| BackgroundChina is now in a period of accelerated aging, the aging on the whole shows such features as a huge scale, a rapid growth, regional imbalances, rural-urban inversion, more women than men, getting aged before getting rich. The aging of the population has become a major impact on non-traditional security of the economic society. In1950s, the concept of successful aging (SA) or healthy aging (HA) was proposed and gradually paid attention. The appearance of the concept of healthy aging as well as its development is of great significance to help face the challenges of aging. The goal of healthy aging is to improve the health and longevity of the most elderly population, namely the life expectancy, and more important, to improve the quality of their life. The nutritional status of older people and their health are closely related, and proper nutrition for the elderly have great influence on keeping normal physiological functions, delaying aging, and preventing diseases. Therefore, it is essential to study the nutritional status of older people and its influential factors so as to develop some measures to promote proper nutrition state.At present, our country is at the transition stage from the family support to the social support. The inadequate state investments in the nursing homes, lack of attention, varying degree of malnutrition among older people in a lot of nursing homes seriously affected the health status and the quality of the life of the elderly. Taking into account so large a special old group, it is necessary to study their status of nutrition and health.Purpose1. With "healthy aging" as the general goal, and on the base of a survey on the nutritional status of the aged in Home for the aged Guangzhou, The paper is mainly focused on the major influential factors on the nutritional status of elderly, to improve the elderly health conditions, and reduce related diseases, and finally promote healthy aging.2.It aims to further improve the management and service of the pension funds, to provide comprehensive, systematic and standardized service to the elderly, and to provide theoretical guidance and basis as well.MethodThis study was made in Home for the aged Guangzhou during June to August applying the cluster sampling survey method to all the old people over the age of60within the inclusion criteria or exclusion criteria. The investigators adopted the face-to-face interviews and collected the structured questionnaires to research on the status of nutrition and influential factors, and measure the indexes of physical examination according to the unified standard (including height, weight, upper arm circumference and blood pressure, etc). The survey data, and other results about nutritional status of the elderly are presented with a statistical description with frequency, constituent ratios, means and the standard deviations. Normal testing and homogeneity of variance testing are applied to continuous variables:using T-test of independent sample and variance analysis on the t-test testable, and otherwise using Mann Whitney U test and Kruskal-Wallis H test. Chi-square test is applied for categorical variables. In addition, taking MNA score as the dependent variable, and the results of the research from seven aspects as the independent variables (including survey data, dietary energy, nutrients intakes, GDS score, HDS score and BADL etc), a multiple linear regression model is established to analyze how related factors influence the nutritional status of the elderly.Content1.The statement of general information about certain old people. By using a questionnaire get involved concrete items such as the personal social status (including gender, age, education, occupation, marital status, etc), the personal economic conditions, the habits of everyday life, the knowledge about nutrition and health care, the prevalence of chronic diseases, and so on.2.The statement of nutritional and health status of the elderly, including the use of Mini Nutritional Assessment (MNA) to investigate the nutritional status of the elderly, and the method of making body measurements.3.The study of the influential factors on the nutritional status of the elderly, including the description of daily activities of the elderly——by means of Activity of Daily Living Scale (ADL)——to evaluate the elderly activity, and to determine whether the ADL function of an aged independent or disordered; the description of the depression status of the elderly——by means of the Geriatric Depression Scale(GDS)——to screen for the depression status and judge whether the depression happens. The simple tests on cognitive function——by means of Hasegawa Dementa Scale (HDS)——to get known whether cognitive functions of the elderly are damaged; the description of the dietary status of the elderly——by means of a combination of measuring method and dietary investigation——to Investigate the24-hour dietary conditions for3consecutive days (to avoid holidays). The investigation includes meals, snacks and nutritional supplements and other food.4.Analysis of the factors affecting the nutritional status of the elderly. Made a synthesis of the various situations of the elderly after the investigations, set the total score of the mini nutritional assessment (MNA) as the dependent variable, the indicators in the above scales variables, find out the main factors which may affect the nutritional status of the elderly, analyze the relation between the influential factors and the total score of MNA through multiple linear regression, build the regression equation, and explore the factors that affect the nutritional status of the elderly and study their effects in significance.Results1.This study investigated the Guangzhou public nursing homes, a total of207elderly people.For the elderly in the nursing home, the malnutrition and over nutrition exist at the same time. MNA results showed that the rate of malnourished is9.4%and malnutrition in high-risk situation68%, BMI results showed that the prevalence of overweight and obesity are at the rate of21.8%and10.9%. According to the assessment of waist-hip ratio, central obesity occurs at a high rate of67.8%, and the female takes up79%.2.The elderly has a high prevalence of chronic diseases and in this study86.96%of the elderly are suffering one or more chronic diseases. The patients with one chronic disease account for24.88%; those with2chronic diseases accounted for21.46%; those suffering3or more chronic diseases reached up to40.98%. The cardio-cerebrovascular disease is listed the first, next in line followed by the bone and joint disease and metabolic diseases. Among the chronic diseases, the prevalence of hypertension comes first with the rate of57.07%, followed by diabetes (24.88%) and coronary heart disease (20%).3.The result of the basic activities of daily living (BADL) of the elderly is better than that of the instrumental activities of daily living (IADL)(P<0.05). With the growth of the age, the independent living ability of the elderly decreased gradually, especially the instrumental activities of daily living, so age is the main factor affecting the activities of daily life of the elderly.4.The score of the elderly depression was4.33, and30.4%of the investigated elderly population are affected with different degree of depression. The mild depression accounts for23%, and the severe depression accounts for7.4%. With the growth of the age, the mild depressive symptoms decreased, while the severe depression had no significant change.5.The elderly patients according to HDS scores22.68, the average score were higher than women in all age groups for men (P<0.05).Block for gender factors,the elderly in different age groups HDS scores decline with age, was statistically significant difference between the groups (P<0.05).29.1%of the investigated elderly population are suffering impaired cognitive function, with a larger proportion of women than men. With the increase of age, cognitive function of the elderly is decreasing.6.The elderly don’t take in enough dietary nutrients, especially dietary fiber, vitamin A, vitamin Bi, vitamin B2, calcium, selenium, zinc and other nutrients. However, they get adequate protein and high quality protein, more fat intake, exceedingly more cholesterol than the standard, which is especially true of women. The ratio of the heat energy of three males is4:3:3, and the heat ratios of protein, fat, carbohydrate generally meet the recommended percentages of China Nutrition Society:10%～15%,20%～30%,and55%～65%separately.7.With MNA score as the dependent variable, influential factors are involved in the multivariate linear regression analysis and classification analysis equation such as (1) age (2) management for money;(3) physical exercise, aerobics, and Tai Chi;(4) self-evaluation of weight, and frequent acquisition of nutritional knowledge;(5) the ADL barrier, arm-circumference, hypertension;(6) depression;(7) vitamin E、 dietary fiber, and vitamin A intake.8.Taking into account the influence of various factors on the MNA score,7important predictive factors come out, in which, frequent acquisition of nutritional knowledge, iron intake, hypertension and self-evaluation of weight have a positive effect on the nutritional status of the elderly, while no management for money, the ADL disorder and depression are the risk factors for the bad nutritional status. Conclude1.High incidence of malnutrition in high-risk situation of the old,central obesity occurs at a high rate.For the elderly in the nursing home, the malnutrition and over nutrition exist at the same time.2.The elderly has a high prevalence of chronic diseases.Among the chronic diseases,the prevalence of The cardio-cerebrovascular disease and hypertension is listed the first,,respectively. With the growth of the age, the ratio of daily life activities ability barrier,the elderly are suffering impaired cognitive function, has a tendency to rise.the elderly depression levels had no obvious change.3.The elderly don’t take in enough dietary nutrients.However, they get exceedingly more cholesterol than the standard, which is especially true of women. The ratio of the heat energy of three males is4:3:3, and the heat ratios of energy-yielding nutrient generally meet the recommended percentages of China Nutrition Society.4.Frequent acquisition of nutritional knowledge, iron intake, hypertension and self-evaluation of weight,dietary fiber, and vitamin A intake have a positive effect on the nutritional status of the elderly, while no management for money, the ADL disorder and depression vitamin E intake are the risk factors for the bad nutritional status. |
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