Okudur Saadet Koc, Smith Lee, Tan Semen Gokce, Yigitalp Veliye, Soysal Pinar
Department of Geriatric Medicine, Manisa State Hospital, Manisa, Turkiye.
The Cambridge Centre for Sport and Exercise Science, Anglia Ruskin University, Cambridge, UK.
North Clin Istanb. 2024 Jan 31;11(1):45-51. doi: 10.14744/nci.2023.07717. eCollection 2024.
Fear of falling (FoF) is common in patients with cognitive impairment. However, the role of sarcopenia and malnutrition, which are two important factors that cause falls, on FoF is unknown. The aim of this study was to explore the association between FoF and malnutrition and sarcopenia in older patients with dementia.
Two hundred and sixty-six dementia patients underwent comprehensive geriatric assessment. The Falls Efficacy Scale-International (FES-I) was applied to assign and classify FoF. Scores for the FES-I scale were categorized as ≥28, 20-27, or 16-19, representing high concern, moderate, and no or low concern about FoF, respectively. Mini Nutritional Assessment (MNA) scores <17, 17-23.5, or >23.5 were categorized as malnutrition, malnutrition risk, and well-nourished, respectively. Sarcopenia was defined using the SARC-F tool. SARC-F score ≥4 was categorized as sarcopenia. Serum folate, Vitamin B12, and Vitamin D deficiencies were also evaluated. The relationship between FoF groups and nutritional status, presence of sarcopenia, and micronutrient status was evaluated.
The mean age was 80.83±6.61 years. The prevalence of moderate and high FoF in dementia patients was 51%. There was a significant difference in terms of cerebrovascular events, the history of falling, instrumental and basic activities of daily living (IADL and BADL), MNA, and SARC-F scores between the FoF groups (p<0.05). The association between sarcopenia and FoF persisted in multivariable analysis adjusted for MNA scores, cerebrovascular events, falls history, BADL, and IADL (OR=2.67, 95% CI: 1.50-4.50), but there was no significant association between malnutrition/micronutrient deficiencies and FoF (p>0.05).
Sarcopenia is associated with the severity of FoF, but malnutrition or micronutrient deficiencies are not associated with the severity of FoF in older patients with dementia.
跌倒恐惧（FoF）在认知障碍患者中很常见。然而，肌肉减少症和营养不良这两个导致跌倒的重要因素对跌倒恐惧的作用尚不清楚。本研究的目的是探讨老年痴呆患者中跌倒恐惧与营养不良及肌肉减少症之间的关联。
266名痴呆患者接受了全面的老年综合评估。应用国际跌倒效能量表（FES-I）对跌倒恐惧进行赋值和分类。FES-I量表得分分为≥28分、20 - 27分或16 - 19分，分别代表对跌倒恐惧高度关注、中度关注以及无或低度关注。微型营养评定法（MNA）得分<17分、17 - 23.5分或>23.5分分别被归类为营养不良、营养不良风险和营养良好。使用SARC-F工具定义肌肉减少症。SARC-F得分≥4被归类为肌肉减少症。还评估了血清叶酸、维生素B12和维生素D缺乏情况。评估了跌倒恐惧组与营养状况、肌肉减少症的存在以及微量营养素状况之间的关系。
平均年龄为80.83±6.61岁。痴呆患者中中度和高度跌倒恐惧的患病率为51%。跌倒恐惧组在脑血管事件、跌倒史、工具性和基本日常生活活动（IADL和BADL）、MNA以及SARC-F得分方面存在显著差异（p<0.05）。在对MNA得分、脑血管事件、跌倒史、BADL和IADL进行调整的多变量分析中，肌肉减少症与跌倒恐惧之间的关联仍然存在（OR = 2.67，95%CI：1.50 - 4.50），但营养不良/微量营养素缺乏与跌倒恐惧之间无显著关联（p>0.05）。
肌肉减少症与老年痴呆患者跌倒恐惧的严重程度相关，但营养不良或微量营养素缺乏与老年痴呆患者跌倒恐惧的严重程度无关。
