Soini H, Routasalo P, Lagstrom H
Herttoniemi Health Centre, City of Helsinki, Finland.
J Nutr Health Aging. 2005 Jul-Aug;9(4):249-53.
Older adults are a potentially vulnerable group for malnutrition. This cross-sectional pilot study aims to assess the nutritional status of elderly patients living at home and receiving home health care services. The data were collected from patient care plans, the Mini Nutritional Assessment (MNA), and a questionnaire on eating problems. In addition, serum nutritional status indicators were measured, and an oral examination including quantitative saliva measurement was carried out. Out of 71 eligible patients 51 (72%) patients aged 76-93 years participated. MNA results showed that 47% were at risk of malnutrition. Care plans for 26 patients made reference to questions of nutrition but provided no detailed forward planning. The mean serum albumin value was 39.1 +/- 3.8 g/l, seven patients had a value lower than 35 g/l. MNA scores were significantly lower for female patients with haemoglobin values lower than 120 g/l (p = 0.027). The dentist's estimation of dry mouth and subjective problems in energy intake were significantly associated with lower MNA scores (p = 0.049 and p = 0.015). Subjects with functioning natural dentition had higher body mass index (BMI) scores than others (p = 0.0485). The results point at the importance of using screening tools such as the MNA for purposes of nutritional assessment, the estimation of oral problems such as dry mouth, chewing and swallowing problems, and advance planning in nutritional issues within the field of home care.
老年人是营养不良的潜在弱势群体。这项横断面试点研究旨在评估居家接受家庭医疗服务的老年患者的营养状况。数据收集自患者护理计划、微型营养评定法(MNA)以及一份关于饮食问题的问卷。此外,还测量了血清营养状况指标,并进行了包括定量唾液测量在内的口腔检查。在71名符合条件的患者中,51名(72%)年龄在76 - 93岁的患者参与了研究。MNA结果显示,47%的患者存在营养不良风险。26名患者的护理计划提及了营养问题,但未提供详细的前瞻性规划。血清白蛋白平均值为39.1 +/- 3.8 g/l,7名患者的值低于35 g/l。血红蛋白值低于120 g/l的女性患者MNA得分显著更低(p = 0.027)。牙医对口干的评估以及能量摄入方面的主观问题与较低的MNA得分显著相关(p = 0.049和p = 0.015)。拥有天然牙列功能的受试者的体重指数(BMI)得分高于其他人(p = 0.0485)。结果表明,使用诸如MNA等筛查工具进行营养评估、评估口干、咀嚼和吞咽问题等口腔问题以及在家庭护理领域对营养问题进行前瞻性规划具有重要意义。