Nutritional Status in Hospitalized Patients Over 65 Years of Age With Mental Disorders (NutriP-SI65)
Nutritional Status, Nutrition-Related Conditions, and Development of a Clinical Pathway for Nutritional Support in Hospitalized Patients Aged 65 Years and Older With Mental Disorders
Study Overview
Status
Status
Conditions
Conditions
Detailed Description
This prospective observational study will be conducted at the Geriatric Psychiatry Unit of the University Psychiatric Clinic Ljubljana and will focus on hospitalized patients aged 65 years and older with mental disorders. Older adults with psychiatric conditions, particularly those with dementia and depression, represent a highly vulnerable population with an increased risk of malnutrition, dysphagia, and related clinical conditions. Despite their clinical importance, these conditions remain under-recognized and insufficiently addressed, particularly in hospital settings, where nutritional status may further deteriorate during admission.
The study aims to provide a comprehensive and systematic evaluation of nutritional status and nutrition-related conditions in this population, while also examining their relationship with clinical, functional, cognitive, psychological, and sociodemographic factors. In addition, the study will explore associations between nutritional conditions and laboratory biomarkers, including markers of inflammation, metabolism, and oxidative stress, to improve understanding of underlying pathophysiological mechanisms.
Data will be collected as part of routine clinical care using a multidisciplinary approach, including medical, nutritional, functional, psychological, and pharmacological assessments. Nutritional status and dysphagia will be evaluated using validated clinical tools and standard diagnostic criteria. Functional status will be assessed through established mobility and performance measures, while cognitive function and mood will be evaluated using standardized psychological instruments. Laboratory parameters will be obtained from routine diagnostics, with additional analyses performed on stored serum samples without increasing patient burden.
Patients will be assessed at hospital admission and followed during hospitalization, with repeated measurements performed in accordance with standard clinical practice. No additional invasive procedures will be performed solely for research purposes, and all participants will receive standard care according to current clinical guidelines. The study will therefore not interfere with treatment or impose additional risk to participants.
The findings of this study are expected to provide the first comprehensive national data on the prevalence of malnutrition and related conditions in hospitalized older adults with mental disorders in Slovenia. Based on these findings, a multidisciplinary clinical pathway for nutritional care will be developed and its feasibility and effectiveness evaluated. The results will contribute to improved early detection, prevention, and management of malnutrition and dysphagia, as well as to the development of national evidence-based clinical guidelines and healthcare strategies for this vulnerable population.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Vesna Simič
- Phone Number: +38615872403
- Email: vesna.simic@psih-klinika.si
Study Contact Backup
- Name: Nina Mohorko
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Age 65 years and older
- Presence of at least one psychiatric diagnosis
- Hospitalization at the Geriatric Psychiatry Unit of the University Psychiatric Clinic Ljubljana
Exclusion Criteria:
- Individuals who did not provide written informed consent (or whose legal representatives did not provide consent)
- Hospitalization shorter than 48 hours
- Presence of delirium
- Patients receiving palliative care or who are terminally ill
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Prevalence of nutrition disorders and nutrition-related conditions
Time Frame: Baseline.
|
The prevalence of predefined nutrition disorders and nutrition-related conditions will be assessed in hospitalized patients aged 65 years and older with mental disorders using validated diagnostic criteria.
Predefined conditions include malnutrition, cachexia, sarcopenia, frailty, overweight, obesity (including sarcopenic obesity and central obesity), and micronutrient abnormalities.
|
Baseline.
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Mini Nutritional Assessment (MNA)
Time Frame: Baseline, Day 7, Day 14, and Day 21 (or hospital discharge if earlier).
|
Nutritional status will be assessed using the Mini Nutritional Assessment (MNA®; score range 0-30).
Higher MNA scores indicate better nutritional status.
|
Baseline, Day 7, Day 14, and Day 21 (or hospital discharge if earlier).
|
|
Appendicular skeletal muscle mass index (ASMI)
Time Frame: Baseline, Day 7, Day 14, and Day 21 (or hospital discharge if earlier).
|
Appendicular skeletal muscle mass index (ASMI, kg/m²) will be assessed by bioelectrical impedance analysis and calculated as appendicular skeletal muscle mass in kilograms divided by height in meters squared.
Higher ASMI values indicate greater appendicular skeletal muscle mass relative to height.
|
Baseline, Day 7, Day 14, and Day 21 (or hospital discharge if earlier).
|
|
Gugging Swallowing Screen (GUSS) score
Time Frame: Baseline and Day 21 (or hospital discharge if earlier).
|
Dysphagia will be assessed using the Gugging Swallowing Screen (GUSS).
The total score ranges from 0 to 20 points, with higher scores indicating better swallowing function.
Established score ranges will be used to describe dysphagia severity.
|
Baseline and Day 21 (or hospital discharge if earlier).
|
|
Phase angle
Time Frame: Baseline, Day 7, Day 14, and Day 21 (or hospital discharge if earlier).
|
Phase angle, expressed in degrees, will be assessed using bioelectrical impedance analysis.
Higher phase angle values generally indicate greater cell membrane integrity and body cell mass.
|
Baseline, Day 7, Day 14, and Day 21 (or hospital discharge if earlier).
|
|
Barthel Index score
Time Frame: Baseline and Day 21 (or hospital discharge if earlier).
|
Activities of daily living will be assessed using the Barthel Index.
The total Barthel Index score (0-100 points) will be recorded.
Higher scores indicate greater independence in activities of daily living.
|
Baseline and Day 21 (or hospital discharge if earlier).
|
|
Handgrip strength
Time Frame: Baseline and Day 21 (or hospital discharge if earlier).
|
Handgrip strength will be assessed using a calibrated hand dynamometer.
One maximal grip strength measurement will be obtained from the dominant hand and recorded in kilograms (kg).
Higher values indicate greater handgrip strength.
|
Baseline and Day 21 (or hospital discharge if earlier).
|
|
Cognitive function
Time Frame: Baseline and Day 21 (or hospital discharge if earlier).
|
Cognitive function will be assessed using the Mini-Mental State Examination (MMSE).
The total score ranges from 0 to 30 points, with higher scores indicating better cognitive function.
|
Baseline and Day 21 (or hospital discharge if earlier).
|
|
Geriatric Depression Scale (GDS) score
Time Frame: Baseline and Day 21 (or hospital discharge if earlier).
|
Depressive symptoms will be assessed using the 15-item Geriatric Depression Scale (GDS-15).
The total score ranges from 0 to 15 points, with higher scores indicating more severe depressive symptoms.
|
Baseline and Day 21 (or hospital discharge if earlier).
|
|
Hospital length of stay
Time Frame: From admission to discharge, an average of 3 weeks.
|
Hospital length of stay will be calculated as the number of calendar days from hospital admission to hospital discharge, based on the hospital medical record.
|
From admission to discharge, an average of 3 weeks.
|
|
Number of participants experiencing at least one in-hospital adverse event
Time Frame: During hospitalization, up to Day 21.
|
The number of participants experiencing at least one predefined adverse event during hospitalization will be recorded.
Predefined adverse events include falls, fractures, delirium, aspiration, pneumonia, urinary tract infection, gastrointestinal infection, sepsis, gastrointestinal bleeding, pressure ulcer, deep vein thrombosis, pulmonary embolism, arrhythmia, stroke, myocardial infarction, cardiopulmonary arrest, or death.
Each participant will be counted once, irrespective of the number of adverse events experienced.
|
During hospitalization, up to Day 21.
|
|
De Morton Mobility Index score
Time Frame: Baseline and Day 21 (or hospital discharge if earlier).
|
Mobility will be assessed using the de Morton Mobility Index (DEMMI).
The DEMMI total score (0-100 points) will be recorded.
Higher scores indicate better mobility.
|
Baseline and Day 21 (or hospital discharge if earlier).
|
|
4-meter gait speed
Time Frame: Baseline and Day 21 (or hospital discharge if earlier).
|
Gait speed will be assessed over a 4-meter walking distance.
Walking speed will be calculated as distance in meters divided by walking time in seconds and expressed in meters per second.
Higher values indicate faster gait speed.
|
Baseline and Day 21 (or hospital discharge if earlier).
|
|
Five Times Sit-to-Stand Test
Time Frame: Baseline and Day 21 (or hospital discharge if earlier).
|
Lower extremity muscle function will be assessed using the Five Times Sit-to-Stand Test (5STS).
The time (seconds) required to complete five consecutive sit-to-stand repetitions will be recorded.
Shorter completion time indicates better lower extremity strength.
|
Baseline and Day 21 (or hospital discharge if earlier).
|
|
Timed Up and Go Test (TUG)
Time Frame: Baseline and Day 21 (or hospital discharge if earlier).
|
Functional mobility will be assessed using the Timed Up and Go (TUG) test.
The time (seconds) required to stand up from a chair, walk around a marker, return, and sit down will be recorded.
Shorter completion time indicates better function.
|
Baseline and Day 21 (or hospital discharge if earlier).
|
|
Clinical Frailty Scale (CFS)
Time Frame: Baseline and Day 21 (or hospital discharge if earlier).
|
Frailty will be assessed using the Clinical Frailty Scale (CFS), ranging from 1 to 9 points.
Higher scores indicate greater frailty.
|
Baseline and Day 21 (or hospital discharge if earlier).
|
|
Age-adjusted Charlson Comorbidity Index (ACCI) score
Time Frame: Baseline.
|
Comorbidity burden will be assessed using the Age-adjusted Charlson Comorbidity Index.
The total ACCI score will be recorded.
|
Baseline.
|
|
Number of regularly prescribed medications
Time Frame: Baseline.
|
The number of regularly prescribed systemic medications documented in the participant's medication list at baseline will be recorded.
Medications prescribed only as needed will not be included.
|
Baseline.
|
|
Geriatric Nutritional Risk Index (GNRI)
Time Frame: Baseline and Day 21 (or hospital discharge if earlier).
|
GNRI will be calculated from serum albumin concentration and the ratio of actual to ideal body weight using the prespecified GNRI equation (Bouillanne et al, 2005).
The GNRI is a unitless score, with higher scores indicating lower nutrition-related risk.
|
Baseline and Day 21 (or hospital discharge if earlier).
|
|
Brain-derived neurotrophic factor (BDNF) concentration
Time Frame: Baseline and Day 21 (or hospital discharge if earlier).
|
Serum brain-derived neurotrophic factor (BDNF) concentration will be measured in serum obtained from venous blood using a validated enzyme-linked immunosorbent assay and expressed in ng/ml.
|
Baseline and Day 21 (or hospital discharge if earlier).
|
|
Interleukin-6 (IL-6) concentration
Time Frame: Baseline and Day 21 (or hospital discharge if earlier).
|
Serum interleukin-6 (IL-6) concentration will be measured in serum obtained from venous blood using a validated laboratory assay and expressed in pg/ml.
|
Baseline and Day 21 (or hospital discharge if earlier).
|
|
Interleukin-1 beta (IL-1β) concentration
Time Frame: Baseline and Day 21 (or hospital discharge if earlier).
|
Serum interleukin-1 beta (IL-1β) concentration (pg/ml) will be measured in serum obtained from venous blood using a validated laboratory assay.
|
Baseline and Day 21 (or hospital discharge if earlier).
|
|
Total antioxidant capacity
Time Frame: Baseline and Day 21 (or hospital discharge if earlier).
|
Total antioxidant capacity, assessed using the DPPH radical scavenging assay, will be expressed as percentage inhibition of the DPPH radical.
Higher values indicate greater antioxidant capacity.
|
Baseline and Day 21 (or hospital discharge if earlier).
|
|
Tumor necrosis factor alpha (TNF-alpha)
Time Frame: Baseline and Day 21 (or hospital discharge if earlier).
|
Serum tumor necrosis factor-alpha (TNF-α) concentration (pg/ml) will be measured in serum obtained from venous blood using a validated laboratory assay.
|
Baseline and Day 21 (or hospital discharge if earlier).
|
|
C-reactive protein (CRP) concentration
Time Frame: Baseline and Day 21 (or hospital discharge if earlier).
|
Serum C-reactive protein (CRP) concentration (mg/l) will be measured in serum obtained from venous blood using routine laboratory methods.
|
Baseline and Day 21 (or hospital discharge if earlier).
|
|
Phenotypic Age (PhenoAge)
Time Frame: Baseline and Day 21 (or hospital discharge if earlier).
|
PhenoAge, expressed in years, will be calculated using the validated equation described by Ruan et al. (2023), based on chronological age, serum albumin, creatinine, glucose, lymphocyte percentage, mean corpuscular volume, red cell distribution width, alkaline phosphatase, and white blood cell count.
Lower values indicate lower biological age.
|
Baseline and Day 21 (or hospital discharge if earlier).
|
|
Skeletal muscle mass percentage
Time Frame: Baseline, Day 7, Day 14, and Day 21 (or hospital discharge if earlier).
|
Skeletal muscle mass percentage will be assessed by bioelectrical impedance analysis and expressed as the percentage of total body mass classified as skeletal muscle mass.
|
Baseline, Day 7, Day 14, and Day 21 (or hospital discharge if earlier).
|
|
Fat mass percentage
Time Frame: Baseline, Day 7, Day 14, and Day 21 (or hospital discharge if earlier).
|
Fat mass percentage will be assessed by bioelectrical impedance analysis and expressed as the percentage of total body mass classified as fat mass.
Higher values indicate a greater proportion of body fat.
|
Baseline, Day 7, Day 14, and Day 21 (or hospital discharge if earlier).
|
|
Calf circumference
Time Frame: Baseline and Day 21 (or hospital discharge if earlier).
|
Calf circumference will be measured in centimeters at the prespecified anatomical site using a non-stretch measuring tape and standardized anthropometric procedures.
|
Baseline and Day 21 (or hospital discharge if earlier).
|
|
Body mass index
Time Frame: Baseline, Day 7, Day 14, and Day 21 (or hospital discharge if earlier).
|
Body mass index (BMI) will be calculated as body weight in kilograms divided by height in meters squared and expressed in kg/m².
|
Baseline, Day 7, Day 14, and Day 21 (or hospital discharge if earlier).
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Polona Rus Prelog, University Psychiatric Clinic Ljubljana
Publications and helpful links
General Publications
- Bouillanne O, Morineau G, Dupont C, Coulombel I, Vincent JP, Nicolis I, Benazeth S, Cynober L, Aussel C. Geriatric Nutritional Risk Index: a new index for evaluating at-risk elderly medical patients. Am J Clin Nutr. 2005 Oct;82(4):777-83. doi: 10.1093/ajcn/82.4.777.
- Ruan Z, Li D, Huang D, Liang M, Xu Y, Qiu Z, Chen X. Relationship between an ageing measure and chronic obstructive pulmonary disease, lung function: a cross-sectional study of NHANES, 2007-2010. BMJ Open. 2023 Nov 2;13(11):e076746. doi: 10.1136/bmjopen-2023-076746.
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Neurologic Manifestations
- Nervous System Diseases
- Neuromuscular Manifestations
- Pathologic Processes
- Nutrition Disorders
- Pathological Conditions, Anatomical
- Overnutrition
- Body Weight
- Digestive System Diseases
- Gastrointestinal Diseases
- Esophageal Diseases
- Otorhinolaryngologic Diseases
- Overweight
- Pharyngeal Diseases
- Muscular Atrophy
- Atrophy
- Pathological Conditions, Signs and Symptoms
- Nutritional and Metabolic Diseases
- Signs and Symptoms
- Frailty
- Malnutrition
- Obesity
- Mental Disorders
- Deglutition Disorders
- Sarcopenia
Other Study ID Numbers
Other Study ID Numbers
- UPCL-Geronto-2026-02
- CRP 2025 No.: V3-2559 (Other Grant/Funding Number: ARIS and the Ministry of Health)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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