Challa S, Sharkey J R, Chen M, Phillips C D
Dept. of Community Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA.
J Nutr Health Aging. 2007 Mar-Apr;11(2):179-84.
Undernutrition (also known as protein-calorie malnutrition or energy-deficiency) is associated with exacerbation of health conditions, increased frailty, and decline in physical, cognitive, and affective function. This is a critical problem for older adults who reside in nursing homes and have many limitations that contribute to reduced food intake.
To determine the relationship of chronic undernutrition [body mass index (BMI) < 18.5 kg/m2] to resident, facility, and geographical characteristics in a national sample of nursing home residents aged 60 y or older in the U.S.
A cross-sectional, secondary analysis of a 10% nationally representative random sample of annual assessments of nursing home residents in the U.S. (n = 128,514), using the Minimum Data Set (MDS). Data included measured weight and height, resident characteristics, facility characteristics, and geographic location.
More than 12% (n = 15,566) were chronically undernourished (energy-deficient), with more than 27% of those being severely undernourished (BMI < 16). Independent correlates of chronic undernutrition (multivariate analysis) included resident characteristics (ADL, having chewing or swallowing problems, or leaving at least 25% of the meal uneaten), facility characteristics (% Medicare and for-profit status), and geographic characteristics (living in nursing home in urban or large towns).
This study found a high percentage of chronic undernutrition in this nationally representative sample of U.S. nursing home residents. Furthermore, resident, facility, and geographic characteristics were associated with chronic undernutrition. Strategies need to be developed and documented that ensure nutritional health to residents with a variety of health problems.
营养不良（也称为蛋白质 - 热量营养不良或能量缺乏）与健康状况恶化、身体虚弱加剧以及身体、认知和情感功能下降有关。对于居住在养老院且存在诸多导致食物摄入量减少因素的老年人来说，这是一个关键问题。
在美国60岁及以上养老院居民的全国样本中，确定慢性营养不良（体重指数[BMI]<18.5 kg/m²）与居民、机构和地理特征之间的关系。
使用最小数据集（MDS），对美国养老院居民年度评估的10%具有全国代表性的随机样本（n = 128,514）进行横断面二次分析。数据包括测量的体重和身高、居民特征、机构特征和地理位置。
超过12%（n = 15,566）的人长期营养不良（能量缺乏），其中超过27%的人严重营养不良（BMI<16）。慢性营养不良的独立相关因素（多变量分析）包括居民特征（日常生活活动能力、有咀嚼或吞咽问题，或每餐至少剩余25%未吃）、机构特征（医疗保险比例和营利性状况）以及地理特征（居住在城市或大城镇的养老院）。
本研究发现，在美国养老院居民的这个具有全国代表性的样本中，慢性营养不良的比例很高。此外，居民、机构和地理特征与慢性营养不良有关。需要制定并记录相关策略，以确保患有各种健康问题的居民的营养健康。
