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老年门诊患者营养不良的患病率及其决定因素。

Prevalence and determinants for malnutrition in geriatric outpatients.

机构信息

Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands.

出版信息

Clin Nutr. 2013 Dec;32(6):1007-11. doi: 10.1016/j.clnu.2013.05.007. Epub 2013 May 17.

Abstract

BACKGROUND & AIMS: Few data is available on the nutritional status of geriatric outpatients. The aim of this study is to describe the nutritional status and its clinical correlates of independently living geriatric older individuals visiting a geriatric outpatient department.

METHODS

From 2005 to 2010, all consecutive patients visiting a geriatric outpatient department in the Netherlands were screened for malnutrition. Nutritional status was assessed by the Mini Nutritional Assessment (MNA). Determinants of malnutrition were categorized into somatic factors (medicine use, comorbidity, walking aid, falls, urinary incontinence), psychological factors (GDS-15 depression scale, MMSE cognition scale), functional status (Activities of Daily Life (ADL), Instrumental ADL (IADL)), social factors (children, marital status), and life style factors (smoking, alcohol use). Univariate and multivariate logistic regression analyses, adjusted for age and sex and all other risk factors were performed to identify correlates of malnutrition (MNA < 17).

RESULTS

Included were 448 outpatients, mean (SD) age was 80 (7) years and 38% was men. Prevalence of malnutrition and risk for malnutrition were 17% and 58%. Depression, being IADL dependent, and smoking were independently associated with an increased risk of malnutrition with OR's (95%CI) of 2.6 (1.3-5.3), 2.8 (1.3-6.4), 5.5 (1.9-16.4) respectively. Alcohol use was associated with a decreased risk (OR 0.4 (0.2-0.9)).

CONCLUSION

Malnutrition is highly prevalent among geriatric outpatients and is independently associated with depressive symptoms, poor functional status, and life style factors. Our results emphasize the importance of integrating nutritional assessment within a comprehensive geriatric assessment. Future longitudinal studies should be performed to examine the effects of causal relationships and multifactorial interventions.

摘要

背景与目的

关于老年门诊患者的营养状况,目前仅有少量数据。本研究旨在描述独立生活的老年门诊就诊者的营养状况及其临床相关因素。

方法

2005 年至 2010 年,荷兰一家老年门诊的所有连续就诊者均接受营养不良筛查。营养状况采用 Mini Nutritional Assessment(MNA)评估。将营养不良的决定因素分为躯体因素(用药、合并症、助行器、跌倒、尿失禁)、心理因素(GDS-15 抑郁量表、MMSE 认知量表)、功能状态(日常生活活动(ADL)、工具性日常生活活动(IADL))、社会因素(子女、婚姻状况)和生活方式因素(吸烟、饮酒)。采用单变量和多变量逻辑回归分析,调整年龄和性别以及所有其他危险因素,以确定营养不良(MNA<17)的相关因素。

结果

共纳入 448 例门诊患者,平均(SD)年龄为 80(7)岁,38%为男性。营养不良和营养不良风险的患病率分别为 17%和 58%。抑郁、IADL 依赖和吸烟与营养不良风险增加独立相关,OR(95%CI)分别为 2.6(1.3-5.3)、2.8(1.3-6.4)和 5.5(1.9-16.4)。饮酒与风险降低相关(OR 0.4(0.2-0.9))。

结论

老年门诊患者营养不良的患病率很高,与抑郁症状、功能状态差和生活方式因素独立相关。我们的研究结果强调了在综合老年评估中纳入营养评估的重要性。未来应进行纵向研究,以检验因果关系和多因素干预的效果。

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