Association between the risk of malnutrition and functional capacity in patients with peripheral arterial disease: A cross-sectional study
Juliana Ferreira de Santana Carvalho, Marília de Almeida Correia, Hélcio Kanegusuku, Paulo Longano, Nelson Wolosker, Raphael Mendes Ritti‐Dias, Gabriel Grizzo Cucato
Abstract
INTRODUCTION: The risk of malnutrition is an important predictor of functional capacity in the elderly population. However, whether malnutrition is associated with functional capacity in patients with peripheral artery disease (PAD) is poorly known. PURPOSE: To analyse the association between the risk of malnutrition and functional capacity in patients with PAD. METHODS: This cross-sectional study included 135 patients with PAD of both genders, ≥50 years old, with symptomatic PAD (Rutherford stage I to III) in one or both limbs and with ankle-brachial index ≤0.90. The risk of malnutrition was assessed by the short form of the Mini Nutritional Assessment-Short Form and patients were classified as having normal nutritional status (n = 92) and at risk of malnutrition (n = 43). Functional capacity was objectively assessed using the six-minute walking test (6MWT, absolute maximal distance and relativized and expressed as a percentage of health subjects), short-physical performance battery (SPPB, balance, gait speed and the sit and stand test) and the handgrip test, and subjectively, using the Walking Impairment Questionnaire and Walking Estimated-Limitation Calculated by History. The association between the risk of malnutrition and functional capacity was analysed using bivariate and multivariate logistic regression adjustments for gender, age, ankle-brachial index, body mass index, use of statins, coronary arterial disease and stroke. For all statistical analyses, significance was accepted at p<0.05. RESULTS: Thirty-two per cent of our patients were classified with a risk of malnutrition. The risk of malnutrition was associated with the absolute 6MWT total distance (OR = 0.994, P = 0.031) relative 6MWT total distance (OR = 0.971, P = 0.038), lowest SPPB total score (OR = 0.682, P = 0.011), sit and stand (OR = 1.173, P = 0.003) and usual 4-meter walk test (OR = 1.757, P = 0.034). CONCLUSION: In patients with PAD, the risk of malnutrition was associated with objective measurements of functional capacity.