Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany.
Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany. Department for Geriatric Medicine, Carl von Ossietzky Universität Oldenburg, Germany.
J Gerontol A Biol Sci Med Sci. 2015 Oct;70(10):1255-61. doi: 10.1093/gerona/glv048. Epub 2015 Apr 23.
The study investigates variations in the associations between body mass index (BMI) and (a) physical and (b) cognitive function across three samples of older adults living in different settings, and moreover determines if the association between BMI and physical function is confounded by cognitive abilities.
One hundred ninety-five patients of a geriatric day hospital, 322 persons receiving home care (HC), and 183 nursing home (NH) residents were examined regarding BMI, cognitive (Mini-Mental State Examination), and physical function (Barthel Index for activities of daily living). Differences in Mini-Mental State Examination and activities of daily living scores between BMI groups (<22, 22-<25, 25-<30, 30-<35, ≥35kg/m(2)) were tested by analysis of covariance considering relevant confounders.
Activities of daily living and Mini-Mental State Examination impairments increased from the geriatric day hospital over the HC to the NH sample, whereas prevalence rates of obesity and severe obesity (35%, 33%, 25%) decreased. In geriatric day hospital patients cognitive and physical function did not differ between BMI groups. In the HC and NH samples, cognitive abilities were highest in obese and severely obese subjects. Unadjusted mean activities of daily living scores differed between BMI groups in HC receivers (51.6±32.2, 61.8±26.1, 67.5±28.3, 72.0±23.4, 66.2±24.2, p = .002) and NH residents (35.6±28.6, 48.1±25.7, 39.9±28.7, 50.8±24.0, 57.1±28.2, p = .029). In both samples significance was lost after adjustment indicating cognitive function as dominant confounder.
In older adults the associations between BMI and physical and cognitive function were dependent on the health and care status corresponding to the setting. In the HC and the NH samples, cognitive status, as measured by the Mini-Mental State Examination, emerged as an important confounder within the association between BMI and physical function.
本研究调查了在生活在不同环境中的三组老年人中，体重指数（BMI）与（a）身体和（b）认知功能之间的关联存在哪些差异，此外还确定了 BMI 与身体功能之间的关联是否受到认知能力的影响。
对 195 名老年日托患者、322 名接受家庭护理（HC）的患者和 183 名养老院（NH）居民进行了 BMI、认知（简易精神状态检查）和身体功能（日常生活活动量表）的检查。通过考虑相关混杂因素的协方差分析，测试了 BMI 组（<22、22-<25、25-<30、30-<35、≥35kg/m2）之间简易精神状态检查表和日常生活活动评分的差异。
日常生活活动和简易精神状态检查表的损伤程度从老年日托患者到 HC 患者再到 NH 患者逐渐增加，而肥胖和重度肥胖的患病率（35%、33%、25%）却逐渐降低。在老年日托患者中，BMI 组之间的认知和身体功能没有差异。在 HC 和 NH 样本中，肥胖和重度肥胖者的认知能力最高。在 HC 接受者中，未经调整的平均日常生活活动评分在 BMI 组之间存在差异（51.6±32.2、61.8±26.1、67.5±28.3、72.0±23.4、66.2±24.2，p=0.002）和 NH 居民（35.6±28.6、48.1±25.7、39.9±28.7、50.8±24.0、57.1±28.2，p=0.029）。在这两个样本中，调整后意义消失，表明认知功能是主要混杂因素。
在老年人中，BMI 与身体和认知功能之间的关联取决于相应环境中的健康和护理状况。在 HC 和 NH 样本中，认知状态（由简易精神状态检查表测量）作为 BMI 与身体功能之间关联的一个重要混杂因素出现。
