Department of Geriatric Medicine, Manisa State Hospital, Manisa, Turkey.
Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
J Am Med Dir Assoc. 2021 Oct;22(10):2134-2139. doi: 10.1016/j.jamda.2021.05.035. Epub 2021 Jun 25.
Both excessive daytime sleepiness (EDS) and nutritional deficiencies are common and can cause similar negative consequences, such as falls, and cognitive impairment in older adults, but there is no study investigating the relationship between the two. The aim of this study is to investigate the relationship between malnutrition/micronutrient deficiency and EDS in patients with and without dementia.
Cross-sectional study.
A total of 800 outpatients (243 of whom had dementia), aged ≥65 years, were included.
All patients underwent comprehensive geriatric assessment. Mini Nutritional Assessment (MNA) scores >23.5, 17-23.5, or <17 were categorized as well-nourished, malnutrition risk, and malnutrition, respectively. Eating Assessment Tool score of ≥3 was accepted as dysphagia. Serum vitamin B, vitamin D, and folate deficiencies were also evaluated. The Epworth Sleepiness Scale score of ≥11 points indicated EDS.
The mean age was 79.1±7.5 years. The prevalence of EDS was 22.75%. In patients with dementia, those with EDS had significantly lower MNA scores and more frequent dysphagia (P < .05). In patients without dementia, those with EDS have lower MNA scores than those without EDS; malnutrition, dysphagia, and vitamin D deficiency were higher (P < .05). In multivariable analysis adjusted for age, gender, living status, ischemic heart disease, cerebrovascular events, polypharmacy, dementia, and insomnia, the association between EDS and malnutrition [odds ratio (OR) 1.73, 95% confidence interval (CI) 1.37-2.20], dysphagia (OR 2.01, 95% CI 1.33-2.88), and vitamin D deficiency (OR 2.0, 95% CI 1.12-3.55) persisted.
There is a significant relationship between EDS and malnutrition risk, dysphagia, and vitamin D deficiency in older adults. Therefore, when examining an older patient with EDS, dysphagia, malnutrition, and vitamin D levels should be evaluated, or EDS should be investigated in an older patient with malnutrition, dysphagia, and vitamin D deficiency. Thus, it will be possible to manage all these conditions more effectively.
日间嗜睡（EDS）和营养缺乏均很常见，并且可导致老年人出现类似的负面后果，如跌倒和认知障碍，但目前尚无研究调查这两者之间的关系。本研究旨在调查患有和不患有痴呆症的患者中，营养不良/微量营养素缺乏与 EDS 之间的关系。
横断面研究。
共纳入 800 名年龄≥65 岁的门诊患者（其中 243 名患有痴呆症）。
所有患者均接受全面老年评估。Mini Nutritional Assessment（MNA）评分>23.5、17-23.5 或<17 分别归类为营养良好、营养不良风险和营养不良。接受 Eating Assessment Tool 评分≥3 作为吞咽困难。还评估血清维生素 B、维生素 D 和叶酸缺乏情况。Epworth 睡眠量表评分≥11 分表示 EDS。
平均年龄为 79.1±7.5 岁。EDS 的患病率为 22.75%。在患有痴呆症的患者中，患有 EDS 的患者 MNA 评分明显较低，并且更频繁地出现吞咽困难（P<.05）。在不患有痴呆症的患者中，患有 EDS 的患者 MNA 评分低于不患有 EDS 的患者；营养不良、吞咽困难和维生素 D 缺乏症更高（P<.05）。在调整年龄、性别、居住状况、缺血性心脏病、脑血管事件、多种药物治疗、痴呆症和失眠后进行多变量分析，EDS 与营养不良[比值比（OR）1.73，95%置信区间（CI）1.37-2.20]、吞咽困难（OR 2.01，95%CI 1.33-2.88）和维生素 D 缺乏（OR 2.0，95%CI 1.12-3.55）之间存在关联。
在老年人中，EDS 与营养不良风险、吞咽困难和维生素 D 缺乏之间存在显著关系。因此，在检查患有 EDS、吞咽困难、营养不良和维生素 D 水平的老年患者时，或者在患有营养不良、吞咽困难和维生素 D 缺乏的老年患者中检查 EDS 时，应该评估这些情况，以便更有效地治疗所有这些疾病。
