Department of Cardiology, Kaiser Permanente San Francisco Medical Center, San Francisco, California, USA.
Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.
Clin Cardiol. 2022 Feb;45(2):180-188. doi: 10.1002/clc.23761. Epub 2022 Feb 2.
The impact of the novel coronavirus disease 2019 (COVID-19) pandemic on diet and nutrition among older adults with chronic medical conditions have not been well-described.
We conducted a survey addressing (1) food access, (2) diet quality and composition, (3) nutritional understanding, and (4) attitudes towards research among adults with heart failure (HF) within an integrated health system. Adults (≥18 years) with diagnosed HF and at least one prior hospitalization for HF within the last 12 months were approached to complete the survey electronically or by mail. Outcomes included all-cause and HF-specific hospitalizations and all-cause death was ascertained via the electronic health record.
Among 1212 survey respondents (32.5% of eligible patients) between May 18, 2020 and September 30, 2020, mean ± SD age was 77.9 ± 11.4 years, 50.1% were women, and median (25th-75th) left ventricular ejection fraction was 55% (40%-60%). Overall, 15.1% of respondents were food insecure, and only 65% of participants answered correctly more than half of the items assessing nutritional knowledge. Although most respondents were willing to participate in future research, that number largely declined for studies requiring blood draws (32.2%), study medication (14.4%), and/or behavior change (27.1%). Food security, diet quality, and nutritional knowledge were not independently associated with outcomes at 90 or 180 days.
In a cohort of older adults with HF and multiple comorbidities, a significant proportion reported issues with food access, diet quality, and nutritional knowledge during the COVID-19 pandemic. Future research should evaluate interventions targeting these domains in at-risk individuals.
新型冠状病毒病 2019（COVID-19）大流行对患有慢性疾病的老年人的饮食和营养的影响尚未得到充分描述。
我们对一个综合医疗系统中的心力衰竭（HF）成年人进行了一项调查，调查内容包括（1）食物获取情况，（2）饮食质量和组成，（3）营养理解，以及（4）对研究的态度。年龄在 18 岁及以上且在过去 12 个月内至少因 HF 住院治疗一次的成年人被邀请通过电子方式或邮寄方式完成调查。研究结果包括全因和 HF 特定的住院治疗，全因死亡通过电子健康记录确定。
在 2020 年 5 月 18 日至 2020 年 9 月 30 日期间，对 1212 名调查对象（合格患者的 32.5%）进行了调查，平均年龄为 77.9±11.4 岁，50.1%为女性，中位数（25 至 75 分位）左心室射血分数为 55%（40%至 60%）。总体而言，15.1%的受访者存在食物不安全问题，只有 65%的参与者答对了评估营养知识的一半以上的项目。尽管大多数受访者愿意参与未来的研究，但对于需要抽取血液样本（32.2%）、研究药物（14.4%）和/或行为改变（27.1%）的研究，参与者数量大幅下降。在 90 天或 180 天内，食物安全、饮食质量和营养知识与结果无独立关联。
在一组患有 HF 和多种合并症的老年人中，相当一部分人在 COVID-19 大流行期间报告了食物获取、饮食质量和营养知识方面的问题。未来的研究应评估针对高危人群的这些领域的干预措施。
