Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria 3021, Australia.
Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St. Albans, Victoria 3021, Australia.
Nutrients. 2019 Jul 9;11(7):1551. doi: 10.3390/nu11071551.
Understanding how changes in nutritional status influence musculoskeletal recovery after falling remains unclear. We explored associations between changes in nutritional status and musculoskeletal health in 106 community-dwelling older adults aged ≥65 years, who attended the Falls and Fractures Clinic at Sunshine Hospital in St Albans, Australia after falling. At baseline and after 6 months, individuals were assessed for Mini Nutritional Assessment (MNA), grip strength, gait speed, Timed Up and Go (TUG) test, Short Physical Performance Battery (SPPB), and bone turnover marker levels. Associations were examined using multiple linear regression, adjusted for baseline covariates and post-fall care plans. Over 6 months, the prevalence of malnutrition or risk thereof decreased from 29% to 15% using MNA <24/30. Specifically, 20 individuals (19%) improved, 7 (7%) deteriorated, and 73 (69%) maintained nutritional status, including 65 (61%) who remained well-nourished and 8 (8%) who remained malnourished/at risk. A 1-point increase in MNA score over 6 months was associated with an increase of 0.20 points (95% confidence interval 0.10, 0.31, < 0.001) in SPPB score. Improvement in nutritional status was associated with improvement in physical performance, providing a basis for interventional studies to ascertain causality and evaluate nutritional models of care for post-fall functional recovery in older adults.
目前尚不清楚营养状况的变化如何影响跌倒后肌肉骨骼的恢复。我们在澳大利亚圣奥尔本斯阳光医院跌倒和骨折诊所对 106 名年龄≥65 岁的社区居住的老年人进行了研究，探讨了营养状况变化与肌肉骨骼健康之间的关系。在基线和 6 个月时，对个体进行了微型营养评估（MNA）、握力、步速、计时起立行走测试（TUG）、简短身体表现测试（SPPB）和骨转换标志物水平的评估。使用多元线性回归，根据基线协变量和跌倒后护理计划进行调整，检查了相关性。在 6 个月期间，使用 MNA <24/30 评估，营养不良或存在风险的患病率从 29%下降到 15%。具体而言，20 名（19%）个体的营养状况得到改善，7 名（7%）恶化，73 名（69%）维持营养状况，包括 65 名（61%）营养状况良好和 8 名（8%）仍处于营养不良/有风险状态。6 个月内 MNA 评分增加 1 分与 SPPB 评分增加 0.20 分（95%置信区间 0.10，0.31，<0.001）相关。营养状况的改善与身体表现的改善相关，为干预研究提供了依据，以确定因果关系，并评估老年人跌倒后功能恢复的营养护理模式。
