1.Predicting Mortality Risks Using Body Mass Index and Weight Loss at Admission in Patients with Heart Failure
Yuria ISHIDA ; Keisuke MAEDA ; Kenta MUROTANI ; Akio SHIMIZU ; Junko UESHIMA ; Ayano NAGANO ; Tatsuro INOUE ; Naoharu MORI
Annals of Geriatric Medicine and Research 2024;28(2):171-177
Background:
The association of the combination of body mass index (BMI) and weight change at admission with prognoses in patients with heart failure (HF) is unclear. Therefore, we investigated whether BMI and weight changes at admission affect mortality in patients with HF.
Methods:
This retrospective cohort study lasted 99 months, starting in April 2014, and included 4,862 patients with HF from a Japanese real-world database. Cubic and thin-plate smoothing spline analyses were performed to investigate the association of BMI and weight changes with mortality. The percentage weight change was calculated every 6 months. The study outcome was the presence or absence of death.
Results:
The patients’ mean age was 81.5±9.6 years, and 1,239 (25.5%) patients died. Cubic spline analysis revealed a negative correlation of BMI with mortality hazard ratio (HR) (BMI of 18.5 kg/m2 and 25 kg/m2; HR=1.3 [1.2–1.4] and 0.8 [0.7–0.9], respectively). Cubic spline analysis of weight change showed that weight loss tended to increase the mortality HR (each 6% decrease in weight change rate was associated with a 1.1 times higher mortality risk (95% CI [1.0–1.2]) Thin-plate smoothing spline analysis showed that the odds ratio (OR) negatively correlated with BMI (1-year mortality: BMI of 18.5 kg/m2, 22 kg/m2, and 25 kg/m2; OR at 0% weight change=1.5, 1.0, and 0.7, respectively; 2-year mortality: BMI=18.5 kg/m2, 22 kg/m2, and 25 kg/m2; OR at 0% weight change=1.4, 0.9, and 0.7, respectively).
Conclusion
A low BMI in patients with HF was associated with a higher risk of mortality. Weight loss in patients, regardless of BMI, was associated with a higher OR for mortality.
2.Effects of Sarcopenia on Changes in the Prevalence of Patients with Depressive Mood during Inpatient Geriatric Rehabilitation
Akio SHIMIZU ; Keisuke MAEDA ; Junko UESHIMA ; Yuria ISHIDA ; Tatsuro INOUE ; Kenta MUROTANI ; Ayano NAGANO ; Naoharu MORI ; Tomohisa OHNO ; Ichiro FUJISIMA
Annals of Geriatric Medicine and Research 2024;28(4):469-475
Background:
The effect of sarcopenia on depressive mood during geriatric rehabilitation remains unclear. This study investigated the potential influence of sarcopenia on depressive mood among geriatric patients in a rehabilitation setting.
Methods:
This observational cohort study enrolled 204 patients aged ≥65 years (mean age, 78.8±7.6 years; women, 45.1%) admitted to a rehabilitation unit between April 2020 and July 2021. Sarcopenia was diagnosed based on the Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment criteria, which include low handgrip strength and muscle mass. Depressive mood was defined as a 15-item Geriatric Depression Scale score of ≥6 points. We applied logistic regression models to examine the influence of sarcopenia on depressive mood at discharge.
Results:
We observed sarcopenia in 58.3% of patients. The logistic regression model showed that sarcopenia negatively influenced depressive mood at discharge (odds ratio=5.460; 95% confidence interval, 2.344–13.415). Of the 68 patients without depressive mood at admission, those with sarcopenia (n=31) had a significantly higher incidence of depressive mood at discharge compared with patients without sarcopenia (n=37) (41.9% vs. 16.2%, p=0.037).
Conclusion
Sarcopenia at admission negatively affected depressive mood at discharge from geriatric rehabilitation. Thus, early and routine assessment of sarcopenia is vital for patients undergoing geriatric rehabilitation.
3.Effects of Sarcopenia on Changes in the Prevalence of Patients with Depressive Mood during Inpatient Geriatric Rehabilitation
Akio SHIMIZU ; Keisuke MAEDA ; Junko UESHIMA ; Yuria ISHIDA ; Tatsuro INOUE ; Kenta MUROTANI ; Ayano NAGANO ; Naoharu MORI ; Tomohisa OHNO ; Ichiro FUJISIMA
Annals of Geriatric Medicine and Research 2024;28(4):469-475
Background:
The effect of sarcopenia on depressive mood during geriatric rehabilitation remains unclear. This study investigated the potential influence of sarcopenia on depressive mood among geriatric patients in a rehabilitation setting.
Methods:
This observational cohort study enrolled 204 patients aged ≥65 years (mean age, 78.8±7.6 years; women, 45.1%) admitted to a rehabilitation unit between April 2020 and July 2021. Sarcopenia was diagnosed based on the Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment criteria, which include low handgrip strength and muscle mass. Depressive mood was defined as a 15-item Geriatric Depression Scale score of ≥6 points. We applied logistic regression models to examine the influence of sarcopenia on depressive mood at discharge.
Results:
We observed sarcopenia in 58.3% of patients. The logistic regression model showed that sarcopenia negatively influenced depressive mood at discharge (odds ratio=5.460; 95% confidence interval, 2.344–13.415). Of the 68 patients without depressive mood at admission, those with sarcopenia (n=31) had a significantly higher incidence of depressive mood at discharge compared with patients without sarcopenia (n=37) (41.9% vs. 16.2%, p=0.037).
Conclusion
Sarcopenia at admission negatively affected depressive mood at discharge from geriatric rehabilitation. Thus, early and routine assessment of sarcopenia is vital for patients undergoing geriatric rehabilitation.
4.Effects of Sarcopenia on Changes in the Prevalence of Patients with Depressive Mood during Inpatient Geriatric Rehabilitation
Akio SHIMIZU ; Keisuke MAEDA ; Junko UESHIMA ; Yuria ISHIDA ; Tatsuro INOUE ; Kenta MUROTANI ; Ayano NAGANO ; Naoharu MORI ; Tomohisa OHNO ; Ichiro FUJISIMA
Annals of Geriatric Medicine and Research 2024;28(4):469-475
Background:
The effect of sarcopenia on depressive mood during geriatric rehabilitation remains unclear. This study investigated the potential influence of sarcopenia on depressive mood among geriatric patients in a rehabilitation setting.
Methods:
This observational cohort study enrolled 204 patients aged ≥65 years (mean age, 78.8±7.6 years; women, 45.1%) admitted to a rehabilitation unit between April 2020 and July 2021. Sarcopenia was diagnosed based on the Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment criteria, which include low handgrip strength and muscle mass. Depressive mood was defined as a 15-item Geriatric Depression Scale score of ≥6 points. We applied logistic regression models to examine the influence of sarcopenia on depressive mood at discharge.
Results:
We observed sarcopenia in 58.3% of patients. The logistic regression model showed that sarcopenia negatively influenced depressive mood at discharge (odds ratio=5.460; 95% confidence interval, 2.344–13.415). Of the 68 patients without depressive mood at admission, those with sarcopenia (n=31) had a significantly higher incidence of depressive mood at discharge compared with patients without sarcopenia (n=37) (41.9% vs. 16.2%, p=0.037).
Conclusion
Sarcopenia at admission negatively affected depressive mood at discharge from geriatric rehabilitation. Thus, early and routine assessment of sarcopenia is vital for patients undergoing geriatric rehabilitation.
5.Development of the Early Nutritional Intervention for Elderly Patients with Advanced Cancer: Details of Nutritional Intervention in the Multimodal NEXTAC-ONE Program
Toshimi INANO ; Teiko YAMAGUCHI ; Haruka CHITOSE ; Ayuko UMEZAWA ; Hiromu NAGAHASHI ; Masami OKAGAKI ; Takashi AOYAMA ; Naoharu MORI ; Takashi HIGASHIGUCHI ; Katsuhiro OMAE ; Keita MORI ; Tateaki NAITO ; Koichi TAKAYAMA
Palliative Care Research 2020;15(2):71-80
Objective: The aim of this study is to elaborate on the nutritional intervention in a multimodal intervention (the NEXTAC-ONE program) for the elderly with advanced cancer and to evaluate its tolerability Methods: We prospectively recruited patients aged ≥70 years scheduled to receive first-line chemotherapy for advanced pancreatic or non-small-cell lung cancer. Three nutritional intervention were planned in 8-week study period. The nutritional counseling consists of standard nutritional advice, evaluation and support for nutrition impact symptom, and evaluation and support for eating-related distress and food environment problems. We also provide the oral nutritional supplements rich in Branched Chain Amino Acids (BCAA). Results: 29 patients (96%) of a total of 30 study registrants participated in all three nutrition interventions. Median proportion of days in which patients recorded a nutritional diary was 90%. Median consumption of supplements was 99 %. There was no adverse event associated with nutritional intervention. Conclusions: Our nutritional intervention program showed an excellent compliance in the elderly with advanced cancer patients, and our data indicated a potential protective effect on nutritional deterioration.