Department of Geriatric Medicine, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.
The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom.
J Am Med Dir Assoc. 2019 Dec;20(12):1593-1598. doi: 10.1016/j.jamda.2019.03.030. Epub 2019 May 17.
Both insomnia and malnutrition are quite common and can cause similar negative consequences, such as falls, depression, and cognitive impairment in older adults, but there is no study investigating the relationship between the 2. The aims were to investigate relationships between insomnia/insomnia severity and Mini Nutritional Assessment (MNA) score and serum nutrient levels.
Aged 65 years or older, 575 outpatients were included.
MNA scores >23.5, 17-23.5, and <17 were categorized as normal nutritional status, malnutrition risk, and malnutrition, respectively. Serum vitamin B, vitamin D, and folate deficiencies were also evaluated. Insomnia Severity Index (ISI) with scores of 8 and higher indicated insomnia, which was further stratified as mild (8-14), moderate (15-21), or severe (22-28).
The mean age was 73.1 ± 7.7 years, with 73.2% being female. The prevalence of patients with no insomnia, mild insomnia, moderate insomnia, and severe insomnia were 34.4%, 20.9%, 30.1%, and 14.6%, respectively. After adjusting for gender, education, number of drugs, Charlson Comorbidity Index, presence of depression, and Mini-Mental State Examination scores, patients with insomnia had lower MNA scores than those without insomnia (OR = 0.84, 95% CI: 0.7-0.9, P < .001). There were significant relationships between moderate/severe insomnia and the presence of malnutrition and risk of malnutrition (OR = 1.6, 95% CI: 1.0-2.5, P = .046; OR = 1.6, 95% CI: 1.0-2.7, P = .042) and MNA scores (OR = 0.83, 95% CI: 0.7-0.9, P < .001)/OR = 0.82, 95% CI: 0.7-0.9, P < .001). There was no significant difference between insomnia severity status and serum vitamin D, vitamin B, folate levels, or classification of these nutrients (P > .05).
CONCLUSIONS/IMPLICATIONS: There is a close relationship between MNA scores and insomnia or insomnia severity in older adults. Therefore, when evaluating an older patient with insomnia, malnutrition should be evaluated, or insomnia should also be questioned in an older patient with malnutrition. Thus, more effective management of the 2 can be possible.
失眠和营养不良都很常见，会给老年人带来类似的负面后果，如跌倒、抑郁和认知障碍，但目前尚无研究调查这两者之间的关系。本研究旨在探讨失眠/失眠严重程度与微型营养评估（MNA）评分和血清营养素水平之间的关系。
年龄在 65 岁及以上的 575 名门诊患者。
MNA 评分＞23.5、17-23.5 和＜17 分别归类为正常营养状态、营养不良风险和营养不良。还评估了血清维生素 B、维生素 D 和叶酸缺乏情况。用失眠严重程度指数（ISI）评分 8 分及以上表示失眠，进一步分为轻度（8-14 分）、中度（15-21 分）或重度（22-28 分）。
患者的平均年龄为 73.1±7.7 岁，女性占 73.2%。无失眠、轻度失眠、中度失眠和重度失眠患者的比例分别为 34.4%、20.9%、30.1%和 14.6%。在调整性别、教育程度、药物数量、Charlson 合并症指数、抑郁存在情况和简易精神状态检查评分后，失眠患者的 MNA 评分低于无失眠患者（比值比=0.84，95%置信区间：0.7-0.9，P＜0.001）。中度/重度失眠与营养不良和营养不良风险的存在显著相关（比值比=1.6，95%置信区间：1.0-2.5，P=0.046；比值比=1.6，95%置信区间：1.0-2.7，P=0.042）和 MNA 评分（比值比=0.83，95%置信区间：0.7-0.9，P＜0.001）/比值比=0.82，95%置信区间：0.7-0.9，P＜0.001）。失眠严重程度与血清维生素 D、维生素 B、叶酸水平或这些营养素的分类之间无显著差异（P＞0.05）。
结论/意义：老年人的 MNA 评分与失眠或失眠严重程度密切相关。因此，在评估老年失眠患者时，应评估营养不良情况，或在老年营养不良患者中询问失眠情况。因此，有可能对这两者进行更有效的管理。
