Lee Hosun
Department of Nutrition Care, Severance Hospital, Yonsei University Health System, Seoul, Korea.
Brain Neurorehabil. 2022 Mar 28;15(1):e1. doi: 10.12786/bn.2022.15.e1. eCollection 2022 Mar.
Neurological disorders can change patients' nutritional status by directly or indirectly affecting dietary intake through mechanisms such as dysphagia, movement disorders, cognitive impairment, and depression. Malnutrition contributes to complications, resulting in delayed rehabilitation and increased morbidity and mortality. It is important to prevent malnutrition in patients with neurological disorders and to improve their nutritional status by identifying nutritional deterioration at an early stage and implementing appropriate nutritional interventions. This review examines the nutritional screening and assessment process in patients with neurological disorders, with a particular focus on stroke patients undergoing rehabilitation. Nutritional assessment, the first step of clinical nutrition management, identifies nutritional problems and their causes, signs, and symptoms through an overall evaluation including anthropometric measurements, dietary assessments, biochemical assessment, nutrition-related physical examinations, and functional assessment data. Based on the assessment, a nutritional intervention plan is established. By synthesizing the assessment results of selected subjective and objective indicators, nutritional screening tools to screen patients at risk of malnutrition and nutritional assessment tools to diagnose malnutrition were developed. It is important to use those tools with a clear understanding of their characteristics and scope.
神经系统疾病可通过吞咽困难、运动障碍、认知障碍和抑郁等机制直接或间接影响饮食摄入,从而改变患者的营养状况。营养不良会导致并发症,进而导致康复延迟以及发病率和死亡率增加。预防神经系统疾病患者的营养不良,并通过早期识别营养状况恶化并实施适当的营养干预措施来改善其营养状况,这一点很重要。本综述探讨了神经系统疾病患者的营养筛查和评估过程,尤其关注正在接受康复治疗的中风患者。营养评估是临床营养管理的第一步,通过包括人体测量、饮食评估、生化评估、营养相关体格检查和功能评估数据在内的全面评估,识别营养问题及其原因、体征和症状。基于该评估,制定营养干预计划。通过综合选定的主观和客观指标的评估结果,开发了用于筛查营养不良风险患者的营养筛查工具和用于诊断营养不良的营养评估工具。清楚了解这些工具的特点和适用范围后再使用它们很重要。