Malnutrition in older adults with cancer undergoing outpatient care: associated factors

To determine the prevalence and factors associated with malnutrition in older adults with cancer upon admission for outpatient treatment.

This cross-sectional study was conducted with older adults with cancer admitted to an oncogeriatrics outpatient clinic from 2015 to 2020 in the Northeast of Brazil. Sociodemographic data, lifestyle, and clinical variables were collected. Nutritional status was assessed using the Mini Nutritional Assessment short-form (MNA-SF) and classified as normal nutritional status (12 to 14 points), at risk of malnutrition (8 to 11 points), or malnourished (0 to 7 points). The multivariate Poisson regression was used to verify the association between the independent variables and malnutrition.

A total of 1954 patients were included. Of these, 14.9% were at risk of malnutrition, and 31.5% were malnourished. The risk factors for malnutrition were female gender (prevalence ratio [PR] = 1.28; 95% confidence interval [CI] = 1.03-1.59), upper gastrointestinal tumor (PR = 2.39; 95%CI = 1.66-3.45), colon, rectum, anus, and anal canal tumors (PR = 2.54; 95%CI = 1.77-3.64), lung tumor (PR = 2.35; 95%CI = 1.37-4.02), metastasis (PR = 1.37; 95%CI = 1.11-1.70), history of falls (PR = 1.27; 95%CI = 1.01-1.61), sedentary lifestyle (PR = 1.46; 95%CI = 1.11-1.93), and risk of depression (PR = 1.42; 95%CI = 1.16-1.73).

The prevalence of nutritional risk and malnutrition was relatively high in older adults with cancer at the beginning of outpatient treatment. These findings underscore the need for routine malnutrition screening at admission in oncology outpatient settings to ensure early identification and management. The associated factors were easily identifiable within standard clinical evaluations, supporting the feasibility of systematic screening.