Department of Geriatric Medicine, Jakobsbergsgeriatriken, Stockholm, Sweden.
Theme Inflammation and Aging, Nursing Unit Aging, Karolinska University Hospital, Huddinge, Sweden.
Eur J Nutr. 2024 Apr;63(3):927-938. doi: 10.1007/s00394-023-03323-5. Epub 2024 Jan 19.
In 2019, the Global Leadership Initiative on Malnutrition (GLIM) suggested a 2-step diagnostic format for malnutrition including screening and diagnosis. Prospective validation and feasibility studies, using the complete set of the five GLIM criteria, are needed. The aims of this study were to determine the prevalence of malnutrition, and investigate how the prevalence varied with mode of screening. Furthermore, we assessed the feasibility of GLIM in geriatric patients.
Consecutive patients from two acute geriatric wards were included. For screening risk of malnutrition, the Mini Nutritional Assessment-Short Form (MNA-SF) or Malnutrition Screening Tool (MST) were used. In accordance with GLIM, a combination of phenotypic and etiologic criteria were required for the diagnosis of malnutrition. Feasibility was determined based on % data completeness, and above 80% completeness was considered feasible.
One hundred patients (mean age 82 years, 58% women) were included. After screening with MNA-SF malnutrition was confirmed by GLIM in 51%, as compared with 35% after screening with MST (p = 0.039). Corresponding prevalence was 58% with no prior screening. Using hand grip strength as a supportive measure for reduced muscle mass, 69% of the patients were malnourished. Feasibility varied between 70 and 100% for the different GLIM criteria, with calf circumference as a proxy for reduced muscle mass having the lowest feasibility.
In acute geriatric patients, the prevalence of malnutrition according to GLIM varied depending on the screening tool used. In this setting, GLIM appears feasible, besides for the criterion of reduced muscle mass.
2019 年，全球营养不良领导倡议（GLIM）提出了一种两步法诊断营养不良的模式，包括筛查和诊断。需要进行前瞻性验证和可行性研究，使用 GLIM 的全部五项标准。本研究的目的是确定营养不良的患病率，并研究筛查方式如何影响患病率。此外，我们评估了 GLIM 在老年患者中的可行性。
连续纳入来自两个急性老年病房的患者。为了筛查营养不良的风险，使用 Mini Nutritional Assessment-Short Form（MNA-SF）或 Malnutrition Screening Tool（MST）。根据 GLIM，需要结合表型和病因标准来诊断营养不良。可行性基于数据完整性的百分比来确定，超过 80%的完整性被认为是可行的。
共纳入 100 例患者（平均年龄 82 岁，58%为女性）。使用 MNA-SF 进行筛查后，根据 GLIM 确认营养不良的患者为 51%，而使用 MST 筛查后为 35%（p=0.039）。相应的患病率为 58%，且无先前的筛查。使用握力作为肌肉减少的支持性指标，69%的患者存在营养不良。不同 GLIM 标准的可行性在 70%至 100%之间变化，以小腿围度作为肌肉减少的替代指标的可行性最低。
在急性老年患者中，根据 GLIM 确定的营养不良患病率因使用的筛查工具而异。在这种情况下，除了肌肉减少的标准外，GLIM 似乎是可行的。
