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We aimed to (1) evaluate the association of nutritional impairment with psychological health and quality of life (QOL) and (2) examine which measures of nutrition had the strongest association with psychological health and QOL among older adults receiving cancer treatment with palliative intent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This secondary analysis was performed on baseline data from a nationwide cluster randomized clinical trial (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      identifier: NCT02107443; PI: Mohile). Adults age \u226570 with advanced cancer and \u22651 geriatric assessment (GA) impairment were enrolled from 2014 to 2017. In line with geriatric oncology standards, we defined nutritional impairment as Mini Nutritional Assessment Short Form (MNA\u2010SF) \u226411, body mass index (BMI) &lt;21\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , or &gt;10% involuntary weight loss in the past 6\u2009months. We conducted multivariable linear regressions to evaluate the association of nutritional impairment with each measure of psychological health and QOL: Geriatric Depression Scale (GDS\u201015, range 0\u201315), Generalized Anxiety Disorder\u20107 (GAD\u20107, range 0\u201321), NCCN Distress Thermometer (NCCN DT, range 0\u201310), and Functional Assessment of Cancer Therapy\u2010General (FACT\u2010G, range 0\u2013108). Analyses were adjusted for patient demographics, clinical characteristics, and GA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 541 patients, the mean age was 77 (range 70\u201396) and 60% had nutritional impairment. Mean baseline scores: GDS\u201015 3.1 (SD 2.7), GAD\u20107 2.9 (SD 4.0), NCCN DT 2.9 (SD 2.7), and FACT\u2010G 80 (SD 15). In the adjusted model, compared to those with no nutritional impairment, older adults with nutritional impairment had greater depression (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.79, 95% CI 0.36\u20131.23) and anxiety severity (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.86, 95% CI 0.19\u20131.53), and worse QOL (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22126.31, 95% CI \u22128.62 to \u22124.00). Of the measures of nutrition, MNA\u2010SF \u226411 demonstrated the strongest associations with depression, anxiety, distress, and QOL.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nutritional impairment is associated with impaired psychological health and worse QOL. Clinicians should use the MNA\u2010SF to screen older adults for nutritional impairment and offer tailored supportive interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.7348","type":"journal-article","created":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T01:40:03Z","timestamp":1718847603000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Nutritional impairment, psychological health and quality of life among older adults with advanced cancer: A secondary analysis of a randomized clinical trial"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4307-319X","authenticated-orcid":false,"given":"Surbhi","family":"Singhal","sequence":"first","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine University of California Davis  Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2317-8915","authenticated-orcid":false,"given":"Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoyang","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Computational Biology University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derick R.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Computational Biology University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard F.","family":"Dunne","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology James P. 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