Impact of nutritional status on mortality in geriatric patients with osteoporosis: a retrospective cohort study

TL;DR

This study found that malnutrition significantly increases mortality risk in older patients with osteoporosis, highlighting the need for early nutritional assessment.

Contribution

The study identifies specific nutritional assessment thresholds that predict mortality in geriatric osteoporosis patients.

Findings

Malnutrition is strongly linked to higher mortality in older osteoporosis patients.

Specific nutritional scores (e.g., MNA Long Form ≤24, PNI ≤49.9) are independent predictors of mortality.

Slower gait speed and higher body shape index also correlate with increased mortality risk.

Abstract

This study investigated the relationship between mortality and numerous characteristics in geriatric patients with osteoporosis, including nutritional, clinical, anthropometric, and biochemical factors.

This retrospective cohort comprised geriatric patients diagnosed with osteoporosis between January 2016 and December 2019. Demographics, anthropometrics, comorbidities, laboratory results, bone mineral density (DEXA) analyses, fracture history, and mortality data were obtained. In addition, nutritional status, hand grip strength, and gait speed were measured. The Geriatric Depression Scale (GDS) was applied and nutritional status was assessed using multiple tools: Mini Nutritional Assessment (MNA) Short and Long Forms, Controlling Nutritional Status (CONUT), Geriatric Nutritional Risk Index (GNRI), and Prognostic Nutritional Index (PNI).

Among the 752 patients (mean age 75.3 ± 6.8 years, 69.7% female), the mortality rate was 18.1% during a median follow-up of 55 months. Nutritional assessments significantly predicted both fracture occurrence and mortality. Optimal cut-offs for predicting mortality were: MNA Short Form ≤ 11, MNA Long Form ≤ 24, CONUT > 1.5, GNRI ≤ 105.5, and PNI ≤ 49.9. Independent predictors of mortality included increasing age (p < 0.001), male sex (p = 0.005), higher body shape index (p = 0.006), slower gait speed (p = 0.001), MNA Long Form score ≤ 24 (p = 0.002), and PNI score ≤ 49.9 (p < 0.001).

Malnutrition is strongly associated with higher mortality risk in older osteoporosis patients. Early identification of malnutrition is critical to administering appropriate interventions, and our results show that malnutrition deserves greater attention to understand its broader impacts on outcomes in geriatric patients, particularly those with osteoporosis.

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