湖南省老年轻度认知障碍患者营养风险影响因素分析

Nutritional risk factors in elderly patients with mild cognitive impairment in Hunan Province

目的了解湖南省轻度认知障碍(MCI)患者营养风险现状,及各因素对其营养风险的综合影响。方法 2014年10月-2016年12月,采用多阶段抽样的方法,调查湖南省5市符合研究要求的205名正常居民(NC组)和176名轻度认知障碍患者(MCI组),了解其一般人口学特征、认知水平和营养风险,分析对象基本情况和认知水平对其营养风险的综合影响。结果 NC组和MCI组对象的老伴健在情况、居住情况、月收入情况、医保方式、生涯主要职业、睡眠质量、社交活动、锻炼习惯、饮食规律情况对其NRS 2002量表得分的影响差异均有统计学意义(均P<0.05);两组对象长沙版Mo CA量表得分(t=29.67,P=0.00)、NRS 2002量表得分(t=15.81,P=0.00),差异均有统计学意义;长沙版Mo CA量表和NRS2002量表得分的相关性分析,NC组(r=0.56,P=0.00)和MCI组(r=0.73,P=0.00)均显示为显著的正向相关性;影响MCI组患者是否发生营养风险的因素依次为:饮食规律(OR=10.80)、认知水平(OR=6.42)、居住方式(OR=4.71)、月收入情况(OR=4.35)、医保方式(OR=3.86)、睡眠质量(OR=2.64)、锻炼情况(OR=2.08)。结论老年MCI患者其营养风险显著大于正常人群,饮食不规律、认知水平较低、独居、月收入水平较低、没有医保、睡眠质量较差、无锻炼习惯的老年人应格外防止营养风险对患者身体状态的负面影响。

Objective To learn about the current situation of nutrition risk of the elderly patients with mild cognitive impairment （ MCI ） in Hunan Province, and to analyze the combined influence of each factor on nutrition risk. Methods By means of multistage sampling, 205 normal cognition residents （NC group） and 176 patients with MCI （MCI group） who met research requirements were selected from 5 cities in Hunan Province from October, 2014 to December, 2016. Their basic demographic information, cognitive level and nutrition risk were surveyed and the combined influence of the respondents ＇ basic situation and cognitive level on their nutrition risk was analyzed. Results For both NC group and MCI group, the survival of the respondents ＇ spouses, their living conditions, monthly income, type of medical insurance, career and occupation, sleep quality, social activities, exercise habit and pattern of diet all significantly influenced their Nutritional Risk Screening （ NRS）2002 score （all P〈0.05）. The Montreal Cognitive Assessment （ MoCA, Changsha version） score （t= 29.67,P=0.00） and NRS 2002 score（ t= 15.81,P=0.00） were significantly different between NC group and MCI group. MoCA score and NRS 2002 score were positively correlated both in NC group （r = 0.56, P = 0.00 ） and MCI group （r= 0.73, P = 0.00）. The factors affecting nutrition risk of the patients in MCI group were pattern of diet（ OR= 10.80）, cognitive level （ 0R=6.42）, living style （ OR=4.71 ）, monthly income （OR=4.35）, type of medical insurance （ OR = 3.86 ）, sleep quality （ OR = 2.64 ） and exercise （ OR = 2.08 ）. Conclusions Nutrition risk of the aged patients of with MCI is significantly higher than that of the normal cognition residents. Typically, the aged with irregular pattern of diet, low cognition level, lonely and solitary life, low monthly income and bad sleep quality as well as those without medical insurance or exercise should prevent the adverse effects of nutrition risk on their health.