日常生活活动能力下降是老年人营养恶化的一个风险因素：一项前瞻性队列研究。
Decline of instrumental activities of daily living is a risk factor for nutritional deterioration in older adults: a prospective cohort study.
机构信息
Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo, 650-8530, Japan.
Department of Physical Therapy, Hyogo Rehabilitation Center, 1080,Akebono-cho,Nishi-ku, Kobe, Hyogo, 651-2181, Japan.
出版信息
BMC Geriatr. 2023 Aug 9;23(1):480. doi: 10.1186/s12877-023-04185-6.
BACKGROUND
The association between functional capacity and the subsequent risk of nutritional deterioration is yet to be understood. The purpose of this study was to elucidate the relationship between functional capacity, comprising instrumental activities of daily living (IADL), intellectual activity, and social function, and future decline in nutritional status.
METHODS
The current study is a two-year prospective cohort study. A total of 468 community-dwelling older adults without nutritional risks were enrolled. We used the Mini Nutritional Assessment Screening Form. Functional capacity, including IADL, intellectual activity, and social function, was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence at baseline. The nutritional status was reassessed at a 2-year follow-up. Risk ratios (RR) of functional capacity for the incidence of nutritional decline were estimated.
RESULTS
Low functional capacity was significantly associated with future deterioration of nutritional status (RR 1.12, 95% confidence interval [CI] 1.02-1.25). Of the subdomains of functional capacity, IADL decline (adjusted RR 2.21, 95% CI 1.18-4.13) was an independent risk factor for the incidence of nutritional risk. Intellectual and social activities were not significant.
CONCLUSION
Decline in functional capacity, especially IADL, is a risk factor for future deterioration in nutritional status. Further studies are required to elucidate the effect of interventions for IADL decline on maintaining nutritional status in older adults.
背景
目前尚不清楚功能能力与随后营养恶化风险之间的关系。本研究旨在阐明功能能力（包括日常生活活动的工具性活动、智力活动和社会功能）与未来营养状况下降之间的关系。
方法
本研究为为期两年的前瞻性队列研究。共纳入 468 名无营养风险的社区居住的老年人。我们使用 Mini Nutritional Assessment Screening Form 评估营养状况。使用东京都立老人研究所能力指数在基线时评估功能能力，包括日常生活活动的工具性活动、智力活动和社会功能。在 2 年的随访时重新评估营养状况。使用风险比（RR）估计功能能力与营养下降发生率之间的关系。
结果
低功能能力与未来营养状况恶化显著相关（RR 1.12，95%置信区间 [CI] 1.02-1.25）。在功能能力的子领域中，日常生活活动的下降（调整 RR 2.21，95% CI 1.18-4.13）是营养风险发生率的独立危险因素。智力和社会活动则不显著。
结论
功能能力下降，尤其是日常生活活动的工具性活动下降，是未来营养状况恶化的危险因素。需要进一步研究阐明针对日常生活活动下降的干预措施对维持老年人营养状况的影响。
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