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居家送餐服务对减少营养不良风险老年人虚弱的初步评估。

Preliminary evaluation of home-delivered meals for reducing frailty in older adults at risk for mal-nutrition.

机构信息

School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH 43210-2205, United States.

Center for Biostatistics, College of Medicine, The Ohio State University, Columbus, OH, United States.

出版信息

J Nutr Health Aging. 2024 Jul;28(7):100283. doi: 10.1016/j.jnha.2024.100283. Epub 2024 Jun 11.

Abstract

OBJECTIVE

To examine the potential benefit of home-delivered meals for reducing frailty levels among community-dwelling older adults at risk for malnutrition.

DESIGN

A retrospective, single-group observational approach.

SETTING

One large home-delivered meal agency in the Midwest United States.

PARTICIPANTS

1090 community-dwelling older adults who received home-delivered meal services, funded through the Older Americans Act, between June 2020 and December 2021.

MEASUREMENT

Frailty status was measured by the Home Care Frailty Scale (HCFS) which was routinely administered by agency staff to home-delivered meal clients as part of a quality improvement project. The HCFS was administered at the start of meal services, 3-months after meals began, and 6-months after meals began.

RESULTS

At baseline, 55.4% of clients were found to be at high risk for malnutrition. While there was a significant and consistent decline in HCFS throughout the follow-up period for both high and low nutritional risk groups, the reduction in frailty from baseline to 6-months was greater for the high nutritional risk group (Δ = -1.9; 95% CI: [-2.7, -1.1]; p < 0.001) compared to those with low nutritional risk (Δ = -1.5; 95% CI: [-2.3, -0.7]; p < 0.001). Compared to those who lived alone, clients who lived with other individuals presented with higher levels of frailty at baseline and 3-month follow-up for both low and high malnutrition risk groups.

CONCLUSION

Home-delivered meal clients are commonly at risk for both frailty and malnutrition. Home-delivered meal programs, which are intended to reduce malnutrition among older adults, may serve as a promising solution for reducing frailty in the vulnerable aging population.

摘要

目的

探讨为有营养不良风险的社区居住老年人提供上门送餐服务对降低衰弱水平的潜在益处。

设计

回顾性、单组观察性方法。

地点

美国中西部的一家大型上门送餐机构。

参与者

1090 名接受上门送餐服务的社区居住老年人,这些服务是通过《美国老年人法案》资助的,服务时间为 2020 年 6 月至 2021 年 12 月。

测量

衰弱状况通过家庭护理衰弱量表(HCFS)进行测量,该量表由机构工作人员在提供上门送餐服务的过程中常规用于上门送餐客户,作为质量改进项目的一部分。HCFS 在送餐开始时、开始后 3 个月和开始后 6 个月进行评估。

结果

在基线时,发现 55.4%的客户有很高的营养不良风险。虽然高营养风险组和低营养风险组在整个随访期间 HCFS 均呈显著且持续下降趋势,但高营养风险组从基线到 6 个月时的衰弱程度下降更为明显(Δ=-1.9;95%CI:[-2.7,-1.1];p<0.001),而低营养风险组的下降幅度为(Δ=-1.5;95%CI:[-2.3,-0.7];p<0.001)。与独居者相比,低营养风险组和高营养风险组的所有参与者在基线和 3 个月随访时都与更高的衰弱程度相关,而且与独居者相比,他们与其他人共同居住。

结论

上门送餐客户通常存在衰弱和营养不良的双重风险。旨在减少老年人营养不良的上门送餐计划可能是为脆弱的老年人群体减少衰弱的一个有前途的解决方案。

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