Prevalence of malnutrition in subjects over 65 years of age in the Community of Madrid: the DREAM + 65 Study
Prevalence of malnutrition in subjects over 65 years of age in the Community of Madrid: the DREAM + 65 Study
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DOI：
10.20960/nh.101
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发表时间：
2016-04-01
期刊：
影响因子：
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通讯作者：
Cruz, Juan José de-la
中科院分区：
文献类型：
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作者：
Cuerda, Cristina;Álvarez, Julia;Cruz, Juan José de-la
前言：疾病相关性营养不良(DRM)是一种常见的社区卫生保健问题，主要影响65岁以上的成年人，增加发病率和死亡率，同时降低生活质量。目的：研究马德里地区社会福利服务机构不同社区卫生保健中心65岁以上成年人DRM的患病率。方法：通过多阶段抽样的方法，在马德里的33个社区卫生保健中心(6个初级卫生保健中心(PC)、9个老年护理中心(CE)、9家医院(H)和9家养老院(NH))进行横断面研究。研究的变量包括年龄、性别、根据红十字会残疾程度量表的依赖程度、入院原因和潜在疾病、栖息地(城市-郊区-农村)和地理分布(北部-中南部)。所有中心都采用微型营养评估(MNA-Screen)作为营养筛查工具。对于筛查阳性(有营养不良风险)的患者，进行了MNA评估。采用SPSS21.0统计软件进行统计分析，包括描述性统计、卡方检验和Fisher‘s精确检验、单因素方差分析、Kruskal-Wallis检验、单因素和多因素Logistic回归分析。结果：共招募受试者1103人(PC 275人，CE 278人，H 281人，NH 269人)，平均年龄79.5±-8.4岁(男性41.2%，女性58.8%)。来自H和NH的受试者的残疾程度更高(p<；0.001)。营养不良的总患病率为10%，其中23.3%处于营养不良的风险中，4种类型的社区卫生保健中心之间存在差异(P<；0.001)。单因素分析显示，不同年龄、性别、依赖程度、社区卫生服务中心类型、居住地和地理区域的儿童营养不良患病率有显著差异。结论：马德里社区65岁以上成年人DRM患病率达10%，另有23.3%存在营养不良风险。在多因素分析中，与营养不良独立相关的变量只有患者的依赖程度和社区卫生服务中心的类型和设置。
Introduction: Disease-related malnutrition (DRM) is a frequent community healthcare problem that predominantly affects adults over 65 years of age and increases morbidity and mortality rates, while also decreasing quality of life.Objective: To study the prevalence of DRM in adults over 65 in different community healthcare centres belonging to the Regional Social Welfare Service of the Community of Madrid.Methods: We conducted a cross-sectional study in 33 community healthcare centres in Madrid (6 primary healthcare centres (pc), 9 care centres for the elderly (CE), 9 hospitals (H) and 9 nursing homes (NH)) selected by means of multistage sampling. The variables studied were age, sex, level of dependence according to the Red Cross disability scale, reason for admission and underlying disease, habitat (urban-periurban-rural) and geographical distribution (north-centre-south).The Mini Nutritional Assessment (MNA-screening) was employed as a nutritional screening tool in all the centres. In the case of patients with positive screening (at risk-malnutrition), the MNA-assessment was carried out. Statistical analysis was conducted with the SPSS 21.0 package and included descriptive statistics, Chi-squaretest and Fisher's exact test, one-way ANOVA, Kruskal-Wallis test and univariate and multivariate binary logistic regression analysis (LR). Statistical significance was considered to be p < 0.05.Results: A total of 1,103 subjects were recruited (275 PC, 278 CE, 281 H, 269 NH), mean age 79.5 +/- 8.4 years (41.2% were males and 58.8% females). The subjects from H and NH had a higher degree of disability (p < 0.001). The overall prevalence of DRM was 10%, 23.3% being at risk of malnutrition, with differences among the 4 types of community healthcare centres (p < 0.001). The univariate LR analysis showed significant differences in the prevalence of malnutrition according to age, sex, degree of dependence, type of community healthcare centre, habitat and geographical zone. Nevertheless, in the multivariate analysis, only the degree of dependence, the type of centre and habitat were statistically significant.Conclusions: The prevalence of DRM in adults over 65 years of age in the Community of Madrid amounts to 10%, with another 23.3% at risk of malnutrition. The variables that were independently related with malnutrition in the multivariate analysis were only the patients' level of dependence and the type and setting of the community healthcare centre.