Faculty of Nursing, University of Alberta, 5-131 Clinical Sciences Building, Edmonton, AB, Canada T6G 2G3.
Clin Nutr. 2011 Apr;30(2):172-7. doi: 10.1016/j.clnu.2010.09.001. Epub 2010 Oct 14.
BACKGROUND & AIMS: Inability to feed oneself is documented in people with Alzheimer disease, however little research has differentiated between eating disability due to dementia and eating disability due to factors other than dementia that may be remediable (i.e. 'excess disability'). The study aim was to estimate the incidence and identify the predictors of eating disability due to dementia and to excess disability.
In a one year, prospective cohort study of 120 nursing homes residents with middle-stage dementia, ability to eat was monitored fortnightly. Potential predictors of disability were assessed using survival analysis.
The estimated incidence of eating disability was 40.8% (95% confidence interval (CI): 32.7%-50.2%). Half of this was attributed to causes other than dementia (23.6%; 95% CI: 16.6%-33.0%). Predictors of eating disability included more advanced dementia (hazard ratio (HR): 2.6, 95% CI: 1.4 to 4.8), more comorbidities (HR: 2.4; 95% CI: 1.3 to 4.3), and less supportive environments (HR: 2.0; 95% CI: 1.1 to 3.6). There were no statistically significant predictors of excess disability.
Approximately half of the eating disability was not due to dementia. Eating disability may be minimized by treating comorbidities and creating supportive social and physical nursing home environments.
阿尔茨海默病患者存在无法进食的情况，但针对痴呆引起的进食障碍与非痴呆因素（即“过度残疾”）引起的进食障碍之间的区别，研究甚少。本研究旨在评估痴呆引起的进食障碍和过度残疾的发生率，并确定其预测因素。
在一项为期 1 年、针对 120 名处于中重度痴呆阶段的养老院居民的前瞻性队列研究中，每两周监测一次进食能力。采用生存分析评估残疾的潜在预测因素。
估计的进食障碍发生率为 40.8%（95%置信区间：32.7%-50.2%）。其中一半归因于痴呆以外的原因（23.6%；95%置信区间：16.6%-33.0%）。进食障碍的预测因素包括更严重的痴呆（危险比（HR）：2.6，95%置信区间：1.4-4.8）、更多的合并症（HR：2.4；95%置信区间：1.3-4.3）和支持性环境较差（HR：2.0；95%置信区间：1.1-3.6）。没有发现与过度残疾相关的统计学显著预测因素。
大约一半的进食障碍不是由痴呆引起的。通过治疗合并症和创建支持性的社会和物理养老院环境，可以最大限度地减少进食障碍。
