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非体重过轻的新入院老年患者的营养与功能状况

Nutritional and Functional Status in Newly Hospitalized Older Patients Who are Not Underweight.

作者信息

Kańtoch Anna, Wielek Jolanta, Gryglewska Barbara, Grodzicki Tomasz

机构信息

a Department of Internal Medicine and Gerontology , Jagiellonian University Medical College , Kraków , Poland.

出版信息

J Nutr Gerontol Geriatr. 2017 Apr-Sep;36(2-3):111-120. doi: 10.1080/21551197.2017.1377138. Epub 2017 Nov 2.

DOI:10.1080/21551197.2017.1377138
PMID:29095131
Abstract

Although malnutrition is commonly associated with being underweight, it occurs whenever nutrient intakes are inadequate, regardless of current body weight. The aim of the study was to determine nutritional status as a predictor of functional status among older patients without underweight according to body mass index (BMI) at hospital admission. This cross-sectional study enrolled 90 patients aged ≥65 years (mean age 78.1 ± 6.4). Assessments included basic and Instrumental Activities of Daily Living (bADL, IADL), Mini Nutritional Assessment (MNA), and BMI. Most of respondents were at risk of malnutrition (46%) or malnutrition (17%) according to MNA. Patients with/at risk of malnutrition had lower scores in bADL (p = 0.020), IADL (p = 0.010) and MNA (p < 0.001). Scores for bADL and IADL positively correlated with MNA (r = 0.34, r = 0.42, respectively) and negatively with age (r = -0.33, r = -0.21). MNA scores were also significant predictors of staying independence in bADL (β = 0.53, p < 0.001) and IADL (β = 0.45, p < 0.001) in regression analysis. Our findings indicated that most older patients with normal/elevated BMI were malnourished or at risk of malnutrition and experienced functional limitations in ADL at admission to hospital. In this population, nutritional status estimated by MNA appears to be one of the most important factors in predicting functional status of older adults who are not underweight.

摘要

虽然营养不良通常与体重不足相关,但无论当前体重如何,只要营养摄入不足就会发生营养不良。本研究的目的是根据入院时的体重指数(BMI)来确定营养状况,作为非体重不足的老年患者功能状态的预测指标。这项横断面研究纳入了90名年龄≥65岁的患者(平均年龄78.1±6.4岁)。评估内容包括基本日常生活活动能力和工具性日常生活活动能力(bADL、IADL)、微型营养评定法(MNA)以及BMI。根据MNA,大多数受访者存在营养不良风险(46%)或营养不良(17%)。存在营养不良/营养不良风险的患者在bADL(p = 0.020)、IADL(p = 0.010)和MNA(p < 0.001)方面得分较低。bADL和IADL得分与MNA呈正相关(分别为r = 0.34,r = 0.42),与年龄呈负相关(r = -0.33,r = -0.21)。在回归分析中,MNA得分也是bADL(β = 0.53,p < 0.001)和IADL(β = 0.45,p < 0.001)保持独立能力的显著预测指标。我们的研究结果表明,大多数BMI正常/升高的老年患者存在营养不良或营养不良风险,且入院时在日常生活活动中存在功能受限。在这一人群中,通过MNA评估的营养状况似乎是预测非体重不足老年人功能状态的最重要因素之一。

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