评估社区居住依赖老年人的肌肉减少症、虚弱和营养不良——一个针对研究中服务不足群体的探索性家庭研究。
Assessing Sarcopenia, Frailty, and Malnutrition in Community-Dwelling Dependant Older Adults-An Exploratory Home-Based Study of an Underserved Group in Research.
机构信息
Department of Clinical Medicine, Trinity College, D02 PN40 Dublin, Ireland.
Older Person Services CHO9, Health Service Executive (HSE), D09 C8P5 Dublin, Ireland.
出版信息
Int J Environ Res Public Health. 2022 Dec 2;19(23):16133. doi: 10.3390/ijerph192316133.
BACKGROUND
Adults of advanced age, with functional dependency, socioeconomic disadvantage, or a need for home care, are expected to be at high risk of sarcopenia, frailty and malnutrition, yet are likely to be underrepresented in research. We aimed to explore the assessment of sarcopenia, frailty, and malnutrition in-home, and to describe the practicality of performing these assessments.
METHODS
Home-based health assessments and post-study feedback surveys were conducted among community-dwelling older adults ≥65 years in receipt of state-funded home care ( 31). Assessments included probable sarcopenia [hand-grip strength (HGS), chair rise-test, and SARC-F case-finding tool], the Mini Nutritional Assessment (MNA), and the Clinical Frailty Scale (CFS).
RESULTS
The study group was of mean age 83.2 ± 8.2 years, 74% were female and 23% lived in socioeconomically disadvantaged areas. Almost all met the criteria for probable sarcopenia (94%, = 29/31), were frail or vulnerable by the CFS (97%, = 30/31), and over a quarter were at risk of malnutrition (26%, = 8). Participants had low physical activity (71.0%, 22/31), with a mean daytime average of 11.4 ± 1.6 h spent sitting. It was possible to assess probable sarcopenia (by HGS and SARC-F, but not the chair rise test), malnutrition (MNA), and frailty (CFS). Home-based research was a complex environment, and unearthed significant unmet need, prompting referrals to health services (36%, = 11), in addition to technology assistance. The majority of participants (93%) reported a willingness to partake in future research.
CONCLUSIONS
Most community-dwelling older people in receipt of home support, assessed in this exploratory study, were at risk of probable sarcopenia, frailty, and low physical activity, with over a quarter were at risk of malnutrition. Our initial findings provide practical data for large scale studies and may inform the development of intervention studies aiming to support ageing in place.
背景
功能依赖、社会经济劣势或需要家庭护理的高龄成年人预计处于肌肉减少症、虚弱和营养不良的高风险中，但他们在研究中可能代表性不足。我们旨在探讨家庭环境中肌肉减少症、虚弱和营养不良的评估，并描述进行这些评估的实用性。
方法
对 31 名接受国家资助家庭护理的社区居住的 65 岁以上老年人进行家庭健康评估和研究后反馈调查。评估包括可能的肌肉减少症（握力、椅子起身测试和 SARC-F 案例发现工具）、微型营养评估（MNA）和临床虚弱量表（CFS）。
结果
研究组的平均年龄为 83.2 ± 8.2 岁，74%为女性，23%居住在社会经济劣势地区。几乎所有人都符合可能的肌肉减少症标准（94%，= 29/31），根据 CFS 标准评估为虚弱或脆弱（97%，= 30/31），超过四分之一有营养不良风险（26%，= 8）。参与者的身体活动量较低（71.0%，= 22/31），白天平均坐着时间为 11.4 ± 1.6 小时。可以评估可能的肌肉减少症（通过 HGS 和 SARC-F，但不是椅子起身测试）、营养不良（MNA）和虚弱（CFS）。家庭研究是一个复杂的环境，发现了大量未满足的需求，促使向卫生服务机构转介（36%，= 11），此外还提供技术援助。大多数参与者（93%）表示愿意参与未来的研究。
结论
在这项探索性研究中，接受家庭支持的大多数社区居住的老年人都有肌肉减少症、虚弱和低身体活动的风险，超过四分之一有营养不良的风险。我们的初步发现为大规模研究提供了实用数据，并可能为旨在支持就地老龄化的干预研究提供信息。
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