Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvarı (Vatan Street), Fatih, 34093, Istanbul, Turkey.
Department of Geriatric Medicine, Manisa State Hospital, Şehzadeler, 45040, Manisa, Turkey.
Aging Clin Exp Res. 2022 Sep;34(9):2023-2030. doi: 10.1007/s40520-022-02143-7. Epub 2022 May 16.
Both obesity and malnutrition are common health problems in older adults.
The aim of our study is to investigate the prevalence of undernutrition and related factors in older obese patients.
1911 older outpatients who underwent comprehensive geriatric assessment were included in this cross-sectional study. Body mass index (BMI) was categorized as follows: 'Underweight' = BMI < 18.5, 'Normal weight' = 18.5 ≤ BMI < 25, 'Overweight' 25 ≤ BMI < 30, and 'Obesity' ≥ BMI 30. Mini-Nutritional Assessment scores > 23.5, 17-23.5, or < 17 were categorized as well-nourished, malnutrition risk, and malnutrition, respectively. Those who were not well-nourished were considered undernutrition.
Of 1911 patients, with a mean age of 77.34 ± 8.0 years, 931 (48.7%) were obese. Of whom 6.0% were malnourished and 26.3% were at risk of malnutrition. Age, females, widowed and those living with their children, the number of drugs used, and the presence of heart failure, Parkinson's disease, and dementia, decreased calf circumference and muscle strength were higher in obese patients with undernutrition than obese well-nourished patients (p < 0.05). After adjustment for the aforementioned factors, basic and instrumental activities of daily livings, and Tinetti scores were lower, and falls and Geriatric Depression Scale-15 scores were higher in those with undernutrition compared to those with well-nourished among older obese patients (p < 0.05).
Half of the older patients were obese and undernutrition was observed in one out of every three older obese patients. Undernutrition was associated with decreased functional capacity, impairment in balance and gait functions, falls, and depressed mood. Therefore, we recommend to screen older obese patients for nutritional status.
肥胖和营养不良都是老年人常见的健康问题。
本研究旨在调查老年肥胖患者营养不良的患病率及相关因素。
本横断面研究纳入了 1911 名接受全面老年评估的老年门诊患者。体重指数（BMI）分类如下：“体重不足” = BMI < 18.5、“正常体重” = 18.5 ≤ BMI < 25、“超重”25 ≤ BMI < 30、“肥胖” ≥ BMI 30。Mini-Nutritional Assessment 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。那些营养状况不佳的人被认为是营养不良。
在 1911 名患者中，平均年龄为 77.34 ± 8.0 岁，其中 931 名（48.7%）为肥胖患者。其中，6.0%为营养不良，26.3%存在营养不良风险。与肥胖营养良好的患者相比，年龄较大、女性、丧偶、与子女同住、使用药物数量较多、存在心力衰竭、帕金森病和痴呆、小腿围和肌肉力量减小的肥胖患者中营养不良的发生率更高（p < 0.05）。在调整了上述因素后，与肥胖营养良好的患者相比，营养不良的患者基本和工具性日常生活活动以及 Tinetti 评分较低，跌倒和老年抑郁量表-15 评分较高（p < 0.05）。
一半的老年患者肥胖，每三名老年肥胖患者中就有一名存在营养不良。营养不良与功能能力下降、平衡和步态功能受损、跌倒和情绪低落有关。因此，我们建议对老年肥胖患者进行营养状况筛查。
