De Rouvray C, Jésus P, Guerchet M, Fayemendy P, Mouanga A M, Mbelesso P, Clément J P, Preux P M, Desport J C
Dr Jésus Pierre, Unité de Nutrition, CHU Dupuytren, 2 Avenue Martin Luther King, 87042 Limoges Cedex, France, Phone : (33) 5 55 05 66 21, Mail :
J Nutr Health Aging. 2014 Dec;18(10):868-75. doi: 10.1007/s12603-014-0483-7.
To determine the nutritional status of elderly African people and to investigate the association between undernutrition and dementia.
Door-to-door cross-sectional surveys in the general population.
Representative districts of Bangui (Central African Republic) and Brazzaville (Republic of Congo).
Population aged over 65 years.
Undernutrition was defined as a body mass index <18.5. Anthropometric parameters (arm circumference, waist circumference and triceps skinfold thickness) were measured, and information was gathered on nutritional habits. PARTICIPANTS underwent cognitive screening using the Community Screening Interview for Dementia (CSI-D) and the Five-Word Test. After further neuropsychological testing and neurological examination, the diagnosis of dementia was confirmed according to DSM-IV criteria. Multivariate logistic regression models were applied in order to identify factors associated with undernutrition in populations with or without dementia.
1016 people were included. In the general population, the prevalence of undernutrition was 19.2%. Dementia was found in 7.4% of elderly people. Compared with healthy people, patients with dementia had an increased prevalence of undernutrition (32.0% vs. 17.7%; p = 0.002), lower weight (49.3 ± 10.5 kg vs. 58.4 ± 13.5 kg ; p < 0.001), and lower BMI (20.8 ± 4.1 vs. 22.9 ± 4.8 ; p < 0.001); they were less likely to eat their fill (38.9% vs. 45.9% ; p = 0.001), had more dietary restrictions (36.1% vs. 24.3% ; p = 0.03) and ate less often with their family (66.7% vs. 90.6% ; p < 0.0001). Eating only one meal per day was the sole factor associated with undernutrition in dementia (OR: 7.23 [CI: 1.65-31.7]; p = 0.03).
The prevalence of undernutrition is high in the older population. The nutritional status of patients with dementia is more impaired than that of healthy patients. However, they are less often malnourished than in French home care settings. This study is the first to look at the nutritional status of at-home patients with dementia in Africa. These comparative data will eventually be used in the development of new nutritional intervention strategies.
确定非洲老年人的营养状况，并调查营养不良与痴呆症之间的关联。
对普通人群进行挨家挨户的横断面调查。
班吉（中非共和国）和布拉柴维尔（刚果共和国）的代表性地区。
65岁以上人群。
营养不良定义为体重指数<18.5。测量人体测量参数（上臂围、腰围和肱三头肌皮褶厚度），并收集营养习惯信息。参与者使用痴呆症社区筛查访谈（CSI-D）和五字测试进行认知筛查。经过进一步的神经心理学测试和神经学检查后，根据《精神疾病诊断与统计手册》第四版标准确诊痴呆症。应用多变量逻辑回归模型，以确定患有或未患有痴呆症人群中与营养不良相关的因素。
共纳入1016人。在普通人群中，营养不良患病率为19.2%。7.4%的老年人患有痴呆症。与健康人相比，痴呆症患者营养不良患病率更高（32.0%对17.7%；p = 0.002），体重更低（49.3±10.5千克对58.4±13.5千克；p < 0.001），体重指数更低（20.8±4.1对22.9±4.8；p < 0.001）；他们吃饱的可能性更小（38.9%对45.9%；p = 0.001），饮食限制更多（36.1%对24.3%；p = 0.03），与家人一起用餐的频率更低（66.7%对90.6%；p < 0.0001）。每天只吃一顿饭是痴呆症患者中与营养不良相关的唯一因素（比值比：7.23 [置信区间：1.65 - 31.7]；p = 0.03）。
老年人群中营养不良患病率较高。痴呆症患者的营养状况比健康患者更差。然而，与法国居家护理环境相比，他们营养不良的情况较少见。本研究首次关注非洲居家痴呆症患者的营养状况。这些比较数据最终将用于制定新的营养干预策略。
