School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia.
Department of Nutrition and Dietetics, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia.
Nutr Diet. 2019 Sep;76(4):472-479. doi: 10.1111/1747-0080.12511. Epub 2019 Jan 24.
To investigate the relationship between nutritional status, functional ability and frailty in older adults participating in a 12-week Transitional Aged Care Service program.
A retrospective analysis of a clinical cohort of older adults aged 65+ years after hospital discharge. At entry into the program and at completion, nutritional status was measured using the Mini Nutritional Assessment (MNA), frailty status was measured using the Groningen Frailty Indicator and functional ability was measured using the Modified Barthel Index (MBI). Demographic data were obtained from electronic medical records.
Baseline data were available for 115 participants (mean age = 81.7 (SD =7.9) years; 20.9% classified as malnourished and 89.6% as frail). A positive association was found between nutritional status and frailty (r = 0.298; P = 0.001), and frailty and functional ability (r = 0.204; P = 0.029). Multiple regression analysis, accounting for the cofounders of baseline MNA, MBI, age, gender, length of hospital stay and living situation, found that nutritional status and functional ability were able to indicate the presence of frailty on admission to the program (P = 0.002, P = 0.007, respectively). In those program completers (n = 79), significant improvements were found in nutritional status, frailty and functional ability (P < 0.0005).
Nutrition status, frailty and functional ability are closely and positively related, and should therefore be considered simultaneously in rehabilitation for older adults. A post-hospital transitional program with a multidisciplinary approach significantly improved all three outcomes, suggesting its value in enabling frail older people to remain independent for as long as possible.
调查参与 12 周过渡期老年护理服务计划的老年人的营养状况、功能能力和虚弱之间的关系。
对出院后 65 岁以上的老年临床队列进行回顾性分析。在进入该计划时和完成时，使用迷你营养评估 (MNA) 测量营养状况，使用格罗宁根虚弱指标 (Groningen Frailty Indicator) 测量虚弱状况，使用改良巴氏指数 (MBI) 测量功能能力。人口统计学数据从电子病历中获得。
115 名参与者的基线数据可用（平均年龄=81.7（SD=7.9）岁；20.9%被归类为营养不良，89.6%为虚弱）。营养状况和虚弱之间存在正相关（r=0.298；P=0.001），虚弱和功能能力之间存在正相关（r=0.204；P=0.029）。多元回归分析，考虑到基线 MNA、MBI、年龄、性别、住院时间和居住情况的共变量，发现营养状况和功能能力能够在入院时表明该计划中存在虚弱（P=0.002，P=0.007）。在那些完成计划的参与者（n=79）中，营养状况、虚弱和功能能力都有显著改善（P<0.0005）。
营养状况、虚弱和功能能力密切相关且呈正相关，因此在老年人康复中应同时考虑这三个方面。多学科方法的住院后过渡期计划显著改善了所有三个结果，表明其在使虚弱的老年人尽可能长时间保持独立方面具有价值。
