Social cognitive predictors of nutritional risk in rural elderly adults

According to Social Cognitive Theory (Bandura, 1997), nutritional risk would be predicted by perceptions of nutrition efficacy, which in turn would be predicted from four sources: modeling, verbal support, physiological conditions, and nutrition habits. In telephone interviews with 154 rural elderly adults (44 men, 110 women; mean age = 74.4 years), nutritional risk was measured with Nutritional Risk Index (NRI), Nutritional Screening Initiative (NSI), and seven-high-risk-nutrients consumed less than 50 percent of RDA (Diet Plus Analysis). Nutrition-efficacy was measured with a new twenty-five-item scale of Perceived Nutrition Barriers (PNB). Sources of nutrition-efficacy included: mealtime modeling--shared meals, household size; verbal support--people talk to each day, hours talked, number of confidants; physiological conditions that may affect nutrition--age, body mass, medications, disability, negative affect, and nutrition habits--daily food variety, use of meal services. Path analysis was performed with each measure of nutritional risk (NRI, NSI, 7-high-risk-nutrients) as a criterion variable, nutrition-efficacy (PNB) as a possible mediating variable, and sources of nutrition-efficacy as predictor variables. Social Cognitive variables accounted for 58 percent of variance in NRI, 49 percent of variance in NSI, and 29 percent of variance in seven-high-risk-nutrients. Nutritional risk was directly predicted by large households, few shared meals, few confidants, high body mass, many medications, and few daily foods; it was indirectly predicted (via PNB) by high levels of negative affect. Perceived Nutrition Barriers (PNB) most often mentioned were food cost, eating alone, food tastelessness, transportation to the store, and chewing difficulty.     

Relation between nutritional risk and metabolic syndrome in the elderly

Nutrition is regarded as a major factor in the development of metabolic syndrome (MS). Undernutrition or nutritional imbalance, rather than overnutrition, can be associated with MS. We evaluated the relationship between nutritional risk and MS in the elderly. We analyzed 2284 Koreans aged over 60 years (689 men and 1595 women) from baseline data of a large prospective study called the Gwangju Dementia and Mild Cognitive Impairment Study (GDEMCIS). MS was determined according to the National Cholesterol Education Program Adult Treatment Panel III, and nutritional risk was evaluated using the Nutrition Screening Initiative (NSI) checklist. Among 2284 subjects, 1219 (53.4%) had MS. NSI score was higher in subjects with MS than in those without MS (2.46 ± 1.89 vs. 2.18 ± 1.87, p < 0.001). The risks of abdominal obesity, elevated blood pressure, elevated glucose, and MS were higher in subjects with moderate or high nutritional risk compared to subjects in a good nutritional state. Nutritional risk was independently associated with MS for subjects in their 60s, but not in their 70s or 80s and above. In conclusion, high nutritional risk is associated with increased risk of MS in the elderly. Measurement of nutritional status in the elderly may serve as a marker for MS, especially for the younger elderly.     

Depression and social support between China' rural and urban empty-nest elderly

This study compared levels of depression and social support among empty-nest elderly who living in the rural and urban area of Hunan province, China. This cross-sectional study enrolled 809 empty-nest elderly living throughout the province as the study respondents. The general information, depression conditions and social supports were investigated by using the self-made General Information Questionnaire, Geriatric Depression Scale (GDS) and Social Support Rating Scale (SSRS). Variables are presented as mean±standard deviation (SD) or frequency. Independent t-test and χ(2)-tests were used to compare the socio-demographic factors, depression score and social support scores of the rural empty-nest elderly to the urban empty-nest ones; multilevel modeling was used to analyze the socio-demographic factors and social support predicted the level of depression among the empty-nest old subjects. The differences in gender, education level, marital status, economic status, self-perceived income, insurance, children visit frequency and religious beliefs factors between rural and urban empty-nester old people were statistically significant (p<0.05). The average GDS score of rural group was (14.57±5.43), which was higher than the average GDS score (13.18±6.51) of urban group (p<0.01). Objective support scores showed statistical significance between the rural and urban empty-nest elderly (p<0.05). There are differences between rural and urban empty-nest elderly in the aspects of general data, depression status, social support and so on, we should intervene them effectively according to their different characteristics.     

北京市城市、农村老年人生活满意度的对比分析

利用＂北京老化多维纵向研究＂１９９２年基线调查资料，对比分析了１６９３例城市老年人和８５０例农村老年人，对夫妻、子女关系、一般生活、经济、住房、健康、休闲活动、医疗等八个方面的满意度，以及由此得出的总体生活满意度的结果。城市老年人中满意度最低的是住房，农村则是健康。满意度最高的都是生活。两地老年人总体生活满意度均在２级左右（１级为很满意，５级计分），农村老年人总体生活满意度较城市高。分析这种差别主要归于受教育水平的不同。     

MNA和MNA-SF评价老年人营养状况比较

目的　比较简易营养评价法 (MNA)和简易营养评价精法 (MNA SF) 2种评价老年人营养状况方法 ,以及 2种方法和传统营养指标的相关性。　 方法　利用MNA、MNA SF量表对住院老年人进行调查 ,同时测定传统营养指标。　 结果　MNA量表测试结果 :住院老年人营养不良患病率为 3 6 1% ;潜在营养不良的有 46 5 % ;营养正常的有 17 4% ;MNA SF量表测试结果 :住院老年人营养不良患病率为 71 5 % ;营养正常的为 2 8 5 %。MNA SF与MNA相比 ,敏感性为 85 7% ,特异性 96 0 % ,准确性 87 5 % ,相关系数为 0 93 3 ,且与传统营养指标的相关性一致。　 结论　MNA与MNA SF是快捷、简便、可靠的老年营养状况评价方法 ,且MNA SF更简便、更适用于临床调查。     

中国老年人宗教信仰的城乡差异及原因

目的分析城乡老年人的宗教信仰状况。方法使用2010年第三次中国妇女社会地位调查的全国性数据,对老年人宗教信仰的城乡分布、地区分布基本状况进行实证分析。结果老年人宗教信仰存在显著的城乡和地区差异,这主要是城乡老年教徒在经济收入、健康状况、社会养老保障和受教育程度上存在显著差异,以及城乡人口老龄化倒置所导致。老年人信仰宗教形成的信仰共同体提供的社会保障是老年人信仰宗教的重要原因,农村社会保障体系不完善、社会保障水平低是老年人宗教信仰城乡差异的根本原因。结论加快完善农村社会养老保障制度、构建农村老年人社会养老服务体系的任务迫在眉睫。     

银川市城乡居民糖尿病患病率比较

目的 调查银川市城乡20岁以上常住居民DM患病率及其影响因素. 方法 用分层整群随机抽样法对银川市城乡各一社区常住居民进行体格检查、问卷调查及血液生化指标检测. 结果 DM患病率为6.6%,空腹血糖受损(IFG)患病率为5.6%,标化患病率分别为3.33%、3.14%.DM患病率男性为9.4%,女性为5.1%,标化患病率分别为4.69%,2.53%,男性高于女性(P<0.05);IFG患病率男性为3.1%,女性为7.2%,标化患病率分别为1.52%、3.97%,女性高于男性(P<0.05).随着年龄增加,DM和IFG患病率旱升高趋势.城乡DM患病率分别为10.7%、3.3%,标化患病率分别为4.58%、1.91%,差异有统计学意义(P<0.05);城乡IFG患病率无统计学差异.多因素logistic回归显示,年龄、吃水果、劳动强度、BMI、SBP、DM家族史与DM有关. 结论 控制体重、降低血脂、管理血压、合理膳食、加强体育锻炼及规范治疗是银川市城乡居民预防控制DM的重要措施.     

辽宁省农村居民高血压和血压正常高值相关危险因素分析

目的比较分析辽宁省农村居民血压正常高值及高血压的危险因素,为防治相关的心脑血管疾病提供策略。方法选择2004—2006年辽宁省农村地区年龄≥35岁的人群,通过整群随机抽样方法,选取45925人进行研究。结果调查发现,共有约44.1%的人为血压正常高值,约37.8%的人为高血压。多因素Logistics回归分析表明:与血压正常人群相比,高龄、饮酒、超重、肥胖、高血压家族史和血脂异常是血压正常高值的危险因素;与血压正常高值人群相比,高龄、饮酒、超重、肥胖、高血压家族史和血脂异常也是高血压的危险因素。女性是高血压的危险因素,但是血压正常高值的保护因素。吸烟是高血压的危险因素,但与血压正常高值无相关联系。结论血压正常高值与高血压的危险因素有相同之处。我们应该强调健康的生活方式,戒烟限酒,预防肥胖,防止血压正常高值进展为高血压,减少相关的心脑血管疾病的发生。     

Difference in nutritional risk between mild cognitive impairment group and normal cognitive function elderly group

The purpose of this study was to delineate the difference in nutritional risk between mild cognitive impairment (MCI) groups and normal cognitive function (NCF) elderly groups in the community. Data obtained from 490 subjects (237 NCF elderly and 253 MCI subjects) between 60 and 90 years of age were analyzed. The study protocol comprised demographic characteristics, history of current and past illnesses, drug history, Korean version of short-form Geriatric Depression Scale (K-SGDS), and nutritional screening initiative (NSI) checklist. Cognitive function was assessed by digit span, Korean short version of Boston naming test (K-BNT), simple Rey figure test, auditory verbal learning test (AVLT), controlled oral word association test (COWAT), stroop, go-no go, and contrasting program. Also, we examined the blood pressure, fasting serum glucose level, lipid profile, body mass index (BMI), and ApoE genotype. Multiple logistic regression analysis found that MCI was associated with moderate or high nutritional risk after adjustment for age, sex, educational level, and K-SGDS score (odds ratio (OR)=1.13, 95%; confidence interval (CI)=1.01-1.26). These results suggest that MCI may be associated with nutritional risk. Screening for nutritional risk should be included in multidimensional geriatric evaluation.     

Satisfaction among rural and urban Japanese elderly in three-generation families

For the purpose of testing an assumption on the dual nature of aging in Japanese society, this study compared and contrasted three-generation adult families in Yamato-machi, a rural town in Niigata Prefecture in northern Japan, and in Setagaya-ku, an urban ward in Tokyo. The average ages for each generation in the study were G1 = 85, G2 = 60, and G3 = 35. The findings reveal regional variation in basic demographic characteristics such as population density, family size, proportions of the elderly 65 and over and 90 and over, as well as the prevalence of the three-generation family households. This supports the existence of dual patterns of aging in Japan today. The data also show significant differences between these regional sectors in the level of educational and economic conditions of the elderly. However, measures of the extent of satisfaction do not reveal any significant difference between rural and urban elderly. It is suspected that this is because only three-generation healthy families were interviewed in this study.     

Comparison of altitude effect on Mycobacterium tuberculosis infection between rural and urban communities in Peru

The mechanism of high altitude effect on tuberculosis (TB) infection has not been fully established. We previously reported a lower positive tuberculin skin test (TST) prevalence in high altitude villages compared with sea level communities in Peru. In this study, four additional communities were tested to assess whether decreased TB transmission was also in urban environments at high altitude. TST results from 3,629 individuals in nine communities were analyzed using generalized estimating equations to account for community clustering. Positive TST prevalence was not significantly different between the urban highland and the urban non-highland communities after adjusting for age, household contacts with a TST-positive person or a TB case, and presence of a Bacillus Calmette-Guérin vaccination scar. The effect of population concentration and increased contact with active TB overwhelmed the protective effect of altitude in urban highlands. Highland cities require the same preventive efforts against TB as non-highland communities.     

老年住院患者营养风险筛查及营养支持状况

目的 调查老年住院患者的营养风险、营养不足发生率以及营养支持状况,为指导老年住院患者营养治疗提供依据.方法 采用定点连续抽样的方法,用营养风险筛查表(NRS2002)对426例老年住院患者进行营养风险筛查,NRS2002总分≥3分为有营养风险;体重指数(BMI) ＜18.5 kg/m2(或血清白蛋白＜ 30 g/L)为营养不足.调查营养干预情况,分析营养风险与营养干预之间的关系.结果 426例老年住院患者中,营养不足和营养风险的发生率分别为30.5％和55.2％,其中老年期痴呆患者(80.6％,)、恶性肿瘤(79.1％)、肺部感染或COPD(71.2％)和危重症患者(心力衰竭、呼吸衰竭或肾功能不全75％)营养风险的发生率较高.426例患者中,199例(46.7％)接受了营养支持,其中有营养不足和营养风险患者的营养支持率为75.8％ (178/235),无营养风险患者的营养支持率为19.9％(38/191).结论 老年住院患者营养不足、营养风险发生率较高,尤其以老年期痴呆患者更为突出,但临床营养支持却存在不合理性.因此,对老年住院患者的临床营养支持的规范性值得进一步探讨.     

消化内科老年住院患者营养不良和营养风险评估分析

目的调查消化内科老年患者入院时的营养状况,为存在营养不良和有营养风险患者实施营养支持提供参考依据。方法采用体质量指数(BMI)、血清清蛋白(ALB)和前清蛋白(PA)水平等指标进行营养状态评估;采用营养风险筛查法(NRS 2002),选择入院48h内、符合NRS 2002标准、可获得BMI的患者264例,以BMI<18.5者计3分进行营养风险评分;对不完全符合NRS 2002标准,不能获得BMI的96例患者,以ALB替代,ALB<30g/L者计3分,进行营养风险评分。NRS 2002≥3分判定为有营养风险,统计营养不良和有营养风险的发生率。结果符合NRS 2002标准的264例患者中,营养风险发生率为37.9%。不完全符合NRS 2002标准的96例患者中,营养风险发生率为41.7%。总计360例患者中营养风险发生率为38.9%。BMI<18.5、ALB<30g/L的患者,营养不良的发生率分别为9.0%、2.8%。在BMI≥18.5患者中,NRS评分≥3分者28.8%。农村和城市老年患者营养风险发生率分别为48.5%和32.5%(P<0.05)。结论消化内科老年患者营养风险的发生率较高,应重视老年患者特别是农村老年患者营养风险的发生。NRS 2002方法能预测和及时发现营养不良患者。     

Comparison of drug abuse clients in urban and rural settings

Examination was made of differences between the demographic and drug-using characteristics of 2,262 persons admitted to rural drug abuse units and 8,017 persons admitted to urban drug abuse treatment units in eight states. Rural clients were far more likely to report marijuana and urban clients to report heroin as their primary drugs of abuse; urban clients were also more likely to be older. Rural opiate users were also more likely to report nondaily use of heroin and were more likely to enter treatment at a younger age than their urban heroin-using counterparts. Implications of these findings for treatment are discussed.     

老年住院患者营养风险筛查及营养支持使用的现状调查

目的 应用营养风险筛查2002（nutrition risk screening,NRS 2002）调查老年科住院患者的营养风险、营养不足发生率及营养支持的现状.方法 选择 2010年1月至2010年6月在长宁区中心医院老年科住院的患者120例,65-89岁,平均年龄（72±6.3）岁.,应用NRS 2002方法对患者入院后第2天和出院时进行营养风险筛查,并调查患者的营养支持状况.NRS 2002≥3分有营养风险,体质指数（BMI）〈18.5kg/m2并结合临床状况判定营养不足.结果 人院时所有患者营养风险发生率为26.6%,所有患者的营养支持率为35.0%,肠外与肠内营养比例为2：7.结论 NRS 2002适用于老年住院患者的营养风险筛查.营养支持在老年患者中不够合理和充分.     

Comparison of quality of life between urban and rural gastric cancer patients and analysis of influencing factors

AIM: The conception of quality of life has been widely accepted by clinic doctors. Evaluations of the treatment effect of chronic diseases have been changed to depend not only on the survival time, but also on the quality of life of the patients. Fuzhou City and Changle County are highincidence areas of the gastric cancer in Fujian Province. The aims of this research were to compare the quality of life of urban patients with that of rural patients and analyze the factors influencing quality of life of gastric cancer patients in Fujian Province. METHODS: The samples were drawn with cluster sampling. The urban sample consisted of 162 patients aged 25 to 75 with 143 males and 19 females. The rural sample consisted of 200 patients aged 32 to 78 with 166 males and 34 females. The patients in both the urban and rural areas were investigated, and their scores on 21 items reflecting the quality of life were measured. The methods of ttest and stepwise regression were used to analyze the data. RESULTS: The average total scores of quality of life of the urban patients and rural patients were 64.11 and 68.69 respectively. There was a significant difference between the means of two samples (P = 0.0004). Seven variables in the regression model estimated by the urban sample and 4 variables in the model by the rural sample were at the level of significance α=0.05. Family income, nutrition and rehabilitating exercise were selected into both the urban and rural regression models. CONCLUSION: Most of the gastric cancer patients have poor quality of life in Fujian Province and the rural patients have lower quality of life than that of urban patients. The patients having more family income have better quality of life, and enhanced nutrition and doing rehabilitating exercise are helpful in improving the quality of life of the gastric cancer patients.     

Hip fracture among the elderly in a mixed urban and rural population

Among the 27314 people aged 60 years or more living in the northern part of the county of Storstr ?m, Denmark, 117 were hospitalized with hip fracture in one year (1978), making an incidence of 4.3 per 1000. All 117 patients were seen soon after their admittance to hospital, and after one year the 86 surviving patients were seen in their homes. A higher death rate was found during the first three months, but only among patients with additional disabling diseases. Among the survivors, the possibility of leading a regular life was found to be only slightly reduced as measured by their activity-level, mobility and state of independence. Thirteen per cent of the survivors were institutionalized. The mean stay in hospital was 66 days, including transfer to a geriatric department in some instances.