老人身體組成評估與應用

Assessment and Application of Body Composition in the Elderly

錢桂玉(Kuei-Yu Chien) ； 張雅萍(Ya-Ping Chang) ； 李美月(Mei-Yueh Lee)

《臺灣膳食營養學雜誌》 9卷2期 (2017/12) Pp. 15-24

https://doi.org/10.6709/TJD.201712_9(2).0002

摘要

身體組成是醫療、照護、運動與營養促進策略共同關切重點，健康促進首重評估，必須要先評估才能擬訂有效適當的健康促進策略。隨著老化過程伴隨而來的身高改變、身體組成分布改變，致使成年體位標準不適用於老人。本文以文獻蒐集、科學實證以及臨床觀點說明各國老人的身體質量指數（body mass index, BMI）、肌肉量（muscle mass）、腰圍、小腿圍與上臂圍的適當範圍及應用。適合亞洲之BMI 建議範圍是22 ~ 27 kg/m^2，若等於低於20 kg/m^2 則有營養不良的風險。四肢骨骼肌量／ BMI 男性建議大於0.72 m2，女性大於0.47 m^2。小腿圍建議男性大於30 cm，女性大於27 cm；上臂圍男性大於23 cm，女性大於22 cm。此外，身體組成評估與應用時需確認與留意下列事項：一、身體組成評估需依照評估目的，選擇適合評斷切點；二、依據可行性選擇評估工具；三、不同年齡層，適用評估指標不同；四、宜縱向長期觀察，方能確認對個案健康狀況，並符合其個人需求之最佳體位；五、若個案合併慢性疾病，則需搭配生理以及血液生化指標進行評估。

關鍵字

高齡 ； 身體質量指數 ； 肌肉量 ； 體圍

並列摘要

Body composition assessment is a major issue in the promotion of strategies in health care, exercise and nutrition. It is necessary to assess the need for an effective and appropriate health promotion strategy. As the aging process is accompanied by changes in height and body composition, adult body composition standards do not apply to the elderly. We attempted to review the literature and scientific evidence, to present the reference for body composition among the elderly, regarding body mass index (BMI), muscle mass, waist circumference, calf circumference and upper arm circumference. We suggested that the ideal range of BMI is 22－27 kg/m^2 for Asian if less than 20 kg/m^2, there is a risk of malnutrition. The recommended value for the ratio of lower limb skeletal muscle mass to BMI is greater than 0.72 m^2 in men, and greater than 0.47 m^2 in women. The recommended calf circumference in men is greater than 30 cm, and greater than 27 cm in women. Upper arm circumference in men is greater than 23 cm, and greater than 22 cm in women. In addition, body composition assessment and application need to confirm and pay attention to the following: (1) body composition assessment in accordance with the purpose of assessment, by selecting the appropriate cut off point; (2) health care professionals should select assessment tools based on their feasibility; (3) the application of appropriately different assessment indicators for different age groups; (4) longitudinal long-term observation, in order to confirm health status, and meet their individual needs to meet the required body composition? (5) health care professionals need to match the physiological and biomarkers in the assessment for the elderly with chronic disease.

並列關鍵字

older adult ； body mass index ； muscle mass ； body circumference