上海地区养护机构老年人吞咽障碍及营养风险调查研究

Investigation of dysphagia and nutrition risk in the elderly from nursing home in Shanghai

目的了解上海地区养护机构老年人吞咽障碍的发生率及其伴随的营养风险，为该人群的合理营养治疗提供依据。方法采用问卷调查对6所养护机构60岁及以上老年人进行现况研究。利用吞咽筛查法了解老年人的吞咽障碍发生率，并采用微型营养评定精法（MNA-SF）进行营养风险的评估。结果931名养护机构中老年人吞咽障碍的发生率为32．5％，男女无差异（P〉0．05）。60-99岁、70-79岁、80～89岁、90～99岁及100岁以上各年龄段的吞咽障碍的发生率为：0％，17．6％，35．6％，43．7％，50％。老年吞咽障碍者中既往有脑卒中病史者最多；其次是患有咀嚼功能障碍和痴呆者；以及其他慢性病如：阻塞性呼吸道疾病、帕金森病等。养护机构的老年人营养不良的发生率为16．3％，潜在营养不良风险为34．1％；老年吞咽障碍者营养不良的发生率为40．3％，潜在的营养不良风险为38．6％，两者相加的比例高达78．9％，远远高于无吞咽障碍的老年人。结论（1）上海地区养护机构老年人吞咽障碍的发生率高，并随着年龄的增长而升高；（2）老年吞咽障碍者的营养不良和潜在营养不良风险者比例高，吞咽障碍是老年人营养不良的危险因素。

Objective To investigate the incidence of dysphagia and nutrition risk in the elderly from nursing home in Shanghai in order to provide evidence for rational nutrition therapy for the elderly. Methods Questionnaire survey was per- formed in the subjects （ age ≥ 60y ） from 6 nursing home. The incidence of dysphagia was determined by swallow screening method, and the nutrition risk was evaluated by short-form mini nutrition assessment （MNA-SF）. Results The incidence of dysphagia was 32.5% among the 931 subjects from 6 nursing home, with no significant difference in gender. The inci- dences of dysphagia were 0% （60-69y）, 17.6% （70-79y）, 35.6% （80-89y）, 43.7% （90-99y） and50% （100 y- ）, respectively. The most common past medical history of elderly with dysphagia was stroke, followed by masticatory dysfunction and dementia. Others included chronic disease, obstructive respiratory disease, Parkinson＇s disease. The in- cidence of malnutrition was 16.3 % in the elderly from nursing home, and the potential malnutrition risk was 38.6 %. The incidence of malnutrition was 40.3% in the elderly with dysphagia, and the potential malnutrition risk was 38.6%. The total risk of malnutrition in the elderly with dysphagia was up to 78.9%, which was much higher than that of the elderly without dysphagia. Conclusions （ 1 ） The dysphagia incidence, increasing with age, is high in the elderly from nursing home in Shanghai. The elderly with dysphagia has a higher risk of malnutrition or potential malnutrition. （2） Dysphagia is the risk factor of malnutrition in the elderly.