Maaravi Y, Berry E M, Ginsberg G, Cohen A, Stessman J
Department of Rehabilitation and Geriatrics, Hadassah-University Hospital, Mount Scopus, Jerusalem, Israel.
Aging (Milano). 2000 Jun;12(3):173-9.
Inadequate nutrition is a major problem of elderly people today. Yet, despite the prevalence and significance of the problem, there is little information on the nutritional status of elderly persons in the community, and its impact on their quality of life. During 1990-1991, as part of a first cross-section in a longitudinal medical and social study of 70-year olds in Jerusalem, we surveyed the nutritional status of this population. During the first phase, 605 people were examined in their homes; data were collected regarding socioeconomic status, education, self-perceived health state, use of medications and health services, and ADL. During the second stage, a sub-group of 463 people was examined in a geriatric outpatient clinic; all subjects underwent medical history, physical examination, cognitive assessment, psychiatric questionnaire, blood and urine tests, electrocardiogram, and pulmonary function tests. In addition, general hospital admissions and morbidity and mortality in the two years following the study were studied. The nutritional status of the participants was determined according to nutritional assessment (NA) scale, based on the Mini Nutritional Assessment (MNA). The majority of the study population lived at home, was without cognitive disturbance (86%), and was independent in ADL (83%). Based on NA > 24, 91% of the study population were in good nutritional state, 8.3% were at risk of undernutrition, and 0.7% were malnourished. There was a significant positive relationship between NA score and ADL as well as cognitive state. In addition, a strong negative relation was found between NA score and visits to the family physician in the previous fortnight, visits to the emergency room in the previous year, and hospital admissions in the following two years. An inverse relation, although not significant, was found between NA score and two-year post-study mortality. These results suggest that the nutritional status of the studied population is inadequate, and that the nutritional state is one of the major determinants of the quality of life in the elderly and therefore, should be part of any geriatric assessment. Elder population surveys are needed to identify and treat at risk elders.
营养不足是当今老年人面临的一个主要问题。然而，尽管这个问题普遍存在且意义重大，但关于社区中老年人营养状况及其对生活质量影响的信息却很少。1990 - 1991年期间，作为对耶路撒冷70岁老人进行的纵向医学和社会学研究的首个横断面研究的一部分，我们调查了这一人群的营养状况。在第一阶段，对605人进行了家访；收集了有关社会经济地位、教育程度、自我感知健康状况、药物和医疗服务使用情况以及日常生活活动（ADL）的数据。在第二阶段，对463人的一个亚组在老年门诊进行了检查；所有受试者都接受了病史询问、体格检查、认知评估、精神问卷、血液和尿液检查、心电图以及肺功能测试。此外，还研究了研究后两年内的综合医院入院情况以及发病率和死亡率。参与者的营养状况根据基于微型营养评定法（MNA）的营养评估（NA）量表来确定。研究人群中的大多数人居家生活，没有认知障碍（86%），并且在日常生活活动方面能够自理（83%）。根据NA > 24，91%的研究人群营养状况良好，8.3%有营养不良风险，0.7%营养不良。NA评分与ADL以及认知状态之间存在显著的正相关关系。此外，还发现NA评分与前两周内看家庭医生的次数、上一年去急诊室的次数以及接下来两年内的住院次数之间存在强烈的负相关关系。虽然不显著，但在NA评分与研究后两年的死亡率之间发现了负相关关系。这些结果表明，所研究人群的营养状况不佳，并且营养状况是老年人生活质量的主要决定因素之一，因此，应成为任何老年评估的一部分。需要进行老年人群调查以识别和治疗有风险的老年人。
