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抗胆碱能负担与老年人营养不良的关联:一项横断面研究。

Association of anticholinergic burden with undernutrition in older adults: A cross-sectional study.

机构信息

Division of Geriatrics, Gulhane Faculty of Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey.

Department of Internal Medicine, Gulhane Faculty of Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey.

出版信息

Nutr Clin Pract. 2022 Oct;37(5):1215-1224. doi: 10.1002/ncp.10821. Epub 2022 Jan 7.

Abstract

BACKGROUND

Limited data are available concerning the contribution of drugs with anticholinergic properties (DAPs) to undernutrition among older adults. This study aimed to determine the potential association of anticholinergic burden (ACB) to nutrition status in older people.

METHODS

We prospectively enrolled participants aged over 65 who underwent a comprehensive geriatric assessment between January 2017 and June 2020. Nutrition status was assessed by the Mini Nutritional Assessment-Short Form (MNA-SF). The ACB was assessed using the ACB scale.

RESULTS

A total of 615 participants were included in the analysis (mean age ± SD, 78.5 ± 6.6 years; male, 55.3%). The prevalence of undernutrition (MNA-SF score <12) was 22.6% (n = 139). Participants with undernutrition were predominantly older (P < 0.001), had lower mean body mass index scores (undernutrition, 27.3 ± 5.4 vs healthy, 29.5 ± 8.0; P = 0.007), had a lower educational level (P = 0.016), had higher cardiovascular disease morbidity (P < 0.001), and had a higher ACB (P < 0.001) when compared with those with normal nutrition status. In adjusted analysis, the odds of having undernutrition were higher among participants with an ACB score >1 (odds ratio, 1.20; 95% CI, 1.01-1.43; P = 0.044). The weighted multivariate linear regression analysis showed a significant inverse association between the total ACB score and MNA-SF score controlling for multiple confounders.

CONCLUSION

ACB appears to be inversely correlated with nutrition status among older adults. Undernutrition may be considered an additional reason to consider deprescribing DAPs in this population.

摘要

背景

关于具有抗胆碱能特性的药物(DAP)对老年人营养不良的影响,相关数据有限。本研究旨在确定抗胆碱能负担(ACB)与老年人营养状况之间的潜在关联。

方法

我们前瞻性纳入了 2017 年 1 月至 2020 年 6 月期间接受全面老年评估的 65 岁以上的参与者。营养状况通过迷你营养评估-短表(MNA-SF)进行评估。ACB 使用 ACB 量表进行评估。

结果

共有 615 名参与者纳入分析(平均年龄±标准差,78.5±6.6 岁;男性,55.3%)。营养不良(MNA-SF 评分<12)的患病率为 22.6%(n=139)。营养不良的参与者主要为老年人(P<0.001),平均体重指数评分较低(营养不良,27.3±5.4 vs 健康,29.5±8.0;P=0.007),教育程度较低(P=0.016),心血管疾病发病率较高(P<0.001),ACB 较高(P<0.001)与营养状况正常的参与者相比。在调整分析中,ACB 评分>1 的参与者营养不良的可能性更高(比值比,1.20;95%置信区间,1.01-1.43;P=0.044)。多变量线性回归分析显示,在控制了多种混杂因素后,总 ACB 评分与 MNA-SF 评分之间存在显著的负相关关系。

结论

ACB 似乎与老年人的营养状况呈负相关。在这一人群中,营养不良可能被视为考虑减少 DAP 处方的另一个原因。

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