Factors Associated with Food Form in Long-Term Care Insurance Facilities
Factors Associated with Food Form in Long-Term Care Insurance Facilities
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DOI：
10.1007/s00455-022-10440-6
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发表时间：
2022-04-12
期刊：
影响因子：
2.6
通讯作者：
Yamazaki, Yutaka
中科院分区：
文献类型：
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作者：
Takeda, Maaya;Okada, Kazutaka;Yamazaki, Yutaka
我们研究了长期护理机构（LTCF）居民的饮食摄入状况（食物形式）相关因素，以确定需要护理的老年人选择适当食物形式的相关因素。我们调查了来自日本37个LTCF的888名居民。评估患者的基本信息（年龄、性别、体重指数[BMI]）、食物形式（吞咽调整饮食类别）、Barthel指数（BI）、临床痴呆评分（CDR）、简单评估进食和吞咽功能、现有/功能性牙齿数量、口腔内动、重复唾液吞咽试验（RSST）和改良饮水吞咽试验。为了阐明与食物形式相关的因素，通过口服摄入获得良好营养的参与者被分为吞咽困难饮食（DD）和正常饮食（ND）组。多水平分析用于检测与食物形态状态相关的口腔功能。在客观评估中，BMI（比值比[OR] 0.979，95%置信区间[CI]-0.022至0.006，p = 0.001），BI（OR 0.993，95% CI - 0.007至- 0.004，p < 0.001），CDR 3.0（OR 1.002，95% CI 0.002-0.236，p = 0.046），有牙（OR 0.993，95% CI - 0.007至- 0.001，p = 0.011），功能性牙齿（OR 0.989，95% CI - 0.011至- 0.005，p < 0.001）和RSST（OR 0.960，95% CI - 0.041至- 0.007，p = 0.006）与DD vs ND辨别显著相关。咳嗽（OR 1.056，0.054-0.198，p = 0.001）和漱口（OR 1.010，0.010-0.174，p = 0.029）的简单评价也可以区分食物形式状态。这些简单的评估提供了深入了解LTCF居民的食物形态状态和饮食能力之间的差异。护理人员的定期评估可能有助于防止吞咽困难的老年人误吸。
We examined factors related to dietary intake status (food form) of long-term care facility (LTCF) residents to identify factors related to proper food form choice for older individuals requiring nursing care. We surveyed 888 residents from 37 LTCFs in Japan. We evaluated basic information (age, sex, body mass index [BMI]), food form (swallowing-adjusted diet class), Barthel Index (BI), Clinical Dementia Rating (CDR), simply evaluated eating and swallowing functions, the number of present/functional teeth, oral diadochokinesis, repetitive saliva swallowing test (RSST), and modified water swallowing test. To clarify factors associated with food form, participants who had good nutrition by oral intake were categorized into the dysphagic diet (DD) and normal diet (ND) groups. Multi-level analyses were used to detect oral functions associated with food form status. Among objective assessments, BMI (odds ratio [OR] 0.979, 95% confidence interval [CI] - 0.022- to 0.006, p = 0.001), BI (OR 0.993, 95% CI - 0.007 to - 0.004, p < 0.001), CDR 3.0 (OR 1.002, 95% CI 0.002-0.236, p = 0.046), present teeth (OR 0.993, 95% CI - 0.007 to - 0.001, p = 0.011), functional teeth (OR 0.989, 95% CI - 0.011 to - 0.005, p < 0.001), and RSST (OR 0.960, 95% CI - 0.041 to - 0.007, p = 0.006) were significantly associated with DD vs ND discrimination. Simple evaluations of coughing (OR 1.056, 0.054-0.198, p = 0.001) and rinsing (OR 1.010, 0.010-0.174, p = 0.029) could also discriminate food form status. These simple evaluations provide insight into the discrepancies between food form status and eating abilities of LTCF residents. Periodic evaluations by the nursing caregiver may help to prevent aspiration by older individuals with dysphagia.