老年痴呆患者的营养状况分析

Nutrition status of elderly patients with dementia

目的了解不同痴呆类型、认知程度和日常生活能力老年(≥70岁)痴呆患者的营养状况,为临床医疗提供指导。方法收集125例老年痴呆患者(其中阿尔茨海默病82例、血管性痴呆43例)的临床资料,根据简易智能状态检查表将患者分为轻度、中度、重度痴呆;根据基本日常生活能力量表将患者分为完全生活自理和轻度、中度和严重功能障碍。对痴呆患者进行微型营养评价精法(MNA-SF)测评和一些营养生化指标的检测,并以同期年龄匹配的因稳定期高血压、轻症冠心病及脑动脉硬化症等疾病住院治疗的老年患者作为对照,统计分析不同组别患者之间检测指标的差异。结果痴呆患者血白蛋白水平明显低于对照组;重度痴呆患者血白蛋白水平低于轻度痴呆患者和对照组;重度痴呆患者MNA-SF值明显低于轻度痴呆患者;严重功能障碍痴呆患者血白蛋白水平和MNA-SF值明显低于轻、中度功能障碍痴呆患者和生活自理痴呆患者。结论重度痴呆和严重功能障碍痴呆患者的营养状况较轻、中度痴呆患者明显恶化,临床上应作针对性治疗。以改善患者的病情。

Objective To assess the nutrition status of elderly patients with dementia. Methods One hundred and twenty five patients with dementia, including 82 cases of Alzheimer＇s disease and 43 cases of vascular dementia were included in the study. Patients were classified as mild, moderate and severe cognitive impairment according to scores of mini-mental state examination; and also classified as mild, moderate and severe functional disability according to Barthel Index. Patients were assessed by Mini Nutritional Assessment short form （MNA-SF）, and serum albumin, prealbumin, lymphocyte count, hemoglobin and transferrin were measured. The nutritional status of patients was compared with controls, and also compared among patients with different level of cognitive impairment and functional disability. Results Serum albumin levels in patients with severe cognitive impairment were lower than those in patients with mild cognitive impairment and controls. MNA-SF score in patients with severe cognitive impairment was lower than that in patients with mild cognitive impairment. Serum albumin levels in patients with severe functional disability were significantly lower than those in patients with mild, moderated disability and independent patients. Conclusion The nutritional status in patients with severe cognitive impairment and severe functional disability is worsening compared to patients with mild and moderated problems.