| OBJECTIVE: To investigate the current nutrition and health status of the elderly living in aged care institutions in Hubei province,and to explore the main nutritional problems and related influencing factors of the population,so as to provide a scientific basis for formulation of the nutrition improvement plan for this group of population,and to provide basic data for the “Nutrition and Dietary Service Standard in Aged Care Institutions ” in Hubei province.METHODS: A multi-stage random sampling method was used to investigate the aged care institutions in 17 cities/ prefectures in Hubei province.The food consumption records of three consecutive days were used to investigate the meals in the canteen of the age care institutions.At the same time,a questionnaire survey and physical measurement were conducted for the elderly living in aged care institutions to understand the status of nutrition and health of the elderly and their related exposure factors.Mini Nutritional Assessment(MNA)was used to assess the nutritional status of the elderly.Basic Activities of Daily Living Scale(BADL)was used to evaluate the disability level of the elderly.The General Anxiety Disorder Scale(GAD-7)and Patient Health Questionnaire-9(PHQ-9)were used to assess the negative emotions of the elderly.Physical measurements were taken to obtain height,weight,upper arm circumference and lower leg circumference.The obtained data were used Epidata3.0 and Excel to establish the database,and SPSS24.0 was used for statistical analysis to analyze the nutrition and health status,and to explore the influencing factors malnutrition in this population.RESULTS: In this study,a total of 18 aged care institutions were sampled in Hubei province.Finally,382 questionnaire survey data of the elderly and 10 valid dietary survey contents of canteen of aged care institutions were obtained.The results were as follows:(1)Nutritional status: The overall dietary structure of aged care institutions participating in dietary survey was not balanced.The average daily intake of cereals and potatoes,vegetables,fruits,livestock and poultry meat,fish and shrimp,eggs,milk and dairy products,beans and nuts,edible oil and salt were 378.13 g,472.80 g,4.32 g,141.87 g,41.67 g,47.21 g,5.26 g,17.05 g,44.37 g and 6.00 g,respectively.The average MNA score of382 subjects was 19.45±3.66.The average scores of the four dimensions of the MNA scale,namely anthropometry,diet evaluation,overall assessment and self-assessment,were4.57±1.91,6.71±1.00,5.66±1.68 and 2.60±1.02,respectively.The rate of malnutrition risk was 65.71%(251/382),and the rate of malnutrition was 23.30%(89/382).(2)Health status: The overall health status of the elderly in aged care institutions is poor.26.84% of the elderly had limited basic daily living ability.84.29% of the subjects suffered from at least one chronic disease,and 21.12% of them suffered from three or more chronic diseases.In terms of self-evaluation of health,27.75% of the subjects rated their health status as very good,25.39% as good.The mental health status of the elderly was relatively good,87.46% of the elderly had no anxiety,88.05% of the elderly had no depression.(3)Analysis of the influencing factors of malnutrition: The nutritional status of the elderly in aged care institutions were affected by social demographic characteristics,lifestyle,dietary habits and health status,etc.Binary logistic regression analysis showed that the residence,self-rated health level and the number of chronic diseases were related to occurrence of malnutrition.Compared with older adults without any chronic disease,the OR value of malnutrition or malnutrition risk was 7.220(95%CI: 1.507,34.596,P=0.013)in those with three or more chronic diseases.Multiple linear regression analysis showed that the type of aged care institution(β=-0.701,P<0.0001),source of nursing expenses(β=-0.954,P=0.023),life satisfaction(β=-0.812,P=0.004),self-rated health level(β=-0.746,P=0.001),exercise habits(β=-1.175,P=0.008),self-care ability(β=-1.023,P<0.0001),fresh vegetable intake frequency(β=-0.607,P=0.015)were the factors influencing the MNA score.CONCLUSIONS: The dietary structure of the elderly in aged care institutions in Hubei province is not reasonable.The rates of malnutrition or malnutrition risk are high.The condition of chronic of the population are not good.The city of residence,the level of self-rated health and the number of chronic diseases were related to the occurrence of malnutrition.Types of aged care institutions,sources of nursing expenses,life satisfaction,self-rated health level,exercise habits,self-care ability,and fresh vegetable intake frequency were the influencing factors for MNA scores of the elderly in aged care institutions.It is suggested to strengthen the nutrition and dietary services,and to establish and improve the health service management system for the elderly in aged care institutions,so as to promote the nutritional status and health level of the population. |
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