老年人与进餐相关的困难和体重减轻：MAPT 研究的纵向数据。

Meal-related difficulties and weight loss in older people: Longitudinal data from MAPT study.

机构信息

INSERM UMR1027, Université de Toulouse, Université de Toulouse III Paul Sabatier, Institut Du Vieillissement, 37 Allées Jules Guesde, Toulouse Cedex 9, 31062, Toulouse, France; Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Cité de La Santé, 20 Rue Du Pont Saint Pierre, TSA 60033, Toulouse Cedex 9, 31059, Toulouse, France.

Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Institut Du Vieillissement, 37 Allées Jules Guesde, Toulouse Cedex 9, 31062, Toulouse, France.

出版信息

Clin Nutr. 2020 Nov;39(11):3483-3488. doi: 10.1016/j.clnu.2020.03.011. Epub 2020 Mar 16.

DOI:10.1016/j.clnu.2020.03.011

PMID:32241710

Abstract

BACKGROUND

Difficulties with meal-related activities (preparing meals and food shopping) may influence food intake, and contribute to nutritional risk among elderly people. All known studies on this topic had a cross-sectional design, thereby no causal relationships could be derived. We aim to investigate if difficulties with meal-related activities can contribute to subsequent weight loss in community-dwelling older people.

METHODS

We used data of older subjects from the MAPT Study (n = 1531, median age = 74 years, 64% women), who provided prospective data on weight every 6 months and cognitive, physical condition, and functional capacities every year during a 3-year period. Difficulties preparing meals and shopping were evaluated each year with the Alzheimer's Disease Cooperative Study-Activities of Daily Living Prevention Instrument (ADCS ADL-PI) Scale. The risk of losing weight (≥5% or ≥ 3 kg in the following year) was estimated using a time-dependent Cox regression model.

RESULTS

During the 3-year follow-up, a total of 851 subjects experienced at least a 5% or 3 kg weight loss. Two hundred thirty-seven subjects declared having difficulties with meal preparation at least once, and 133 declared having difficulties shopping. Subjects reporting any meal-related difficulties were older (p < 0.001), had more depressive symptoms (p < 0.001), and a lower physical function (p < 0.001) compared to those without difficulties. They also had a lower cognitive score (preparing meals: p < 0.001; shopping: p = 0.005) and a lower body mass index (preparing meals: p = 0.005; shopping: p = 0.023) at the end of the study. Meal-related activities were not associated with weight loss in unadjusted analysis and after adjustment for sex, age, depression, physical and cognitive status.

CONCLUSION

Difficulties preparing meals and shopping had no effect on weight loss in community-dwelling older people, despite their association with advanced age, functional decline, and depressive symptoms.

摘要

背景

与膳食相关的活动（准备饭菜和购买食物）困难可能会影响老年人的食物摄入，导致营养风险。所有关于这一主题的已知研究均采用横断面设计，因此无法得出因果关系。我们旨在研究与膳食相关的活动困难是否会导致社区居住的老年人随后体重减轻。

方法

我们使用了 MAPT 研究（n=1531，中位年龄 74 岁，64%为女性）中老年人的数据，他们在 3 年期间每年提供关于认知、身体状况和功能能力的前瞻性数据，并每 6 个月报告一次体重。每年使用阿尔茨海默病合作研究-日常生活活动预防工具（ADCS ADL-PI）量表评估准备饭菜和购物的困难程度。使用时间依赖性 Cox 回归模型估计体重减轻的风险（下一年体重减轻≥5%或≥3kg）。

结果

在 3 年的随访期间，共有 851 名受试者经历了至少 5%或 3kg 的体重减轻。237 名受试者至少一次报告准备饭菜有困难，133 名受试者报告购物有困难。与没有困难的受试者相比，报告有任何膳食相关困难的受试者年龄更大（p<0.001），抑郁症状更多（p<0.001），身体功能更差（p<0.001）。他们的认知评分也更低（准备饭菜：p<0.001；购物：p=0.005），体重指数也更低（准备饭菜：p=0.005；购物：p=0.023）。在研究结束时。未经调整分析和调整性别、年龄、抑郁、身体和认知状况后，膳食相关活动与体重减轻无关。