Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Aging Clin Exp Res. 2020 Jul;32(7):1279-1287. doi: 10.1007/s40520-019-01309-0. Epub 2019 Sep 3.
Despite decades of research evaluating different predictive strategies to identify persons at risk for falls, nutritional issues have received little attention. Malnutrition leads to weight loss associated with muscle weakness and consequently increases the risk of falls.
The current study assessed the association between nutritional state and fall risk scores in a geriatric in-patient unit in Ain Shams University Hospital, Cairo, Egypt.
A cross-sectional study was conducted to assess the nutritional state of 190 older inpatients using a short form of the Mini-Nutritional Assessment (MNA-SF), and the risk of falls was assessed using the Morse Fall Scale (MFS), Johns Hopkins fall risk assessment tool (JH-FRAT), Schmid Fall Risk Assessment Tool (Schmid-FRAT), Hendrich II Fall Risk Model (HII-FRM) and Functional Assessment Instrument (FAI). The generalised linear models (GLM) and odds ratio (OR) were calculated to test the nutritional status as a risk factor for falls.
Malnutrition was significantly associated with high fall risk as assessed by MFS and HII-FRM (OR = 2.833, 95% CI 1.358-5.913, P = 0.006; OR = 3.477, 95% CI 1.822-6.636, P < 0.001), with the highest OR for JH-FRAT (OR = 5.455, 95% CI 1.548-19.214, P = 0.008). After adjusting for age, the adjusted Charlson Comorbidity Index (ACCI), number of fall risk-increasing drugs (FRIDs), risk of malnutrition or malnourished were significantly associated with high fall risk as assessed by MFS (OR = 2.761, 95% CI 1.306-5.836, P = 0.008), JH-FRAT (OR = 4.938, 95% CI 1.368-17.828, P = 0.015), and HII-FRM (OR = 3.486, 95% CI 1.783-6.815, P < 0.001).
This study demonstrated a significant association between malnutrition and fall risk assessment scores, especially JH-FRAT, in hospitalised older patients.
尽管几十年来一直在研究不同的预测策略以识别有跌倒风险的人群，但营养问题一直没有得到关注。营养不良会导致与肌肉无力相关的体重减轻，从而增加跌倒的风险。
本研究评估了营养状况与埃及开罗艾因夏姆斯大学医院老年住院患者跌倒风险评分之间的关系。
采用简易营养评估量表（MNA-SF）对 190 名老年住院患者进行营养状况的横断面研究，采用 Morse 跌倒量表（MFS）、约翰霍普金斯跌倒风险评估工具（JH-FRAT）、Schmid 跌倒风险评估工具（Schmid-FRAT）、Hendrich II 跌倒风险模型（HII-FRM）和功能评估工具（FAI）评估跌倒风险。采用广义线性模型（GLM）和比值比（OR）计算营养状况作为跌倒风险的危险因素。
营养不良与 MFS 和 HII-FRM 评估的高跌倒风险显著相关（OR=2.833，95%CI 1.358-5.913，P=0.006；OR=3.477，95%CI 1.822-6.636，P<0.001），JH-FRAT 的 OR 最高（OR=5.455，95%CI 1.548-19.214，P=0.008）。调整年龄、调整后的 Charlson 合并症指数（ACCI）、增加跌倒风险的药物数量（FRIDs）、营养不良或营养不足的风险后，MFS（OR=2.761，95%CI 1.306-5.836，P=0.008）、JH-FRAT（OR=4.938，95%CI 1.368-17.828，P=0.015）和 HII-FRM（OR=3.486，95%CI 1.783-6.815，P<0.001）评估的高跌倒风险与营养状况显著相关。
本研究表明，在住院老年患者中，营养不良与跌倒风险评估评分，尤其是 JH-FRAT，之间存在显著相关性。
