Department of Gerontology and Geriatric, Catholic University of Sacred Heart, Rome, Italy.
J Am Med Dir Assoc. 2013 Feb;14(2):119-24. doi: 10.1016/j.jamda.2012.10.022. Epub 2012 Dec 4.
The principal aims of the present study were to explore the prevalence of anorexia and the factors correlated to anorexia in a large population of older people living in nursing home. Secondary, we evaluated the impact of anorexia on 1-year survival.
Data are from baseline evaluation of 1904 participants enrolled in the Un Link Informatico sui Servizi Sanitari Esistenti per l'Anziano study, a project evaluating the quality of care for older persons living in an Italian nursing home. All participants underwent a standardized comprehensive evaluation using the Italian version of the inter Resident Assessment Instrument Minimum Data Set (version 2.0) for Nursing Home. We defined anorexia as the presence of lower food intake. The relationship between covariates and anorexia was estimated by deriving ORs and relative 95% CIs from multiple logistic regression models including anorexia as the dependent variable of interest. Hazard ratios and 95% CIs for mortality by anorexia were calculated.
More than 12% (240 participants) of the study sample suffered from anorexia, as defined by the presence of decreased food intake or the presence of poor appetite. Participants with functional impairment, dementia, behavior problems, chewing problems, renal failure, constipation, and depression, those treated with proton pump inhibitors and opioids had a nearly 2-fold increased risk of anorexia compared with participants not affected by these syndromes. Furthermore, participants with anorexia had a higher risk of death for all causes compared with nonanorexic participants (hazard ratio 2.26, 95% CI: 2.14-2.38).
The major finding is that potentially reversible causes, such as depression, pharmacologic therapies, and chewing problems, were strongly and independently associated with anorexia among frail older people living in nursing home. Furthermore, anorexia was associated with higher rate of mortality, independently of age and other clinical and functional variables.
本研究的主要目的是探讨在居住在养老院的大量老年人中，厌食症的流行情况以及与厌食症相关的因素。其次，我们评估了厌食症对 1 年生存率的影响。
数据来自于“Un Link Informatico sui Servizi Sanitari Esistenti per l'Anziano”研究的基线评估，该研究评估了居住在意大利养老院的老年人的护理质量。所有参与者均接受了标准化的全面评估，使用意大利版居民评估工具最小数据集（第 2.0 版）。我们将厌食症定义为食物摄入量较低。通过从包含厌食症作为感兴趣的因变量的多元逻辑回归模型中得出 OR 和相对 95%置信区间，来估计协变量与厌食症之间的关系。通过计算厌食症患者的死亡率和 95%置信区间来计算死亡率的风险比。
研究样本中超过 12%（240 名参与者）的人患有厌食症，定义为食物摄入量减少或食欲不振。与未受这些综合征影响的参与者相比，有功能障碍、痴呆、行为问题、咀嚼问题、肾衰竭、便秘和抑郁症的参与者，以及接受质子泵抑制剂和阿片类药物治疗的参与者，患有厌食症的风险增加近 2 倍。此外，与非厌食症参与者相比，患有厌食症的参与者因各种原因死亡的风险更高（风险比 2.26，95%置信区间：2.14-2.38）。
主要发现是，潜在可逆转的原因，如抑郁、药物治疗和咀嚼问题，与居住在养老院的体弱老年人的厌食症强烈且独立相关。此外，厌食症与更高的死亡率相关，独立于年龄和其他临床和功能变量。
