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社区居住的新发阿尔茨海默病老年人的营养状况:营养不良的患病率以及各种因素与营养状况的关系。

Nutritional status of community-dwelling elderly with newly diagnosed Alzheimer's disease: prevalence of malnutrition and the relation of various factors to nutritional status.

机构信息

Geriatric Medicine, Medical Centre Leeuwarden, Po Box 888 Leeuwarden 8901 BR, The Netherlands.

出版信息

J Nutr Health Aging. 2013 Jul;17(7):606-10. doi: 10.1007/s12603-013-0032-9.

Abstract

OBJECTIVES

To determine the prevalence of malnutrition and its relation to various factors in community-dwelling elderly with newly diagnosed Alzheimer's disease (AD).

DESIGN

Retrospective cross-sectional study.

SETTING

Memory clinic in a rural part of the Netherlands.

PARTICIPANTS

312 Community-dwelling AD patients, aged 65 years or older, were included.

MEASUREMENTS

At the time the diagnosis AD was made, socio-demographic characteristics and data on nutritional status (Mini Nutritional Assessment (MNA)), cognitive function (Mini Mental State Examination (MMSE), Cambridge Cognitive Examination (Camcog)), functional status (Interview for Deterioration in Daily Living Activities in Dementia (IDDD), Barthel Index (BI)) and behaviour (Revised Memory and Behaviour Problems Checklist (RMBPC)) were assessed. Characteristics of well-nourished patients (MNA score >23.5) were compared to characteristics of patients at risk of malnutrition (MNA score 17-23.5). Linear regression analysis was performed to assess the effect of various factors on nutritional status.

RESULTS

The prevalence of malnutrition was 0% and 14.1% was at risk of malnutrition. AD patients at risk of malnutrition were more impaired in basic and complex daily functioning than well-nourished AD patients (median IDDD score 41.5 [25th -75th percentile 38.8-48.0] versus median IDDD score 40.0 [25th -75th percentile 37.0-43.0], p = 0.028). The degree of impairment in basic and complex daily functioning (IDDD) was independently related to nutritional status (MNA) (p = 0.001, B = -0.062).

CONCLUSION

One in seven community-dwelling elderly with newly diagnosed AD is at risk of malnutrition. The degree of impairment in daily functioning is independently related to nutritional status. Therefore, assessment of the nutritional status should be included in the comprehensive assessment of AD patients. The relation between daily functioning, nutritional status and AD warrants further investigation.

摘要

目的

确定新诊断为阿尔茨海默病(AD)的社区居住老年人中营养不良的流行情况及其与各种因素的关系。

设计

回顾性横断面研究。

地点

荷兰农村地区的记忆诊所。

参与者

共纳入 312 名年龄在 65 岁及以上的社区居住的 AD 患者。

测量

在做出 AD 诊断时,评估了社会人口统计学特征和营养状况(迷你营养评估(MNA))、认知功能(简易精神状态检查(MMSE)、剑桥认知检查(Camcog))、功能状态(痴呆日常生活活动恶化访谈(IDDD)、巴氏指数(BI))和行为(修订后的记忆和行为问题清单(RMBPC))。比较了营养良好患者(MNA 评分>23.5)和营养不良风险患者(MNA 评分 17-23.5)的特征。进行线性回归分析以评估各种因素对营养状况的影响。

结果

营养不良的患病率为 0%,14.1%有营养不良风险。与营养良好的 AD 患者相比,有营养不良风险的 AD 患者在基本和复杂日常功能方面的受损程度更严重(中位数 IDDD 评分 41.5[25 分位数-75 分位数 38.8-48.0]与中位数 IDDD 评分 40.0[25 分位数-75 分位数 37.0-43.0],p=0.028)。基本和复杂日常功能(IDDD)的受损程度与营养状况(MNA)独立相关(p=0.001,B=-0.062)。

结论

新诊断为 AD 的社区居住老年人中,有七分之一存在营养不良风险。日常功能的受损程度与营养状况独立相关。因此,AD 患者的营养状况评估应纳入综合评估。日常功能、营养状况和 AD 之间的关系需要进一步研究。

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