题名

台灣老人營養狀況與認知衰退之關聯性探討

并列篇名

The Impact of Nutritional Status on Cognitive Decline in Elderly Taiwanese

DOI

10.6288/TJPH2013-32-01-05

作者

黃純甄(Chuen J. Huang);蔡仲弘(Alan C. Tsai)

关键词

認知風險 ; 營養狀況 ; 老年人 ; cognitive decline ; nutritional status ; elderly

期刊名称

台灣公共衛生雜誌

卷期/出版年月

32卷1期(2013 / 02 / 01)

页次

42 - 51

内容语文

繁體中文

中文摘要

Objectives: To investigate the association of nutritional status and cognitive status and to identify a possible causal role of nutritional status in the future risk of cognitive decline in older Taiwanese. Methods: The study analyzed the 1999 and 2003 datasets of the ”Survey of Health and Living Status of the Elderly in Taiwan”. Subjects were interviewed, face-to-face, with a structured questionnaire. The Mini Nutritional Assessment (MNA) was used to rate nutritional status and the Short Portable Mental Status Questionnaire (SPMSQ)、was used to rate cognitive status. This cross-sectional study included 2,672 elderly at baseline while the longitudinal analysis included the 1895 subject who survived in 2003, less those who had severe cognitive impairment at baseline and those who failed to complete the 2003 interview. Both models controlled for socio-demographic factors, lifestyle, food intake, and health and medical conditions. Results: In regression models that controlled for possible confounders, cross-sectional analysis showed a significant association between nutritional status and cognitive status (OR=2.07, 95% CI=1.57-2.75, p<0.001); whereas the longitudinal analysis showed that poor nutrition was associated with a 43% increase (1.43, 1.01-2.04, p=0.049) in cognitive decline four years later. Conclusions: Results suggest that nutritional status can affect subsequent cognitive function. It is therefore important for the elderly to pay greater attention to their nutritional status in order to reduce the risk of the age-related cognitive decline. The MNA can predict functional decline as well as rate the nutritional status of the elderly.

英文摘要

Objectives: To investigate the association of nutritional status and cognitive status and to identify a possible causal role of nutritional status in the future risk of cognitive decline in older Taiwanese. Methods: The study analyzed the 1999 and 2003 datasets of the ”Survey of Health and Living Status of the Elderly in Taiwan”. Subjects were interviewed, face-to-face, with a structured questionnaire. The Mini Nutritional Assessment (MNA) was used to rate nutritional status and the Short Portable Mental Status Questionnaire (SPMSQ)、was used to rate cognitive status. This cross-sectional study included 2,672 elderly at baseline while the longitudinal analysis included the 1895 subject who survived in 2003, less those who had severe cognitive impairment at baseline and those who failed to complete the 2003 interview. Both models controlled for socio-demographic factors, lifestyle, food intake, and health and medical conditions. Results: In regression models that controlled for possible confounders, cross-sectional analysis showed a significant association between nutritional status and cognitive status (OR=2.07, 95% CI=1.57-2.75, p<0.001); whereas the longitudinal analysis showed that poor nutrition was associated with a 43% increase (1.43, 1.01-2.04, p=0.049) in cognitive decline four years later. Conclusions: Results suggest that nutritional status can affect subsequent cognitive function. It is therefore important for the elderly to pay greater attention to their nutritional status in order to reduce the risk of the age-related cognitive decline. The MNA can predict functional decline as well as rate the nutritional status of the elderly.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. 行政院衛生署國民健康局:中老年身心社會生活狀況長期追蹤調查系列/調查簡介。台北:行政院衛生署國民健康局,2009。Bureau of Health Promotion. Department of Health, Executive Yuan, R.O.C. (Taiwan). The Summary of Survey of Health and Living Status of the Older in Taiwan (SHLSET). Taipei: Bureau of Health Promotion, Department of Health, Executive Yuan, R.O.C. (Taiwan). 2009. [In Chinese]
  2. Ahmed, F.E.(1992).Effect of nutrition on the health of the elderly.J Am Diet Assoc,92,1102-8.
  3. Chandra, R.K.,Imbach, A.,Moore, C.,Skelton, D.,Woolcott, D.(1991).Nutrition of the elderly.Can Med Assoc J,145,1475-87.
  4. Chen, R.C.,Chang, Y.H.,Lee, M.S.,Wahlqvist, M.L.(2011).Dietary quality may enhance survival related to cognitive impairment in Taiwanese elderly.Food Nutr Res,55
  5. Chodosh, J.,Seeman, T.E.,Keeler, E.(2004).Cognitive decline in high-functioning older persons is associated with an increased risk of hospitalization.J Am Geriatr Soc,52,1456-62.
  6. Craik, F.I.M.(ed.),Salthouse, T.M.(ed.)(2000).Handbook of Aging and Cognition.Mahwah, NJ:Erlbaum.
  7. Davidson, J.,Getz, M.(2004).Nutritional risk and body composition in free-living elderly participating in congregate meal-site programs.J Nutr Elder,24,53-68.
  8. de Groot, L.,Beck, A.M.,Schroll, M.,van Staveren, W.A.(1998).Evaluating the determine your nutritional health checklist and the mini nutritional assessment as tools to identify nutritional problems in elderly Euroeans.Eur J Clin Nutr,52,877-83.
  9. Deschamps, V.,Astier, X.,Ferry, M.,Rainfray, M.,Emeriau, J.P.(2002).Nutritional status of healthy elderly persons living in Dordogne, France, and relation with mortality and cognitive or functional decline.Eur J Clin Nutr,56,305-12.
  10. Ferdous, T.,Cederholm, T.,Kabir, Z.N.,Hamadani, J.D.,Wahlin, A.(2010).Nutritional status and cognitive function in community-living rural Bangladeshi older adults: data from the poverty and health in ageing project.J Am Geriatr Soc,58,919-24.
  11. Fillenbaum, G.G.,Smyer, M.A.(1981).The development, validity, and reliability of the OARS multidimensional functional assessment questionnaire.J Gerontol,36,428-34.
  12. Goldman, N.,Lin, I.F.,Weinstein, M.,Lin, Y.H.(2003).Evaluating the quality of self-reports of hypertension and diabetes.J Clin Epidemiol,56,148-54.
  13. Guerin, O.,Soto, M.E.,Brocker, P.(2005).Nutritional status assessment during Alzheimer's disease: results after one year.J Nutr Health Aging,9,81-4.
  14. Iizaka, S.,Tadaka, E.,Sanada, H.(2008).Comprehensive assessment of nutritional status and associated factors in the healthy, community-dwelling elderly.Geriatr Gerontol Int,8,24-31.
  15. Ji, L.,Meng, H.,Dong, B.(2012).Factors associated with poor nutritional status among the oldest-old.Clin Nutr,31,922-6.
  16. Joseph, J.,Cole, G.,Head, E.(2009).Nutrition, brain aging, and neuro-degeneration.J Neurosei,29,12795-801.
  17. Joseph, J.A.,Shukitt-Hale, B.,Lau, F.C.(2007).Fruit polyphenols and their effects on neuronal signaling and behavior in senescence.Ann N Y Acad Sci,1100,470-85.
  18. Karakula, H.,Opolska, A.,Kowal, A.,Domanski, M.,Plotka, A.,Perzyriski, J.(2009).Does diet affect our mood? The significance of folic acid and homocysteine.Pol Merkur Lekarski,26,136-41.
  19. Kesse-Guyot, E.,Fezeu, L.,Jeandel, C.(2011).French adults' cognitive performance after daily supplementation with antioxidant vitamins and minerals at nutritional doses: a post hoc analysis of the Supplementation in Vitamins and Mineral Antioxidants (SU.VI.MAX) trial.Am J Clin Nutr,94,892-9.
  20. Launer, L.J.,Andersen, K.,Dewey, M.E.(1999).Rates and risk factors for dementia and Alzheimer's disease: results from EURODEM pooled analyses, EURODEM Incidence Research Group and Work Groups. European Studies of Dementia.Neurology,52,78-84.
  21. Lee, Y.,Back, J.H.,Kim, J.(2010).Systematic review of health behavioral risks and cognitive health in older adults.Int Psychogeriatr,22,174-87.
  22. Levey, A.,Lah, J.,Goldstein, F.,Steenland, K.,Bliwise, D.(2006).Mild cognitive impairment: an opportunity to identify patients at high risk for progression to Alzheimer's disease.Clin Ther,28,991-1001.
  23. Marshall, T.A.,Stumbo, P.J.,Warren, J.J.,Xie, X.J.(2001).In adequate nutrient intakes are common and are dwelling elderly.J Nut,131,2192-6.
  24. Odlund, Olin A.,Koochek, A.,Ljungqvist, O.,Cederholm, T.(2005).Nutritional status, wellbeing and functional ability in frail elderly service flat residents.Eur J Clin Nutr,59,263-70.
  25. Pearson, J.M.,Schlettwein-Gsell, D.,Brzozowska, A.,van Staveren, W.A.,Bjornsbo, K.(2001).Life style characteristics associated with nutritional risk in elderly subjects aged 80-85 years.J Nutr Health Aging,5,278-83.
  26. Péneau, S.,Galan, P.,Jeandel, C.(2011).Fruit and vegetable intake and cognitive function in the SU.VI.MAX 2 prospective study.Am J Clin Nutr,94,1295-303.
  27. Petersen, R.C.,Doody, R.,Kurz, A.(2001).Current concepts in mild cognitive impairment.Arch Neurol,58,1985-92.
  28. Pfeiffer, E.(1975).A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients.J Am Geriatr Soc,23,433-41.
  29. Spaccavento, S.,Del Prete, M.,Craca, A.,Fiore, P.(2009).Influence of nutritional status on cognitive, functional and neuropsychiatric deficits in Alzheimer's disease.Arch Gerontol Geriatr,48,356-60.
  30. Tsai, A.C.,Chang, T.L.,Yang, T.W.,Chang-Lee, S.N.,Tsay, S.F.(2010).A modified mini nutritional assessment without BMI predicts nutritional status of community-living elderly in Taiwan.J Nutr Health Aging,14,183-9.
  31. Tu, M.C.,Huang, C.W.,Chen, N.C.(2010).Hyperhomocysteinemia in Alzheimer dementia patients and cognitive decline after 6 months follow-up period.Acta Neurol Taiwan,19,168-77.
  32. van de Rest, O.,Geleijnse, J.M.,Kok, F.J.(2008).Effect of fish-oil supplementation on mental well-being in older subjects: a randomized, double-blind, placebo-controlled trial.Am J Clin Nutr,88,706-13.
  33. Vellas, B.,Guigoz, Y.,Garry, P.(1999).The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients.Nutrition,15,116-22.
  34. Williams, K.N.,Kemper, S.(2010).Interventions to reduce cognitive decline in aging.J Psychosoc Nurs Ment Health Serv,48,42-51.
  35. Yen, Y.C.,Rebok, G.W.,Yang, M.J.,Lung, F.W.(2008).A multilevel analysis of the influence of apolipoprotein E genotypes on depressive symptoms in late-life moderated by the environment.Prog Neuropsychopharmacol Biol Psychiatry,32,479-86.
  36. 行政院經濟建設委員會(2008)。中華民國台灣97年至145年人口推計。台北=Taipei:行政院經濟建設委員會=Council for Economic Planning and Development, Executive Yuan, R.O.C. (Taiwan)。
被引用次数
  1. 陳姿蓉、王俊毅(2016)。台灣中老年人閱讀與認知衰退之關聯性分析。臺灣公共衛生雜誌,35(1),94-104。
  2. 謝良博,陳文意,林玉惠(2021)。以成人身高推論出生時期營養狀態對老年時期認知功能障礙的關聯性。醫學與健康期刊,10(1),57-71。
  3. 鄭雨虹、張晉賢(2016)。從實證醫學及文獻初探中醫藥運用於「預防老人失能」的發展性。中醫藥雜誌,27(2),001-011。