Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia.
Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia; Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
Mech Ageing Dev. 2021 Jul;197:111500. doi: 10.1016/j.mad.2021.111500. Epub 2021 May 16.
Malnutrition is associated with poor functional performance in geriatric rehabilitation inpatients. However, it is unclear if malnourished patients have poor functional trajectories over time. This study aimed to determine the association between (the risk of) malnutrition at admission and trajectories of Activities of Daily Living (ADL) and Instrumental ADL (IADL) from pre-admission to post-discharge in geriatric rehabilitation inpatients. An observational, longitudinal study was conducted in the REStORing health of acutely unwell adulTs (RESORT) cohort of geriatric rehabilitation inpatients. A total of 618 patients (mean age 82.1 ± 7.8 years, 57.4 % females) were included. The prevalence of the risk of malnutrition, by Malnutrition Screening Tool (MST) was 41.3 % (n = 255) and malnutrition by the Global Leadership Initiative on Malnutrition (GLIM) and European Society for Clinical Nutrition and Metabolism (ESPEN) criteria were 53.5 % (n = 331) and 13.1 % (n = 81) respectively. Malnutrition by the GLIM criteria but not the ESPEN criteria nor the risk of malnutrition, was associated with ADL trajectories of 'remained poor' (OR: 3.33, 95 %CI: 1.21-9.19) and 'deteriorated' (OR: 1.68, 95 %CI: 1.13-2.52) compared to the 'recovered' trajectory. The risk of malnutrition and malnutrition were not associated with IADL trajectories. Malnutrition at admission was associated with poor ADL trajectories but not IADL trajectories in geriatric rehabilitation inpatients.
营养不良与老年康复住院患者的功能表现不良有关。然而,目前尚不清楚营养不良的患者是否随着时间的推移功能轨迹较差。本研究旨在确定入院时(营养不良的)风险与老年康复住院患者从入院前到出院后日常生活活动(ADL)和工具性日常生活活动(IADL)轨迹之间的关联。在老年康复住院患者的REStORing health of acutely unwell adulTs(RESORT)队列中进行了一项观察性、纵向研究。共纳入 618 名患者(平均年龄 82.1 ± 7.8 岁,57.4%为女性)。根据营养不良筛查工具(MST),营养不良风险的患病率为 41.3%(n = 255),而根据全球营养不良领导倡议(GLIM)和欧洲临床营养与代谢学会(ESPEN)标准,营养不良的患病率分别为 53.5%(n = 331)和 13.1%(n = 81)。根据 GLIM 标准诊断的营养不良,但不是根据 ESPEN 标准或营养不良风险,与 ADL 轨迹“仍较差”(OR:3.33,95%CI:1.21-9.19)和“恶化”(OR:1.68,95%CI:1.13-2.52)相关,与“恢复”轨迹相比。营养不良风险和营养不良与 IADL 轨迹无关。入院时的营养不良与老年康复住院患者的 ADL 轨迹较差相关,但与 IADL 轨迹无关。