Prevalence of Malnutrition and Frailty in Elderly Cancer Patients and Resulting Impact on Primary Treatment Recommendations in Colorectal and Breast Cancer

Objectives To estimate the prevalence of malnutrition in elderly cancer patients and its association with frailty and primary cancer treatment recommendations in patients with the two most prevalent cancers(colorectal cancer,CRC and breast cancer,BC)in the Centre-Val de Loire region of France.Methods The entire cohort of 704 patients aged 75 years or older presenting with cancer who underwent comprehensive geriatric assessment(CGA)between 2014 and 2017 was included.Nutritional status,frailty(defined by the Balducci classification system based on CGA parameters and comorbidity),and pathological criteria were analyzed in terms of the cancer treatment recommendations suggested by geriatricians both in the whole cohort and in those with CRC and BC.Results In the whole group of 704 patients(84.3+/-4.8 years),the prevalence of malnutrition was 62.9%,and was higher in CRC than in BC patients(71.1%vs 55.4%,P<0.01).In a multivariate analysis,malnutrition and frailty(as determined by the Balducci classification system)were independently related in CRC patients(OR:7.28,95%CI,1.58~34.03;P=0.012)and were unrelated to metastasis[odds ratio(OR):1.34,95%CI,0.56~3.18;P=0.5].By contrast,malnutrition in BC patients was related exclusively to the extent of metastasis(OR:3.52,95%CI,1.50~8.24;P=0.002).It was also demonstrated that geriatricians had a greater tendency to suggest only palliative care to CRC patients presenting with malnutrition(15.4%vs 2.7%,P=0.006)than to BC patients(9.8%vs 5.4%,NS).Conclusion Malnutrition in elderly cancer patients is prevalent,especially in those with colorectal cancer,where malnutrition is frailty-related and may strongly impact on cancer treatment strategies.

Prevalence of Undernutrition and Related Dietary Factors among People Aged 75 Years or Older in China during 2010-2012

Objective Undernutrition is highly prevalent among older people. The aim of this study was to estimate the prevalence of undernutrition in elderly Chinese residents and explore the relationship between undernutrition and dietary factors. Methods Data were collected from 2,552 elderly people aged 75 years and over from the Chinese Nutrition and Health Surveillance during 2010-2012 using questionnaires, anthropometric measurement, and individual consecutive 3-day 24-hour dietary records. Results The present study showed that 10.5% of participants had undernutrition. The prevalence was higher among the population living in rural areas, those living in the South region, those who smoked, and those with low income levels. Most participants failed to meet the Chinese Dietary Reference Intakes for energy（66.1%） and protein（72.1%）. When comparing quartiles of food intake, high rice consumption [odds ratio（OR） = 2.44, 95% confidence interval（CI）： 1.35-4.40）], animal oil intake（OR = 1.60, 95% CI： 1.18-2.17）, and high fat intake from animal sources（OR = 1.56, 95% CI： 1.06-2.31） were positively associated with underweight whereas high wheat consumption（OR = 0.44, 95% CI： 0.26-0.74）, a proper proportion（24%-32%） of energy intake from fat（OR = 0.54, 95% CI： 0.35-0.83）, and high fat intake from plant sources（OR = 0.67, 95% CI： 0.46-0.99） were inversely related.Conclusion The prevalence of undernutrition was high among elderly Chinese people, especially in rural areas. Dietary factors, such as high consumption of rice, were associated with undernutrition.