Bourdel-Marchasson Isabelle, Rolland Charlotte, Jutand Marthe-Aline, Egea Christian, Baratchart Béatrice, Barberger-Gateau Pascale
CHU of Bordeaux, Department of Gerontology; UMR 5536 CNRS/University V Segalen Bordeaux 2, Bordeaux, France.
Nutrition. 2009 Feb;25(2):155-64. doi: 10.1016/j.nut.2008.07.016. Epub 2008 Oct 9.
This study aimed to describe the nutritional status of geriatric home residents according to their place of dwelling and to identify institutional factors associated with higher rates of undernutrition.
All institutions (514) in the Aquitaine region were interviewed for staff ratio, nutritional procedures, staff training, and other procedures in the area of nutrition. A stratified random sample of 601 residents in a subsample of 42 institutions underwent Mini-Nutritional Assessment.
The estimated prevalence of undernutrition was 19.1 (95% confidence interval [CI] 14.0-24.2), with a higher rate in long-term care (48.0%, 95% CI 15.9-80.2) than in nursing homes (14.5%, 95% CI 10.6-18.4, P < 0.0001). In univariate analyses the risk of undernutrition was higher in long-term care (P < 0.0001), in settings with better weighing equipment (P < 0.0001), with a higher staff ratio (P = 0.0001), and a higher rate of subjects needing help for eating (P < 0.0001) and was lower in settings with a higher rate of training in nutritional screening (P = 0.0001) and management (P < 0.0001). In nursing homes, each item of the Mini-Nutritional Assessment Short Form was independently predictive of undernutrition. In multivariate analyses in nursing homes only, better weighing equipment (adjusted odds ratio 2.34, 95% CI 1.39-4.12, P = 0.0017) and higher staff ratio (adjusted odds ratio 1.03, 95% CI 1.00-1.05, P = 0.0230) were associated with higher rates of undernutrition.
Undernutrition in institutions was linked to the resident health problems, with little evidence in favor of the influence of institutional policies.
本研究旨在根据老年居家居民的居住地点描述其营养状况，并确定与营养不良发生率较高相关的机构因素。
对阿基坦地区的所有机构（514个）进行访谈，了解员工比例、营养程序、员工培训以及营养领域的其他程序。在42个机构的子样本中，对601名居民进行分层随机抽样，进行简易营养评估。
估计营养不良患病率为19.1（95%置信区间[CI]14.0 - 24.2），长期护理机构中的患病率（48.0%，95%CI 15.9 - 80.2）高于养老院（14.5%，95%CI 10.6 - 18.4，P < 0.0001）。在单因素分析中，长期护理机构中营养不良的风险较高（P < 0.0001），在称重设备较好的机构中（P < 0.0001）、员工比例较高的机构中（P = 0.0001）以及需要进食帮助的受试者比例较高的机构中（P < 0.0001），而在营养筛查（P = 0.0001）和管理培训率较高的机构中风险较低（P < 0.0001）。在养老院中，简易营养评估简表的每个项目都独立预测营养不良。仅在养老院的多因素分析中，较好的称重设备（调整后的优势比2.34，95%CI 1.39 - 4.12，P = 0.0017）和较高的员工比例（调整后的优势比1.03，95%CI 1.00 - 1.05，P = 0.0230）与较高的营养不良发生率相关。
机构中的营养不良与居民健康问题有关，几乎没有证据支持机构政策的影响。
