Geriatric Assessments Predict Malnutrition Risks in Older Patients With Breast Cancer

Cancer stage and functional status, as well as other geriatric symptoms, may predict the risk of malnutrition in older women with breast cancer. These results of a recent study were reported in the Clinical Journal of Oncology Nursing.

The study was aimed at assessing malnutrition in women treated for breast cancer who were at least 70 years old, and included data obtained from comprehensive geriatric assessments. Malnutrition was evaluated using Mini Nutritional Assessment (MNA) scores. Functional status was evaluated using the Timed Up and Go (TUG) Test and the Activities of Daily Living (ADL) Scale, depression was evaluated using the Geriatric Depression Scale (GDS), and pain was assessed with the Numeric Pain Rating Scale. The researchers performed analyses to identify associations with scores on the MNA.

The study included 72 patients, with a mean age of 77.9 years (SD, 5.9). Cancer was stage I in 30 patients, stage II in 18 patients, stage III in 5 patients, and stage IV in 19 patients. The most common breast cancer type was infiltrating ductal carcinoma, present in 52 patients.

Most patients were not receiving chemotherapy (59 vs 13 patients receiving it). Aromatase inhibitors were used in 35 patients; 37 patients were not receiving this therapy. Most patients had undergone surgery.

In this population, mean MNA score was 12.21, which indicates a normal nutritional status; although 38 participants reported a nutritional limitation.

The mean time on the TUG test (11.57 seconds) does not indicate a fall risk, but the mean ADL score of 5.55 does suggest functional limitation. Nine participants reported some type of functional limitation; however, those who did not have an ambulatory assistive device or who were confined to a wheelchair did not perform the TUG Test.

The mean pain score was 1.17. Fourteen participants reported some pain, with 8 rating their pain as 5 or higher.

The mean GDS score of 2.25 did not suggest depression, yet approximately 14 participants screened positive for depression.

Overall, cancer stage and geriatric symptoms — including malnutrition, impaired function, pain, and depression — were considered to be associated with each other.

The researchers recommend anticipating the predictive factors for malnutrition, such as cancer stage (P =.02) and functional status (P = .04), in the cancer treatment plans for older patients with breast cancer.

“For older adult patients with breast cancer, nurses can complete comprehensive assessments to detect problems before they impair function, interfere with cancer treatment, and degrade quality of life,” the researchers concluded.

Reference

Overcash J, Goetz R, Williams N. Prediction of malnutrition and the relationships among pain, function, depression, and cancer stage in older women with breast cancer. Clin J Oncol Nurs. 2023;27(4):411-417. doi:10.1188/23.CJON.411-417