Kuzuya Masafumi, Hasegawa Jun, Enoki Hiromi, Izawa Sachiko
Department of Community healthcare & Geriatrics, Nagoya University Graduate School of Medicine, 2) Inistution for Future Society, NAGOYA COISTREAM, Nagoya University.
Nihon Ronen Igakkai Zasshi. 2015;52(2):170-6. doi: 10.3143/geriatrics.52.170.
To clarify the routes of nutrition and types of diet and their relevance to the risk of mortality and hospitalization among community-dwelling dependent elderly provided various home care services under the long-term care insurance program.
The present study consisted of the collection of baseline data of participants in the Nagoya Longitudinal Study of the Frail Elderly (NLS-FE) and data regarding mortality and hospitalization during a three-year follow-up period. The study population consisted of 1,872 subjects, and the baseline data included demographic characteristics, basic activities of daily living (ADLs), comorbidities, nutritional routes and types of diet, which were evaluated by trained visiting nurses.
Among the participants, 1,786 were on oral nutrition (solid regular-texture diet: 1,487 (79.5%); modified-texture diet (minced/pureed texture): 299 (16.0%), 82 (4.4%) were on enteral nutrition and four (0.2%) were on parenteral nutrition. During the three-year follow-up period, 453 participants died and 798 participants experienced admission to the hospital (pneumonia-related death and hospitalization: n=103 and 155, respectively). Cox regression models revealed that a modified-texture diet and tube feeding are associated with all-cause mortality and hospitalization. In particular, feeding tube use showed a high risk of pneumonia-related mortality and hospitalization, even after adjusting for potential confounders, including comorbidities and the ADL status.
在长期护理保险计划下，明确接受各种居家护理服务的社区居住失能老年人的营养途径、饮食类型及其与死亡风险和住院治疗的相关性。
本研究包括收集名古屋虚弱老年人纵向研究（NLS-FE）参与者的基线数据以及三年随访期内的死亡和住院数据。研究人群包括1872名受试者，基线数据包括人口统计学特征、日常生活活动能力（ADL）、合并症、营养途径和饮食类型，由经过培训的访视护士进行评估。
在参与者中，1786人采用口服营养（固体常规质地饮食：1487人（79.5%）；改良质地饮食（切碎/泥状质地）：299人（16.0%），82人（4.4%）采用肠内营养，4人（0.2%）采用肠外营养。在三年随访期内，453名参与者死亡，798名参与者住院（与肺炎相关的死亡和住院分别为103例和155例）。Cox回归模型显示，改良质地饮食和管饲与全因死亡率和住院治疗相关。特别是，即使在调整了包括合并症和ADL状态在内的潜在混杂因素后，使用饲管仍显示出与肺炎相关的死亡和住院的高风险。
