Tze-Pin Ng, Gerontology Research Programme, National University of Singapore, Department of Psychological Medicine, NUHS Tower Block, 9th Floor, 1E Kent Ridge Road, Singapore 119228 Fax: 65-67772191, Tel: 65-67723478 Email:
J Prev Alzheimers Dis. 2018;5(2):142-148. doi: 10.14283/jpad.2017.46.
Physical frailty is well known to be strongly associated with malnutrition, but the combined impact of physical frailty and cognitive impairment among non-demented older persons (cognitive frailty) on malnutrition prevalence is not well documented.
Cross-sectional cohort study.
Community-dwelling older Singaporeans aged ≥55y (n=5414) without dementia in the Singapore Longitudinal Ageing Study (SLAS-1 and SLAS-2).
The Mini Nutritional Assessment - short form (MNA-SF) and Nutrition Screening Initiative (NSI) Determine Checklist were used to determine their nutritional status. Participants were categorized as cognitive normal (CN) or cognitive impaired (CI) by Mini Mental State Examination (MMSE<=23), as pre-frail (PF) (score=1-2) or frail (F) (score=3-5) using Fried's criteria, and as cognitive pre-frail (PF+CI) or cognitive frail (F+CI).
The prevalence of cognitive frailty was 1.6%, and cognitive pre-frailty was 5.5% (total, 7.1%). The prevalence of MNA malnutrition was 2.4%, and NSI high nutritional risk was 6.3%. The prevalence of MNA malnutrition was lowest among Robust-CN and highest among Frail-CI (0.5% in Robust-CN, 0.6% in Robust-CI, 2.8% in Pre-frail-CN, 7.3% in Pre-frail-CI, 15.4% in Frail-CN, and 23.1% in Frail-CI). Similarly, the prevalence of NSI high nutritional risk was lowest in Robust-CN (3.7%) and highest in Frail-CI (13.6%). Adjusted for sociodemographic and health status, pre-frailty/frailty-CI versus Robust-CN was associated with the highest odds ratio of association with MNA malnutrition (OR=8.16, p<0.001), although not the highest with NSI high nutritional risk (OR=1.48, p=0.017).
An extraordinary high prevalence of malnutrition was observed among older adults with cognitive frailty who should be specially targeted for active intervention.
众所周知，身体虚弱与营养不良密切相关，但非痴呆老年人（认知虚弱）中身体虚弱和认知障碍的综合影响对营养不良患病率的影响尚未得到充分记录。
横断面队列研究。
无痴呆的新加坡社区居住的≥55 岁老年人（n=5414），参加新加坡纵向老龄化研究（SLAS-1 和 SLAS-2）。
使用迷你营养评估-简短表格（MNA-SF）和营养筛查倡议（NSI）确定清单来确定他们的营养状况。参与者根据简易精神状态检查（MMSE<=23）分为认知正常（CN）或认知受损（CI），根据弗里德的标准分为虚弱前期（PF）（评分=1-2）或虚弱（F）（评分=3-5），以及认知虚弱前期（PF+CI）或认知虚弱（F+CI）。
认知虚弱的患病率为 1.6%，认知虚弱前期为 5.5%（总计 7.1%）。MNA 营养不良的患病率为 2.4%，NSI 高营养风险的患病率为 6.3%。MNA 营养不良的患病率在强壮-CN 中最低，在虚弱-CI 中最高（强壮-CN 中为 0.5%，虚弱-CN 中为 0.6%，虚弱前期-CN 中为 2.8%，虚弱前期-CI 中为 7.3%，虚弱-CN 中为 15.4%，虚弱-CI 中为 23.1%）。同样，NSI 高营养风险的患病率在强壮-CN 中最低（3.7%），在虚弱-CI 中最高（13.6%）。调整社会人口统计学和健康状况后，虚弱/虚弱-CI 与强壮-CN 相比，与 MNA 营养不良的关联具有最高的优势比（OR=8.16，p<0.001），尽管与 NSI 高营养风险的关联并非最高（OR=1.48，p=0.017）。
在认知虚弱的老年人中观察到极高的营养不良患病率，他们应作为特别干预的目标。
