上海市闵行社区老年人营养不良风险评估及其影响因素
Risk assessment and influencing factors of malnutrition among community-dwelling older adults in Minhang District of Shanghai
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摘要:
背景 老年人群营养不良发生率较高，通过合适的筛查量表对社区老年人进行营养不良风险筛查，提前干预，能有效改善老年人的生活质量。
目的 评估上海社区老年人营养不良风险并探讨其影响因素。
方法 2021年10月至12月，在上海市闵行区采取分层随机抽样方法抽取居委会（村）65岁及以上老年人共960人，由经过统一培训的调查员对满足纳入条件老年人进行一对一问卷调查，调查量表包括一般情况调查表、老年人抑郁量表（GDS）、日常生活能力量表（ADL）、老年人营养不良风险评估表，并测量身高、体重、腰围、小腿围。通过
χ 2检验和logistic回归分析老年人营养不良风险的影响因素。结果 闵行区960例社区老年人中，存在营养不良13人（1.35%），存在营养不良风险311人（32.40%）。
χ 2检验结果显示，不同年龄、性别、家庭月收入、文化程度、婚姻、腰围、牙齿健康状况、日常活动能力、营养知识获得情况及是否患有慢性病、是否患慢性病数＞3种、是否长期服药种类＞3种、是否抑郁、不同的睡眠时间、每日户外活动时间、每日摄入奶类/豆制品/鱼肉禽蛋类食物种类数、每日摄入蔬菜水果量、每日烹调油食用量、锻炼频率、吸烟频率以及是否独居的老年人之间营养状况差异有统计学意义（P ＜0.05）。logistic回归分析结果显示，不良牙齿状况、每日摄入奶类/豆制品/鱼肉禽蛋类不足（<3种）、每日摄入蔬菜水果量不足（<500 g）、每日烹调油食用量过多（>25 g）、每日户外活动时间不足（<1 h·d−1）、独居、低文化程度（小学及以下）、患有慢性病、慢性病数＞3种、长期服药种类数＞3种、未婚/丧偶/离婚是老年人营养异常的主要危险因素（P ＜0.05）。结论 上海市闵行区社区老年人营养风险异常率高，且营养状况受多因素影响，不良牙齿状况、膳食结构不合理、户外活动时间不足、患有慢性病、慢性病数量＞3种、长期服药种类数＞3种、低文化程度、独居、未婚/丧偶/离婚为其可能危险因素。
Abstract:Background The prevalence of malnutrition in older adults is high. Early use of appropriate screening scales for malnutrition risk and early intervention can effectively improve life quality of the elderly in communities.
Objective To evaluate the risk of malnutrition among the community-dwelling elderly in a district of Shanghai and explore its influencing factors.
Methods From October to December 2021, a total of 960 seniors aged 65 years and above in community committees (villages) of Minhang District were selected by stratified random sampling. Trained investigators conducted one-to-one interviews with included seniors using questionnaires. The questionnaires included the Geriatric Depression Scale (GDS), the Activity of Daily Living Scale (ADL), and the malnutrition risk assessment for elderly adults. Height, weight, waist circumference, and calf circumference were measured. Chi-square test and logistic regression were used to analyze potential influencing factors of malnutrition in the elderly.
Results Among the 960 community-dwelling seniors of Minhang District, 13 (1.35%) were malnourished and 311 (32.40%) were at the risk of malnutrition. There were statistically significant differences in nutritional status across different categories of age, sex, monthly family income, education level, marital status, waist circumference, dental health status, activity of daily living, nutrition knowledge, suffering from chronic diseases, having > 3 chronic diseases, taking > 3 long-term prescriptions, depression symptoms, sleeping duration, daily outdoor activity time, number of daily food species (milk/soy products/fish/meat/poultry/eggs), daily intake of vegetables and fruits, daily consumption of cooking oil, frequency of physical exercise, frequency of smoking, and living alone (
P < 0.05). The logistic regression analysis results showed that poor dental conditions, insufficient daily intake of milk/soy products/fish/meat/poultry/eggs (<3 kinds), insufficient daily intake of vegetables and fruits (<500 g), excessive daily consumption of cooking oil (>25 g), insufficient daily outdoor activities (<1 h·d −1), living alone, low educational level (primary school and below), suffering from chronic diseases, having > 3 chronic diseases, taking > 3 long-term prescriptions, and being single/widowed/divorced were the main risk factors for nutritional abnormalities in the elderly (P < 0.05).Conclusion The elderly in Minhang District of Shanghai have a high malnutrition risk, and their nutritional status is affected by multiple factors, including poor dental status, irrational dietary structure, insufficient time for outdoor activities, suffering from chronic diseases, having > 3 chronic diseases, taking > 3 long-term prescriptions, low educational level, living alone, and being single/widowed/divorced.
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