Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Łódź, Hallera 1 Square, 90-647 Łódź, Poland.
Int J Environ Res Public Health. 2023 Jan 4;20(2):916. doi: 10.3390/ijerph20020916.
Objectives: The aim of the present study was to examine and compare the relationship between nutritional status, physical activity (PA) level, concomitant chronic diseases, and quality of life (QoL) in community-dwelling (CD) older people and nursing home (NH) residents. Material and Methods: One hundred NH residents aged 60 years and above and one hundred sex- and age-matched CD older adults were examined. The QoL was examined with the EuroQol-5D questionnaire. Nutritional status was assessed with the Mini Nutritional Assessment questionnaire (MNA), anthropometric measures, and bioimpedance analysis (BIA). The 7-Day Recall Questionnaire and the Stanford Usual Activity Questionnaire were performed to evaluate the PA energy expenditure level (PA-EE) and the health-related behaviours (PA-HRB), respectively. Results: CD subjects presented a significantly higher self-assessment in the VAS scale in comparison with NH residents (CD: 65.3 ± 19.4 vs. NH 58.2 ± 21.4; p < 0.05), but there were no differences within the five dimensions of QoL. In NH patients, the VAS scale was not correlated with any of the variables evaluating the nutritional status and body composition, while in the CD group correlated positively with MNA (rS = 0.36; p < 0.001), % of FFM (rS = 0.22; p< 0.05), body density (rS = 0.22; p < 0.05) and negatively with % of FM (rS = −0.22; p < 0.05). In an institutional environment, only concomitant diseases (mainly urinary incontinence) were found as independent determinants for QoL. In the community, independent determinants of QoL besides concomitant diseases (mainly ischaemic heart disease) were nutritional status or PA-HRB. Conclusions: Determinants of QoL are different depending on the living environment the older adults. Proper nutritional status and beneficial PA behaviours, are crucial for higher QoL of CD elderly, while for NH residents, the main determinants of QoL are chronic conditions.
本研究旨在探讨和比较社区居住（CD）老年人与养老院（NH）居民的营养状况、身体活动（PA）水平、并存慢性疾病与生活质量（QoL）之间的关系。
共检查了 100 名 60 岁及以上的 NH 居民和 100 名性别和年龄匹配的 CD 老年人。采用欧洲五维健康量表（EQ-5D）问卷评估 QoL。采用微型营养评估问卷（MNA）、人体测量学指标和生物电阻抗分析（BIA）评估营养状况。使用 7 天回顾问卷和斯坦福日常活动问卷分别评估 PA 能量消耗水平（PA-EE）和与健康相关的行为（PA-HRB）。
与 NH 居民相比，CD 受试者在 VAS 量表上的自我评估显著更高（CD：65.3 ± 19.4 与 NH 58.2 ± 21.4；p < 0.05），但在 QoL 的五个维度中没有差异。在 NH 患者中，VAS 量表与评估营养状况和身体成分的任何变量均不相关，而在 CD 组中与 MNA 呈正相关（rS = 0.36；p < 0.001），FFM%（rS = 0.22；p < 0.05），体密度（rS = 0.22；p < 0.05）呈负相关，与 FM%（rS = −0.22；p < 0.05）呈负相关。在机构环境中，仅并存疾病（主要为尿失禁）被发现是 QoL 的独立决定因素。在社区中，除并存疾病（主要为缺血性心脏病）外，营养状况或 PA-HRB 也是 QoL 的独立决定因素。
老年人生活环境不同，决定 QoL 的因素也不同。适当的营养状况和有益的 PA 行为对 CD 老年人群的 QoL 至关重要，而对于 NH 居民，QoL 的主要决定因素是慢性疾病。
