Two Distinct Nutritional Assessment Tools Have Dissimilar Outcomes in a Sample of Older Adult Patients With Cancer

Introduction: Malnutrition is strongly associated with negative outcomes in aged populations with cancer. Several studies have compared outcomes of nutritional screening tools, but knowledge covering older adult’s patients with cancer specifically remains limited. The aim of this study was to compare the outcomes of two tools, the Patient-Generated Subjective Global Assessment (PG-SGA) versus the Mini Nutritional Assessment (MNA) for this population.
Methodology: Cross-sectional study with 432 participants who consented to participate and were enrolled at the admission to medical and surgical wards at a tertiary referral hospital. The participant's nutritional statuses were simultaneously assessed using the PG-SGA and the
MNA, and the outcomes compared using the kappa statistical test. The Receiver Operating Characteristic Curve (ROC) was employed to calculate the MNA sensitivity, specificity, positive and negative predictive values, compared with PG-SGA. Results: Prevalence of well-nourishment was observed in 62.5% and 61.1% of the participants detected by PG-SGA and
MNA, respectively. Both tools concurred moderately (kappa=0.453). Importantly, there were significant differences in the diagnosis of malnutrition (7.6% vs. 4.6%, p=0.000). The MNA showed sensitivity of 72.2% and specificity of 75.9% in detecting well-nourishment for the
population investigated. Conclusion: The MNA may not present greater sensitivity possibly due to lack of coverage of gastrointestinal symptoms. It is a quick and efficient tool for nutritional assessment of older adult patients with cancer, but as it is more specific than sensitive, caution
is recommended when identifying borderline or early malnourished individuals of this population.