Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
Nutrition. 2020 May;73:110660. doi: 10.1016/j.nut.2019.110660. Epub 2019 Nov 22.
Malnutrition is frequent among older adults, especially those living in nursing homes, but the association between residential setting and nutritional status is controversial. The aim of this study was to examine the association between living setting (nursing home versus community) and malnutrition while adjusting for demographic, socioeconomic, health-related, and psychosocial factors.
This cross-sectional study included a randomly selected representative sample of Portuguese adults ≥65 y of age. Interviewers collected data regarding demographic and socioeconomic characteristics, nutritional status, physical activity, energy intake, cognitive function, self-reported general health, functional status, symptoms of depression, and loneliness. Logistic regression models were used to estimate the association between residential setting and malnutrition.
Participants were 1186 nursing home residents (72.8% women, 49.2% ≥85 y of age) and 1120 community dwellers (49% women, 21.3% ≥85 y of age). Following Mini Nutritional Assessment (MNA®) criteria, 29.6% of nursing home residents and 14.1% of community dwellers were at risk of malnutrition, whereas 2.3% and 0.3%, respectively, were malnourished. The living setting was not significantly associated with malnutrition after adjusting for functional status, symptoms of depression, and feelings of loneliness (odds ratio, 1.03; 95% confidence interval, 0.67-1.58).
Risk of malnutrition and malnutrition are more prevalent among nursing home residents than community dwellers. Physical (functional status) and mental health (symptoms of depression and loneliness) seems more relevant to nutritional status than residential setting by itself. These findings should be taken into account when designing public health policies to tackle malnutrition among older adults.
营养不良在老年人中很常见，尤其是那些住在养老院的老年人，但居住环境与营养状况之间的关系存在争议。本研究旨在调整人口统计学、社会经济学、健康相关和心理社会因素后，检验居住环境（养老院与社区）与营养不良之间的关系。
本横断面研究包括了一个随机选择的葡萄牙≥65 岁成年人的代表性样本。调查员收集了有关人口统计学和社会经济学特征、营养状况、身体活动、能量摄入、认知功能、自我报告的一般健康状况、功能状态、抑郁症状和孤独感的数据。使用逻辑回归模型估计居住环境与营养不良之间的关联。
参与者包括 1186 名养老院居民（72.8%为女性，49.2%≥85 岁）和 1120 名社区居民（49%为女性，21.3%≥85 岁）。根据迷你营养评估（MNA®）标准，29.6%的养老院居民和 14.1%的社区居民存在营养不良风险，而分别有 2.3%和 0.3%的居民处于营养不良状态。在调整功能状态、抑郁症状和孤独感后，居住环境与营养不良之间无显著相关性（优势比，1.03；95%置信区间，0.67-1.58）。
与社区居民相比，养老院居民的营养不良风险和营养不良更为普遍。身体（功能状态）和心理健康（抑郁症状和孤独感）似乎比居住环境本身更能反映营养状况。在制定针对老年人营养不良的公共卫生政策时，应考虑到这些发现。
