老年人营养不良状况及影响因素分析

doi:10.3969/j.issn.1003-9198.2022.08.017

摘要/Abstract

摘要： 目的评估老年人的营养状况并分析其危险因素,以制定改善老年人营养状况的措施,提高老年人生活质量。方法应用微型营养评估简表(Mini-Nutritional Assessment Short-Form,MNA-SF),采取整群抽样方法,对2019年12月至2020年3月烟台市65岁以上262 226例老年人进行营养评估,采用多因素 Logistic回归分析一般人口学资料、功能状态和老年综合征对营养不良的影响。结果在烟台市 219 222例有效调查老年人中,24 489例(11.2%)被评估为营养不良风险,1589例(0.7%)被评估为营养不良。单因素分析显示,营养不良风险及营养不良组与营养正常组年龄、文化程度、居住地、婚姻状况、养老模式、多重用药、自理能力、认知功能、误吸风险、跌倒风险、压疮风险、抑郁状态方面差异均有统计学意义(P＜0.01)。多因素Logistic回归分析显示,高龄、居住城镇、机构养老、自理能力下降、认知功能障碍、误吸风险、跌倒风险、压疮风险、抑郁状态、多重用药是营养不良的危险因素,文化程度高、已婚是老年人营养不良的保护因素(P＜0.01)。结论老年人营养不良受很多因素的影响,应重视对该群体营养状况的评估,以制订针对性的干预措施改善其营养状况。

关键词: 营养不良, 影响因素, 微型营养评估简表, 老年人

Abstract: Objective To assess the nutritional status in the elderly and to analyze the risk factors affecting the nutrition. Methods Through cluster sampling methods, 262,226 elderly people aged over 65 years old in Yantai City from December 2019 to March 2020 were selected and underwent Mini-Nutritional Assessment Short-Form (MNA-SF) assessment. Multivariate Logistic regression was used to analyze the risk factors influencing malnutrition. Results The results showed that among the 219 222 validly surveyed elderly people in Yantai, 24 489 (11.2%) were assessed to be at risk of malnutrition and 1589 (0.7%) were assessed as malnutrition. Compared with the normal nutrition group, there were statistical differences in age, education level, place of residence, marital status, pension mode, polypharmacy, self-care ability, cognitive function, risk of aspiration, risk of falling, risk of pressure ulcer, and depressive state in the risk of malnutrition and malnutrition group. Multivariate Logistic regression analysis showed that older age, urban residence, institutional care, decline in self-care ability, cognitive dysfunction, risk of aspiration, risk of falling, risk of pressure ulcers, depression and polypharmacy were the risk factors of malnutrition (P＜0.01). Higher education level and being married were the protective factors of malnutrition in the elderly (P＜0.01). Conclusions The incidence rate of malnutrition in the elderly is influenced by lots of factors. Attention should be paid to the assessment of the nutritional status, and targeted interventions should be formulated to improve their nutritional status.

Key words: malnutrition, influencing factors, Mini-Nutritional Assessment Short-Form, aged

中图分类号:

R153.3

郁阿翠, 陈喜, 杨萌娜, 宋晓明, 李浩, 慈莉娅. 老年人营养不良状况及影响因素分析[J]. 实用老年医学, 2022, 36(8): 822-826.

YU A-cui, CHEN Xi, YANG Meng-na, SONG Xiao-ming, LI Hao, CI Li-ya. Nutrition status and the risk factors in the elderly[J]. Practical Geriatrics, 2022, 36(8): 822-826.

参考文献

[1] RASHEEDY D, EL-KAWALY W H. The accuracy of the Geriatric Nutritional Risk Index in detecting frailty and sarcopenia in hospitalized older adults[J]. Aging Clin Exp Res, 2020, 32(12): 2469-2477.
[2] CRICHTON M, CRAVEN D, MACKAY H, et al. A systematic review, meta-analysis and meta-regression of the prevalence of protein-energy malnutrition: associations with geographical region and sex[J]. Age ageing, 2019, 48(1): 38-48.
[3] KAISER M J, BAUER J M, RAMSCH C, et al. Validation of the Mini Nutritional Assessment Short-Form (MNA©-SF): a practical tool for identification of nutritional status[J]. J Nutr Health Aging,2009, 13(9): 782-788.
[4] 巴睿婕,任威卫.误吸风险评估表在老年病科使用的护理体会[J].当代护士:上旬刊,2017(2):142-144
[5] 诸葛毅,俎德玲,王小同,等.卫生部指南量表测试老年人跌倒风险[J].中国老年学杂志,2014,34(1):188-190.
[6] HOYL M T, ALESSI C A, HARKER J O, et al. Development and testing of a five‐item version of the Geriatric Depression Scale[J].J Am Geriatr Soc,1999, 47(7): 873-878.
[7] BERGSTROM N, BRADEN BJ, LAGUZZA A, et al. The Braden Scale for predicting pressure sore risk[J]. Nurs Res, 1987, 36(4): 205-210.
[8] BORSON S, SCANLAN J M, CHEN P, et al. The Mini-Cog as a screen for dementia: validation in a population-based sample[J]. J Am Geriatr Soc, 2003, 51(10): 1451-1454.
[9] PELAVSKI A D, DE MIGUEL M, ALCARAZ GARCIA-TEJEDOR G, et al. Mortality, geriatric, and nongeriatric surgical risk factors among the eldest old: a prospective observational study[J]. Anesth Analg, 2017, 125(4): 1329-1336.
[10] 中华人民共和国国务院办公厅.国民营养计划(2017—2030)[EB/OL](2017-07-13)[2019-03-02] .http://www.gov.cn/zhengce/content/2017-07/13/content_5210134.htm.
[11] WILLIS H. Causes, assessment and treatment of malnutrition in older people[J]. Nurs Older People, 2017, 29(2): 20-25.
[12] KUSHWAHA S, KIRAN T, SRIVASTAVA R, et al. Estimates of malnutrition and risk of malnutrition among the elderly (≥ 60 years) in India: A systematic review and meta-analysis[J]. Ageing Res Rev, 2020: 101137.
[13] BACKLUND A, HOLMBECK O, KUMLIEN C, et al. A registry study of nursing assessments, interventions and evaluations according to nutrition for persons living in municipal residential care homes[J]. Nurs Open,2018,5(3):341-350.
[14] HALLAJ F A. Assessment of the nutritional status of residents in homes for the elderly in Lattakia, Syrian Arab Republic[J]. East Mediterr Health J, 2015,21(10):753-761.
[15] CORISH C A, BARDON L A. Malnutrition in older adults: screening and determinants[J]. Proc Nutr Soc,2019,78(3):372-379.
[16] VAN ZWIENEN-POT J I, VISSER M, KUIJPERS M, et al. Undernutrition in nursing home rehabilitation patients[J]. Clin Nutr,2017,36(3):755-759.
[17] SALMINEN K S, SUOMINEN M H, SOINI H, et al. Associations between nutritional status and health-related quality of life among long-term care residents in Helsinki[J]. J Nutr Health Aging,2019,23(5):474-478.
[18] LAMBERT K, TAYLOR E, BOWDEN S, et al. Nutritional status according to the Mini Nutritional Assessment predicts speed and degree of functional improvement and discharge outcomes in rehabilitation patients[J]. J Nutr Gerontol Geriatr,2020,39(1):16-29.
[19] LELLI D, TOLONE S, PULIGNANO G, et al. Nutritional status is associated with physical function and disability in older adults with chronic heart failure[J]. Eur J Intern Med,2020,74:73-78.
[20] BELL C L, LEE A S, TAMURA B K. Malnutrition in the nursing home[J]. Curr Opin Clin Nutr Metab Care, 2015,18(1):17-23.
[21] PODA G G, HSU C Y, RAU H H, et al. Impact of socio-demographic factors, lifestyle and health status on nutritional status among the elderly in Taiwan[J]. Nutr Res Pract, 2019, 13(3): 222-229.
[22] PEREIRA MACHADO R S, SANTA CRUZ COELHO M A. Risk of malnutrition among Brazilian institutionalized elderly: a study with the Mini Nutritional Assessment (MNA) Questionnaire[J]. J Nutr Health Aging, 2011,15(7): 532-535.