Malnutrition in older adults: screening and determinants
Malnutrition in older adults: screening and determinants
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DOI：
10.1017/s0029665118002628
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发表时间：
2019-08-01
影响因子：
7
通讯作者：
Bardon, Laura A.
中科院分区：
文献类型：
--
作者：
Corish, Clare A.;Bardon, Laura A.
老年人面临蛋白质能量营养不良（PEM）的风险。PEM对健康、认知和身体功能以及生活质量产生负面影响。鉴于全球人口老龄化背景下的这些负面健康结果，“健康饮食促进健康生活”老年人营养不良问题联合方案拟订倡议力求建立一个关于老年人营养不良问题的知识中心。这篇综述总结了与营养不良的筛查和决定因素有关的发现。基于一个评分系统，包括有效性，参数和实用性，建议设置特定的筛选工具，用于老年人。这些是：为社区而设的“确定你的健康清单”、为复康而设的“长者营养表格”、为院舍而设的“简易营养评估表-住宿照顾”及为医院而设的“营养不良筛选工具”或“简易营养评估表”。对MaNuEL伙伴国家的六项纵向研究进行了荟萃分析，以确定营养不良的决定因素。年龄增加、未婚/分居/离婚状态（与已婚但非丧偶相比）、100米步行或爬楼梯困难以及基线前一年或随访期间住院可预测营养不良。营养不良的性别特异性预测因素在爱尔兰老龄化纵向研究数据集中进行了探索。对于女性来说，认知障碍或接受社会支持预示着营养不良。男性的预测因素是过去2年内跌倒，过去一年住院和自我报告爬楼梯困难。将这些发现纳入公共卫生政策和临床实践将有助于营养不良的早期识别和管理。
Older adults are at risk of protein-energy malnutrition (PEM). PEM detrimentally impacts on health, cognitive and physical functioning and quality of life. Given these negative health outcomes in the context of an ageing global population, the Healthy Diet for a Healthy Life Joint Programming Initiative Malnutrition in the Elderly (MaNuEL) sought to create a knowledge hub on malnutrition in older adults. This review summarises the findings related to the screening and determinants of malnutrition. Based on a scoring system that incorporated validity, parameters used and practicability, recommendations on setting-specific screening tools for use with older adults were made. These are: DETERMINE your health checklist for the community, Nutritional Form for the Elderly for rehabilitation, Short Nutritional Assessment Questionnaire-Residential Care for residential care and Malnutrition Screening Tool or Mini Nutritional Assessment-Short Form for hospitals. A meta-analysis was conducted on six longitudinal studies from MaNuEL partner countries to identify the determinants of malnutrition. Increasing age, unmarried/separated/divorced status (vs. married but not widowed), difficulties walking 100 m or climbing stairs and hospitalisation in the year prior to baseline or during follow-up predicted malnutrition. The sex-specific predictors of malnutrition were explored within The Irish Longitudinal Study of Ageing dataset. For females, cognitive impairment or receiving social support predicted malnutrition. The predictors for males were falling in the previous 2 years, hospitalisation in the past year and self-reported difficulties in climbing stairs. Incorporation of these findings into public health policy and clinical practice would support the early identification and management of malnutrition.