Nutritional assessment of amyotrophic lateral sclerosis in routine practice: value of weighing and bioelectrical impedance analysis

Muscle Nerve. 2015 Apr;51(4):479-84. doi: 10.1002/mus.24419. Epub 2015 Feb 24.

Abstract

Introduction: We evaluated clinical and bioelectrical impedance (BIA) parameters at the time of diagnosis and during follow-up and associated these parameters with survival in amyotrophic lateral sclerosis (ALS) patients.

Methods: One hundred seventeen patients were enrolled and were evaluated prospectively every 3 months. All patients underwent at least 1 BIA-based assessment, and 73 underwent at least 2 assessments. Data regarding the site of onset, age at onset, weight, body mass index (BMI), amyotrophic lateral sclerosis functional rating scale score (ALSFRS), fat-free mass (FFM), fat mass (FM), and phase angle (PA) were collected.

Results: At the time of diagnosis, weight loss exceeding 5% of the premorbid weight and low PA were poor prognostic factors. During follow-up, a decrease of PA and FFM were associated with shorter survival, regardless of weight loss.

Conclusions: These results confirm that BIA is useful to identify poor prognostic factors at the time of diagnosis and during follow-up and thus could be used to monitor patients during follow-up. Early identification of poor prognostic factors enables nutritional management and might improve patient survival.

Keywords: amyotrophic lateral sclerosis; bioelectrical impedance; metabolism; prognosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amyotrophic Lateral Sclerosis / diagnosis*
  • Amyotrophic Lateral Sclerosis / physiopathology
  • Body Composition / physiology*
  • Body Mass Index
  • Body Weight / physiology*
  • Electric Impedance
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nutrition Assessment*
  • Nutritional Status / physiology*
  • Prognosis