19.8) and IADL (OR: 7.04), and falling risk (OR: 5.16). Conclusion: This study has figured out the complex situation in which geriatric care finds itself the complexity and severe impairment of elderly people. The possibilities of intervention are often limited, but the literature confirms the benefits of good nutritional status on the general health status. The data that emerged from our study fit into this assumption, highlighting the close association between the nutritional domain and the other CGA domains.