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老年人的衰老速度会影响社区中与营养不良相关的因素和决定因素:系统评价和叙述性综合。

Ageing rate of older adults affects the factors associated with, and the determinants of malnutrition in the community: a systematic review and narrative synthesis.

机构信息

School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland.

Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland.

出版信息

BMC Geriatr. 2021 Dec 4;21(1):676. doi: 10.1186/s12877-021-02583-2.


DOI:10.1186/s12877-021-02583-2
PMID:34863118
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8642873/
Abstract

BACKGROUND: Malnutrition negatively impacts on health, quality of life and disease outcomes in older adults. The reported factors associated with, and determinants of malnutrition, are inconsistent between studies. These factors may vary according to differences in rate of ageing. This review critically examines the evidence for the most frequently reported sociodemographic factors and determinants of malnutrition and identifies differences according to rates of ageing. METHODS: A systematic search of the PubMed Central and Embase databases was conducted in April 2019 to identify papers on ageing and poor nutritional status. Numerous factors were identified, including factors from demographic, food intake, lifestyle, social, physical functioning, psychological and disease-related domains. Where possible, community-dwelling populations assessed within the included studies (N = 68) were categorised according to their ageing rate: 'successful', 'usual' or 'accelerated'. RESULTS: Low education level and unmarried status appear to be more frequently associated with malnutrition within the successful ageing category. Indicators of declining mobility and function are associated with malnutrition and increase in severity across the ageing categories. Falls and hospitalisation are associated with malnutrition irrespective of rate of ageing. Factors associated with malnutrition from the food intake, social and disease-related domains increase in severity in the accelerated ageing category. Having a cognitive impairment appears to be a determinant of malnutrition in successfully ageing populations whilst dementia is reported to be associated with malnutrition within usual and accelerated ageing populations. CONCLUSIONS: This review summarises the factors associated with malnutrition and malnutrition risk reported in community-dwelling older adults focusing on differences identified according to rate of ageing. As the rate of ageing speeds up, an increasing number of factors are reported within the food intake, social and disease-related domains; these factors increase in severity in the accelerated ageing category. Knowledge of the specific factors and determinants associated with malnutrition according to older adults' ageing rate could contribute to the identification and prevention of malnutrition. As most studies included in this review were cross-sectional, longitudinal studies and meta-analyses comprehensively assessing potential contributory factors are required to establish the true determinants of malnutrition.

摘要

背景:营养不良会对老年人的健康、生活质量和疾病结局产生负面影响。不同研究报告的与营养不良相关的因素和决定因素并不一致。这些因素可能因衰老速度的不同而有所差异。本综述批判性地审查了最常报告的与社会人口统计学因素和营养不良决定因素相关的证据,并根据衰老速度确定了差异。

方法:2019 年 4 月,我们对 PubMed Central 和 Embase 数据库进行了系统检索,以确定与衰老和营养状况不良相关的论文。确定了许多因素,包括人口统计学、食物摄入、生活方式、社会、身体功能、心理和疾病相关领域的因素。在可能的情况下,根据研究中评估的社区居住人群(N=68)的衰老速度将其分为“成功”、“通常”或“加速”。

结果:在成功衰老类别中,似乎较低的教育水平和未婚状态与营养不良更为相关。移动和功能下降的指标与营养不良有关,并随着衰老类别的增加而加重。无论衰老速度如何,跌倒和住院都与营养不良有关。与食物摄入、社会和疾病相关领域相关的营养不良因素在加速衰老类别中严重程度增加。认知障碍似乎是成功衰老人群营养不良的决定因素,而痴呆症则被报道与通常和加速衰老人群的营养不良有关。

结论:本综述总结了社区居住的老年人中与营养不良和营养不良风险相关的因素,重点关注根据衰老速度确定的差异。随着衰老速度的加快,与食物摄入、社会和疾病相关领域相关的因素数量不断增加;这些因素在加速衰老类别中严重程度增加。了解根据老年人的衰老速度与营养不良相关的具体因素和决定因素,有助于识别和预防营养不良。由于本综述中大多数研究都是横断面研究,因此需要进行全面评估潜在促成因素的纵向研究和荟萃分析,以确定营养不良的真正决定因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acbc/8642873/a7cb780c69b7/12877_2021_2583_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acbc/8642873/bff9c442e850/12877_2021_2583_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acbc/8642873/7b1396288c03/12877_2021_2583_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acbc/8642873/a7cb780c69b7/12877_2021_2583_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acbc/8642873/bff9c442e850/12877_2021_2583_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acbc/8642873/7b1396288c03/12877_2021_2583_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acbc/8642873/a7cb780c69b7/12877_2021_2583_Fig3_HTML.jpg

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本文引用的文献

[1]
Multiple Antihyperglycemic Drug Use is Associated with Undernutrition Among Older Adults with Type 2 Diabetes Mellitus: A Cross-Sectional Study.

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[2]
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Clin Nutr. 2018-12-11

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