Malnutrition, frailty and disability & nutritional assessment.
Clinical signs of malnutrition, starvation, cachexia and sarcopenia overlap, as they all imply muscle wasting to a various extent, however the underlying mechanisms differ fundamentally and therefore distinction between these phenomena has therapeutical and prognostic implications. We aimed to determine whether dietitians in selected European countries have ‘proper knowledge’ regarding malnutrition, starvation, cachexia and sarcopenia, and use these terms in their daily clinical work.
An anonymous online survey was performed among dietitians in Belgium, the Netherlands, Norway and Sweden. ‘Proper knowledge’ was defined as having mentioned at least two of the three common domains of malnutrition: ‘nutritional balance’, ‘body composition’ and ‘functionality and clinical outcome’, and a correct answer to three cases on starvation, cachexia and sarcopenia. Chi-square test was used to analyse differences in experience, working place and number of malnourished patients treated between dietitians with ‘proper knowledge’ vs. ‘less proper knowledge’.
From the 712 respondents, 369 were included in the analysis (5%). The term ‘malnutrition’ is being used in clinical practice by 88% of the respondents, and starvation, cachexia and sarcopenia by respectively 3%, 30% and 12%.The cases on starvation, cachexia and sarcopenia were correctly identified by respectively 58%, 43% and 74%. 13% of the respondents had ‘proper knowledge’. The proportion of respondents with ‘proper knowledge’ was significantly higher in those working in a hospital or in municipality (16%, P