School of Geriatric Nursing and Care Management, College of Nursing, Taipei Medical University, Taipei, Taiwan.
J Clin Nurs. 2011 Aug;20(15-16):2153-61. doi: 10.1111/j.1365-2702.2010.03686.x. Epub 2011 Apr 26.
To determine differences in the physical and psychological factors and feeding difficulty between people who are well-nourished and malnourished and to determine the predictors of risk of malnutrition and malnutrition in Taiwanese residents with dementia.
Malnutrition is a common problem among nursing home residents but frequently is unrecognised. Nutritional status of older people is associated with cognitive impairment and patients with dementia have high risk for malnutrition because of difficulties in eating.
A cross-sectional design was used to determine predictors of risk of malnutrition and malnutrition.
Subjects were recruited from five Taiwanese long-term care facilities. Data were collected using Mini Nutritional Assessment Screening Form, body mass index, Short Portable Mental Status Questionnaire, Barthel index, Edinburgh Feeding Evaluation in Dementia scale and eating time.
Eighty-three subjects participated. According to the Mini Nutritional Assessment Screening Form cut-point scores, 75 (90·4%) residents with dementia had risk of malnutrition. However, using the World Health Organization (WHO) body mass index cut-point of <18·5, the prevalence rate of malnutrition was 19%. Using logistic regression, gender (odds ratio: 38·627, 95% CI: 1·927-774·407) and eating time (odds ratio: 0·814, 95% CI: 0·689-0·962) were significant predictors of risk of malnutrition. However, only gender (odds ratio: 6·12, 95% CI: 1·05-35·662) was a significant predictor of malnutrition using the WHO body mass index cut-point.
The prevalence of the risk for malnutrition was high in residents with dementia in Taiwanese nursing homes. Feeding difficulty, activities of daily living dependence, cognitive impairment, number of medications and age increased with malnutrition while shorter eating times were associated with poorer nutrition. However, when the factors were considered together, only being female and eating time were significant risk factors for malnutrition. Being female was the only significant factor of malnutrition.
Monthly monitoring of weight and assessment with Mini Nutritional Assessment Screening Form are essential to early identification of emerging malnutrition and implementation of interventions. Providing nutritional supplements and energy and protein-dense food may be needed for good nutrition and more time for eating or feeding assistance may delay malnutrition or even improve nutritional status.
确定营养良好和营养不良人群在身体和心理因素以及喂养困难方面的差异，并确定台湾地区痴呆患者发生营养不良和营养风险的预测因素。
营养不良是养老院居民中常见的问题，但常常未被识别。老年人的营养状况与认知障碍有关，而由于进食困难，痴呆患者发生营养不良的风险较高。
采用横断面设计来确定营养不良和营养风险的预测因素。
从台湾的 5 家长期护理机构招募受试者。使用 Mini 营养评估筛查表、体重指数、简短精神状态问卷、巴氏指数、爱丁堡痴呆进食评估量表和进食时间收集数据。
共有 83 名受试者参与。根据 Mini 营养评估筛查表的截断点评分，75 名（90.4%）痴呆患者存在营养风险。然而，根据世界卫生组织（WHO）体重指数<18.5 的截断点，营养不良的患病率为 19%。使用逻辑回归，性别（比值比：38.627，95%置信区间：1.927-774.407）和进食时间（比值比：0.814，95%置信区间：0.689-0.962）是营养风险的显著预测因素。然而，只有性别（比值比：6.12，95%置信区间：1.05-35.662）是使用 WHO 体重指数截断点预测营养不良的显著因素。
台湾地区养老院中痴呆患者的营养风险患病率较高。喂养困难、日常生活活动依赖、认知障碍、药物数量和年龄随着营养不良而增加，而较短的进食时间与较差的营养状况相关。然而，当考虑这些因素时，只有女性和进食时间是营养不良的显著危险因素。女性是营养不良的唯一显著因素。
每月监测体重并使用 Mini 营养评估筛查表进行评估对于早期发现新出现的营养不良和实施干预至关重要。提供营养补充剂和能量及蛋白质丰富的食物可能有助于获得良好的营养，而增加进食时间或提供喂养协助可能延迟营养不良的发生，甚至改善营养状况。
