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老年患者低肌肉量、血源性营养状况与心理健康之间的关联。

Associations between low muscle mass, blood-borne nutritional status and mental health in older patients.

作者信息

Gariballa Salah, Alessa Awad

机构信息

1Internal Medicine, Faculty of Medicine & Health Sciences, United Arab Emirates University (UAEU), Al Ain, United Arab Emirates.

2University of Sheffield, Sheffield, UK.

出版信息

BMC Nutr. 2020 Mar 6;6:6. doi: 10.1186/s40795-019-0330-7. eCollection 2020.

Abstract

BACKGROUND

Although low muscle mass is an important predictor of increased physical morbidity in older patients, information on its impact on mental health and well-being is lacking. The first aim of this report is to look for associations if any between low muscle mass and mental health of older people in clinical practice. The second aim is to study underlying mechanisms including nutritional status.

METHODS

In this prospective longitudinal study we randomly selected and studied 432 hospitalized older patients' baseline demographic data, clinical characteristics and nutritional status on admission, at 6 weeks and at 6 months. Low muscle mass was diagnosed using anthropometric measures based on the European Working Group criteria. Mental health outcome measures including cognitive state, depression symptoms and quality of life were also measured.

RESULTS

Out of 432 patients assessed 44 (10%) were diagnosed with low muscle mass. Patients diagnosed with low muscle mass at admission and over a 6-month follow up period had significantly poor cognitive function, quality of life and increased depression symptoms compared with those with normal muscle mass. After adjustment for poor prognostic indicators, age, disability, severity of acute illness and low muscle mass were associated with poor cognitive function and quality of life and higher depression symptoms in older patients over a 6 months period ( < 0.05). Although patients with low muscle mass had lower micronutrient concentrations compared to those patients with normal muscle mass, only serum albumin showed significant correlations with quality of life at admission and depression symptoms at 6 weeks.

CONCLUSION

Low muscle mass is associated with poor blood-borne poor nutritional status and mental health in hospitalized older patients, however, this is partly explained by underlying co morbidity.

摘要

背景

尽管肌肉量低是老年患者身体发病率增加的重要预测指标,但关于其对心理健康和幸福感影响的信息却很缺乏。本报告的首要目的是在临床实践中探寻低肌肉量与老年人心理健康之间是否存在关联(若存在关联)。第二个目的是研究潜在机制,包括营养状况。

方法

在这项前瞻性纵向研究中,我们随机选取并研究了432名住院老年患者入院时、6周时和6个月时的基线人口统计学数据、临床特征及营养状况。基于欧洲工作组标准,采用人体测量学方法诊断低肌肉量。还测量了包括认知状态、抑郁症状和生活质量在内的心理健康结局指标。

结果

在评估的432名患者中,44名(10%)被诊断为低肌肉量。与肌肉量正常的患者相比,入院时及6个月随访期内被诊断为低肌肉量的患者认知功能显著较差、生活质量较低且抑郁症状增加。在对不良预后指标进行调整后,年龄、残疾、急性疾病严重程度和低肌肉量与老年患者6个月期间的认知功能差、生活质量低及抑郁症状加重相关(<0.05)。尽管与肌肉量正常的患者相比,低肌肉量患者的微量营养素浓度较低,但仅血清白蛋白与入院时的生活质量及6周时的抑郁症状显著相关。

结论

低肌肉量与住院老年患者血液中营养状况差及心理健康不佳有关,然而,这部分可由潜在的合并症来解释。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb4c/7066831/48b277fb14ab/40795_2019_330_Fig1_HTML.jpg

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