老年人营养状态与认知功能的相关性分析  

Correlation analysis between nutritional status and cognitive function in elderly people

作　　者：李娇娇 王秋梅 LI Jiaojiao;WANG Qiumei(Department of Geriatrics,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院老年医学科,北京100730

出　　处：《中国临床保健杂志》2025年第1期67-71,共5页Chinese Journal of Clinical Healthcare

基　　金：国家重点研发计划项目(2022YFF1100400)。

摘　　要：目的探讨老年人营养与认知功能之间的相关性。方法回顾性分析2016年9月至2019年6月北京协和医院老年科住院患者临床资料,应用简易智力状态量表评估认知功能,Fried衰弱量表评估衰弱状态,营养评估使用微营养评估量表简表(MNA-SF);并收集患者营养相关生化指标,包括血红蛋白、白蛋白、前白蛋白、维生素B 12和叶酸等。结果共纳入425例老年患者,中位年龄76岁;其中认知功能正常且强壮者294例(69.2%),仅衰弱者31例(7.3%),仅认知障碍者77例(18.1%),认知障碍且衰弱者23例(5.4%)。单因素分析显示,各组间的营养相关生化指标差异无统计学意义(P>0.05),但营养状态评估有明显差异(P<0.01)。上述4组的MNA-SF评分中位值分别为12、11、10和7分,营养不良的发生率分别为36.8%、56.0%、71.4%和81.8%,其中认知障碍且衰弱组老年人MNA-SF评分最低,营养不良发生率最高。二元逻辑回归分析显示,调整年龄、疾病负担后,营养状态评分与仅认知障碍(OR=0.84,95%CI:0.78~0.91)、仅衰弱(OR=0.79,95%CI:0.71~0.89)和认知障碍且衰弱(OR=0.71,95%CI:0.62~0.80)独立相关,且有统计学意义(均P<0.001)。结论独立于衰弱,老年人营养状态与认知功能相关。Objective To explore the association between nutrition and cognitive function.Methods A retrospective analysis was conducted among inpatients in the Department of Geriatrics of Peking Union Medical College Hospital from September 2016 to June 2019.Cognitive function was assessed by using the Mini-Mental State Examination,frailty status was evaluated with the Fried Frailty Phenotype,and nutritional status was assessed using the Mini Nutritional Assessment-Short Form(MNA-SF).Additionally,nutrition-related biochemical indicators including hemoglobin,albumin,prealbumin,vitamin B 12,and folate were collected.Results A total of 425 elderly patients were included,with a median age of 76 years;among them,294(69.2%)were in the normal and strong cognitive function group,31(7.3%)were frail only,77(18.1%)had cognitive impairment only,and 23(5.4%)had both frailty and cognitive impairment(cognitive frailty).Univariate analysis revealed no differences in nutrition-related biochemical indicators among the groups(P>0.05),but significant differences in nutritional status assessments(P<0.01).The median MNA-SF scores for the four groups were 12,11,10,and 7 points,respectively;the incidence of malnutrition was 36.8%,56.0%,71.4%,and 81.8%,respectively.The cognitive frailty group had the lowest MNA-SF scores and the highest incidence of malnutrition.Binary logistic regression analysis showed that nutritional status scores were independently associated with only cognitive impairment(OR=0.84,95%CI:0.78-0.91),only frailty(OR=0.79,95%CI:0.71-0.89),and cognitive impairment and frailty(OR=0.71,95%CI:0.62-0.80),with statistical significance(all P<0.001)after adjusting for age and disease burden.Conclusion Independent of frailty,nutritional status in the elderly is associated with cognitive impairment.

关 键 词：认知功能障碍 营养不良 衰弱 危险因素 老年人 

分 类 号：R74[医药卫生—神经病学与精神病学]