Dataset Information

What is the overlap between malnutrition, frailty and sarcopenia in the older population? Study protocol for cross-sectional study using UK Biobank.

ABSTRACT:

Background

In an increasingly older adult population, understanding the inter-relationship between three age related conditions malnutrition, frailty and sarcopenia is important in order to improve their recognition, treatment and prevention. This study aims to determine the overlap between malnutrition, frailty and sarcopenia by measuring estimates of prevalence for each individual condition. In addition, we will compare two models of frailty which are the accumulation of deficits and phenotype models.

Methods/design

This is a cross-sectional study that will use the UK Biobank database, which will include a subset of 381,000 participants: males and females aged 50 years and above who completed the baseline assessments. For the baseline assessments, details of the participants' characteristics will be included. All three conditions will be identified and mapped to variables collected at the baseline assessment. Variables for malnutrition will be mapped according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Frailty will be defined according to two models: the 36 deficits and the phenotype model. Finally, sarcopenia will be assessed according to the European Working Group on Sarcopenia in Older People (EWGSOP) standard.

Discussion

This proposed study will help to understand the presence of malnutrition, frailty and sarcopenia in the older population and describe any overlap between the conditions. There is little published research on the overlap between these three conditions. Despite the similarity and shared criteria used for the identification of malnutrition, frailty and sarcopenia there is still a lack of cohesive thinking around the overlap of applied definitions and identification criteria.

Trial registration

ClinicalTrials.gov NCT04655456 approved on the 10th of December 2020.

SUBMITTER: AlMohaisen N

PROVIDER: S-EPMC9725160 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

What is the overlap between malnutrition, frailty and sarcopenia in the older population? Study protocol for cross-sectional study using UK Biobank.

AlMohaisen Nada N Gittins Matthew M Todd Chris C Burden Sorrel S

PloS one 20221206 12

<h4>Background</h4>In an increasingly older adult population, understanding the inter-relationship between three age related conditions malnutrition, frailty and sarcopenia is important in order to improve their recognition, treatment and prevention. This study aims to determine the overlap between malnutrition, frailty and sarcopenia by measuring estimates of prevalence for each individual condition. In addition, we will compare two models of frailty which are the accumulation of deficits and p ...[more]

PMID: 36472992

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Project description:BackgroundMalnutrition, sarcopenia and frailty are distinct, albeit interrelated, conditions associated with adverse outcomes in adults with cancer, but whether they relate to multimorbidity, which affects up to 90% of people with cancer, is unknown. This study investigated the relationship between multimorbidity with malnutrition, sarcopenia and frailty in adults with cancer from the UK Biobank.MethodsThis was a cross-sectional study including 4122 adults with cancer (mean [SD] age 59.8 [7.1] years, 50.7% female). Malnutrition was determined using the Global Leadership Initiative on Malnutrition criteria. Probable sarcopenia and sarcopenia were defined using the European Working Group on Sarcopenia in Older People 2 criteria. (Pre-)frailty was determined using the Fried frailty criteria. Multimorbidity was defined as ≥2 long-term conditions with and without the cancer diagnosis included. Logistic regression models were fitted to estimate the odds ratios (ORs) of malnutrition, sarcopenia and frailty according to the presence of multimorbidity.ResultsGenitourinary (28.9%) and breast (26.1%) cancers were the most common cancer diagnoses. The prevalence of malnutrition, (probable-)sarcopenia and (pre-)frailty was 11.1%, 6.9% and 51.2%, respectively. Of the 11.1% of participants with malnutrition, the majority (9%) also had (pre-)frailty, and 1.1% also had (probable-)sarcopenia. Of the 51.2% of participants with (pre-)frailty, 6.8% also had (probable-)sarcopenia. No participants had (probable-)sarcopenia alone, and 1.1% had malnutrition, (probable-)sarcopenia plus (pre-)frailty. In total, 33% and 65% of participants had multimorbidity, including and excluding the cancer diagnosis, respectively. The most common long-term conditions, excluding the cancer diagnosis, were hypertension (32.5%), painful conditions such as osteoarthritis or sciatica (17.6%) and asthma (10.4%). Overall, 80% of malnourished, 74% of (probable-)sarcopenia and 71.5% of (pre-)frail participants had multimorbidity. Participants with multimorbidity, including the cancer diagnosis, had higher odds of malnutrition (OR 1.72 [95% confidence interval, CI, 1.31-2.30; P < 0.0005]) and (pre-)frailty (OR 1.43 [95% CI 1.24-1.68; P < 0.0005]). The odds increased further in people with ≥2 long-term conditions in addition to their cancer diagnosis (malnutrition, OR 2.41 [95% CI 1.85-3.14; P < 0.0005]; (pre-)frailty, OR 2.03 [95% CI 1.73-2.38; P < 0.0005]). There was little evidence of an association of multimorbidity with sarcopenia.ConclusionsIn adults with cancer, multimorbidity was associated with increased odds of having malnutrition and (pre-)frailty but not (probable-)sarcopenia. This highlights that multimorbidity should be considered a risk factor for these conditions and evaluated during nutrition and functional screening and assessment to support risk stratification within clinical practice.

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Project description:IntroductionFalls are a major health problem for older people; 35% of people aged 65+ years fall every year, leading to fractures in 10%-15%. Upper limb fractures are often the first sign of osteoporosis and routine screening for osteoporosis is recommended by the National Institute for Health and Care Excellence to prevent subsequent hip fractures. However, both frailty and sarcopenia (muscle weakness) are associated with increased risk of falling and fracture but are not routinely identified in this group. The aim of this study is to evaluate the feasibility of assessing and managing frailty and sarcopenia among people aged 65+ years with an upper limb fracture.Methods and analysisThis study will be conducted in three fracture clinics in one acute trust in England. 100 people aged 65+ years with an upper arm fracture will be recruited and assessed using six validated frailty measures and two sarcopenia tools. The prevalence of the two conditions and the best tools to use will be determined. Those with either condition will be referred to geriatric clinical teams for comprehensive geriatric assessment (CGA). We will document the proportion who are referred for CGA and those who receive CGA. Other outcome measures including falls, fractures and healthcare resource use over 6 months will be collected. In-depth interviews with a purposive sample of patients who undergo the frailty and sarcopenia assessments and healthcare professionals in fracture clinics and geriatric services will be carried out to their acceptability of assessing frailty and sarcopenia in a busy environment.Ethics and disseminationThe study was given the relevant ethical approvals from NHS Research Ethics Committee (REC No: 18/NE/0377), the University Hospital Southampton NHS Foundation Trust, and the University of Southampton, Faculty of Medicine Ethics Committee and Research Governance Office. Findings will be published in scientific journals and presented to local, national and international conferences.Trial registration numberISRCTN13848445.

Dataset Information

What is the overlap between malnutrition, frailty and sarcopenia in the older population? Study protocol for cross-sectional study using UK Biobank.

Background

Methods/design

Discussion

Trial registration

Publications

What is the overlap between malnutrition, frailty and sarcopenia in the older population? Study protocol for cross-sectional study using UK Biobank.

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