社區高齡者營養狀態與衰弱之關聯性研究

Abstract

隨著全球人口高齡化，人口老化帶來的健康衝擊接踵而來，成為各國當今不容忽視的重要議題。營養狀況為高齡者整體健康的關鍵因素之一，根據國外研究顯示，充足的營養是健康老化的關鍵，對於預防高齡族群衰弱風險，甚至疾病防範皆至關重要。而過往國內較少針對高齡者營養狀態與衰弱之相關研究探討，故本研究旨於瞭解社區高齡者營養狀態與衰弱之現況及探討兩者間的關聯性。本研究採橫斷性研究設計，以便利取樣方式，於2020年9月至2022年1月期間於臺大醫院老年醫學部蒐集資料。招募共301位65歲或以上可自行進行日常生活活動與行為，並排除嚴重聽力、重度認知功能障礙、視力失能或嚴重衰弱狀態之高齡者。本研究由訪員以問卷方式調查個人基本資料、居住狀態、疾病史及藥物使用，並運用迷你營養評估-簡表及臨床衰弱評估量表等評估工具，蒐集高齡者營養狀態及衰弱程度，最終總計共278位納入數據分析。統計方法採用描述性統計、卡方檢定及多元邏輯斯回歸進行分佈與關聯性分析。本研究共計278位65歲以上社區高齡者納入分析，平均年齡：77.4±8.5歲，54.7%為女性；有營養不良風險者占23.4%；而於衰弱程度分佈中，無衰弱65.8%、衰弱前期9.7%、有衰弱24.5%。經由初步卡方分析結果顯示，高齡者之營養狀態與衰弱程度間在於分佈中呈現顯著差異，後續進一步進行多元邏輯斯回歸分析探討營養狀態與衰弱程度之關聯性，結果顯示營養狀態與衰弱前期及衰弱之間皆無顯著相關。研究結果中發現，高齡者營養狀態與衰弱程度雖然於分佈上有顯著差異，但卻於關聯性間無顯著相關，建議未來研究可納入其他與營養相關之客觀數據，以利進一步進行營養狀態與衰弱之關聯研究。With global population aging, the associated health impacts have become a pressing issue worldwide. Nutritional status plays a critical role in the overall health of elderly individuals. According to international research, adequate nutrition is pivotal for healthy aging, essential in preventing frailty and various diseases among the elderly population. However, there has been limited domestic research investigating the relationship between nutritional status and frailty among the elderly in our country. Therefore, this study aims to explore the current nutritional status and frailty among community-dwelling elderly individuals, as well as investigate the correlation between the two. This study was designed as a cross-sectional study, using convenience sampling method to collect. Data were collected at the Department of Geriatrics and Gerontology , National Taiwan University Hospital from September 2020 to January 2022. A total of 301 community-dwelling elderly individuals aged 65 years and above, capable of independently performing daily activities, were recruited, excluding those with severe hearing impairment, significant cognitive dysfunction, visual impairment, or severe frailty. This study employed interviewer-administered questionnaires to gather data on participants' demographics, living conditions, medical history, and medication usage. Additionally, tools such as the Mini Nutritional Assessment-Short Form and Clinical Frailty Scale were utilized to assess nutritional status and frailty levels. Data from 278 participants were included for final analysis. Statistical methods included descriptive statistics, chi-square test and multivariable logistic regression were employed for distribution and correlation analyses. This study analyzed a total of 278 community-dwelling older adults aged 65 years and above. The mean age was 77.4 ± 8.5 years, and 54.7% were female. Among them, 23.4% were at risk of malnutrition. Regarding the distribution of frailty status, 65.8% were non-frail, 9.7% were pre-frail, and 24.5% were frail. Initial chi-square analysis indicated significant differences in nutritional status among older adults across different frailty statuses. Subsequently, further multivariable logistic regression analysis explored the association between nutritional status and frailty status. The results revealed no significant correlation between nutritional status and pre-frailty or frailty. The study findings revealed significant differences in the distribution of nutritional status and frailty levels among the elderly; however, there was no significant correlation between them. Future research is recommended to incorporate additional objective nutritional data to further investigate the association between nutritional status and frailty.