Coexistence of malnutrition, frailty, physical frailty and disability in patients with COPD starting a pulmonary rehabilitation program

被引:33
作者
ter Beek, L. [1 ,2 ,3 ]
van der Vaart, H. [2 ]
Wempe, J. B. [2 ]
Krijnen, W. P. [1 ,4 ]
Roodenburg, J. L. N. [3 ]
van der Schans, C. P. [1 ,5 ,6 ]
Jager-Wittenaar, H. [1 ,3 ]
机构
[1] Hanze Univ Appl Sci, Res Grp Hlth Ageing Allied Hlth Care & Nursing, Petrus Driessenstr 3, NL-9714 CA Groningen, Netherlands
[2] Univ Groningen, Univ Med Ctr Groningen, Ctr Rehabil, Dept Pulm Dis & TB, POB 30-002, NL-9750 RA Groningen, Netherlands
[3] Univ Groningen, Univ Med Ctr Groningen, Dept Maxillofacial Surg, POB 30-001, NL-9700 RB Groningen, Netherlands
[4] Univ Groningen, Fac Sci & Engn, Groningen, Netherlands
[5] Univ Groningen, Univ Med Ctr Groningen, Dept Rehabil Med, Groningen, Netherlands
[6] Univ Groningen, Univ Med Ctr Groningen, Hlth Psychol Res, Groningen, Netherlands
关键词
Pulmonary disease; Chronic obstructive; Malnutrition; Frailty; NUTRITIONAL-STATUS; OLDER-ADULTS; DISEASE; PREVALENCE; OVERLAP; CANCER; INDEX;
D O I
10.1016/j.clnu.2019.11.016
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background & aims: Malnutrition, frailty, physical frailty, and disability are common conditions in patients with chronic obstructive pulmonary disease (COPD). Insight in the coexistence and relations between these conditions may provide information on the nature of the relationship between malnutrition and frailty. Such information may help to identify required interventions to improve the patient's health status. We therefore aimed to explore whether malnutrition, frailty, physical frailty, and disability coexist in patients with COPD at the start of pulmonary rehabilitation. Methods: For this cross-sectional study, from March 2015 to May 2017, patients with COPD were assessed at the start of a pulmonary rehabilitation program. Nutritional status was assessed with the Scored Patient-Generated Subjective Global Assessment (PG-SGA) based Pt-Global app. Frailty was assessed by the Evaluative Frailty Index for Physical activity (EFIP), physical frailty by Fried's criteria, and disability by the Dutch version of World Health Organization Disability Assessment Schedule 2.0 (WHODAS). These variables were dichotomized to determine coexistence of malnutrition, frailty, physical frailty, and disability. Associations between PG-SGA score and respectively EFIP score, Fried's criteria, and WHODAS score were analyzed by Pearson's correlation coefficient. Two tailed P-values were used, and significance was set at P < 0.05. Results: Of the 57 participants included (age 61.2 +/- 8.7 years), malnutrition and frailty coexisted in 40%. Malnutrition and physical frailty coexisted in 18%, and malnutrition and disability in 21%. EFIP score and PG-SGA score were significantly correlated (r = 0.43, P = 0.001), as well as Fried's criteria and PG-SGA score (r = 0.37, P = 0.005). Conclusions: In this population, malnutrition substantially (40%) coexists with frailty. Although the prevalence of each of the four conditions is quite high, the coexistence of all four conditions is limited (11%). The results of our study indicate that nutritional interventions should be delivered by health care professionals across multiple disciplines. (C) 2019 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
引用
收藏
页码:2557 / 2563
页数:7
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