臺北市社區老年人營養不良風險、低小腿圍、低握力與可能肌少症之盛行率及其相關性探討

Assessing the Prevalence and Association of Malnutrition and Possible Sarcopenia Among Community-Dwelling Older Adults in Taipei City

張惠萍(Hui-Ping Chang) ； 王培竹(Pei-Chu Wang) ； 魏子秦(Tzu-Chin Wei) ； 林芷瑄(Chih-Hsuan Lin) ； 吳明潔(Ming-Jie Wu) ； 龔亭綺(Ting-Chi Gong) ； 吳家彤(Chia-Tung Wu) ； 戴暐庭(Wei-Ting Tai) ； 周秀娟(Hsiu-Chuan Chou) ； 黃孟娟(Meng-Chuan Huang)

《臺灣膳食營養學雜誌》 15卷1期 (2023/06) Pp. 13-29

https://doi.org/10.6709/TJD.202306_15(1).0002

摘要

本研究旨在探討臺北市社區長者營養不良風險、低小腿圍、低握力與可能肌少症的盛行率，以及它們之間的相關性。研究採橫斷式方便取樣，收案1000位65歲以上的長者，收集迷你營養評估量表－短版（Mini Nutritional Assessment Short-Form, MNA-SF）、可能肌少症問卷（strength, assistance with walking, rising from a chair, climbing stairs, and falls, SARC-F）、小腿圍（calf circumference, CC）及握力（hand grip strength, HGS）等資料。MNA-SF≤11分定義為具營養不良風險，SARC-F、CC、HGS則依據2019亞洲肌少症工作小組診治共識切點進行分析。結果顯示，參與者平均年齡74.1±6.8歲，74.9%為女性；營養不良風險、可能肌少症、低小腿圍及低握力之盛行率分別為11.1%、15.2%、26.5%及37.2%。多變量邏輯斯迴歸分析發現老年人具營養不良風險（odds ratio [OR] = 1.960, 95% confidence interval [CI] =1.098－3.496）、低小腿圍（OR=1.678, 95%CI=1.088－2.589）與低握力呈現顯著正相關。在年齡部份，相較於65～74歲，75～84（OR=2.339, 95%CI=1.563－3.500）及≥85歲（OR=5.290, 95%CI=2.569－10.890）發生低握力風險呈現倍數的增加。進一步以低握力個案進行次族群分析，營養不良風險及低小腿圍之盛行率分別僅有17.8%及37.5%，可知MNA-SF和CC是常用於篩檢社區長者營養不良風險之工具，但可能會低估或遺漏低握力的問題，需要進一步研究其敏感性和特異性。此外，相對於肌肉質量減少，老年族群所面臨更嚴重肌力低下之風險問題，未來應即早進行篩檢，擬定營養、運動和生活型態之介入措施，以達預防及延緩失能之目標。

關鍵字

營養不良 ； 握力 ； 肌力 ； 肌少症 ； 可能肌少症 ； 迷你營養評估量表－短版

並列摘要

This study aimed to explore the prevalence of malnutrition risk and its correlation with possible sarcopenia among community-dwelling older adults in Taipei City. A convenience sample of 1000 participants, aged 65 or older, was recruited for this cross-sectional study. Data were collected using the Mini Nutritional Assessment-Short Form (MNA-SF) and the strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) questionnaire, as well as calf circumference (CC) and handgrip strength (HGS). Participants with an MNA-SF score between 0-11 points were classified as "at-risk or malnutrition." The SARC-F scores, CC, and HGS measurements, were analyzed based on the 2019 Asian Working Group for Sarcopenia consensus cut-off points. The mean age of the participants was 74.1 ± 6.8 years (74.9% female). The prevalence of at- risk or malnutrition, possible sarcopenia, low CC, and low HGS, was 11.1%, 15.2%, 26.5%, and 37.2%, respectively. Multivariate logistic regression analysis found that elderly participants had a risk of malnutrition (odds ratio [OR] = 1.960, 95% CI = 1.098-3.496), and low CC (OR = 1.678, 95% CI = 1.088-2.589) was significantly positively correlated with low grip strength. Comparing different age groups, participants aged 75-84 years (OR = 2.339, 95% CI= 1.563-3.500), and those ≥ 85 years (OR = 5.290, 95% CI= 2.569-10.890) had higher risks of low grip strength than participants aged 65-74 years. Moreover, there was a significant age-dose response effect. Subgroup analysis of the participants with low HGSs indicated that the prevalence of at-risk or malnutrition and low CC was 17.8% and 37.5%, respectively. Although MNA-SF and CC are commonly used screening tools for malnutrition among community-dwelling older adults, they may underestimate or overlook the problem of low HGS. Further research is needed to evaluate sensitivity and specificity. Considering decreased muscle mass, the risk of muscle strength loss in the elderly population must be recognized early, and nutrition and exercise lifestyle intervention strategies are needed to prevent disability.

並列關鍵字

malnutrition ； handgrip strength ； muscle strength ； sarcopenia ； possible sarcopenia ； Mini-Nutritional Assessment Short-Form (MNA-SF)