Reuther S, van Nie N, Meijers J, Halfens R, Bartholomeyczik S
Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Standort Witten, Stockumer Str. 12, 58453, Witten, Deutschland.
Z Gerontol Geriatr. 2013 Apr;46(3):260-7. doi: 10.1007/s00391-012-0346-y.
Dementia is one of most challenging problems for the care of older people in Germany. Although malnutrition in nursing homes is also associated with dementia, few systematic studies have described health care structures in German nursing homes for people with dementia and their individual nutritional status. Therefore, the aim of this study was to determine dementia-specific differences concerning the nutrition situation for the elderly in German nursing homes.
A cross-sectional multicenter study was performed using a standardized multilevel instrument (observation, questionnaire) developed at the University of Maastricht. Variables are indicators for malnutrition and its risks, quality indicators, care dependency and types of interventions.
In the 2008 and 2009 surveys, 53% of 4,777 participants (77.9% women, 22.1% men, mean age 82 years) were identified (based on care documentation) as having dementia. More than one third of this population (n = 759, 85.1% women, 14.1% men, mean age 85 years) was probably malnourished; thus, the prevalence rate in the group of people with dementia was 10% higher compared to the group without dementia. People with dementia showed a higher risk in all relevant risk indicators (weight history, body mass index, and food intake) for malnutrition compared to those without dementia. Furthermore, people with dementia had higher care dependency rates and required more assistance for eating and drinking.
The study results confirm the relationship between malnutrition and dementia. The use of standardized nutrition screening tools is not common practice in German nursing homes yet. However, the results suggest that with an increasing risk for malnutrition combined with dementia the proportion of nursing interventions also increases, which means that nurses must react adequately. Nevertheless, the interventions concerning malnutrition should be improved especially with respect to preventive measurements.
痴呆是德国老年人护理中最具挑战性的问题之一。尽管养老院中的营养不良也与痴呆有关，但很少有系统研究描述德国痴呆症患者养老院的医疗保健结构及其个体营养状况。因此，本研究的目的是确定德国养老院中老年人营养状况的痴呆症特异性差异。
使用马斯特里赫特大学开发的标准化多层次工具（观察、问卷）进行横断面多中心研究。变量是营养不良及其风险、质量指标、护理依赖和干预类型的指标。
在2008年和2009年的调查中，4777名参与者中有53%（77.9%为女性，22.1%为男性，平均年龄82岁）根据护理记录被确定患有痴呆症。该人群中超过三分之一（n = 759，85.1%为女性，14.1%为男性，平均年龄85岁）可能营养不良；因此，痴呆症患者组的患病率比无痴呆症组高10%。与无痴呆症的人相比，痴呆症患者在所有与营养不良相关的风险指标（体重史、体重指数和食物摄入量）上显示出更高的风险。此外，痴呆症患者的护理依赖率更高，饮食需要更多帮助。
研究结果证实了营养不良与痴呆之间的关系。在德国养老院中，使用标准化营养筛查工具还不普遍。然而，结果表明，随着营养不良和痴呆风险的增加，护理干预的比例也会增加，这意味着护士必须做出充分反应。尽管如此，关于营养不良的干预措施，尤其是预防措施，仍应改进。
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