FACTORS ASSOCIATED WITH LOW BODY-MASS INDEX AND WEIGHT-LOSS IN NURSING-HOME RESIDENTS
FACTORS ASSOCIATED WITH LOW BODY-MASS INDEX AND WEIGHT-LOSS IN NURSING-HOME RESIDENTS
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DOI：
10.1093/gerona/50a.3.m162
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发表时间：
1995-05-01
影响因子：
5.1
通讯作者：
FIATARONE, MA
中科院分区：
文献类型：
--
作者：
BLAUM, CS;FRIES, BE;FIATARONE, MA
背景。疗养院居民的营养不良是一个重大且可能可以改变的公共卫生问题。我们评估了一些潜在可改变因素与居民营养不良相关的假设。方法。本研究是对 7 个州 202 家疗养院中的 6,832 名社区疗养院居民进行的横断面二次数据分析。数据来自最小数据集 (MDS)，这是美国社区疗养院使用的 HCFA 授权的居民评估工具。两个因变量代表营养不良： (a) 低体重指数 (BMI)，定义为样本中最低四分位 BMI（19.42 kg/m(2) 及以下）； (b) 体重减轻，MDS 衡量标准定义为 30 天内体重减轻 5%，或 180 天内体重减轻 10%（样本的 9.9%）。自变量包括居民人口统计数据、饮食相关变量、测量功能、认知和情感状态的变量以及医疗状况。对低 BMI 和体重减轻的单独逻辑回归模型进行了估计，以测试多变量关联。结果。口腔摄入不良、饮食依赖、褥疮和咀嚼问题会增加低 BMI 和体重减轻的可能性。女性、85 岁或以上、卧床不起和髋部骨折只会增加低 BMI 的几率；抑郁行为和两种或多种慢性疾病只会增加减肥的几率。结论。疗养院居民营养不良是一种多因素综合症。改进口服喂养方法和治疗抑郁症是通过针对可逆特征来抵消疗养院居民营养不良的潜在重要方法。
Background. Undernutrition in nursing home residents is a significant and possibly modifiable public health problem. We evaluated the hypothesis that some potentially modifiable factors are associated with resident undernutrition.Methods. This study is a cross-sectional, secondary data analysis of 6,832 community nursing home residents sampled from 202 nursing homes in 7 states. Data were from the Minimum Data Set (MDS), an HCFA-mandated resident assessment instrument used in U.S. community nursing homes. Two dependent variables represented undernutrition: (a) low body mass index (BMI), defined as the lowest quartile BMI of the sample (19.42 kg/m(2) and below); and (b) weight loss, an MDS measure defined as 5% decrease in weight in 30 days, or a 10% decrease in 180 days (9.9% of the sample). independent variables included resident demographics, eating-related variables, variables measuring functional, cognitive, and affective statuses, and medical conditions. Separate logistic regression models were estimated for low BMI and weight loss to test multivariate associations.Results. Poor oral intake, eating dependency, decubiti, and chewing problems increase the likelihood of both low BMI and weight loss. Female gender, age 85 or older, bedfast, and hip fracture increase the odds of low BMI only; depressed behaviors and two or more chronic diseases increase the odds of weight loss only.Conclusion. Undernutrition in nursing home residents is a multifactorial syndrome. Improved oral feeding methods and treatment of depression are potentially important ways to counteract undernutrition in nursing home residents by targeting reversible features.