北京市养老机构老年人营养状况调查及其影响因素研究

背景　在人口老龄化日益加剧的社会背景之下，家庭养老功能不断减弱，机构养老成为今后发展的必然趋势。据报道，很多养老机构的老年人营养不合理，严重影响老年人的健康状况与生活质量。目的　通过调查北京市养老机构老年人营养现状及其影响因素，为全科医师营养教育及老年人生活质量提升提供理论依据。方法　2014年10月-2015年12月，采用方便整群抽样的方法，抽取了北京市7家养老机构，对符合纳入标准的老年人进行面对面问卷调查，问卷内容包括：一般情况、微型营养评定量表（MNA）、日常生活活动能力指数（BI）、老年人抑郁量表（GDS）。采用二元Logistic回归分析养老机构老年人营养状况的影响因素。结果　本研究共发放问卷258份，回收有效问卷258份，有效回收率为100%。被调查的258例老年人中，存在营养不良及存在营养不良发生风险的老年人共计75例（29.1%）。不同年龄、性别、婚姻状况、体质指数（BMI）、医疗费用支付方式、生活自理能力及精神状态的老年人营养状况比较，差异有统计学意义（P<0.05）。二元Logistic回归分析结果显示：年龄〔OR（95%CI）=2.349（1.070，5.156）〕、BMI〔OR（95%CI）=0.092（0.036，0.239）〕、医疗费用支付方式〔OR（95%CI）=0.208（0.083，0.522）〕、日常活动能力〔OR（95%CI）=10.214（3.099，33.669）〕、患病种数〔OR（95%CI）=2.682（1.248，5.763）〕及精神状态〔OR（95%CI）=4.822（2.005，11.600）〕是老年人营养状况的影响因素（P<0.05）。结论　北京地区养老机构的老年人面临着营养不良及营养不良发生风险的健康威胁，高龄、低BMI、抑郁、合并多种疾病、日常活动能力低下及无医保是其独立危险因素，需要对老年人加强个性化营养教育和营养治疗。

Investigation on the nutritional status of the elderly in some nursing home and its influencing factors in Beijing

Background　Under the social background of increasing aging population，the function of family to support the elderly has been weakened，and nursing institutions are becoming an inevitable trend in the future.It is reported that the elderly in many old-age care institutions suffer from unreasonable nutritional status，which seriously affects their health status and quality of life.Objective　By investigating the nutritional status and its related factors of the elderly in some nursing home in Beijing，in order to provide a theoretical basis for the nutrition education of general practitioners and the improvement of the quality of life of the elderly.Methods　This survey was implemented from October 2014 to December 2015.Using a convenient cluster sampling method，seven nursing home were selected in Beijing，and we conducted a face-to-face questionnaire survey on senior individuals who met the inclusion and exclusion criteria.The questionnaire included the general situation，Mini Nutrition Assessment（MNA），the Barthel Index（BI） and the Geriatric Depression Scale（GDS）.The influencing factors of nutritional status of the elderly were analyzed by binary Logistic regression.Results　The effective response rate of questionnaire was 100%（258/258）in this study.Among the 258 elderly people who were surveyed，there were 75 individuals with malnutrition or at a risk of malnutrition，accounting for 29.1%.The differences were statistically significant in nutritional status of the elderly with different age，gender，marital status，body mass index（BMI），payment methods of medical expenses，daily activity capacity and mental state（P<0.05）.Binary Logistic regression analysis showed that age〔OR（95%CI）=2.349（1.070，5.156）〕，BMI〔OR（95%CI）=0.092（0.036，0.239）〕，payment methods of medical expenses〔OR（95%CI）=0.208（0.083，0.522）〕，daily activity capacity〔OR（95%CI）=10.214（3.099，33.669）〕，number of comorbidities〔OR（95%CI）=2.682（1.248，5.763）〕and mental state〔OR（95%CI）=4.822（2.005，11.600）〕 affected the nutritional status of the elderly（P<0.05）.Conclusion　The elderly in nursing home of Beijing are facing health threats of malnutrition and at a risk of malnutrition.Advanced age，low BMI，depression，multiple comorbidities，low daily activity capacity and lacking of medical insurance are independent risk factors.The personalized nutrition education and nutritional treatment for the elderly need to be strengthened.