Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
Department of Clinical and Social Dentistry, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.
Arch Gerontol Geriatr. 2020 Sep-Oct;90:104150. doi: 10.1016/j.archger.2020.104150. Epub 2020 Jun 10.
This multicenter cross-sectional study aimed to investigate the factors associated with the overlap of frailty and nutrition in older adults residing in nursing homes.
Older adults (n = 344, mean age ± SD = 77.7 ± 9.1) were selected from 17 nursing homes, 10 in Piracicaba and seven in João Pessoa, Brazil. The modified Fried's questionnaire and the Mini Nutrition Assessment Short-Form (MNA-SF) were used for screening frailty phenotypes and nutritional status, respectively. These variables overlapped into (1) frail and malnourished; (2) nonfrail and malnourished or frail and nourished; and (3) nonfrail and nourished. The independent variables were sex, age, mobility, number of medications, dependence for activities of daily living (ADL), maximal grip strength, muscle mass, body fat and body mass index (BMI). Spearman's correlation and Poisson regression were used to analyze the data (α = 0.05).
The Spearman's test demonstrated a moderate correlation (r=-0.441) between frailty (mean ± SD = 2.8 ± 1.7) and nutritional status (mean ± SD = 10.5 ± 2.9). Regarding the overlap of frailty and nutrition, 139 participants (40.5 %) were frail and malnourished, 121 (35.3 %) were nonfrail and malnourished or frail and nourished, and 83 (24.2 %) were nonfrail and nourished. The Poisson regression showed association of the coexistence of frailty and malnutrition with age (PR = 1.009, 95 % CI = 1.003-1.016), number of medications (PR = 1.016, 95 % CI = 1.006-1.027), dependence for ADL (PR = 1.061, 95 % CI = 1.016-1.108), maximal grip strength (PR = 0.992, 95 % CI = 0.986-0.998) and BMI (PR = 0.997, 95 % CI = 0.996-0.998).
The findings showed that frailty and malnutrition were prevalent in institutionalized older adults and associated with advanced age, greater use of medicines, dependence for ADL, lower maximal grip strength and lower BMI.
本多中心横断面研究旨在探讨与居住在养老院的老年人衰弱和营养重叠相关的因素。
从巴西皮拉西卡巴和若昂佩索阿的 17 家养老院中选择了 344 名老年人（平均年龄±标准差=77.7±9.1）。使用改良的弗里德问卷和微型营养评估简短表格（MNA-SF）分别筛查衰弱表型和营养状况。这些变量重叠为（1）衰弱和营养不良；（2）非衰弱和营养不良或衰弱和营养充足；和（3）非衰弱和营养充足。自变量为性别、年龄、活动能力、用药数量、日常生活活动（ADL）依赖、最大握力、肌肉量、体脂肪和体重指数（BMI）。采用 Spearman 相关和 Poisson 回归分析数据（α=0.05）。
Spearman 检验显示衰弱（平均±标准差=2.8±1.7）和营养状况（平均±标准差=10.5±2.9）之间存在中度相关性（r=-0.441）。关于衰弱和营养的重叠，139 名参与者（40.5%）衰弱且营养不良，121 名（35.3%）非衰弱且营养不良或衰弱且营养充足，83 名（24.2%）非衰弱且营养充足。Poisson 回归显示，衰弱和营养不良并存与年龄（PR=1.009，95%CI=1.003-1.016）、用药数量（PR=1.016，95%CI=1.006-1.027）、ADL 依赖（PR=1.061，95%CI=1.016-1.108）、最大握力（PR=0.992，95%CI=0.986-0.998）和 BMI（PR=0.997，95%CI=0.996-0.998）相关。
研究结果表明，衰弱和营养不良在机构老年人中较为普遍，与年龄较大、更多使用药物、ADL 依赖、最大握力较低和 BMI 较低有关。
