Highlights
- •HF patients in the MNA "at risk" category have higher risk of worse functional status.
- •Older HF patients in the MNA "at risk" category have higher risk of disability.
- •These associations are independent of muscular mass and caloric intake.
Abstract
Background
The association between nutritional status (NS) and physical performance and disability
in older adults with chronic heart failure (CHF) is not well established. We aimed
at evaluating whether NS, estimated using the Mini Nutritional Assessment (MNA), is
associated with gait speed (GS) and disability (ADL/IADL impairment) in this population
and to assess whether energy intake (EI) and appendicular skeletal muscle mass index
(ASMMI) influence this relationship.
Methods
In this cross-sectional study we enrolled 88 older adults admitted to a cardiology
outpatient clinic for CHF. MNA was analyzed both as continuous and categorical variable
(risk of malnutrition [RM]/well-nourished [WN]). The association between NS and GS
and disability was assessed using linear and logistic regression models, respectively,
crude, adjusted firstly for age, sex, ejection fraction, and mood status, and then
for EI and ASMMI.
Results
Mean age was 77.8 years, 73% were men. MNA score was positively associated with GS:
β adjusted = 0.022, P = 0.035; the coefficient was unaffected by adjustment for EI and ASMMI (β = 0.022, P = 0.052). Compared to WN, RM participants had a lower gait speed (0.82 vs 0.99 m/s,
P = 0.006); the difference was attenuated after adjustment for potential confounders
(β − = 0.138, P = 0.055). MNA score was inversely associated with ADL impairment (Adjusted OR: 0.80,
95%CI 0.64–0.98), but not with IADL impairment (Adjusted OR: 0.94, 95%CI 0.78–1.13).
Conclusion
Reduced MNA score is associated with poorer physical function and ADL impairment in
older adults affected by CHF, independently of EI and ASMMI. Routinely evaluation
of NS should be performed in this population.
Keywords
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Article info
Publication history
Published online: December 21, 2019
Accepted:
December 15,
2019
Received in revised form:
December 4,
2019
Received:
October 26,
2019
Identification
Copyright
© 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
