Association of Nutritional Risk With Gait Function and Activities of Daily Living in Older Adult Patients With Hip Fractures
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective: To investigate the association of nutritional risk with gait function and activities of daily living (ADLs) in older adult patients with hip fractures.Methods: The retrospective data of older adult patients diagnosed with hip fractures who visited the recovery-phase rehabilitation ward between January 2019 and December 2022 were reviewed. Nutritional risk was evaluated using the Geriatric Nutritional Risk Index; gait function and ADLs were assessed using the modified Harris Hip Score subitem and Functional Independence Measure, respectively. Multivariate linear regression and path analysis with structural equation modeling were used to examine the factors associated with ADLs and the associations among the study variables.Results: This study included 206 participants (172 females and 34 males; mean age, 85.0±7.3 years). In the multivariate analysis, gait function (β=0.488, p<0.001), cognitive function (β=0.430, p<0.001), and surgery (β=-0.143, p<0.001) were identified as independent factors. Pathway analysis revealed that nutritional risk was not directly correlated with ADLs but was directly associated with gait and cognitive functions. Gait and cognitive functions, in turn, were directly related to ADLs.Conclusion: Nutritional risk was found to be associated with ADLs through an intermediary of gait and cognitive functions.
Abstract
Objective: To investigate the association of nutritional risk with gait function and activities of daily living (ADLs) in older adult patients with hip fractures.Methods: The retrospective data of older adult patients diagnosed with hip fractures who visited the recovery-phase rehabilitation ward between January 2019 and December 2022 were reviewed. Nutritional risk was evaluated using the Geriatric Nutritional Risk Index; gait function and ADLs were assessed using the modified Harris Hip Score subitem and Functional Independence Measure, respectively. Multivariate linear regression and path analysis with structural equation modeling were used to examine the factors associated with ADLs and the associations among the study variables.Results: This study included 206 participants (172 females and 34 males; mean age, 85.0±7.3 years). In the multivariate analysis, gait function (β=0.488, p<0.001), cognitive function (β=0.430, p<0.001), and surgery (β=-0.143, p<0.001) were identified as independent factors. Pathway analysis revealed that nutritional risk was not directly correlated with ADLs but was directly associated with gait and cognitive functions. Gait and cognitive functions, in turn, were directly related to ADLs.Conclusion: Nutritional risk was found to be associated with ADLs through an intermediary of gait and cognitive functions.
참고문헌 (37)
- Odén A, "Burden of high fracture probability worldwide : secular increases 2010-2040", Osteoporos Int, 26, pp.2243~2248 (2015)
- Takusari E, "Trends in hip fracture incidence in Japan : estimates based on nationwide hip fracture surveys from 1992 to 2017", JBMR Plus, 5, pp.e10428~ (2020)
- Malafarina V, "Nutritional status and nutritional treatment are related to outcomes and mortality in older adults with hip fracture", Nutrients, 10, pp.555~ (2018)
- Bohl DD, "Serum albumin predicts survival and postoperative course following surgery for geriatric hip fracture", J Bone Joint Surg Am, 99, pp.2110~2118 (2017)
- Baumgarten M, "Pressure ulcers in elderly patients with hip fracture across the continuum of care", J Am Geriatr Soc, 57, pp.863~870 (2009)
- Mazzola P, "Association between preoperative malnutrition and postoperative delirium after hip fracture surgery in older adults", J Am Geriatr Soc, 65, pp.1222~1228 (2017)
- Drevet S, "Prevalence of protein-energy malnutrition in hospital patients over 75 years of age admitted for hip fracture", Orthop Traumatol Surg Res, 100, pp.669~674 (2014)
- Helminen H, "Comparison of the Mini-Nutritional Assessment short and long form and serum albumin as prognostic indicators of hip fracture outcomes", Injury, 48, pp.903~908 (2017)
- Goisser S, "Malnutrition according to Mini Nutritional Assessment is associated with severe functional impairment in geriatric patients before and up to 6 months after hip fracture", J Am Med Dir Assoc, 16, pp.661~667 (2015)
- Inoue T, "Pre-fracture nutritional status is predictive of functional status at discharge during the acute phase with hip fracture patients : a multicenter prospective cohort study", Clin Nutr, 36, pp.1320~1325 (2017)
- Nishioka S, "Nutritional status changes and activities of daily living after hip fracture in convalescent rehabilitation units : a retrospective observational cohort study from the Japan Rehabilitation Nutrition Database", J Acad Nutr Diet, 118, pp.1270~1276 (2018)
- Liu HY, "Combined effects of cognitive impairment and nutritional trajectories on functional recovery for older patients after hip-fracture surgery", J Am Med Dir Assoc, 23, pp.1962~ (2022)
- Araiza-Nava B, "Short-and long-term prognostic factors associated with functional recovery in elderly patients with hip fracture : a systematic review", Osteoporos Int, 33, pp.1429~1444 (2022)
- Bauer JM, "The Mini Nutritional Assessment--its history, today’s practice, and future perspectives", Nutr Clin Pract, 23, pp.388~396 (2008)
- Inoue T, "Acute phase nutritional screening tool associated with functional outcomes of hip fracture patients : a longitudinal study to compare MNA-SF, MUST, NRS-2002 and GNRI", Clin Nutr, 38, pp.220~226 (2019)
- Thorsdottir I, "Fast and simple screening for nutritional status in hospitalized, elderly people", J Hum Nutr Diet, 18, pp.53~60 (2005)
- Neelemaat F, "Comparison of five malnutrition screening tools in one hospital inpatient sample", J Clin Nurs, 20, pp.2144~2152 (2011)
- Bouillanne O, "Geriatric Nutritional Risk Index : a new index for evaluating at-risk elderly medical patients", Am J Clin Nutr, 82, pp.777~783 (2005)
- Liu N, "Association between nutritional indices and mortality after hip fracture : a systematic review and meta-analysis", Eur Rev Med Pharmacol Sci, 27, pp.2297~2304 (2023)
- Edwards PK, "Are range of motion measurements needed when calculating the Harris Hip Score?", J Arthroplasty, 31, pp.815~819 (2016)
- Randa L, "Providing evidence for content validity of the most frequently used hip specific recovery outcome measures in hip fracture studies: an International Classification of Functioning approach", Disabil Rehabil (2023)[DOI]
- Luo S, "Total hip arthroplasty versus hemiarthroplasty in the treatment of active elderly patients over 75 years with displaced femoral neck fractures : a retrospective study", BMC Musculoskelet Disord, 24, pp.745~ (2023)
- Osawa Y, "Significantly poor outcomes of total hip arthroplasty after failed periacetabular osteotomy", J Arthroplasty, 31, pp.1904~1909 (2016)
- Rix A, "Measurement of mobility and physical function in patients hospitalized with hip fracture : a systematic review of instruments and their measurement properties", Phys Ther, 103, pp.pzac142~ (2022)
- Quan H, "Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries", Am J Epidemiol, 173, pp.676~682 (2011)
- Ortiz-Alonso FJ, "The pattern of recovery of ambulation after hip fracture differs with age in elderly patients", J Gerontol A Biol Sci Med Sci, 67, pp.690~697 (2012)
- Cederholm T, "ESPEN guidelines on definitions and terminology of clinical nutrition", Clin Nutr, 36, pp.49~64 (2017)
- Li Y, "Investigation and analysis of frailty and nutrition status in older adult patients with hip fracture", Nutr Clin Pract, 38, pp.1063~1072 (2023)
- Steihaug OM, "Sarcopenia in patients with hip fracture : a multicenter cross-sectional study", PLoS One, 12, pp.e0184780~ (2017)
- Rodríguez-Mañas L, "Searching for an operational definition of frailty : a Delphi method based consensus statement : the frailty operative definition-consensus conference project", J Gerontol A Biol Sci Med Sci, 68, pp.62~67 (2013)
- Cruz-Jentoft AJ, "Sarcopenia : revised European consensus on definition and diagnosis", Age Ageing, 48, pp.16~31 (2019)
- Orwig DL, "Application of SDOC cut points for low muscle strength for recovery of walking speed after hip fracture", J Gerontol A Biol Sci Med Sci, 75, pp.1379~1385 (2020)
- Jeon YT, "Post-operative physical performance factors associated with gait speed in patients surgically treated for hip fracture : a cross-sectional study", Ann Rehabil Med, 43, pp.570~580 (2019)
- Kimura A, "Malnutrition is associated with behavioral and psychiatric symptoms of dementia in older women with mild cognitive impairment and early-stage Alzheimer’s disease", Nutrients, 11, pp.1951~ (2019)
- Min JY, "Chronic status of serum albumin and cognitive function : a retrospective cohort study", J Clin Med, 11, pp.822~ (2022)
- Cabrerizo S, "Serum albumin and health in older people : review and meta analysis", Maturitas, 81, pp.17~27 (2015)
- Handoll HH, "Multidisciplinary rehabilitation for older people with hip fractures", Cochrane Database Syst Rev, 11, pp.CD007125~ (2021)
