Department of Gerontology-Geriatric and Medicine Rehabilitative, Catholic University of Sacred Heart, Rome, Italy.
J Nutr Health Aging. 2012 Jan;16(1):79-83. doi: 10.1007/s12603-011-0064-y.
We describe the prevalence of secondary anorexia in a population of older people living in community and receiving home care. In addition, we examined the relationship between secondary anorexia and mortality.
We analyzed data from a large collaborative observational study group, the Italian Silver Network Home Care project, that collected data on patients admitted to home care programs. A total of twelve Home Health Agencies participated in such project evaluating the implementation of the Minimum Data Set for Home Care (MDS-HC) instrument. A total of 2757 patients were enrolled in the present study. The main outcome measures were the prevalence of anorexia, weight loss and survival.
More than 25% (744 subjects) of the study sample suffered from anorexia. During a mean follow-up of 10 months from initial MDS-HC assessment, 468 patients (17%) died. There was uneven distribution of the risk. After adjusting for age, gender and for all other possible risk factors for death (living alone, physical and cognitive disability, behavior problems, urinary incontinence, pressure ulcer, hearing impairment, congestive heart failure, hypertension, depression, diabetes, renal failure, cancer), subjects with anorexia were more likely to die relative to patients without anorexia (RR, 1.83; 95% CI 1.45-2.31). Even though the risk of mortality was higher among subjects suffering from anorexia and weight loss, the anorexia per se was associated with higher risk compared with subjects without anorexia (RR, 1.45; 95% CI 1.01-2.19).
Anorexia is associated with a significant higher risk of all-cause mortality. The present findings support the possibility that anorexia has an independent effect on survival even among old people receiving home care.
我们描述了在社区居住并接受家庭护理的老年人群中继发性厌食症的流行情况。此外，我们还研究了继发性厌食症与死亡率之间的关系。
我们分析了来自意大利银网家庭护理项目的大型合作观察性研究组的数据，该研究组收集了接受家庭护理计划的患者的数据。共有 12 家家庭健康机构参与了该项目，评估了家庭护理最低数据集（MDS-HC）工具的实施情况。共有 2757 名患者纳入本研究。主要观察指标为厌食症、体重减轻和生存率的患病率。
研究样本中超过 25%（744 例）的患者患有厌食症。在 MDS-HC 评估初始后的 10 个月平均随访期间，468 例患者（17%）死亡。风险分布不均。调整年龄、性别以及所有其他可能的死亡危险因素（独居、身体和认知障碍、行为问题、尿失禁、压疮、听力障碍、充血性心力衰竭、高血压、抑郁、糖尿病、肾衰竭、癌症）后，患有厌食症的患者死亡的相对风险高于没有厌食症的患者（RR，1.83；95%CI 1.45-2.31）。尽管患有厌食症和体重减轻的患者死亡风险较高，但与没有厌食症的患者相比，厌食症本身与更高的风险相关（RR，1.45；95%CI 1.01-2.19）。
厌食症与全因死亡率显著升高相关。本研究结果支持这样一种可能性，即厌食症即使在接受家庭护理的老年人中也可能对生存有独立影响。
