住院老年患者日常生活能力与营养状况的相互影响

目的探讨住院老年患者日常生活能力与营养状况的相互影响。方法使用日常生活能力量表（ADL）、微型营养评价法（MNA）及传统营养指标等测定140例60岁以上的住院老年患者,进行单因素分析及多元逐步回归分析。结果ADL、MNA与年龄不相关,与病情程度相关（P〈0．01）;MNA与ADL相关（P〈0．01）;随着日常生活能力的下降,MNA得分愈低;工具性日常生活能力（IADL）较躯体生活自理能力（PSMS）对营养的影响大;将影响MNA的ADL指标及病情进行回归分析,病情、梳洗、上厕所、打电话、做家务、服药等ADL指标进入了影响MNA的逐步回归方程（P〈0．01）;影响ADL的营养指标及病情多元逐步回归分析显示,病情、甘油三酯（TG）是主要影响因素（P〈0．05）,上臂围（AMC）、前白蛋白（PAB）是重要影响因素（P〈0．05）。结论日常生活能力与营养状况相关,住院老年患者的日常生活能力主要受病情及TG、AMC、PAB等营养指标影响,营养状况主要受病情及具备梳洗、上厕所、做家务、服药等ADL功能影响。     

147例胸心外科住院患者营养状况调查

近年研究发现临床外科住院患者常伴有蛋白质一热量缺乏性营养不良，国内报道为30％～50％。营养不良是外科患者术后发生并发症及增加死亡率的重要因素，本研究主要调查147例胸心外科住院患者的营养状况。     

肿瘤住院患者营养状况调查评价

肿瘤病人多存在不同程度的营养问题。随着病情的发展 ,手术、化疗或放疗的进行 ,病人往往会出现一系列胃肠道症状如厌食、恶心、味觉改变等 ,这又会进一步加重病人的营养不良 ,而营养不良又会降低病人对治疗的耐受性 ,形成恶性循环［１］。因此在肿瘤病人的治疗过程中进行动态的临床营养评价 ,以便及时针对病人的实际情况 ,给予合理的营养支持、饮食指导是很重要的。１资料与方法１．１资料２７３例住院患者均为临床及病理诊断证实 ,其中男性１５２例 ,女性１２１例 ,年龄２３～７８岁 ,平均４６．３岁 ;肝癌３９例、食管癌４２例、胃癌２６…     

综合康复护理对老年卧床患者日常生活能力及抑郁症状的影响

目的 探讨综合康复护理对老年卧床患者日常生活活动能力及抑郁症状的应用效果。 方法 选取2018年6－9月在乌鲁木齐市养老福利院居住的128例老年卧床患者,根据卧床不起诊断标准将其分为 A、B、C 三个等级,将不同卧床级别的患者随机分为观察组和对照组。对照组给予常规治疗和护理,观察组在对照组的基础上实施综合康复护理干预,在干预前和干预之后的8周,通过Barthel指数和老年抑郁量表(Geriatric Depression Scale-30,GDS-30)来评估日常生活能力和抑郁症状。 结果 干预前各等级的对照组、观察组患者日常生活能力(activities of daily living,ADL)评分、GDS评分差异无统计学意义(P>0.05)。干预后8周,A、B、C卧床级别的观察组患者Barthel指数评定量表(Barthel Index,BI)ADL评分显著上升[A级:(68.70±5.68)vs.(83.69±8.29), t=11.247, P<0.001;B级:(52.50±5.26)vs.(74.75±9.39) , t=15.112, P<0.001; C级:(31.36±5.81) vs.(34.32±5.19), t=2.891, P=0.009],GDS评分显著下降[A级:(13.39±4.08)vs.(10.04±4.33), t=-3.076, P=0.006;B级:(15.51±4.83)vs.(11.90±4.29) , t=-5.190, P<0.001; C级:(18.23±4.93) vs.(14.50±5.46), t=-3.582, P=0.002],差异均有统计学意义(P<0.05);各级对照组干预前后ADL评分[A级:(68.81±6.51)vs.(70.00±7.07), t=1.588, P=0.135;B级:(53.64±4.92)vs.(55.45±5.96) , t=1.789, P=0.088; C级:(30.75±5.45) vs.(31.25±4.55), t=0.567, P=0.577]、GDS评分[A级:(13.52±4.78)vs.(13.10±4.39) , t=-1.752, P=0.095;B级:(16.36±5.20)vs.(15.14±5.15) , t=-1.618, P=0.121; C级:(19.10±5.95)vs.(19.30±6.03) , t=1.453, P=0.163],差异均无统计学意义(P>0.05)。干预后不同卧床级别观察组患者上述指标均显著优于对照组同期的评估结果,差异有统计学意义(P<0.05)。 结论 综合康复护理能够提高老年卧床患者的日常生活能力,延缓卧床不起的进程,减轻抑郁情绪。     

利用简易营养评价法调查住院老年人的营养状况

目的 利用简易营养评价法(MNA)评价住院老年人的营养状况，了解MNA与传统营养指标的相关性。方法 利用MNA量表对144名住院老年人进行调查，同时收集人体测量指标、生化指标和其他资料。结果 住院老年人营养不良的患病率为36．1％，潜在营养不良为46．5％，营养正常占17．4％；年龄、牙齿状况和疾病状态是影响老年人营养的重要因素；MNA与多数传统营养指标之间有良好相关性。结论 住院老年人营养不良的患病率高，MNA是一种可靠、快捷、简便的老年人营养状况评价方法。     

老年住院病人的营养状况评价

目的:应用微型营养评价精法(MNA-SF)评价老年住院病人的营养状况,并比较不同营养状况三组病人间传统营养评价指标的差异. 方法:随机选取234例老年住院病人,采用MNA-SF对其进行营养状况评价,同时测定传统营养指标,并进行分析. 结果:老年住院病人营养不良、营养不良风险的发生率分别为12.39％和46.58％,而营养正常的病人仅占40.03％.对三种不同营养状况病人的传统营养指标分析后发现,三组病人的体重指数(BMI)、上臂围(AMC)、小腿围(CC)、握力、体力活动水平(ADL)、总蛋白(TP)、清蛋白(ALB)和血红蛋白(Hb)等差异均有显著性统计学意义(P＜0.05);三组病人之间两两比较后,BMI、AMC、CC、握力、ADL、ALB均有显著性差异(P＜0.05).营养正常组病人TP和Hb明显高于营养不良组(P＜0.05),但与营养不良风险组之间无显著性差异.营养不良风险组病人Hb也明显高于营养不良组(P＜0.05). 结论:老年住院病人营养不良和营养不良风险的发生率较高,其类型多为蛋白质-热量营养不良.     

老年神经疾病住院患者营养状态的前瞻性调查

目的　调查老年神经疾病住院患者的营养状态,评估不同营养状态患者的临床结局。方法　对2012年4月1日至5月31日在北京医院神经内科和老年科住院年龄≥65岁的老年神经疾病患者,试用微型营养评定精法（MNA-SF）等方法,进行前瞻性调查研究,了解其营养状态,总结临床结局指标,并描述不同营养状态患者的临床结局。结果　本研究纳入老年神经系统疾病患者1 480例,年龄（74.86±5.77）岁,体质量指数（BMI）（23.39±3.01）kg/m2;利手握力（16.92±13.44）kg;上臂围（25.86±2.99）cm,小腿围（32.19±3.02）cm;其中握力随年龄增长有所下降;1 405例患者完成了MNA-SF,顺应性94.9%;其中13.88%存在营养不良,37.51%有营养不良危险;随年龄增长,营养不良和营养不良危险发生率均增加,其中营养不良者的死亡率高、住院时间长和总住院费用多。结论　老年神经疾病的住院患者营养不良发生率较高,并且可能使临床结局恶化,应重视住院期间的营养状况评价和干预。     

老年住院患者死亡原因及其趋势分析

[目的]描述和分析老年住院患者死亡疾病谱的分布特征及其变化趋势。[方法]以我院1996～2005年间收治的≥65岁老年人住院患者45020例为对象,按前后5年分组,以国际疾病分类编码ICD-9和ICD-10分类,对位居前10位的死亡原因进行比较和分布描述。[结果]2001～2005年老年住院患者死因排序与前5年比较,肺部感染、脑梗塞、肝恶性肿瘤和胰腺恶性肿瘤排序明显提前,而脑出血排序明显下降;病死率10年间呈现逐年降低趋势。[结论]慢性病和心脑血管事件是老年人的主要杀手,应高度重视脑卒中的危害性。     

老年患者日常生活能力与衰弱情况的关系分析

目的 探讨老年患者日常生活能力与衰弱情况的关系.方法 随机选取2018年2月至2020年2月我院老年病科住院患者100例,根据Barthel指数将其分为A组(轻度功能障碍,43例)、B组(中度功能障碍,34例)、C组(重度功能障碍,23例).同时另选取同期30例健康体检者为对照组.比较四组的衰弱情况,评估患者日常生活能...     

中国社区老年居民日常生活活动能力失能状况调查

目的 调查我国城乡社区老年人失能现状及其流行特征。方法 调查对象来自2015年老年期重点疾病预防和干预项目。采用多阶段分层整群随机抽样,抽取6省市共23 803名≥ 60岁城乡社区老年人,对其进行问卷调查和身体测量,采用日常生活活动能力量表（ADL）评估老年人失能情况。采用χ²检验分析基础性日常生活活动能力量表（BADL）和工具性日常生活活动能力量表（IADL）各项功能受损率及BADL/IADL失能率在不同特征老年人群间的差异,采用多因素logistic回归模型分析失能的影响因素。结果 BADL功能中洗澡受损率最高（1.7%）,吃饭受损率最低（0.6%）;IADL功能中打电话受损率最高（16.6%）,其次是乘公共汽车（5.5%）,吃药受损率最低（1.8%）。社区老年人BADL失能率2.1%,IADL失能率19.1%。BADL失能率在女性、无配偶、文盲、低体重和肥胖老年人中较高（P<0.05）。IADL失能率在女性、农村、无配偶、低文化程度和低体重老年人中较高（P<0.05）。多因素分析显示,BADL失能的危险性随年龄增加而升高,非正常体重也增加其危险性,而文化程度较高的老年人群BADL失能的危险性相对较低。增加IADL失能的危险因素有女性、增龄、农村、无配偶和低体重;而文化程度高和肥胖的老年人群IADL失能的危险性相对比较低。结论 本研究结果显示,受年龄老化和人口学诸多因素影响,我国老年人群失能率仍维持在一个高水平,加强老年人群躯体性的和工具性的日常生活活动能力下降预防和干预工作是非常必要的。     

Physical condition and activity of daily living among HIV patients infected through blood products in Japan

OBJECTIVE: To examine the present status and trends in physical condition and activity of daily living (ADL) among patients infected HIV by blood products in Japan. METHODS: Data from a survey of 605 HIV patients infected through blood products were available quarterly between April 1997 and March 2000. Physical condition (summary index of 13 symptoms) and ADL in the first quarter of 2000 were assessed by comparing proportions of patients in good physical condition and having good ADL according to the level of CD4 counts and the use of antiretroviral treatments. Trends in those proportions during the study period were investigated, and these trends were also assessed by the changes in CD4 counts and antiretroviral treatments. RESULTS AND CONCLUSIONS: The proportion of patients in good physical condition was 70.6% and having good ADL was 65.7% in the first quarter of 2000, which was associated with the CD4 counts and antiretroviral therapy. The proportion of patients in good physical condition decreased from 79.2% to 66.2%, and ADL also decreased from 72.1% to 61.3% during the study period. These declines were presumably associated with the changes in CD4 counts and antiretroviral treatments.     

河南省老年人日常生活活动能力与社会参与状况分析

目的 了解河南省60岁及以上老年人日常生活活动能力及社会参与现状,并分析其影响因素,为河南省老年人健康促进提供参考依据。方法 采用多阶段分层整群随机抽样法从河南省18个地区抽取60岁及以上老年人共8441人进行问卷调查,采用〖XC小五号.EPS;P〗检验和 logistic回归模型分析老年人日常生活活动能力与社会参与的影响因素。结果 本研究共纳入8441名老年人,其中2453人（29.1%）日常生活活动能力受限,6499人（76.9%）未参与社会活动。二元logistic回归分析显示,女性（ OR =1.234,95% CI :1.123~1.356）、70~79岁（ OR =1.540,95% CI :1.360~1.744）、80岁及以上（ OR =3.101,95% CI :2.556~3.762）、无配偶（ OR =1.205,95% CI :1.043~1.392）、肥胖（ OR =1.553,95% CI :1.289~1.871）、自评不健康（ OR =12.454,95% CI :9.785~15.853）、1种慢性病（ OR =2.009,95% CI :1.763~2.290）、2种慢性病（ OR =2.995,95% CI :2.560~3.502）、3种及以上慢性病（ OR =4.453,95% CI :3.320~5.971）是老年人日常生活活动能力受损的危险因素（ P 值均<0．05),70~79岁（ OR =1.368,95% CI :1.211~1.547）、80岁及以上（ OR =2.187,95% CI :1.726~2.770）、肥胖（ OR =1.362,95% CI :1.109~1.546）、自评不健康（ OR =1.833,95% CI :1.514~2.219）、2种慢性病（ OR =1.125,95% CI :1.035~1.270）、3种及以上慢性病（ OR =1.316,95% CI :1.214~1.476）是老年人社会参与的危险因素（ P 值均<0．05)。结论 河南省老年人日常生活活动能力与社会参与水平较低。可基于影响因素特点,从健康体重、慢性病防治和积极养老入手,提高老年人的日常生活活动能力与社会参与水平。     

Relationship of normal levels of activity of daily living and daily habits among elderly women at home

PURPOSE: The relationship of activities of daily living (ADL) with daily habits and age was investigated with a focus on the results of measurements of the normal speed (ordinary level: OL) and maximum speed (maximum capacity: MC) in performing items on a functional fitness test. The significance of the measurement of the ordinary level was also discussed. METHODS: The subjects were 69 women, aged 60-90 years old, who participated in a health workshop for the elderly sponsored by a local municipality and who performed at least 4 items on a functional fitness test. Public health nurses asked subjects about habitual life style, subjective health status and degree of satisfaction in daily life. The ADL level was measured using the tests of functional fitness developed by Oida et al and partially revised by ourselves and physical fitness tests (grip strength, sit and reach, and balancing on one leg with opened eyes). OL was measured as the time needed to perform functional fitness items at normal speed, and MC as the time needed when performing these tasks as quickly as possible. RESULTS: All functional fitness items were accomplished significantly faster with MC than OL. Correlation coefficient values between OL and MC were high significant. Age was found to be significantly related to the hand working test (Hand-T) to evaluate dexterity and the rope working test (Rope-T) to evaluate self-care, except with the MC. An analysis of covariance with age as the covariant revealed that, with OL, there were relationships between Hand-T and Rope-T and the item "active at home," and between the zigzag walking (Zigzag-T) and Rope-T and "walking or riding a bicycle to go shopping." With MC, there were relationships between Hand-T and "active at home," and between Zigzag-T and "walking of riding a bicycle to go shopping." Regarding physical capacity, relationships were seen between both hands and "high level of physical fitness" and "walking fast" and grip strength (Left hand), respectively. CONCLUSION: The ADL items measured in the preset study were related to the daily activities of elderly people. As the OL and MC results demonstrated a high correlation and the ADL items related with OL were found to have almost the same link with MC, we conclude that OL is suitable for testing with the advantage of safety. However, we could not explain differences in relationships between measurements and daily activities, pointing to a need for further research. Elderly people must maintain their capacity for ADL to support a good quality of life, and we have demonstrated the utility of measurements that include normal levels of activity as indicators.     

河南省老年人日常生活活动能力及衰减拐点研究

目的 了解河南省老年人日常生活活动能力现状,探讨其衰减拐点,为医养结合机构工作者提供精确的服务以及评估老年人照护需求提供参考依据。方法 采用多阶段分层整群抽样方法,选取河南省18个省辖市的5 570名60岁及以上老年人作为研究对象。采用Barthel指数评定量表调查老年人的日常生活活动能力（activity of daily living, ADL）。绘制年龄预测ADL衰减的ROC曲线确定衰减拐点,并进行logistic回归,结合ROC曲线下面积AUC评价年龄诊断ADL衰减的预测价值。结果 河南省老年人ADL受损率为20.4%,且随着年龄的增长,ADL受损率呈上升趋势（χ2趋势 = 668.429,P＜0.001）。ROC曲线结果显示,ADL衰减的拐点为74.5岁,女性（72.5岁）比男性（74.5岁）早2年;AUC均在0.7～0.9之间（P＜0.001）。logistic回归分析显示,调整混杂因素后,＞74岁的老年人发生ADL受损的风险是≤74岁的4.592倍（P＜0.001）。Hosmer - Lemeshow检验显示,预测模型具有较高的校准度（χ2 = 10.191,P = 0.252）。结论 老年人ADL衰减拐点为74.5岁,年龄对ADL受损情况具有较高的预测价值。     

中国老年人的失能水平到底有多高?--多个数据来源的比较

目的了解上海市松江区老年人日常生活能力现状。方法采用多阶段随机抽样方法抽取调查对象,采用统一的调查问卷收集相关信息,采用卡方检验分析不同特征老年人口失能率之间的差异。结果本次调查共计收集到4 003份有效调查问卷,调查结果显示松江区老年人平均的失能率为11.8%。人群工具性日常生活能力失能率高于躯体性日常生活能力的失能率。不同性别、年龄、文化程度、婚姻状况等特征老年人的日常生活能力失能率之间差异有统计学意义。结论高龄是老年人生活能力丧失的主要危险因素,女性的失能率高于男性;城区、具有较高受教育水平及在婚状态的老年人其生活能力较完备。     

社区老年严重精神障碍患者的自理能力与社会支持现况

【目的】了解社区老年严重精神障碍患者的日常生活能力和社会支持现状,为社区照护与卫生服务提供依据。【方法】随机抽取400名社区在册老年严重精神障碍患者,采用日常生活能力量表(ADL)、社会支持评定量表(SSRS)进行现况调查和专题小组讨论。【结果】社区老年严重精神障碍患者ADL筛查发现,功能有明显障碍者为34.25%,性别间无显著差异(P>0.05),年龄和受教育程度间有差异(P<0.01)。共患多种慢性躯体疾病者ADL功能受损增多;社会支持评定总得分为(31.81±3.82)、客观支持得分为(7.10±2.09)、主观支持得分为(16.81±2.74)、支持的利用度得分为(7.84±2.07),低于社区一般老年人群(P<0.01),不同居住状况者社会支持评定得分差异有统计学意义(P<0.01);专题小组讨论印证了上述调查结果。【结论】社区老年精神障碍患者日常生活功能受损严重、社会支持评定结果低,应重视这些脆弱人群的日常生活功能的维护和康复,并提供相应的社会支持。     

The effects of daily physical activity on QOL in the elderly

OBJECTIVE: To ascertain the meaning and the influence of daily physical activity on QOL among the elderly, we surveyed their lifestyle exercise habits, cross-sectionally and longitudinally. METHODS: The subjects of this study were all residents living in a certain suburb of Nagoya-city, aged 63, 68, 73, 78, 83 years of age. They answered questionnaires regarding their exercise, physical activity, and QOL with six categories. The same questionnaire survey was conducted again 3 years later, and 958 people who answered both of them were examined in this study. The three-year-trend for physical activities, exercise habits and QOL scores, were analyzed and a comparison of QOL was made between the first and third year data based on the primary physical-activity-scores. In addition we applied logistic regression analysis to investigate the influence of physical activity changes (independent variable) on maintaining or improving of QOL scores (dependent variable). RESULTS: Daily physical activities were well maintained, but the percentage of feasible activities decreased by 5-10% as the sample population aged. On the other hand, 20 to 30% of the subjects increased their physical activity. The more people moved, the higher the QOL scores they had in both cross-sectional and longitudinal analyses. According to the logistic regression analysis, baseline physical activity habits positively contributed to most QOL change, increase in exercise tending to maintain or improve the QOL scores. CONCLUSIONS: Daily physical activity was relatively well maintained among the sample population, and some increased their physical activity scores over the period studied. Those with high values had better physical conditions and a consistently high QOL. These results suggest that maintaining or increasing physical activity positively influences QOL in the elderly.