Institute for Biomedicine of Aging, Friedrich-Alexander Universität Erlangen-Nürnberg, Nürnberg, Germany.
J Nutr Health Aging. 2013 Apr;17(4):345-50. doi: 10.1007/s12603-012-0409-1.
The aims of this work were (a) to provide a detailed description of the association between nutritional (Mini Nutritional Assessment; MNA®) and functional status in a sample of older adults receiving home care, using both questionnaire- and performance-based functional methods, and (b) to investigate the impact of different MNA subscales on this association.
Multi-centre, cross-sectional.
Home care.
296 persons ≥65 years in need of care (80.7±7.7 y).
Nutritional status was determined by the MNA and functional status by two questionnaires (Instrumental and Basic Activities of Daily Living; IADL, ADL) and three performance tests (handgrip strength, HGS; Short Physical Performance Battery, SPPB; Timed 'Up and Go' Test, TUG). A categorical and a covariance analytical approach were used to test for differences in functional status between MNA groups (well nourished, risk of malnutrition, malnourished). In addition, functional parameters were correlated with total MNA, a modified MNA version (modMNA), where functional items were excluded, and MNA subscales ('functionality', 'general assessment', 'anthropometry', 'dietary assessment', and 'subjective assessment').
57% of the participants were at risk of malnutrition and 12% malnourished. 35% reported severe limitations in IADL, 18% in ADL. 40%, 39% and 35% had severe limitations in HGS, SPPB and TUG; 9%, 28% and 34% were not able to perform the tests. Functional status deteriorated significantly from the well nourished to the malnourished group in all functional measures. The modMNA was weak but still significantly related to all functional parameters except TUG. The subscale 'functionality' revealed strongest correlations with functional measures. All other MNA subscales showed only weak or no associations.
More than one half of the seniors receiving home care were at nutritional risk and poor functional level, respectively. Malnutrition according to MNA was significantly associated to both questionnaire- and performance-based functional measures even after exclusion of functional MNA items.
本研究的目的是（a）使用问卷和基于表现的功能方法，详细描述接受家庭护理的老年人群体中营养（迷你营养评估；MNA®）和功能状态之间的关联，以及（b）研究不同 MNA 子量表对这种关联的影响。
多中心，横断面研究。
家庭护理。
需要护理的 296 名≥65 岁的老年人（80.7±7.7 岁）。
营养状况通过 MNA 确定，功能状态通过两份问卷（工具性和基本日常生活活动；IADL，ADL）和三项表现测试（握力，HGS；简短体能表现电池，SPPB；计时“站起和行走”测试，TUG）来评估。使用分类和协方差分析方法来检验 MNA 组之间（营养良好、营养不良风险、营养不良）功能状态的差异。此外，功能参数与总 MNA、修改后的 MNA 版本（modMNA）、排除功能项目后的版本以及 MNA 子量表（“功能”、“总体评估”、“人体测量”、“饮食评估”和“主观评估”）进行了相关性分析。
57%的参与者存在营养不良风险，12%的参与者存在营养不良。35%的人报告 IADL 严重受限，18%的人报告 ADL 严重受限。40%、39%和 35%的人 HGS、SPPB 和 TUG 严重受限；9%、28%和 34%的人无法进行测试。在所有功能测量中，营养良好组和营养不良组的功能状态均显著恶化。modMNA 虽然较弱，但与所有功能参数仍显著相关，除了 TUG 之外。子量表“功能”与功能测量的相关性最强。其他所有 MNA 子量表仅显示出较弱或没有关联。
接受家庭护理的老年人中，超过一半存在营养风险和功能障碍。即使排除了功能 MNA 项目，MNA 确定的营养不良与问卷和基于表现的功能测量均显著相关。
