Department of Oral Health Sciences, Population Studies in Oral Health, KU Leuven, Kapucijnenvoer 7 blok a - bus 7001, 3000 Leuven, Belgium; LUCAS, Center for Care Research and Consultancy, KU Leuven, Minderbroederstraat 8, 3000 Leuven, Belgium.
Department of Oral Health Sciences, Population Studies in Oral Health, KU Leuven, Kapucijnenvoer 7 blok a - bus 7001, 3000 Leuven, Belgium.
Clin Nutr. 2024 Nov;43(11):166-173. doi: 10.1016/j.clnu.2024.09.024. Epub 2024 Sep 14.
BACKGROUND & AIMS: Malnutrition often remains undetected in older persons, leading to increased health problems and comorbidity, prolonged hospital stays and readmissions. In 2020, data from the interRAI Home Care (interRAI HC) instrument was used to determine malnutrition status according to some of the criteria of the Global Leadership Initiative on Malnutrition (GLIM). The interRAI HC instrument showed to be effective as a screening tool for the risk of malnutrition. The goal of the present study is to use the interRAI Long Term Care Facilities (interRAI LTCF) instrument for nursing home residents to identify factors related to older people's health that are significantly associated with the development of malnutrition.
This study analyzes data collected in the period 2019-2023 from nursing home residents, 65 or older, with a follow-up period of 1 year. After applying the GLIM criteria to the available interRAI LTCF data, a cross-sectional sample a longitudinal sample were analyzed by means of bivariate analysis. Factors included in the bivariate analysis were based in previous studies and expert opinion. Unadjusted and adjusted regression models were built to explore associations between several potential risk factors and nutritional status.
The sample consisted of 5598 older people with a mean age of 83.98 ± 7.30 years old and 71.2 % being female. Most people needed extensive assistance with activities of daily living (70.9%) and had at least a mild cognitive impairment (63.9%). According to the GLIM definition using the interRAI items, 8.43% of the residents were malnourished and 4.67% of the residents became malnourished over the period of 1 year. The final adjusted logistic regression yielded significant odds ratios for seven determinants: age (O.R. 1.03; C.I.: 1.01; 1.04), depressive symptoms (O.R.: 1.32; 1.01; 1.73), assistance needed for walking (O.R. 1.49; C.I.: 1.13; 1.95), wandering behavior (O.R. 1.16; C.I.: 1.01; 1.33), falls (O.R. 1.17; C.I.: 1.02; 1.35), visual impairment (O.R. 1.22; C.I.: 1.05; 1.42) and diabetes (protective factor - O.R.: 0.67; C.I.: 0.46; 0.98).
The study showed the main risk factor for malnourishment in nursing home residents, such as age, depressions, assistance for walking, wandering and visual impairment. These significant factors can be used to identify people at risk of malnourishment. Periodically screening residents with the interRAI LTCF can help identify malnourished residents or residents at risk of malnourishment.
老年人的营养不良往往未被发现，导致健康问题和合并症增加、住院时间延长和再次入院。2020 年，使用 interRAI 家庭护理（interRAI HC）工具中的数据，根据全球营养不良领导倡议（GLIM）的一些标准来确定营养不良状况。interRAI HC 工具已被证明是一种有效的营养不良风险筛查工具。本研究的目的是使用 interRAI 长期护理设施（interRAI LTCF）工具来确定与老年人健康相关的因素，这些因素与营养不良的发展显著相关。
本研究分析了 2019 年至 2023 年期间 65 岁或以上居住在养老院的居民的数据，随访期为 1 年。在将 GLIM 标准应用于可用的 interRAI LTCF 数据后，通过双变量分析对横断面样本和纵向样本进行了分析。双变量分析中纳入的因素基于先前的研究和专家意见。建立了未调整和调整后的回归模型，以探索几个潜在风险因素与营养状况之间的关联。
该样本由 5598 名平均年龄为 83.98±7.30 岁的老年人组成，其中 71.2%为女性。大多数人在日常生活活动方面需要大量帮助（70.9%），并且至少有轻度认知障碍（63.9%）。根据使用 interRAI 项目的 GLIM 定义，8.43%的居民营养不良，1 年内有 4.67%的居民出现营养不良。最终调整后的逻辑回归得出了七个决定因素的显著优势比：年龄（O.R. 1.03；C.I.：1.01；1.04）、抑郁症状（O.R.：1.32；1.01；1.73）、行走辅助需求（O.R.：1.49；C.I.：1.13；1.95）、漫游行为（O.R.：1.16；C.I.：1.01；1.33）、跌倒（O.R.：1.17；C.I.：1.02；1.35）、视力障碍（O.R.：1.22；C.I.：1.05；1.42）和糖尿病（保护因素 - O.R.：0.67；C.I.：0.46；0.98）。
该研究表明了养老院居民营养不良的主要危险因素，如年龄、抑郁、行走辅助、漫游和视力障碍。这些重要因素可用于识别有营养不良风险的人。定期使用 interRAI LTCF 对居民进行筛查有助于识别营养不良的居民或有营养不良风险的居民。
