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养老机构中营养不良老年人的营养状况与综合身体机能指标之间的相关性

Correlation between nutritional status and comprehensive physical performance measures among older adults with undernourishment in residential institutions.

作者信息

Singh Devinder K A, Manaf Zahara A, Yusoff Noor Aini M, Muhammad Nur A, Phan Mei Fang, Shahar Suzana

机构信息

Physiotherapy Program, School of Rehabilitation Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

Nutrition and Dietetics Program, School of Health Care Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

出版信息

Clin Interv Aging. 2014 Aug 25;9:1415-23. doi: 10.2147/CIA.S64997. eCollection 2014.

Abstract

PURPOSE

The consequences of combined undernourishment and decreased physical performance in older adults are debilitating and increases cost of care. To date, the information regarding the association between nutritional status and physical performance does not provide a complete picture. Most studies used limited or self-reported measures to evaluate physical performance. The objective of this study was to examine the correlation between nutritional status and comprehensive physical performance measures among undernourished older adults who reside in residential institutions.

METHODS

Forty-seven older adults (26 males, 21 females) aged ≥ 60 (69.23 ± 8.63) years who were identified as undernourished from two residential institutions participated in this study. A battery of physical performance tests (10 m gait speed test, dominant hand grip strength test, timed five-repetition sit-to-stand test, ten step test, arm curl test, scratch test, and respiratory muscle strength test), biochemical profiles (serum albumin, hemoglobin, serum ferritin, and prealbumin levels), and falls risk using the short-form Physiological Profile Approach were performed. The Functional Ability Questionnaire and Geriatric Depression Scale were also administered.

RESULTS

The results demonstrated that generally older adults with undernourishment scored poorly on the physical performance tests, had depression, and a high risk of falls. Biochemical results demonstrated that 10.9% of the participants were anemic, 63% had hypoalbuminemia (<3.5 g/dL), and 21.7% were at risk of protein energy malnutrition with prealbumin level (100-170 mg/L). A significant correlation (P<0.05) was demonstrated between hand grip strength and ferritin, between self-reported mobility dependence and prealbumin levels, and between self-reported mobility tiredness and body mass index.

CONCLUSION

These results confirm that older adults with undernutrition have poor physical function, higher falls risk, and depression. Clinically, overall health that includes nutritional status, physical function, and depression level should be taken into consideration in the assessment and treatment of older adults residing at residential institutions.

摘要

目的

老年人营养不良与身体机能下降相结合的后果是使人衰弱,并增加护理成本。迄今为止,关于营养状况与身体机能之间关联的信息并不全面。大多数研究使用有限的或自我报告的方法来评估身体机能。本研究的目的是在居住于养老机构的营养不良老年人中,检验营养状况与综合身体机能指标之间的相关性。

方法

从两家养老机构中筛选出47名年龄≥60岁(69.23±8.63岁)的老年人(26名男性,21名女性)参与本研究,这些老年人被确定为营养不良。进行了一系列身体机能测试(10米步行速度测试、优势手握力测试、定时五次坐立测试、十步测试、手臂卷曲测试、抓挠测试和呼吸肌力量测试)、生化指标检测(血清白蛋白、血红蛋白、血清铁蛋白和前白蛋白水平),并使用简化生理特征法评估跌倒风险。还发放了功能能力问卷和老年抑郁量表。

结果

结果表明,一般来说,营养不良的老年人在身体机能测试中得分较低,有抑郁症状,且跌倒风险较高。生化结果显示,10.9%的参与者贫血,63%的人有低白蛋白血症(<3.5 g/dL),21.7%的人因前白蛋白水平(100 - 170 mg/L)存在蛋白质能量营养不良风险。握力与铁蛋白之间、自我报告的行动依赖与前白蛋白水平之间、自我报告的行动疲劳与体重指数之间存在显著相关性(P<0.05)。

结论

这些结果证实,营养不良的老年人身体功能较差、跌倒风险较高且有抑郁症状。临床上,在评估和治疗居住于养老机构的老年人时,应考虑包括营养状况、身体功能和抑郁水平在内的整体健康状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a481/4149334/26205650d193/cia-9-1415Fig1.jpg

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