养老机构老年人营养状况与生活质量相关性研究

目的了解潍坊市养老机构老年人营养状况与生活质量的现状,并探讨其相关性。方法抽取潍坊市12所养老机构506名老年人作为研究对象,采用简易营养评价量表(MNA)和老年人生活质量量表进行问卷调查。结果微型营养评价法(MNA)506名老年人总分为(21.08±2.85)分,生活质量总分为(26.81±2.59)分。相关分析显示,营养状况和生活质量呈明显的相关性(r=0.602,P0.01)。多重线性回归分析显示,影响潍坊市养老机构老年人生活质量的因素有:年龄、婚姻状况、文化程度、个人月收入、有无慢性病、营养状况。结论老年人营养状况与生活质量密切相关,可以从加强老年人的平衡营养和合理膳食等方面入手,改善老年人营养状况从而促进综合生活质量的提高。     

不同营养评价方法在肝病病人中的比较及适宜肝病营养评价的方法

目的:应用不同营养筛查/评估方法对肝病病人进行营养状况调查,筛选出新的适合肝病病人的营养评价方法. 方法:选择慢性肝病住院病人525例,其中慢性肝炎149例,肝硬化360例,肝衰竭16例.应用主观全面评定法(SGA)、营养风险筛查NRS 2002、微型营养评价精法(MNA-SF)和传统营养指标的测定和比较,通过多因素分析筛选出适合慢性肝病病人的营养评价指标. 结果:应用SGA法、MNA-SF法和上臂肌围(MAMC)、肱三头肌皮皱厚度(TSF)、血清清蛋白(ALB)、前清蛋白(PA)、淋巴细胞总数(LCT)指标评估营养状态时,不同疾病分组营养状况差异存在统计学意义(P＜0.05).TSF、MAMC、ALB和活动能力是影响慢性肝病病人发生感染、胸腹水、器官功能衰竭和进入ICU的危险因素,并以此建立肝病病人营养评价方法(NALD). 结论:应用NALD,更适合评价肝病病人的营养状况.     

老年人营养摄入不足

[英 ]ｅｄｉｔｏｒ∥ＮｕｔｒＲｅｓＮｅｗｓｌｅｔｔ . 2 0 0 1 ,2 0 ( 1 1 ) . 1 2饮食习惯、营养摄入和年龄增长三者互相关联 ,而且对老年人也很重要。较差的营养状况与住老年公寓和住院的老年人的发病率和死亡率上升相关。本研究评价了参加口腔健康研究 (评价口腔疾病和口腔软组织疾病 )的老年人的饮食习惯和营养摄入。研究旨在描述居住在衣阿华乡村老年公寓的 79岁以上老年人的营养摄入、膳食种类和营养危险性 ,继而研究营养调查Ｉ(ＮＳＩ)核对清单内容、膳食质量与膳食种类的相关性。该研究为横断面调查 ,1 996～ 1 998年间对研究对象…     

老年营养风险指数在高龄老年患者中的应用与研究

目的:观察营养筛查工具老年营养风险指数(GNRI)在高龄老年患者中的适用性;方法:选取高龄老年(年龄≥80岁)患者60例,随机分为对照组、观察组各30例,对照组采用营养风险筛查方案(NRS2002),观察组采用老年营养风险指数(GNRI),分别进行营养风险筛查,比较两种筛查方法的评估结果、营养支持应用率、营养相关并发症发生率.结果:观察组的患者营养风险检出率高于对照组(P<0.05),观察组的患者营养支持应用率、营养相关并发症发生率均低于对照组(P<0.05);结论:老年营养风险指数(GNRI)作为一个简单易行的客观评价指标,与高龄老年患者的营养状况密切相关.在评估高龄老年患者营养风险中,老年营养风险指数(GNRI)准确性较高,临床运用方便有效,值得推广.     

消化系统恶性肿瘤住院病人营养状况与生活质量的相关性分析

目的:探讨消化系统恶性肿瘤住院病人营养状况与生活质量的相关性.方法:采用NRS 2002营养风险筛查量表、PG-SGA营养评估量表对昆明医科大学第一附属医院自2018年1月至2019年12月病理确诊为消化系统恶性肿瘤者行营养诊断,采用欧洲癌症研究与治疗组织生存质量问卷(第3版)调查生活质量,分析营养状况与生活质量的相关...     

营养评定工具NRS2002、MNA和实验室检查在老年住院病人营养调查中的应用

目的:通过对老年住院病人进行营养筛查,为进一步营养支持治疗提供参考信息. 方法:选取在我院住院≥70岁的老年病人119例,采用营养风险筛查(NRS 2002)和微型营养评定(MNA)分别评定病人的营养风险和营养状况,同时记录入院时病人的年龄、体质量指数(BMI)、消化功能、有无感染等基本信息,以及前清蛋白、清蛋白、血红蛋白、淋巴细胞计数、总胆固醇、三酰甘油、肌酐、尿素氮、血清铁等实验室检验指标. 结果:①NRS 2002评估结果为“营养风险”的老年病人有21例,占17.6％;MNA评估结果为“营养不良风险或营养不良”的老年病人共有42例,占35.3％.②在上述调查中有营养风险的老年病人入院时BMI、前清蛋白、清蛋白、血红蛋白均明显低于无营养风险组.③在上述检测指标中,清蛋白与NRS 2002或MNA的相关性均优于其他指标,且其灵敏性和特异性均较高. 结论:NRS 2002和MNA均可用于评定老年病人的营养状况,BMI、前清蛋白、清蛋白、血红蛋白也可用于辅助评定老年病人的营养状况.在无条件行营养工具筛查时,清蛋白是最佳的营养评定指标.     

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。     

简易营养评价精法在老年高血压病患者中的应用

目的评价老年高血压患者的营养状况,探讨简易营养评价精法在对老年高血压患者营养状况评价中的可行性。方法利用MNA-SF量表对老年高血压患者的营养状况进行调查,分析老年高血压患者的营养状况及可能的相关因素。结果本次调查中营养不良者占11%,营养状况良好者占89%。结论老年高血压患者仍然存在营养不良现象。MNA-SF问卷对老年高血压患者进行营养状况评估具有可行性。     

河南省某精神专科医院老年抑郁症患者营养现状及相关因素分析

目的了解老年抑郁症住院患者的营养状况,并探讨影响其营养状况的相关因素。方法采用微型营养评定量表(MNA)结合实验室检查,对263例住院的老年抑郁症患者(观察组)及263例非抑郁症老年人(对照组)进行营养状况调查,对两组研究对象的营养状况与人口学资料等进行多元线性逐步回归分析。结果 263例老年抑郁症患者中,存在营养不良的患者占27.4%,存在营养不良风险者占57.4%,营养良好者仅占15.2%,营养风险发生率显著高于263例非抑郁症老年人(χ~2=55.307,P0.001)。两组的血液总胆固醇(t=-5.412,P0.001)、甘油三酯(Z=-5.105,P0.001)、低密度脂蛋白(t=-4.924,P0.001)、总蛋白(Z=-14.697,P0.001)、白蛋白(Z=-16.260,P0.001)、球蛋白(Z=-8.933,P0.001)、前白蛋白(t=-7.855,P0.001)、红细胞计数(t=-2.647,P=0.009)和血红蛋白(t=-8.109,P0.001)水平差异具有统计学意义;多元逐步线性回归分析结果显示,老年抑郁症住院患者营养状况的影响因素为进食情况(t=8.582,P0.001)、家庭人均月收入(t=4.606,P0.001)、咀嚼功能(t=3.698,P0.001)及抑郁严重程度(t=-3.344,P=0.001),而年龄(t=-4.084,P0.001)及文化程度(t=2.203,P=0.028)是影响非抑郁症老年人营养状况的影响因素。结论老年抑郁症住院患者营养不良及营养不良风险的发生率较高,需要进一步加强个性化的营养支持和治疗,改善病情及预后。     

集束化营养护理在改善老年胃癌化疗患者营养状况和生活质量中的应用

目的 探讨集束化营养干预改善老年胃癌化疗患者营养状况和生活质量的效果。方法 选择天津市宁河区医院2021年10月—2022年9月收治的老年胃癌化疗患者80例为研究对象,随机分为对照组和观察组各40例。对照组予以常规营养干预,观察组在此基础上予以集束化营养干预,比较两组干预前后营养状况和生活质量。结果 观察组干预后体质量、血红蛋白、血清白蛋白高于对照组,差异有统计学意义(P<0.05)。观察组干预后整体健康评分及部分生活质量维度评分高于对照组,差异有统计学意义(P<0.05)。结论 集束化营养干预与常规营养干预相比,可以进一步改善老年胃癌化疗患者营养状况和生活质量,值得临床推广应用。     

The Validity of Nutrition Screening Initiative DETERMINE Checklist Responses in Older Georgians

The Nutrition Screening Initiative DETERMINE Checklist (NSI) is used throughout the United States to assess nutrition risk of those requesting the services of the Older Americans Act Nutrition Program (OAANP). This study examined the ability of the NSI to evaluate nutrition risk by comparing the responses between NSI and matched comparable survey questions using the self-administered mail survey data that were collected among 924 new OAANP applicants in Georgia (mean age 75.0 ± 9.2 years, 68.8% women, 26.1% Black). Ninety-four percent of our sample provided at least one discordant response (i.e., disagreement between responses to the NSI and matched questions). Questions regarding food intake most frequently yielded discordant responses. Black participants were more likely to provide discordant responses for the meal frequency question. Food insecure individuals were less likely to provide discordant responses for food intake questions. Those who lived alone were less likely to provide discordant responses for the dairy intake question. Some NSI items may have limited ability to reliably assess nutritional risk of older adults. Further efforts are warranted to improve nutritional assessment tools for use in vulnerable older adults.     

The validity of Nutrition Screening Initiative DETERMINE Checklist responses in older Georgians

The Nutrition Screening Initiative DETERMINE Checklist (NSI) is used throughout the United States to assess nutrition risk of those requesting the services of the Older Americans Act Nutrition Program (OAANP). This study examined the ability of the NSI to evaluate nutrition risk by comparing the responses between NSI and matched comparable survey questions using the self-administered mail survey data that were collected among 924 new OAANP applicants in Georgia (mean age 75.0 ± 9.2 years, 68.8% women, 26.1% Black). Ninety-four percent of our sample provided at least one discordant response (i.e., disagreement between responses to the NSI and matched questions). Questions regarding food intake most frequently yielded discordant responses. Black participants were more likely to provide discordant responses for the meal frequency question. Food insecure individuals were less likely to provide discordant responses for food intake questions. Those who lived alone were less likely to provide discordant responses for the dairy intake question. Some NSI items may have limited ability to reliably assess nutritional risk of older adults. Further efforts are warranted to improve nutritional assessment tools for use in vulnerable older adults.     

Nutritional risk among Oklahoma congregate meal participants

OBJECTIVE: To determine if there were differences by demographic variables in response rates to Nutrition Screening Initiative (NSI) Checklist statements reported by over 50% of Oklahoma Older Americans Act Nutrition Program (OAANP) congregate meal participants categorized at high nutritional risk based on cumulative NSI Checklist scores. DESIGN: This study evaluated Oklahoma State Unit on Aging statewide archival demographic and NSI Checklist data from 8892 OAANP congregate participants. ANALYSIS: Data were analyzed using chi-square analyses. RESULTS: Eighteen percent of congregate participants were categorized at high nutritional risk. Over 50% of participants categorized at high nutritional risk reported "yes" to having an illness or condition that affected food eaten; eating alone; taking 3 or more medications; and inability to shop, cook, and feed themselves. Significant differences were observed in participant "yes" response rates to these NSI Checklist statements by demographic variables. Participants responded "yes" more to these statements if they were female, of advanced age, and living alone or in rural areas. CONCLUSIONS AND IMPLICATIONS: The results of this study indicate problem areas and population groups for targeting nutrition education programs and services among Oklahoma OAANP congregate meal participants.     

农村老年人行为习惯及营养状况影响因素分析

目的 探讨农村老年人群营养卫生状况及影响因素.方法 采用整群抽样法在安徽省某县农村地区抽取2个行政村,实足年龄在60岁～常住老年人,采用自编调查表进行问卷调查.结果 营养初筛量表评分为(6.194±4.139)分.农村老年人营养卫生良好469人(21.2%)、中度危险597人(27.0%)、营养卫生不良1 146人(51.8%).自评营养卫生状况与营养初筛量表得分明显相关(Spearman相关系数r3为0.359,P<0.000 1).多因素有序结果的累积比数Logistic回归分析显示,年龄较高(OR=0.71)、起居困难较重(OR=0.30)、参加娱乐活动(OR=0.81)、睡眠良好(OR=0.55)、经济来源本人或配偶(OR=0.79)、社会支持较好(OR=0.97)为保护因素;而文化程度较高(OR=1.48)、子女外出务工(OR=1.51)孤独感较重(OR=1.04)为危险因素.结论 农村老年人群营养卫生状况不容乐观,且受多种因素影响,应大力加强营养健康教育,从而顺利实现健康老龄化进程.     

Nutrition and health risks in the elderly: the nutrition screening initiative.

OBJECTIVES. The Nutrition Screening Initiative is a national collaborative effort committed to the identification and treatment of nutritional problems in older persons. METHODS. A 14-item checklist of characteristics associated with nutritional status was administered to a random sample of Medicare beneficiaries, aged 70 years and older, in New England. Regression analysis was used to derive item weights that would predict poor nutrient intakes and low perceived health status. Sensitivity and specificity values were reviewed to define low, moderate, and high nutritional risk scores. RESULTS. A revised checklist containing 10 yes/no items was adopted. Scores of 6 or more points defined persons at high nutritional risk. Twenty-four percent of the Medicare population was estimated to be at high nutritional risk according to the checklist. Among those in the high-risk group, 56% perceived their health to be "fair" or "poor" and 38% had dietary intakes below 75% of the recommended dietary allowances for three or more nutrients. CONCLUSIONS. The Nutrition Screening Initiative Checklist is a brief, easily scored instrument that can accurately identify noninstitutionalized older persons at risk for low nutrient intake and health problems.     

Nutrition Screening Practices in Adult Day Care Centers

Older adults have been identified as one of the largest groups at risk of malnutrition in America and represent the target population of the Nutrition Screening Initiative. At the University of Delaware Adult Day Care Center, nutrition screening is an integral component of basic services provided to clients and their caregivers. To determine the extent of current nutrition screening practices in other adult day care centers, centers across the United States were surveyed. A total of 160 centers (53%) responded, 101 indicated nutrition screening was an on-going service. A number of differences and similarities in nutrition screening parameters was evident. Most centers responding assessed the following parameters: food intolerance, medical history, weight, height, swallowing difficulties, and bowel habits. Hematological parameters and other anthropometric measurements were evaluated with least frequency. Interest in nutrition screening appeared great. Further research should examine relationships between nutrition screening and other factors such as staffing patterns, center settings, and funding sources.     

Practitioners' opinions on Food and Nutrition Care Indicators in assisted living facilities for older adults

This study assessed the utility of the 57-indicator Food and Nutrition Care Indicators Checklist for assessing food and nutrition services in assisted-living facilities for older adults among registered dietitians (RDs). They were members of two American Dietetic Association practice groups focusing on aging and long-term care and were also employed in assisted-living facilities. The 1,281 respondents rated the importance of each checklist item and provided their views on the role of assisted-living facilities and their level of agreement with statements regarding the importance of residents' autonomy for making food choices and their ability to make wise dietary choices. Registered dietitians practicing in assisted-living facilities considered all of the domains on food and nutrition quality indicators on the Food and Nutrition Care Indicators Checklist to be highly important (92% of dining room environment items, 83% of foodservice operations, 92% of general nutrition, and 89% of therapeutic nutrition items). They preferred a service style that included both health and amenities, as did national health and aging experts. Registered dietitians should work with other professionals to further validate the checklist, promote its use, and establish optimal service models for food and nutrition services in assisted-living facilities for older adults.     

Impact of Home-Delivered Meals on Nutrition Status and Nutrient Intake among Older Adults in Central Texas

Objective

This study aimed to measure changes in nutrition risk and nutrient intake after older adults received home-delivered meals (HDM) for 3 months.

Design

This study used a pre-posttest study design, with data collected before and after 3 months of HDM services.

Setting

Two HDM programs that serve the metropolitan areas of Austin and San Antonio, Texas.

Participants

Study participants were aged 60 years or older, without dementia or terminal illness, and receiving HDM in Austin, Texas and San Antonio, Texas for 3 months.

Measurements

The Nutrition Screening Initiative (NSI) and Mini Nutrition Assessment-Short Form (MNA-SF) were used to assess nutritional risk. The National Cancer Institute Diet History Questionnaire II (DHQ II) was used to assess nutrient intake over the past month.

Results

After receiving 3 months of HDM, nutrition status significantly improved as measured by the NSI and MNA-SF. More participants met or exceeded the recommended dietary allowances (RDA) for magnesium and zinc after receiving HDM compared to before receiving HDM. Dietary supplement intake was associated with a higher nutritional risk.

Conclusion

Improvements in nutrition status were found after 3 months of receiving HDM, whereas intake of most nutrients did not change significantly. Results of this study provide further evidence that HDM can reduce nutritional risk of older adults, and may inform HDM programs on the differences of NSI and/or MNA-SF to assess nutritional risk of clients.

     

Nutrition Screening Initiative Checklist may be a Better Awareness/Educational Tool than a Screening One

Objective To evaluate the Nutrition Screening Initiative (NSI) checklist as a screening and an awareness/educational tool in an elderly population.Design Epidemiologic follow-up study. Information similar to the questions of the NSI checklist was collected by the Nutrition Status Survey of Boston elders between 1981 and 1984. Vital status of volunteers was obtained during 8 to 12 years of follow-up.Subjects/setting Community-dwelling men (n=200) and women (n=381) aged 60 years and older who participated in the survey.Statistical analyses performed Multivariate analysis was used to assess the association between mortality and each of the NSI-similar questions and the cumulative score, which is the sum of the values assigned to each question. Attributable risk percent, a measure of association, was calculated to measure the percentage of deaths that could potentially be prevented if the risk factors or their consequences were eliminated.Results Eating meals alone, problems biting or chewing, difficulties with shopping or cooking, and taking more than three medications per day were positively associated with mortality (P<.05). The cumulative score, although significant, was a weaker predictor of mortality. Attributable risk percent of mortality was 19.9% and 51.2% for men and women, respectively.Applications/conclusions Some but not all of the individual questions of the NSI checklist equivalent were significantly associated with mortality and identify specific problems that may have a long-term negative effect yet may be missed if the cumulative score were the sole criterion for screening people. The attributable risk percent suggests that the checklist may be best used as an awareness/educational tool as intended originally and could have an important public health effect on early death of community-dwelling elderly people.     

Elderly food stamp participants are different from eligible nonparticipants by level of nutrition risk but not nutrient intake

Nutrition risk, nutrient intake, and selected socioeconomic characteristics of elderly food stamp recipients were compared with elderly people who were eligible for food stamps but did not participate in the program. Data were collected by survey using a convenience sample of 200 low-income elderly people living in subsidized housing. Although there were no significant differences in food group or nutrient intake between participants and nonparticipants, overall, these low-income subjects did not meet minimum Dietary Reference Intake (DRI) standards for many nutrients and had caloric and food group serving intakes that were below recommendations. Food Stamp Program participants were at significantly higher nutrition risk than their nonparticipating peers as detected by the Nutrition Screening Initiative Checklist (P< or =.01) and other indicators of disability. It seems that those already at highest risk were in fact participating in the Food Stamp Program because those eligible but not participating had significantly higher incomes and were at significantly lower nutritional risk.