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日本社区居住老年人的营养不良筛查:日本营养风险筛查工具(NRST)的初步开发与评估

Screening for Malnutrition in Community Dwelling Older Japanese: Preliminary Development and Evaluation of the Japanese Nutritional Risk Screening Tool (NRST).

作者信息

Htun N C, Ishikawa-Takata K, Kuroda A, Tanaka T, Kikutani T, Obuchi S P, Hirano H, Iijima K

机构信息

Kazuko Ishikawa-Takata, Section of Nutritional Care and Management, Department of Nutritional Education, National Institute of Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, 162-8636 Tokyo, Japan; Tel: +81-3-3203-5721, Fax: +81-3-3202-3278,

出版信息

J Nutr Health Aging. 2016 Feb;20(2):114-20. doi: 10.1007/s12603-015-0555-3.

Abstract

BACKGROUND

Early and effective screening for age-related malnutrition is an essential part of providing optimal nutritional care to older populations.

OBJECTIVE

This study was performed to evaluate the adaptation of the original SCREEN II questionnaire (Seniors in the Community: Risk Evaluation for Eating and Nutrition, version II) for use in Japan by examining its measurement properties and ability to predict nutritional risk and sarcopenia in community-dwelling older Japanese people. The ultimate objective of this preliminary validation study is to develop a license granted full Japanese version of the SCREEN II.

PARTICIPANTS

The measurement properties and predictive validity of the NRST were examined in this cross-sectional study of 1921 community-dwelling older Japanese people.

MEASUREMENTS

Assessments included medical history, and anthropometric and serum albumin measurements. Questions on dietary habits that corresponded to the original SCREEN II were applied to Nutritional Risk Screening Tool (NRST) scoring system. Nutritional risk was assessed by the Geriatric Nutrition Risk Index (GNRI) and the short form of the Mini-Nutritional Assessment (MNA-SF). Sarcopenia was diagnosed according to the criteria of the European Working Group on Sarcopenia in Older People.

RESULTS

The nutritional risk prevalences determined by the GNRI and MNA-SF were 5.6% and 34.7%, respectively. The prevalence of sarcopenia was 13.3%. Mean NRST scores were significantly lower in the nutritionally at-risk than in the well-nourished groups. Concurrent validity analysis showed significant correlations between NRST scores and both nutritional risk parameters (GNRI or MNA-SF) and sarcopenia. The areas under the receiver operating characteristic curves (AUC) of NRST for the prediction of nutritional risk were 0.635 and 0.584 as assessed by GNRI and MNA-SF, respectively. AUCs for the prediction of sarcopenia were 0.602 (NRST), 0.655 (age-integrated NRST), and 0.676 (age and BMI-integrated NRST).

CONCLUSIONS

These results indicate that the NRST is a promising screening tool for the prediction of malnutrition and sarcopenia in community-dwelling older Japanese people. Further development of a full Japanese version of the SCREEN II is indicated.

摘要

背景

对与年龄相关的营养不良进行早期有效筛查是为老年人群提供最佳营养护理的重要组成部分。

目的

本研究旨在通过检测其测量特性以及预测日本社区居住老年人群营养风险和肌肉减少症的能力,评估原始SCREEN II问卷(社区老年人:饮食与营养风险评估,第二版)在日本的适用性。这项初步验证研究的最终目标是开发获得许可的全日文版SCREEN II。

参与者

在这项对1921名日本社区居住老年人的横断面研究中,检测了营养风险筛查工具(NRST)的测量特性和预测效度。

测量

评估包括病史、人体测量和血清白蛋白测量。对应原始SCREEN II的饮食习惯问题应用于营养风险筛查工具(NRST)评分系统。通过老年营养风险指数(GNRI)和微型营养评定简表(MNA-SF)评估营养风险。根据老年人肌肉减少症欧洲工作组的标准诊断肌肉减少症。

结果

由GNRI和MNA-SF确定的营养风险患病率分别为5.6%和34.7%。肌肉减少症的患病率为13.3%。营养风险组的NRST平均得分显著低于营养良好组。同时效度分析显示NRST得分与营养风险参数(GNRI或MNA-SF)和肌肉减少症之间存在显著相关性。通过GNRI和MNA-SF评估,NRST预测营养风险的受试者工作特征曲线(AUC)下面积分别为0.635和0.584。预测肌肉减少症的AUC分别为0.602(NRST)、0.655(年龄综合NRST)和0.676(年龄和BMI综合NRST)。

结论

这些结果表明,NRST是预测日本社区居住老年人营养不良和肌肉减少症的一种有前景的筛查工具。表明需要进一步开发全日文版的SCREEN II。

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