School of Food and Nutrition, Massey University, Auckland, New Zealand.
Department of Surgery, University of Auckland, Auckland, New Zealand.
BMC Geriatr. 2018 Mar 21;18(1):78. doi: 10.1186/s12877-018-0771-x.
Malnutrition in patients admitted to hospital may have detrimental effects on recovery and healing. Malnutrition is preceded by a state of malnutrition risk, yet malnutrition risk is often not detected during admission. The aim of the current study was to investigate the magnitude and potential predictors of malnutrition risk in older adults, at hospital admission.
A cross-sectional was study conducted in 234 older adults (age ≥ 65 or ≥ 55 for Māori or Pacific ethnicity) at admission to hospital in Auckland, New Zealand. Assessment of malnutrition risk status was performed using the Mini Nutritional Assessment Short-Form (MNA®-SF), dysphagia risk by the Eating Assessment Tool (EAT-10), muscle strength by hand grip strength and cognitive status by the Montreal Cognitive Assessment (MoCA) tool.
Among 234 participants, mean age 83.6 ± 7.6 years, 46.6% were identified as at malnutrition risk and 26.9% malnourished. After adjusting for age, gender and ethnicity, the study identified [prevalence ratio (95% confidence interval)] high dysphagia risk [EAT-10 score: 0.98 (0.97-0.99)], low body mass index [kg/m: 1.02 (1.02-1.03)], low muscle strength [hand grip strength, kg: 1.01 (1.00-1.02)] and decline in cognition [MoCA score: 1.01 (1.00-1.02)] as significant predictors of malnutrition risk in older adults at hospital admission.
Among older adults recently admitted to the hospital, almost three-quarters were malnourished or at malnutrition risk. As the majority (88%) of participants were admitted from the community, this illustrates the need for routine nutrition screening both at hospital admission and in community-dwelling older adults. Factors such as dysphagia, unintentional weight loss, decline in muscle strength, and poor cognition may indicate increased risk of malnutrition.
住院患者营养不良可能对康复和愈合产生不利影响。营养不良之前是营养不良风险状态，但在入院期间往往无法检测到营养不良风险。本研究的目的是调查老年人入院时营养不良风险的程度和潜在预测因素。
在新西兰奥克兰的 234 名老年人（年龄≥65 岁或毛利人或太平洋族裔≥55 岁）入院时进行了横断面研究。使用微型营养评估简短表格（MNA®-SF）评估营养不良风险状况，使用饮食评估工具（EAT-10）评估吞咽困难风险，使用握力评估肌肉力量，使用蒙特利尔认知评估（MoCA）工具评估认知状态。
在 234 名参与者中，平均年龄 83.6 ± 7.6 岁，46.6%被确定为存在营养不良风险，26.9%为营养不良。在调整年龄、性别和种族后，研究发现[患病率比（95%置信区间）]高吞咽困难风险[EAT-10 评分：0.98（0.97-0.99）]、低体重指数[kg/m：1.02（1.02-1.03）]、低肌肉力量[握力，kg：1.01（1.00-1.02）]和认知能力下降[MoCA 评分：1.01（1.00-1.02）]是老年人入院时营养不良风险的显著预测因素。
在最近入院的老年人中，近四分之三存在营养不良或存在营养不良风险。由于 88%的参与者是从社区入院的，这表明需要在医院入院和社区居住的老年人中进行常规营养筛查。吞咽困难、非故意体重减轻、肌肉力量下降和认知能力差等因素可能表明营养不良风险增加。
