Arensberg Mary Beth, Gahche Jaime, Clapes Raquel, Kerr Kirk W, Merkel Joyce, Dwyer Johanna T
Abbott Nutrition Division of Abbott, Columbus, OH, United States.
Office of Dietary Supplements, National Institutes of Health, Bethesda, MD, United States.
Front Med (Lausanne). 2023 Sep 12;10:1225689. doi: 10.3389/fmed.2023.1225689. eCollection 2023.
Globally, the number of older adults is growing exponentially. Yet, while living longer, people are not necessarily healthier. Nutrition can positively impact healthy aging and quality of life (QoL). Two decades ago, nutrition and diet were rarely viewed as key QoL domains, were not part of QoL screening, and QoL studies frequently used unvalidated tools. It is unclear how the nutrition and QoL research area may have since evolved.
A scoping review was conducted in Pubmed of research with community-living older adults (aged ≥65) from developed economies that included 1 of 29 common, valid QoL instruments, nutrition indices, and was published between 1/2000-12/2022. The review followed published methodology guidance and used the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow diagram to document identified studies and record number of included/excluded studies (based on scoping review's pre-specified criteria).
Of 258 studies identified initially, 37 fully met scoping review inclusion criteria; only 2 were QoL studies, 30 focused on nutrition, 3 on measurement tool validation/testing, and 2 were other study types. Most studies ( = 32) were among populations outside of North America; majority were conducted in Europe ( = 22) where the EuroQol 5 Dimension (Eq5D) was used in >1/2 the studies. Of 5 North American studies, the 36-Item Short Form Survey (SF-36) was most frequently used ( = 4). Myriad nutrition indices described various aspects of eating, dietary intake, and nutrition status, making comparability between studies difficult. Studies included several different nutrition questionnaires; Mini Nutritional Assessment (MNA) ( = 8) or Mini Nutritional Assessment Short Form (MNA-SF) ( = 5) were used most frequently. The most frequent anthropometric measure reported was Body Mass Index (BMI) ( = 28). Nutrition-related biochemical indices were reported infrequently ( = 8).
The paucity of studies over the last two decades suggests research on nutrition and QoL among community-living older adults remains underdeveloped. Valid QoL instruments and nutrition indices are now available. To ensure greater comparability among studies it is important to develop consensus on core indices of QoL and particularly nutrition. Greater agreement on these indices will advance further research to support healthy aging and improve QoL for community-dwelling older adults.
在全球范围内,老年人数量呈指数级增长。然而,尽管人们寿命延长,但不一定更健康。营养可对健康老龄化和生活质量(QoL)产生积极影响。二十年前,营养和饮食很少被视为关键的生活质量领域,不是生活质量筛查的一部分,而且生活质量研究经常使用未经验证的工具。目前尚不清楚营养与生活质量研究领域此后是如何发展的。
在PubMed上对来自发达经济体的社区居住老年人(年龄≥65岁)的研究进行了范围综述,这些研究包括29种常见的有效生活质量工具之一、营养指数,且发表于2000年1月至2022年12月之间。该综述遵循已发表的方法学指南,并使用系统评价和Meta分析的首选报告项目(PRISMA)流程图来记录已识别的研究,并记录纳入/排除研究的数量(基于范围综述预先指定的标准)。
在最初确定的258项研究中,37项完全符合范围综述纳入标准;只有2项是生活质量研究,30项关注营养,3项关注测量工具的验证/测试,2项是其他研究类型。大多数研究(n = 32)来自北美以外的人群;大多数研究在欧洲进行(n = 22),其中超过一半的研究使用了欧洲五维健康量表(EuroQol 5 Dimension,Eq5D)。在5项北美研究中,最常使用的是36项简短调查问卷(SF - 36)(n = 4)。众多营养指数描述了饮食、膳食摄入和营养状况的各个方面,使得研究之间难以进行比较。研究包括几种不同的营养问卷;最常使用的是简易营养评估(Mini Nutritional Assessment,MNA)(n = 8)或简易营养评估简表(Mini Nutritional Assessment Short Form,MNA - SF)(n = 5)。报告最频繁的人体测量指标是体重指数(BMI)(n = 28)。很少报告与营养相关的生化指标(n = 8)。
过去二十年研究的匮乏表明,关于社区居住老年人营养与生活质量的研究仍不发达。现在已有有效的生活质量工具和营养指数。为确保研究之间具有更高的可比性,就生活质量的核心指标,尤其是营养指标达成共识非常重要。就这些指标达成更大程度的一致将推动进一步的研究,以支持健康老龄化并改善社区居住老年人的生活质量。