Chang Shu-Fang
Professor, Department of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, Taiwan.
J Nurs Scholarsh. 2017 Jan;49(1):63-72. doi: 10.1111/jnu.12258. Epub 2016 Oct 25.
We investigated the relationships among geriatric syndrome, physiological functions, and body composition in community-dwelling older people with varying nutritional statuses. Other factors correlated with nutritional status in community-dwelling older people were also explored.
The World Health Organization has initiated preventive programs for addressing malnutrition. However, few studies have focused on the correlations among geriatric syndrome, physiological functions, and body composition in older people at risk of malnutrition.
We conducted a cross-sectional study.
Older people who lived in an urban Taiwanese community were recruited for this research study. The inclusion criteria were age 65 years or older, ability to communicate in Taiwanese, clear consciousness, and ability to communicate independently. The nutritional status of participants was evaluated with the Mini Nutritional Assessment-Short Form. The frailty status was assessed with the Study of Osteoporotic Fractures (SOF) index. The SOF index included the following three items: body weight loss of >5% within 1 year, difficulty in standing from a sitting position in a chair without an armrest five times, and feeling deprived of energy. Participants over 65 years of age, living in a community and without mental illness or acute disease were included in the study.
Compared with well-nourished older adults, those at risk of malnutrition were predominantly male; presented with lower body weight, lower body mass index values, lower skeletal mass indices, and poorer muscle strength; and were unable to rise from a seated position in a chair without using the armrest five times. Subjects at risk of malnutrition were less energetic, were more commonly characterized as being sarcopenia, and demonstrated frailty. Body composition analysis demonstrated that a skeletal muscle index of approximately 9.93 and a body fat mass of less than 12.25 kg were related to an increased risk of malnutrition. Older people who were frail exhibited a particularly high risk of malnutrition.
The results revealed that the evaluation of malnutrition risk should be conducted in older persons living in the community. Frailty in particular was identified as a major risk factor for malnutrition in community-dwelling elderly persons.
Community nurses should pay attention to the nutritional conditions of community-dwelling elderly persons. Community nurses should assess the at-risk population and provide effective preventive strategies and programs to reduce the prevalence of malnutrition and frailty.
我们调查了不同营养状况的社区老年人中，老年综合征、生理功能和身体组成之间的关系。还探讨了与社区老年人营养状况相关的其他因素。
世界卫生组织已启动应对营养不良的预防项目。然而，很少有研究关注处于营养不良风险的老年人中，老年综合征、生理功能和身体组成之间的相关性。
我们进行了一项横断面研究。
招募居住在台湾城市社区的老年人参与本研究。纳入标准为年龄65岁及以上、能用台语交流、意识清醒且能独立交流。用简易营养评估简表评估参与者的营养状况。用骨质疏松性骨折研究（SOF）指数评估衰弱状态。SOF指数包括以下三项：1年内体重减轻>5%、在没有扶手的椅子上从坐姿站起困难5次、感到精力不足。纳入研究的是65岁以上、居住在社区且无精神疾病或急性疾病的参与者。
与营养良好的老年人相比，有营养不良风险的老年人以男性为主；体重较低、身体质量指数值较低、骨骼质量指数较低且肌肉力量较差；在不使用扶手的情况下，无法从椅子上的坐姿站起5次。有营养不良风险的受试者精力较差，更常被诊断为肌肉减少症，并表现出衰弱。身体组成分析表明，骨骼肌指数约为9.93且身体脂肪量小于12.25千克与营养不良风险增加有关。衰弱的老年人营养不良风险尤其高。
结果显示，应在社区居住的老年人中进行营养不良风险评估。尤其是衰弱被确定为社区居住老年人营养不良的主要风险因素。
社区护士应关注社区居住老年人的营养状况。社区护士应评估高危人群，并提供有效的预防策略和项目，以降低营养不良和衰弱的患病率。
