Relation of Disease with Standardized Phase Angle among Older Patients

A low phase angle (PA) has been associated with negative outcome in specific diseases. However, many patients suffer from several co-morbidities. This study aims at identifying the impact of the type and the severity of diseases on PA in a retrospective cohort study of older people.

We included all people ≥65 years who underwent a PA measurement (Nutriguard®) between 1990 and 2011 at the Geneva University Hospitals. PA was standardized for gender, age and body mass index according to German reference values. Co-morbidities were reported in form of the Cumulative Illness Rating Scale which considers 14 different organs/systems (disease categories), each rated from 0 (healthy) to 4 (severe illness) (severity grades). The association between the diseases categories and standardized PA was evaluated by a multivariate linear regression. For each significant disease category, we performed univariate regression models. The adjusted R2 was used to identify the best predictors of standardized PA. We considered that the severity grade affected standardized PA if there was a progressive decrease in the regression coefficients.

We included 1181 people (37% women). The multivariate regression model showed that the disease categories explain 17% of the variance of standardized PA. Many disease categories affect standardized PA and the ones best associated with standardized PA were the hematopoietic and vascular (R2 7.4%), the musculo-skeletal (R2 5.5%) and the respiratory (R2 4.0%) diseases. The regression coefficients in the univariate linear regression model decreased progressively with higher severity grades in respiratory (-0.15, -0.27, -0.55, -0.67) and musculo-skeletal diseases (-0.09, -0.46, -0.85, -0.86).

Many different diseases affect standardized PA. The higher the severity grade in musculo-skeletal and respiratory diseases, the lower is the standardized PA.