老年日住院患者的营养和功能状况- MNA 简短表格与完整 MNA 比较。
Nutritional and Functional Status in Geriatric Day Hospital Patients - MNA Short Form Versus Full MNA.
机构信息
JProf. Dr. Dorothee Volkert, Institut für Biomedizin des Alterns, Friedrich-Alexander-Universität Erlangen-Nürnberg, Kobergerstraße 60, 90408 Nürnberg, Germany; Tel.: +49 911 5302 96150, Fax: +49 911 5302 96151,
出版信息
J Nutr Health Aging. 2016;20(9):918-926. doi: 10.1007/s12603-016-0691-4.
OBJECTIVES
The aims of this study were to determine the prevalence of malnutrition in patients of a geriatric day hospital using the Mini Nutritional Assessment short form (MNA-SF) and the full MNA, to compare both tools, and to examine the relationship between nutritional and functional status.
DESIGN
Cross-sectional study.
SETTING
Geriatric day hospital.
PARTICIPANTS
190 patients (72.1% female, median 80 years) aged 65 years or older.
MEASUREMENTS
In consecutively admitted geriatric day hospital patients nutritional status was assessed by MNA-SF and full MNA, and agreement between both tools calculated by Cohen´s kappa. Basic activities of daily living (ADL), instrumental activities of daily living (IADL) and short physical performance battery (SPPB) were determined and related to MNA categories (Chi2-test, Mann-Whitney-U-test).
RESULTS
36.3 % and 44.7% of the patients were at risk of malnutrition, 8.9 % and 5.8 % were malnourished according to MNA-SF and full MNA, respectively. Agreement between both MNA forms was moderate (κ=0.531). No significant associations between MNA-SF and ADL, IADL and SPPB, and between full MNA and SPPB were observed. According to full MNA, the proportion of patients with limitations in ADL and IADL significantly increased with declining nutritional status (ADL: 2.1 vs. 8.2 vs. 18.2 %, p=0.044; IADL: 25.5 vs. 47.1 vs. 54.5 %, p=0.005) with a simultaneous decrease of the proportion of patients without limitations. Well-nourished patients reached significantly higher ADL scores than patients at risk of malnutrition (95 (90-100) vs. 95 (85-100), p=0.005) and significantly higher IADL scores than patients at risk or malnourished (8 (6-8) vs. 7 (5-8) vs. 6 (4-8), p=0.004).
CONCLUSION
The high prevalence of risk of malnutrition and the observed association between functional status and nutritional status according to full MNA call for routine nutritional screening using this tool in geriatric day hospital patients.
目的
本研究旨在使用微型营养评估简表（MNA-SF）和完整的 MNA 评估老年日医院患者的营养不良患病率，比较这两种工具，并探讨营养和功能状态之间的关系。
设计
横断面研究。
地点
老年日医院。
参与者
190 名年龄在 65 岁或以上的患者（72.1%为女性，中位数 80 岁）。
测量方法
连续入住老年日医院的患者采用 MNA-SF 和完整的 MNA 评估营养状况，并通过 Cohen's kappa 计算两种工具之间的一致性。基本日常生活活动（ADL）、工具性日常生活活动（IADL）和简短体能表现测试（SPPB）也被确定，并与 MNA 类别相关（卡方检验，Mann-Whitney-U 检验）。
结果
根据 MNA-SF，36.3%和 44.7%的患者有营养不良风险，8.9%和 5.8%的患者营养不良，根据 MNA-SF 和完整的 MNA 评估。两种 MNA 形式之间的一致性为中等（κ=0.531）。MNA-SF 与 ADL、IADL 和 SPPB 之间，以及完整 MNA 与 SPPB 之间均无显著相关性。根据完整的 MNA，ADL 和 IADL 受限患者的比例随着营养状况的下降而显著增加（ADL：2.1%、8.2%、18.2%，p=0.044；IADL：25.5%、47.1%、54.5%，p=0.005），同时无限制患者的比例下降。营养良好的患者 ADL 评分明显高于营养不良风险患者（95（90-100）与 95（85-100），p=0.005），IADL 评分明显高于营养不良风险或营养不良患者（8（6-8）与 7（5-8）与 6（4-8），p=0.004）。
结论
根据完整的 MNA，营养不良风险的高患病率以及功能状态和营养状态之间的观察到的关联，需要在老年日医院患者中使用该工具进行常规营养筛查。
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