洞察养老院居民营养不良的相关风险因素：纵向研究。

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition Pub Date : 2024-09-14 DOI:10.1016/j.clnu.2024.09.024

Johanna de Almeida Mello , Emilie Schoebrechts , Patricia Ann Ivonne Vandenbulcke , Anja Declercq , Jan De Lepeleire , Christophe Matthys , Dominique Declerck , Joke Duyck

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引用次数: 0

摘要

背景和目的：老年人的营养不良往往未被发现，从而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，interRAI 家庭护理（interRAI HC）工具的数据被用来根据全球营养不良领导倡议（GLIM）的一些标准确定营养不良状况。结果表明，interRAI 家庭护理工具作为营养不良风险筛查工具非常有效。本研究的目的是使用针对疗养院居民的 interRAI 长期护理设施（interRAI LTCF）工具来确定与老年人健康有关的因素，这些因素与营养不良的发生密切相关：本研究分析了 2019-2023 年期间收集的数据，这些数据来自 65 岁或以上的疗养院居民，随访期为 1 年。在对现有 interRAI LTCF 数据应用 GLIM 标准后，通过双变量分析法对横截面样本和纵向样本进行了分析。双变量分析中包含的因素是基于以往的研究和专家意见。建立了未调整和调整回归模型，以探讨几个潜在风险因素与营养状况之间的关联：样本包括 5598 名老年人，平均年龄为 83.98 ± 7.30 岁，71.2% 为女性。大多数人在日常生活中需要大量帮助（70.9%），至少有轻度认知障碍（63.9%）。根据 GLIM 使用 interRAI 项目的定义，8.43% 的居民营养不良，4.67% 的居民在一年内营养不良。最终调整后的逻辑回归结果显示，以下七个决定因素的几率比较大：年龄（O.R. 1.03；C.I. ：1.01；1.04）、抑郁症状（O.R. ：1.32；1.01；1.73）、行走所需帮助（O.R. ：1.49；C.I. ：1.13；1.95）。1.13; 1.95）、徘徊行为（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）：研究显示了养老院居民营养不良的主要风险因素，如年龄、抑郁、行走辅助、徘徊和视力障碍。这些重要因素可用于识别营养不良的高危人群。定期使用 interRAI LTCF 对住院者进行筛查有助于识别营养不良的住院者或有营养不良风险的住院者。

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Insights into the associated risk factors of malnutrition among nursing home residents: A longitudinal study

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.

Methods

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.

Results

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).

Conclusions

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.

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来源期刊

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.