Tsai Alan C, Lai Mei-Yen
Department of Healthcare Administration, Asia University, 500 Liufeng Road, Wufeng, Taichung 41354, Taiwan, ROC; Department of Health Services Management, School of Public Health, China Medical University, Taichung 40402, Taiwan, ROC.
Department of Healthcare Administration, Asia University, 500 Liufeng Road, Wufeng, Taichung 41354, Taiwan, ROC; Nursing Department, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
Clin Nutr. 2014 Oct;33(5):844-9. doi: 10.1016/j.clnu.2013.10.010. Epub 2013 Oct 23.
BACKGROUND & AIMS: Falling is a major issue in geriatric health. Tools that identify individuals at risk of falling can help reduce the risk of falling. The study aimed to determine whether the full and short-form Mini Nutritional Assessment (MNAs) have the ability to predict the risk of falling in older adults.
Subjects were 3118 ≥ 53-year old Taiwanese who completed both the 1999 and 2003 "Taiwan Longitudinal Study on Aging" surveys. We rated these subjects with normalized versions of the MNA and applied the standard cut-offs to define under-nutrition (≤23.5 and ≤11 points, respectively). We used multivariate logistic regression analysis and receiver operating characteristics to evaluate the ability of these tools in predicting the risk of falling three years later.
Older adults rated as at risk of malnutrition with the full MNA (OR = 1.87, 95% confidence interval = 1.33-2.63, p < 0.001) or the short-form (1.39, 1.07-1.80, p = 0.014) were associated with increased risk of falling three years later. Both versions significantly predicted the risk of falling and performed slightly better in ≥65-year old persons than in younger (53-64-year old) persons. The short-form performed relatively well compared to the full scale.
Results suggest that the full and short-form MNAs, in addition to rating the risk of malnutrition, also predict the risk of falling in older adults. Although the short-form is slightly less effective than the full scale in predicting the future risk of falling, its simplicity, effectiveness and efficiency make it ideal as a multipurpose screening tool in clinical settings.
跌倒在老年健康中是一个主要问题。识别有跌倒风险个体的工具有助于降低跌倒风险。本研究旨在确定完整版和简版微型营养评定法(MNA)是否有能力预测老年人的跌倒风险。
研究对象为3118名年龄≥53岁的台湾人,他们完成了1999年和2003年的“台湾老龄化纵向研究”调查。我们用MNA的标准化版本对这些受试者进行评分,并应用标准临界值来定义营养不良(分别为≤23.5分和≤11分)。我们使用多因素逻辑回归分析和受试者工作特征曲线来评估这些工具预测三年后跌倒风险的能力。
用完整版MNA评定为有营养不良风险的老年人(比值比=1.87,95%置信区间=1.33 - 2.63,p<0.001)或简版(1.39,1.07 - 1.80,p = 0.014)与三年后跌倒风险增加相关。两个版本都能显著预测跌倒风险,且在≥65岁人群中的表现略优于年轻(53 - 64岁)人群。简版与完整版相比表现相对较好。
结果表明,完整版和简版MNA除了能评定营养不良风险外,还能预测老年人的跌倒风险。虽然简版在预测未来跌倒风险方面比完整版略逊一筹,但其简单、有效且高效,使其成为临床环境中理想的多用途筛查工具。