title: Geriatric syndromes increased the nutritional risk in elderly cancer patients independently from tumour site and metastatic status. The ELCAPA-05 cohort study.
abstract: OBJECTIVE
  We assessed the prevalence and risk factors of malnutrition in elderly cancer patients.
  
  
  METHODS
  We studied a prospective cohort of solid cancer patients aged ≥70 years at referral to two geriatric oncology clinics between 2007 and 2010. Nutrition was evaluated using the Mini-Nutritional Assessment (MNA) using validated cut-offs (<17: malnutrition, 17-23.5: at-risk for malnutrition). Patients with non-digestive tumours (breast, prostate, urinary tract) and with digestive (colorectal, upper digestive tract and liver) were analysed separately using multinomial logistic regression.
  
  
  RESULTS
  Of 643 consecutive patients, 519 had available data (median age, 80; men, 48.2%; metastases, 46.3%; digestive cancer 47.8%). In non-digestive group, 13.3% had malnutrition versus 28.6% in digestive group. The link between metastasis and malnutrition was significantly higher in non-digestive group (adjusted odds ratio [ORa ], 25.25; 95%CI: 5.97-106.8) than in digestive group (ORa, 2.59; 1.08-6.24; p for heterogeneity = 0.04). Other factors independently associated with malnutrition were cognitive impairment (ORa MMMSE ≤ 24 versus > 24 in non-digestive group: 16.68; 4.89-56.90 and in digestive group: 3.93; 1.34-11.50), and depressed mood (ORa MiniGDS ≥1 versus <1 in non-digestive group: 11.11; 3.32-37.17 and in digestive group: 3.25; 1.29-8.15) and fall risk (ORa fall risk versus no fall risk in non-digestive group: 4.68; 1.77-12.37; in digestive group: 100% of malnourished patients were faller's).
  
  
  CONCLUSIONS
  We highlighted, in elderly cancer patients, the high prevalence of malnutrition and that geriatrics syndromes (i.e. cognitive impairment, depressed mood and fall risk) were independent risk factors for malnutrition. Moreover, metastatic status was significantly much more strongly associated with malnutrition in non-digestive than digestive tumours.
authors.affiliation: Department of Internal Medicine and Geriatrics, AP-HP, Henri-Mondor Hospital, Onco-Geriatric Clinic, F-94010 Créteil, France; LIC EA 4393, Université Paris Est Créteil (UPEC), F-94010 Créteil, France. Electronic address: Elena.paillaud@ach.aphp.fr.
authors.forename: E
authors.initials: E
authors.lastname: Paillaud
authors.affiliation: Department of Internal Medicine and Geriatrics, AP-HP, Henri-Mondor Hospital, Onco-Geriatric Clinic, F-94010 Créteil, France.
authors.forename: E
authors.initials: E
authors.lastname: Liuu
authors.affiliation: Department of Internal Medicine and Geriatrics, AP-HP, Henri-Mondor Hospital, Onco-Geriatric Clinic, F-94010 Créteil, France; LIC EA 4393, Université Paris Est Créteil (UPEC), F-94010 Créteil, France.
authors.forename: M
authors.initials: M
authors.lastname: Laurent
authors.affiliation: LIC EA 4393, Université Paris Est Créteil (UPEC), F-94010 Créteil, France; Clinical Research Unit (URC-Mondor), AP-HP, Henri-Mondor Hospital, F 94010 Créteil, France.
authors.forename: A
authors.initials: A
authors.lastname: Le Thuaut
authors.affiliation: Department of Geriatrics, AP-HP, Paul-Brousse Hospital, F-94804 Villejuif, France.
authors.forename: H
authors.initials: H
authors.lastname: Vincent
authors.affiliation: Department of Geriatrics, AP-HP, Bichat Hospital, F-75018 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Raynaud-Simon
authors.affiliation: LIC EA 4393, Université Paris Est Créteil (UPEC), F-94010 Créteil, France; Department of Public Health, AP-HP, Henri-Mondor Hospital, F-94010 Créteil, France.
authors.forename: S
authors.initials: S
authors.lastname: Bastuji-Garin
authors.affiliation: Department of Oncology, AP-HP, Henri-Mondor Hospital, F-94010 Créteil, France.
authors.forename: C
authors.initials: C
authors.lastname: Tournigand
authors.affiliation: Department of Internal Medicine and Geriatrics, AP-HP, Henri-Mondor Hospital, Onco-Geriatric Clinic, F-94010 Créteil, France; LIC EA 4393, Université Paris Est Créteil (UPEC), F-94010 Créteil, France.
authors.forename: P
authors.initials: P
authors.lastname: Caillet
authors.affiliation: LIC EA 4393, Université Paris Est Créteil (UPEC), F-94010 Créteil, France; Department of Public Health, AP-HP, Henri-Mondor Hospital, F-94010 Créteil, France.
authors.forename: F
authors.initials: F
authors.lastname: Canoui-Poitrine
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D003863:Depression / Q000209:etiology / Q000473:pathology; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000453:epidemiology*; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000473:pathology*; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: Cancer; Cognitive impairment; Depression; Elderly; Falls; Malnutrition