입원 노인의 연령별 영양불량 위험요인
Risk Factors of Malnutrition by Age in Hospitalized Older Adults
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목적: 영양불량은 모든 연령대의 대상자들에게 영향을 미치지만 노인의 경우 특히 취약하다. 본 연구는 입원 노인의 연령별 영양불량에 영향을 미치는 요인을 평가했다. 방법: 2010년부터 2017년까지 입원하여 영양지원을 받은 노인을 대상으로 후향적 조사연구를 시행하였다. 인구사회학적 자료, 진단명, 영양지원 방법, 동반질환 개수, 낙상 위험 평가, APACHE 점수, 중환자실 입실 여부 등의 자료를 수집하였다. 영양불량은 BMI 18.5 kg/m2미만으로 정의하였다. 대상자는 연소노인(65~74세), 고령노인(75세~84세), 초고령노인(85세 이상)으로 범주화 하였다. 결과: 총 7,130명의 대상자가 포함되었고, 4,028명은 연소노인, 2,506명은 고령노인, 596명은 초고령노인으로 분류되었다. 초고령노인은 다른 노인집단과 비교하여 영양불량 유병률이 가장 높았다. 다변량 분석결과, 전체 대상자의 영양불량 위험요인으로 정맥 영양 요법, 음주, 낙상 고위험이 확인되었다. 연령별로 살펴보면, 연소노인에서는 정맥 영양 요법과 음주 요인이, 고령노인에서는 낙상 고위험요인, 초고령노인에서는 성별 중 남성 노인이 영양불량 위험요인으로 확인되었다. 결론: 고령은 노인의 영양불량에 가장 큰 영향을 미치는 요인이다. 또한, 노인의 연령에 따라 영양불량에 영향을 미치는 요인이 다르므로, 입원 노인의 영양상태 개선을 위해서는 연령에 따른 구체적인 영양지원 전략이 필요하다.
Abstract
Purpose: Malnutrition affects all age groups, but older adults are particularly more vulnerable to nutritional deficiencies. This study evaluated the age-specific factors affecting malnutrition in hospitalized older adults. Methods: A retrospective study was conducted on inpatient elderly people who received artificial nutrition from 2010 to 2017. Data of demographics, diagnosis, type of nutrition therapy, number of comorbidity, fall risk assessment, Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) score, and intensive care unit admission were collected. Malnutrition was defined as a body mass index (BMI) of less than 18.5 kg/m2. Patients were classified as the young-old (65~74 years old), the old-old (75~84 years old), or the oldest-old (85 years old or older). Results: A total of 7,130 older adults were included, and 4,028 patients were classified as the young-old, 2,506 into the old-old, and 596 into the oldest-old. Proportion of malnutrition was higher in the oldest-old compared to the other groups. In multivariate analysis, parenteral nutrition, alcohol, and high risk of falls were factors affecting malnutrition in all groups. Parenteral nutrition and alcohol in the young-old, high risk of falls in the old-old, and male sex in the oldest-old were the factors affecting malnutrition by the age group. Conclusion: Older age was the most significant factor affecting malnutrition. Specific strategies by age are needed to improve nutritional status in hospitalized older adults as influencing factors for malnutrition vary among different age groups.
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