[Nutritional status in patients with visual impairment and frailty].

Abstract

Geriatric care for the elderly assesses the patient's status using a comprehensive geriatric assessment, including questionnaires assessing nutritional, psychological and functional status, as well as screening examinations for deficits in sensory systems, including visual deficits. Nowadays, there is pure data on how visual deficits affect the development of certain geriatric syndromes in older people. The objectives of the research was to study the relationship between nutritional status and vision organ diseases, as well as mental status indicators assessed by screening methods in elderly patients of senile age.

Material and methods: The medical records with comprehensive geriatric assessment of patients (n=479, average age 80.1±0.2 years) have been studied. The pathology of the visual organ was assessed using standard ophthalmological examination methods necessary to make a diagnosis. To study nutritional status, cognitive impairment and likelihood of depression, a Mini Nutritional Assessment, the Mini-Mental State Examination and the Geriatric Depression Scale survey were conducted respectively. The degree of frailty was determined by a geriatrician based on a set of geriatric syndromes. Associations between malnutrition and ophthalmic pathology were assessed in univariate analysis and subsequently using multiple logistic regression using odds ratios, both adjusted and unadjusted.

Results: The study included the records of 384 (80.2%) women, 95 (19.8%) men. Malnutrition was detected in 5 (1.0%) cases, the risk of malnutrition was shown in 169 (35.3%) patients without gender differences. The analysis revealed associations between the degree of frailty, age, mild cognitive impairment, depression and malnutrition. According to the results of logistic regression, nutritional problems were 82% more common in patients with glaucoma [OR 1.82, 95% CI (1.21-2.74), p=0.004], taking into account age and gender - 93% more often [OR 1.93, 95 CI (1.26-2.94), p=0.002]; 84% more likely in patients with secondary retinopathy (including diabetic) [OR 1.84, 95% CI (1.07-3.16), p=0.027], taking into account age and gender - 93% more often [OR 1.93, 95% CI (1.11-3.38), p=0.021].

Conclusion: Participants with malnutrition and visual deficits are more likely to experience cognitive impairment, depression and frailty. Secondary retinopathy and glaucoma can be used as ophthalmic pathology markers for the diagnosis of other geriatric impairments and this may serve as a basis for changing the routing of an elderly patient with visual pathology. Elderly patients with ophthalmic pathology require special attention in the construction of care management and a multidisciplinary approach to the diagnosis and correction of geriatric syndromes.