Phase Angle as a Prognostic Indicator of Survival in Institutionalized Psychogeriatric Patients

Abstract

Phase angle (PhA) has been evidenced to be a useful survival indicator and predictor of morbi-mortality in different pathologies, but not in psychogeriatric patients. The aim of this study was to evaluate the clinical utility of PhA as a prognostic indicator of survival in a group of institutionalized psychogeriatric patients. A survival study was conducted on 157 patients (46.5% dementia, 43.9% schizophrenia). Functional impairment stage, frailty, dependence, malnutrition (MNA), comorbidity, polypharmacy, BMI, and waist circumference were registered. Body composition was analyzed using a 50-kHz whole-body BIA; PhA was recorded. The association between mortality and standardized-PhA was evaluated through univariate and multivariate Cox regression models and ROC-curve. The risk of death decreased when Z-PhA, BMI, and MNA were higher. Mortality increases with age, frailty, and dependence. The risk of death was statistically significantly lower (56.5%) in patients with schizophrenia vs. dementia (89%). The Z-PhA cut-off point was −0.81 (Sensitivity:0.75; Specificity:0.60). Mortality risk was multiplied by 1.09 in subjects with a Z-PhA < −0.81, regardless of age, presence of dementia, and BMI. PhA presented a remarkable clinical utility as an independent indicator of survival in psychogeriatric patients. Moreover, it could be useful to detect disease-related malnutrition and to identify subjects eligible for an early clinical approach.

Keywords

• bioelectrical impedance
• phase angle
• dementia
• schizophrenia
• psychogeriatric patients
• nutritional status assessment