各年龄段老年人生活方式对生活质量的影响

目的 探讨老年人上臂围（MAC）和小腿围（CC）诊断营养不良的最佳截断值，为老年人营养状况评估提供参考依据。 方法 于2015年9 — 12月采用分层随机整群抽样方法在山东省济南市和上海市抽取868名 ≥ 60岁老年人进行身高、体重、MAC、CC、血压、空腹血糖（FBG）、总胆固醇（TC）和甘油三酯（TG）等指标的测量和检测，分析男性和女性老年人营养学指标的差异及MAC和CC截断值的有效性，并采用受试者工作特征曲线（ROC）和约登指数法获得MAC和CC判定营养不良的最佳截断值。
结果 济南市和上海市调查的868名老年人中，营养不良者60例，营养不良率为6.91 %；男性老年人的MAC和CC值分别为（29.79 ± 4.50）和（35.98 ± 4.51）cm，均大于女性老年人的（28.90 ± 4.20）和（34.41 ± 3.60）cm，差异均有统计学意义（均P < 0.01）；男性老年人MAC和CC的最佳截断值分别为28.10和32.60 cm，女性老年人MAC和CC的最佳截断值分别为25.10和31.10 cm，经有效性分析，所得到的男、女性老年人的MAC和CC最佳截断值均能较好地将营养不良者与营养正常者区分开，且区分效果与根据体质指数（BMI）定义的营养状况无显著差异。 结论 在评价老年人营养状况时可采用适合目标人群的MAC和CC最佳截断值作为重要的参考指标。

Assessing the nutritional status of the elderly: the Mini Nutritional Assessment as part of the geriatric evaluation

Objective To explore optimal cut-off value of mid-arm circumference (MAC) and calf circumference (CC) in malnutrition diagnosis and to provide references for nutritional assessment among elderly residents in China. Methods Totally 868 community residents aged 60 years or older were recruited in 3 districts and a county in Ji′nan city of Shandong province and 2 districts of Shanghai city with stratified random cluster sampling; then, measurements of height, weight, MAC, CC, and blood pressure and detections for fasting blood glucose (FBG), total cholesterol (TC), and triglycerides (TG) were conducted among the elderly from September to December 2015. The differences in all the nutritional indicators and the validity of MAC and CC cut-off values were analyzed; receiver operating characteristics curve (ROC) and Youden index (YI) were adopted to identify optimal MAC and CC cut-off values for malnutrition assessment. Results Among all the elderly surveyed, 60 (6.91%) were assessed as malnutrition. Compared to those in the female elderly, significantly higher mean MAC (29.79 ± 4.50 cm vs. 28.90 ± 4.20 cm) and CC (35.98 ± 4.
51 cm vs. 34.41 ± 3.60 cm) were measured among the male elderly (both P < 0.01). In terms of malnutrition assessment, the optimal cut-off values of MAC and CC for were 28.10 cm and 32.60 cm for the male elderly and 25.10 cm and 31.10 cm for the female elderly, respectively. With those optimal MAC and CC cut-off values, the elderly individuals with malnutrition could be identified effectively and there was no significant difference in the assessment results compared to those using the body mass index (BMI) as the indicator. Conclusion Mid-arm circumference and calf circumference could be used as valid indicators in evaluation of malnutrition among community elderly residents in China.