摘要
目的:探讨老年慢性病共病患者营养不良的现状及影响因素分析。方法:选取2020年1月~2023年4月于南京医科大学附属脑科医院就诊的625例老年慢性病共病患者作为研究对象,采用医院自制调查问卷收集患者一般资料,按照营养风险筛查量表(NRS)2002方案对患者进行营养状况评估,根据结果将患者分为营养不良组和营养良好组,分析其营养不良现状,并对不同营养状况患者的一般资料、焦虑自评量表(SAS)、抑郁自评量表(SDS)、社会支持评定量表(SSRS)、简易智力状态检查量表(MMES)得分进行对比分析,将存在显著差异的指标纳入慢性病共病患者发生营养不良的非条件Logistic回归性分析。结果:研究共纳入625例慢性病共病患者,营养不良患者213例(34.08%)。营养不良组患者的SAS和SDS评分均高于营养良好组(P<0.05),SSRS和MMES均低于营养良好组(P<0.05)。营养不良患者年龄更大、BMI更低、无医疗保险、慢性病种类超过2种、用药种类超过5种、使用抗生素、焦虑、抑郁、认知障碍、离婚/丧偶、不和子女居住占比更大(P<0.05)。多因素Logistic回归模型显示,年龄(>70)、慢性病种类(≥3种)、有焦虑、有抑郁、有认知障碍是慢性病共病患者发生营养不良的危险因素(P<0.05),SSRS评分高是患者发生营养不良的保护因素(P<0.05)。结论:年龄、慢性病种类、心理状况、社会支持水平以及认知功能均是慢性病共病患者发生营养不良的影响因素。
Objective:To investigate the current prevalence of malnutrition and its influencing factors in elderly patients with chronic comorbidities.Methods:625 elderly patients with chronic comorbidities treated in Nanjing Brain Hospital between January 2020 and April 2023 were included.Demographic and general data were collected using a self-administered questionnaire.The nutritional status of the subjects was assessed using the 2002 Nutritional Risk Screening Scale(NRS),and then the patients were categorized into malnourished group and well-nourished group for analyzing the prevalence rate of malnutrition.Comparative analysis was conducted on the general information,and the scoring on Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),Social Support Rating Scale(SSRS)and Mini-Menial State Examination(MMSE).Variables with significant difference were entered into unconditional logistic regression model to analyze the factors affecting malnutrition prevalence in patients of chronic comorbidities.Results:In total,625 patients with chronic comorbidities were included in current study,in whom malnutrition was identified in 213(34.08%).The SAS and SDS scores of patients in the malnourished group were higher than those in the well-nourished group(P<0.05),whereas the SSRS and MMES scores were lower than those in the well-nourished group(P<0.05).Malnourished patients were older,and had lower BMI and no medical insurance,suffered from more than 2 types of chronic diseases,were treated with more than 5 types of drugs and antibiotics,and had higher proportion of anxiety,depression,cognitive impairment,divorce/widowhood and living independently(P<0.05).Multivariate logistic regression analysis showed that age(>70),types of chronic diseases(≥3),anxiety,depression,and cognitive impairment were risk factors for malnutrition in patients with comorbidities of chronic diseases(P<0.05),yet higher SSRS scores were protective factors for malnutrition in the patients(P<0.05).Conclusion:Age,types of chronic diseases,mental statu
作者
戴丽
李志佳
张凌娟
张兰
DAI Li;LI Zhijia;ZHANG Lingjuan;ZHANG Lan(Department of Geriatric Medicine,Nanjing Brain Hospital,Nanjing 210000,Jiangsu,China)
出处
《皖南医学院学报》
CAS
2024年第3期275-278,共4页
Journal of Wannan Medical College
基金
淮北市科技计划项目(2020HK59)。
关键词
慢性病共病
营养不良
社会支持
认知功能
chronic comorbidities
malnutrition
social support
cognitive function
