The relationship between Controlling Nutritional Status (CONUT) Score and Mortality in Elderly Dementia Patients Followed up in the Neurology Outpatient Clinic

Merve Yilmaz; Hanife Karakaya

doi:10.22391/fppc.1496392

Research Article

Nöroloji polikliniğinde takip edilen demanslı yaşlı bireylerde nütrisyonel durum kontrolü (CONUT) skoru ile mortalite ilişkisi

Year 2025, Volume: 10 Issue: 2, 53 - 59, 27.06.2025

Merve Yilmaz , Hanife Karakaya

https://doi.org/10.22391/fppc.1496392

Abstract

Giriş: Demans, dünya genelinde beklenen yaşam süresinin uzaması ile yaygın hale gelen, bağımlılığa ve sonunda ölüme yol açan bir sağlık sorunudur. 65 yaş üstü demanslı bireyler, besin alımındaki çeşitli problemler nedeniyle artan yetersiz beslenme riski altındadırlar. Hastalığın seyri sırasında yeterli besin alımının ve beslenme durumunun korunması önemlidir. Vücut ağırlığındaki kayıp ve fonksiyonel azalma ile zayıflığın eşlik ettiği kas kütlesi kaybının demanslı bireylerde artan morbidite ve mortalite riskiyle ilişkili olduğu belirtilmektedir. Rehberler beslenme müdahalelerinin demans tedavisinin mutlak bir parçası olması gerektiğine vurgu yapmaktadır. Ancak demansın ilerleyen dönemlerinde bağımlılık durumlarının artması ağırlık ölçümünü ve ağırlıktaki değişimin hesaplanmasını zorlaştırmaktadır. Beslenme durumunun değerlendirilmesi için farklı ölçekler ve indeksler kullanılabilmekle beraber, altın bir standart yoktur. Serum albümin, total kolesterol ve total lenfositin skorlanması ile oluşturulan, Nütrisyonel Durum Kontrolü (Controlling Nutritional Status-CONUT) skorlamasının farklı hasta gruplarında malnütrisyonun erken teşhisi ve takibinde kullanılabileceği gösterilmiştir. Bu nedenle bu çalışmada, nöroloji polikliniğinde takip edilen 65 yaş ve üstü demanslı bireylerin malnütrisyon durumlarının belirlenmesinde CONUT skoru ile Mini Nütrisyonel değerlendirme-Kısa Form (MNA-SF) korelasyonunun değerlendirilmesi ve mortalite ile ilişkisinin incelenmesi amaçlanmıştır.
Yöntem: Belediyeye bağlı bir gündüz hastanesinin nöroloji polikliniğinde, en az 1 yıldır demans tanısı bulunan 187 hastadan, geriye dönük verilerine ulaşılabilen 65 yaş üstü 113 hasta çalışmaya dahil edilmiş olup, ağırlık, boy ölçümleri ve MNA-SF puanları ile serum albümin, total lenfosit ve total kolesterol değerleri sistemden kaydedilmiştir. CONUT skoru biyokimyasal verilerinden hesaplanmış ve 3 aylık mortalite durumları e-nabız sisteminden kontrol edilmiştir.
Bulgular: Hastaların yaş ortalamaları 80,9 (±7,48) yıl olup, %63,7 si kadındır. Bireylerin çoğunluğu Alzheimer tipi demansa (%76,9) sahiptir ve %53,9 unun beden kütle indeksi (BKİ) <23 kg/m2 dir. Beslenme durumları açısından MNA-SF (≤7) ve CONUT skoruna (≥2) göre malnütrisyon oranları sırasıyla %61,9, %61 dir ve aralarında negatif yönlü korelasyon bulunmuştur. CONUT ile belirlenen malnütrisyon ile demans yılı ve son 3 ayda>%5 ağırlık kaybı arasında pozitif yönde, BKİ ile negatif yönde korelasyon bulunmuştur. Hastaneye en az bir kez başvuru ve başvuru sayısında fark olmamasına rağmen malnütrisyonu olanların daha fazla hastaneye yatış ihtiyacı olmuştur (p=0,029). Hastaların herhangi bir sebeple mortalite durumları açısından yaş ve demans yılından bağımsız olarak. CONUT skor ≥2 olması ile istatistiksel olarak (AUC = 0.63, 95% CI: 0.57–0.73) anlamlıdır.
Sonuç: Malnütrisyonun belirlenmesinde biyokimyasal belirteçler ile hesaplanan CONUT skor (≥2 puan) ile yaşlılarda sıklıkla kullanılması önerilen MNA-SF arasında negatif yönlü korelasyon gösterilmiştir. CONUT skorunun, BKİ ve istemsiz ağırlık azalması ile ilişkili olması özellikle ağırlığı ölçülemeyen ve/veya bilinemeyen demanslı hastalarda objektif bir hesaplama olarak kullanılabilir bir yöntem olması açısından önemlidir. CONUT skor ile herhangi bir sebeple yaş ve demans yılından bağımsız olarak mortalite durumunun ilişkili olduğu gösterilmiştir.

Keywords

Demans , Yaşlılık , Malnütrisyon , CONUT skor , Beslenme Değerlendirmesi

Ethical Statement

Ethical approval was obtained from the İzmir Tınaztepe University Non-Interventional Clinical Research Ethics Committee on May 17, 2024 (Decision No: 2024/23). Institutional permission was granted by the chief physician before accessing the study data from the system. Additionally, verbal notification was provided to the patients and/or their relatives, and their informed consent was obtained.

Thanks

We would like to thank academic member Dr. Banu Özgürel for her guidance in interpreting the statistics of the study.

References

1. Volkert D, Chourdakis M, Faxen-Irving G, Frühwald T, Landi F, Suominen MH, et al. ESPEN guidelines on nutrition in dementia. Clin Nutr. 2015;34(6):1052–73. https://doi.org/10.1016/j.clnu.2015.09.004
2. A public health priority. World Health Organization. (‎2012)‎. Dementia: a public health priority. World Health Organization. https://iris.who.int/handle/10665/75263.
3. TurkStat, statistics by the Aged 2023. Available at: https://data.tuik.gov.tr/Bulten/Index?p=Istatistiklerle-Yaslilar-2023 (Access Date: February 16, 2024)
4. Arslantaş D, Özbabalık D, Metintaş S, Özkan S, Kalyoncu C, Gazi Özdemir AA. Prevalence of dementia and associated risk factors in Middle Anatolia. J Clin Neurosci. 2009;16(11):1455–9. https://doi.org/10.1016/j.jocn.2009.03.033
5. Yaman A, Yaman H. Dementia subtypes in Antalya, Turkey: A retrospective study. Postgrad Med. 2014;126(5):109–12.
6. Guérin O, Andrieu S, Schneider SM, Cortes F, Cantet C, Gillette-Guyonnet S, et al. Characteristics of Alzheimer’s disease patients with a rapid weight loss during a six-year follow-up. Clin Nutr. 2009;28(2):141–6. https://doi.org/10.1016/j.clnu.2009.01.014
7. Hanson LC, Ersek M, Lin FC, Carey TS. Outcomes of feeding problems in advanced dementia in a nursing home population. J Am Geriatr Soc. 2013;61(10):1692–7.
8. Cipriani G, Carlesi C, Lucetti C, Danti S, Nuti A. Eating behaviors and dietary changes in patients with dementia. Am J Alzheimers Dis Other Demen. 2016;31(8):706–16. doi: 10.1177/1533317516673155
9. Brockdorf Y, Morley JE. Nutrition and dementia. J Nutr Heal Aging. 2021;25(5):590–2.
10. Rakıcıoğlu N. Determination of malnutrition in old age [In Turkish]. Tebakademi [Internet]. 2009;115–20. Available from: e-kutuphane.teb.org.tr/pdf/tebakademi/geriatri_2009/21.pdf
11. Ignacio De Ulíbarri J, González-Madroño A, De Villar NGP, González P, González B, Mancha A, et al. CONUT: A tool for controlling nutritional status. First validation in a hospital population. Nutr Hosp. 2005;20(1):38–45.
12. Asil E, Yıldız E. Determination of nutritional status in heart failure patients. [In Turkish]. Bes Diy Derg. 2017;45(3):273–7.
13. Sarikaya D, Halil M, Kuyumcu ME, Kilic MK, Yesil Y, Kara O, et al. Mini nutritional assessment test long and short form are valid screening tools in Turkish older adults. Arch Gerontol Geriatr. 2015; Jul-Aug;61(1):56-60. doi: 10.1016/j.archger.2015.04.006. https://doi.org/10.1016/j.archger.2015.04.006
14. Perry E, Walton K, Lambert K. Prevalence of malnutrition in people with dementia in long-term care: A systematic review and meta-analysis. Nutrients. 2023;15(13). doi: 10.3390/nu15132927
15. Borda MG, Ayala Copete AM, Tovar-Rios DA, Jaramillo-Jimenez A, Giil LM, Soennesyn H et all. Association of malnutrition with functional and cognitive trajectories in people living with dementia: a five-year follow-up study. J Alzheimers Dis. 2021;9(4):1713-1722. doi: 10.3233/JAD-200961
16. Zhang Z, Pereira SL, Luo M, Matheson EM. Evaluation of blood biomarkers associated with risk of malnutrition in older adults: A systematic review and meta-analysis. Nutrients. 2017;9(8). doi: 10.3390/nu9080829
17. Jones S. Nutritional interventions for preventing malnutrition in people with dementia. Nurs Older People. 2019;Jul 10. doi: 10.7748/nop.2019.e1144
18. Tangvik RJ, Tell GS, Eisman JA, Guttormsen AB, Henriksen A, Nilsen RM, et al. The nutritional strategy: Four questions predict morbidity, mortality and health care costs. Clin Nutr [Internet]. 2014;33(4):634–41. Available from: http://dx.doi.org/10.1016/j.clnu.2013.09.008
19. Haugsgjerd TR, Dierkes J, Vollset SE, Vinknes KJ, Nygård OK, Seifert R, et al. Association between weight change and mortality in community living older people followed for up to 14 years. The Hordaland Health Study (HUSK). J Nutr Heal Aging. 2017;21(8):909–17. Doi: 10.1007/s12603-016-0866-z
20. Sanders CL, Wengreen HJ, Schwartz S, Behrens SJ, Corcoran C, Lyketsos CG, et al. Nutritional status is associated with severe dementia and mortality. Alzheimer Dis Assoc Disord. 2018;32(4):298–304. doi: 10.1097/WAD.0000000000000274
21. Cabrerizo S, Cuadras D, Gomez-Busto F, Artaza-Artabe I, Marín-Ciancas F, Malafarina V. Serum albumin and health in older people: Review and meta analysis. Maturitas. 2015;81(1):17–27. Doi: 10.1016/j.maturitas.2015.02.009
22. Weiss A, Beloosesky Y, Schmilovitz-Weiss H, Grossman E, Boaz M. Serum total cholesterol: A mortality predictor in elderly hospitalized patients. Clin Nutr [Internet]. 2013;32(4):533–7. Available from: http://dx.doi.org/10.1016/j.clnu.2012.11.012
23. Li S, Zhang J, Zheng H, Wang X, Liu Z, Sun T. Prognostic role of serum albumin, total lymphocyte count, and mini nutritional assessment on outcomes after geriatric hip fracture surgery: A meta-analysis and systematic review. J Arthroplasty [Internet]. 2019;34(6):1287–96. Doi:10.1016/j.arth.2019.02.003
24. Chen J, Song P, Peng Z, Liu Z, Yang L, Wang L, et al. The controlling nutritional status (conut) score and prognosis in malignant tumors: a systematic review and meta-analysis. Nutr Cancer [Internet]. 2022;74(9):3146–63. Available from: https://doi.org/10.1080/01635581.2022.2059091
25. Di Vincenzo O, D’Elia L, Ballarin G, Pasanisi F, Scalfi L. Controlling Nutritional Status (CONUT) score and the risk of mortality or impaired physical function in stroke patients: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis. 2023;33(8):1501–10. Doi: 10.1016/j.numecd.2023.05.012
26. Sungur MA, Sungur A, Can F, Esen A, Güngör B, Yıldırımtürk Ö. Relationship between CONUT score and mortality in patients with pulmonary arterial hypertension. Pamukkale Med J. 2023;548–56. doi:https://dx.doi.org/10.31362/patd.1324430
27. Yassine HN, Samieri C, Livingston G, Glass K, Wagner M, Tangney C, et al. Nutrition state of science and dementia prevention: recommendations of the nutrition for dementia prevention working group. Lancet Heal Longev. 2022;3(7):e501–12. Doi: 10.1016/s2666-7568(22)00120-9

The relationship between Controlling Nutritional Status (CONUT) Score and Mortality in Elderly Dementia Patients Followed up in the Neurology Outpatient Clinic

Year 2025, Volume: 10 Issue: 2, 53 - 59, 27.06.2025

Merve Yilmaz , Hanife Karakaya

https://doi.org/10.22391/fppc.1496392

Abstract

Introduction: Dementia is a health issue that has become increasingly prevalent worldwide due to the rising life expectancy. It leads to dependency and eventually death. Patients over the age of 65 with dementia are at increased risk of malnutrition due to various problems with food intake. Maintaining adequate nutritional intake and nutritional status during the disease is crucial. It has been noted that loss of muscle mass, accompanied by loss of body weight and functional decline, is associated with an increased risk of morbidity and mortality in dementia patients. Guidelines emphasize that nutritional interventions should be an integral part of dementia treatment. However, the increase in dependency situations in the later stages of dementia makes it difficult to measure weight and calculate the weight change. Although different scales and indexes can be used to assess nutritional status, there is no gold standard. It has been shown that Controlling Nutritional Status (CONUT) scoring, which is created by scoring serum albumin, total cholesterol, and total lymphocytes, can be used in the early diagnosis and follow-up of malnutrition in different patient groups. Therefore, this study aims to evaluate the correlation between the CONUT score and the Mini Nutritional Assessment-Short Form (MNA-SF) in determining the malnutrition status of dementia patients aged 65 and over who are followed up in a neurology outpatient clinic and to examine the relationship between the CONUT score and mortality.
Method: In the neurology outpatient clinic of a municipal day hospital, 113 patients aged 65 and over, out of 187 patients with a dementia diagnosis of at least one year, whose retrospective data were accessible, were included in the study. Their weight, height measurements, MNA-SF scores, serum albumin, total lymphocyte, and total cholesterol values were recorded from the system. The CONUT score was calculated based on biochemical data, and their three-month mortality statuses were checked from the e-Nabız system.
Results: The average age of the patients was 80.9 (±7.48) years, with 63.7% being female. Most of the patients had Alzheimer's type dementia (76.9%), and 53.9% had a body mass index (BMI) of <23 kg/m². According to the MNA-SF (≤7) and CONUT score (≥2), the malnutrition rates were 61.9% and 61%, respectively, and a negative correlation was found between them. A positive correlation was found between malnutrition determined by CONUT and the number of years with dementia, and weight loss of >5% in the last three months, while a negative correlation was found with BMI. Although there was no difference in the number of hospital admissions, those with malnutrition had a higher need for hospital admission (p=0.029). The mortality status of patients, regardless of age and years with dementia, was statistically significant with a CONUT score of ≥2 (0.63 (95% CI: 0.57-0.73)).
Conclusion: A negative correlation was shown between the CONUT score (≥2 points), calculated with biochemical markers, and the MNA-SF, which is recommended for frequent use in the elderly for determining malnutrition. The CONUT score's association with BMI and involuntary weight loss highlights its importance as an objective calculation method, particularly for dementia patients whose weight cannot be measured or known. It has been demonstrated that the CONUT score is related to mortality status regardless of age and years with dementia.

Keywords

Dementia , Elderly , Malnutrition , CONUT Score , Nutrition Assessment

Ethical Statement

Thanks

We would like to thank academic member Dr. Banu Özgürel for her guidance in interpreting the statistics of the study.

References

1. Volkert D, Chourdakis M, Faxen-Irving G, Frühwald T, Landi F, Suominen MH, et al. ESPEN guidelines on nutrition in dementia. Clin Nutr. 2015;34(6):1052–73. https://doi.org/10.1016/j.clnu.2015.09.004
2. A public health priority. World Health Organization. (‎2012)‎. Dementia: a public health priority. World Health Organization. https://iris.who.int/handle/10665/75263.
3. TurkStat, statistics by the Aged 2023. Available at: https://data.tuik.gov.tr/Bulten/Index?p=Istatistiklerle-Yaslilar-2023 (Access Date: February 16, 2024)
4. Arslantaş D, Özbabalık D, Metintaş S, Özkan S, Kalyoncu C, Gazi Özdemir AA. Prevalence of dementia and associated risk factors in Middle Anatolia. J Clin Neurosci. 2009;16(11):1455–9. https://doi.org/10.1016/j.jocn.2009.03.033
5. Yaman A, Yaman H. Dementia subtypes in Antalya, Turkey: A retrospective study. Postgrad Med. 2014;126(5):109–12.
6. Guérin O, Andrieu S, Schneider SM, Cortes F, Cantet C, Gillette-Guyonnet S, et al. Characteristics of Alzheimer’s disease patients with a rapid weight loss during a six-year follow-up. Clin Nutr. 2009;28(2):141–6. https://doi.org/10.1016/j.clnu.2009.01.014
7. Hanson LC, Ersek M, Lin FC, Carey TS. Outcomes of feeding problems in advanced dementia in a nursing home population. J Am Geriatr Soc. 2013;61(10):1692–7.
8. Cipriani G, Carlesi C, Lucetti C, Danti S, Nuti A. Eating behaviors and dietary changes in patients with dementia. Am J Alzheimers Dis Other Demen. 2016;31(8):706–16. doi: 10.1177/1533317516673155
9. Brockdorf Y, Morley JE. Nutrition and dementia. J Nutr Heal Aging. 2021;25(5):590–2.
10. Rakıcıoğlu N. Determination of malnutrition in old age [In Turkish]. Tebakademi [Internet]. 2009;115–20. Available from: e-kutuphane.teb.org.tr/pdf/tebakademi/geriatri_2009/21.pdf
11. Ignacio De Ulíbarri J, González-Madroño A, De Villar NGP, González P, González B, Mancha A, et al. CONUT: A tool for controlling nutritional status. First validation in a hospital population. Nutr Hosp. 2005;20(1):38–45.
12. Asil E, Yıldız E. Determination of nutritional status in heart failure patients. [In Turkish]. Bes Diy Derg. 2017;45(3):273–7.
13. Sarikaya D, Halil M, Kuyumcu ME, Kilic MK, Yesil Y, Kara O, et al. Mini nutritional assessment test long and short form are valid screening tools in Turkish older adults. Arch Gerontol Geriatr. 2015; Jul-Aug;61(1):56-60. doi: 10.1016/j.archger.2015.04.006. https://doi.org/10.1016/j.archger.2015.04.006
14. Perry E, Walton K, Lambert K. Prevalence of malnutrition in people with dementia in long-term care: A systematic review and meta-analysis. Nutrients. 2023;15(13). doi: 10.3390/nu15132927
15. Borda MG, Ayala Copete AM, Tovar-Rios DA, Jaramillo-Jimenez A, Giil LM, Soennesyn H et all. Association of malnutrition with functional and cognitive trajectories in people living with dementia: a five-year follow-up study. J Alzheimers Dis. 2021;9(4):1713-1722. doi: 10.3233/JAD-200961
16. Zhang Z, Pereira SL, Luo M, Matheson EM. Evaluation of blood biomarkers associated with risk of malnutrition in older adults: A systematic review and meta-analysis. Nutrients. 2017;9(8). doi: 10.3390/nu9080829
17. Jones S. Nutritional interventions for preventing malnutrition in people with dementia. Nurs Older People. 2019;Jul 10. doi: 10.7748/nop.2019.e1144
18. Tangvik RJ, Tell GS, Eisman JA, Guttormsen AB, Henriksen A, Nilsen RM, et al. The nutritional strategy: Four questions predict morbidity, mortality and health care costs. Clin Nutr [Internet]. 2014;33(4):634–41. Available from: http://dx.doi.org/10.1016/j.clnu.2013.09.008
19. Haugsgjerd TR, Dierkes J, Vollset SE, Vinknes KJ, Nygård OK, Seifert R, et al. Association between weight change and mortality in community living older people followed for up to 14 years. The Hordaland Health Study (HUSK). J Nutr Heal Aging. 2017;21(8):909–17. Doi: 10.1007/s12603-016-0866-z
20. Sanders CL, Wengreen HJ, Schwartz S, Behrens SJ, Corcoran C, Lyketsos CG, et al. Nutritional status is associated with severe dementia and mortality. Alzheimer Dis Assoc Disord. 2018;32(4):298–304. doi: 10.1097/WAD.0000000000000274
21. Cabrerizo S, Cuadras D, Gomez-Busto F, Artaza-Artabe I, Marín-Ciancas F, Malafarina V. Serum albumin and health in older people: Review and meta analysis. Maturitas. 2015;81(1):17–27. Doi: 10.1016/j.maturitas.2015.02.009
22. Weiss A, Beloosesky Y, Schmilovitz-Weiss H, Grossman E, Boaz M. Serum total cholesterol: A mortality predictor in elderly hospitalized patients. Clin Nutr [Internet]. 2013;32(4):533–7. Available from: http://dx.doi.org/10.1016/j.clnu.2012.11.012
23. Li S, Zhang J, Zheng H, Wang X, Liu Z, Sun T. Prognostic role of serum albumin, total lymphocyte count, and mini nutritional assessment on outcomes after geriatric hip fracture surgery: A meta-analysis and systematic review. J Arthroplasty [Internet]. 2019;34(6):1287–96. Doi:10.1016/j.arth.2019.02.003
24. Chen J, Song P, Peng Z, Liu Z, Yang L, Wang L, et al. The controlling nutritional status (conut) score and prognosis in malignant tumors: a systematic review and meta-analysis. Nutr Cancer [Internet]. 2022;74(9):3146–63. Available from: https://doi.org/10.1080/01635581.2022.2059091
25. Di Vincenzo O, D’Elia L, Ballarin G, Pasanisi F, Scalfi L. Controlling Nutritional Status (CONUT) score and the risk of mortality or impaired physical function in stroke patients: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis. 2023;33(8):1501–10. Doi: 10.1016/j.numecd.2023.05.012
26. Sungur MA, Sungur A, Can F, Esen A, Güngör B, Yıldırımtürk Ö. Relationship between CONUT score and mortality in patients with pulmonary arterial hypertension. Pamukkale Med J. 2023;548–56. doi:https://dx.doi.org/10.31362/patd.1324430
27. Yassine HN, Samieri C, Livingston G, Glass K, Wagner M, Tangney C, et al. Nutrition state of science and dementia prevention: recommendations of the nutrition for dementia prevention working group. Lancet Heal Longev. 2022;3(7):e501–12. Doi: 10.1016/s2666-7568(22)00120-9

There are 27 citations in total.

Details

Primary Language	English
Subjects	Nutrition and Dietetics (Other), Geriatrics and Gerontology
Journal Section	Original Research
Authors	Merve Yilmaz 0000-0003-0730-8908 Hanife Karakaya 0000-0001-5653-144X
Publication Date	June 27, 2025
Submission Date	June 5, 2024
Acceptance Date	April 14, 2025
Published in Issue	Year 2025 Volume: 10 Issue: 2

Cite

APA	Yilmaz, M., & Karakaya, H. (2025). The relationship between Controlling Nutritional Status (CONUT) Score and Mortality in Elderly Dementia Patients Followed up in the Neurology Outpatient Clinic. Family Practice and Palliative Care, 10(2), 53-59. https://doi.org/10.22391/fppc.1496392
AMA	Yilmaz M, Karakaya H. The relationship between Controlling Nutritional Status (CONUT) Score and Mortality in Elderly Dementia Patients Followed up in the Neurology Outpatient Clinic. Fam Pract Palliat Care. June 2025;10(2):53-59. doi:10.22391/fppc.1496392
Chicago	Yilmaz, Merve, and Hanife Karakaya. “The Relationship Between Controlling Nutritional Status (CONUT) Score and Mortality in Elderly Dementia Patients Followed up in the Neurology Outpatient Clinic”. Family Practice and Palliative Care 10, no. 2 (June 2025): 53-59. https://doi.org/10.22391/fppc.1496392.
EndNote	Yilmaz M, Karakaya H (June 1, 2025) The relationship between Controlling Nutritional Status (CONUT) Score and Mortality in Elderly Dementia Patients Followed up in the Neurology Outpatient Clinic. Family Practice and Palliative Care 10 2 53–59.
IEEE	M. Yilmaz and H. Karakaya, “The relationship between Controlling Nutritional Status (CONUT) Score and Mortality in Elderly Dementia Patients Followed up in the Neurology Outpatient Clinic”, Fam Pract Palliat Care, vol. 10, no. 2, pp. 53–59, 2025, doi: 10.22391/fppc.1496392.
ISNAD	Yilmaz, Merve - Karakaya, Hanife. “The Relationship Between Controlling Nutritional Status (CONUT) Score and Mortality in Elderly Dementia Patients Followed up in the Neurology Outpatient Clinic”. Family Practice and Palliative Care 10/2 (June2025), 53-59. https://doi.org/10.22391/fppc.1496392.
JAMA	Yilmaz M, Karakaya H. The relationship between Controlling Nutritional Status (CONUT) Score and Mortality in Elderly Dementia Patients Followed up in the Neurology Outpatient Clinic. Fam Pract Palliat Care. 2025;10:53–59.
MLA	Yilmaz, Merve and Hanife Karakaya. “The Relationship Between Controlling Nutritional Status (CONUT) Score and Mortality in Elderly Dementia Patients Followed up in the Neurology Outpatient Clinic”. Family Practice and Palliative Care, vol. 10, no. 2, 2025, pp. 53-59, doi:10.22391/fppc.1496392.
Vancouver	Yilmaz M, Karakaya H. The relationship between Controlling Nutritional Status (CONUT) Score and Mortality in Elderly Dementia Patients Followed up in the Neurology Outpatient Clinic. Fam Pract Palliat Care. 2025;10(2):53-9.