Toplum İçinde Yaşayan Yaşlılarda Malnütrisyon ve El Kavrama Gücü İlişkilidir

Yıl 2024, Cilt: 33 Sayı: 5, 342 - 350, 13.12.2024

Mehmet Göl , Ayse Elkoca , İbrahim Halil Türkbeyler , Melek Tarakçıoğlu , Alican Çelik , Kazım Ersin Altınsoy

https://doi.org/10.17942/sted.1423753

Öz

Amaç: El kavrama gücü (EKG), yaşlıların beslenme durumunu değerlendirmek için yararlı bir araçtır. Çalışmanın amacı yaşlılarda beslenme durumu ile el kavrama gücü arasındaki ilişkiyi araştırmaktır.
Yöntem: 65 yaş üstü 195 hasta çalışmaya dahil edilmiştir. Hastaların 60'ı malnütrisyonlu, 65'i malnütrisyon riski altında ve 70'i iyi beslenmişti. Hastalara Mini Nutrisyonel Değerlendirme-Kısa Formu (MNA-SF), Katz Günlük Yaşam Aktivitelerinde Bağımsızlık Endeksi (Katz İndeksi GYA) ve Lawton&Brody Enstrümantal Günlük Yaşam Aktiviteleri Ölçeği (Lawton&Brody EGYA) uygulandı. Normal dağılıma sahip ikiden fazla bağımsız örneklemi karşılaştırmak için tek yönlü ANOVA kullanılmıştır. Değişkenler arasında doğrusal bir ilişkiyi ortaya koyabilmek için Pearson korelasyonu kullanılmıştır.
Bulgular: İyi beslenen yaşlıların EKG (p=0,003), Katz İndeksi GYA (p=0,004) ve Lawton&Brody EGYA (p=0,003) puanları daha yüksekti. El gücü ile MNA-SF arasında orta ile yüksek düzeyde bir pozitif korelasyon (p=0,001, r:0,654), MNA-SF ile Beden Kütle İndeksi (BKİ) arasında zayıf ile orta bir korelasyon (p=0,001, r:0,346) gözlenmiştir.
Sonuç: El kavrama gücü yaşlılarda fizik muayenenin önemli bir parçası olmalıdır.

Anahtar Kelimeler

günlük yaşam aktiviteleri, yaşlı, el kavrama gücü, malnütrisyon

Malnutrition and Handgrip Strength are Correlated in Community Dwelling Elderly

Öz

Aim: Hand grip strength (HGS) is a useful tool to assess the nutritional status of the elderly. The aim of the study is to explore the relationship between nutritional status and hand grip strength in the elderly.
Method: 195 patients over the age of 65 were included. 60 were malnourished, 65 were at the risk of malnutrition and 70 were well–nourished. Patients Underwent Mini Nutritional Assessment–Short Form (MNA–SF), Katz Index of Independence in Activities of Daily Living (Katz Index ADL) and Lawton&Brody Instrumental Activities of Daily Living Scale (Lawton&Brody IADL). One way ANOVA was used to compare more than two independent samples with normal distribution. To be able to reveal a linear relationship between variables Pearson’s correlation was used.
Results: Well–nourished elderly had higher scores in HGS (p=0.003), Katz Index ADL (p=0.004) and Lawton&Brody IADL (p=0.003). A moderate to high positive correlation was observed between HGS and MNA–SF (p=0.001, r:0.654), a weak to moderate correlation was between MNA–SF and Body Mass Index (BMI) (p=0.001, r:0.346).
Conclusion: Handgrip strength should be an essential part of the physical examination in the elderly.

Anahtar Kelimeler

activities of daily living, aged, hand strength, malnutrition

Kaynakça

• Clark AB, Reijnierse EM, Lim WK, Maier AB. Prevalence of malnutrition comparing the GLIM criteria, ESPEN definition and MST malnutrition risk in geriatric rehabilitation patients: RESORT. Clin Nutr. 2020;39(11):3504-11.
• Jayanama K, Theou O, Blodgett JM, Cahill L, Rockwood K. Frailty, nutrition-related parameters, and mortality across the adult age spectrum. BMC Med. 2018;16(1):188.
• Kiesswetter E, Colombo MG, Meisinger C, Peters A, Thorand B, Holle R, et al. Malnutrition and related risk factors in older adults from different health-care settings: an enable study. Public Health Nutr. 2020;23(3):446-56.
• Demirdag F, Kolbasi EN, Pehlivan O. Prevalence of Malnutrition According to the Global Leadership Initiative on Malnutrition Criteria in Community-dwelling Older Adults in Turkey. Medeni Med J. 2022;37(3):234-9.
• Doroudi T, Alizadeh-Khoei M, Kazemi H, Hormozi S, Taati F, Ebrahimi M, et al. Comparison of Two Validation Nutrition Tools in Hospitalized Elderly: Full Mini Nutritional Assessment and Short-form Mini Nutritional Assessment. Int J Prev Med. 2019;10:168.
• Sarikaya D, Halil M, Kuyumcu ME, Kilic MK, Yesil Y, Kara O, et al. Mini nutritional assessment test long and short form are valid screening tools in Turkish older adults. Arch Gerontol Geriatr. 2015;61(1):56-60.
• Dişli E, Samancıoglu S. Geriatrik Hastalarda Malnütrisyon Ve Düşme Riski Arasındaki İlişki. Karya Journal of Health Science. 2018;3(1):24-9.
• Norman K, Haß U, Pirlich M. Malnutrition in Older Adults-Recent Advances and Remaining Challenges. Nutrients. 2021;13(8).
• Hoogendijk EO, Flores Ruano T, Martínez-Reig M, López-Utiel M, Lozoya-Moreno S, Dent E, et al. Socioeconomic Position and Malnutrition among Older Adults: Results from the FRADEA Study. J Nutr Health Aging. 2018;22(9):1086-91.
• Bardon LA, Corish CA, Lane M, Bizzaro MG, Loayza Villarroel K, Clarke M, et al. Ageing rate of older adults affects the factors associated with, and the determinants of malnutrition in the community: a systematic review and narrative synthesis. BMC geriatrics. 2021;21:1-39.
• Kupisz-Urbanska M, Marcinowska-Suchowierska E. Malnutrition in Older Adults-Effect on Falls and Fractures: A Narrative Review. Nutrients. 2022;14(15).
• Valk-Draad MP, Bohnet-Joschko S. Nursing Home-Sensitive Hospitalizations and the Relevance of Telemedicine: A Scoping Review. International journal of environmental research and public health. 2022;19(19).
• Chiavarini M, Ricciotti GM, Genga A, Faggi MI, Rinaldi A, Toscano OD, et al. Malnutrition-related Health outcomes in older adults with hip fractures: a systematic review and Meta-analysis. Nutrients. 2024;16(7):1069.
• Larsson L, Degens H, Li M, Salviati L, Lee YI, Thompson W, et al. Sarcopenia: Aging-Related Loss of Muscle Mass and Function. Physiol Rev. 2019;99(1):427-511.
• Bohannon RW. Grip Strength: An Indispensable Biomarker For Older Adults. Clin Interv Aging. 2019;14:1681-91.
• Roberts HC, Denison HJ, Martin HJ, Patel HP, Syddall H, Cooper C, et al. A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. Age Ageing. 2011;40(4):423-9.
• Norman K, Stobaus N, Gonzalez MC, Schulzke JD, Pirlich M. Hand grip strength: outcome predictor and marker of nutritional status. Clin Nutr. 2011;30(2):135-42.
• Flood A, Chung A, Parker H, Kearns V, O’Sullivan TA. The use of hand grip strength as a predictor of nutrition status in hospital patients. Clin Nutr. 2014;33(1):106-14.
• Kılıç C, Önal A, Tufan G, Karan M, Bahat-Öztürk G. Geriatri Polikliniğinden Takip Edilen 75 Yaş Üstü Bireylerin Nütrisyonel Değerlendirmesi ve Fonksiyonel Kapasiteleri ile İlişkisinin Araştırılması. Akademik Geriatri Dergisi. 2014;6.
• Boulton ER, Horne M, Todd C. Multiple influences on participating in physical activity in older age: Developing a social ecological approach. Health Expect. 2018;21(1):239-48.
• Unal M, Kose O, Arik HO, Guler F, Acar B, Yuksel HY. Hand grip strength: Age and gender stratified normative data in Anatolian population. Hand and Microsurgery. 2018;7(1):16-.
• Akbulut Ö. Korelasyon ve regresyon. Baykul Y, editor: Pegem Akademi; 2016. 257-93 p.
• Nagai K, Komine T, Ikuta M, Gansa M, Matsuzawa R, Tamaki K, et al. Decline of instrumental activities of daily living is a risk factor for nutritional deterioration in older adults: a prospective cohort study. BMC Geriatr. 2023;23(1):480.
• Wei K, Nyunt MSZ, Gao Q, Wee SL, Ng TP. Long-term changes in nutritional status are associated with functional and mortality outcomes among community-living older adults. Nutrition. 2019;66:180-6.
• Ekici E, Çolak MY, Kozan EH. Huzurevinde yaşayan yaşlıların beslenme durumları ve günlük yaşam aktivitelerinin belirlenmesi. Online Türk Sağlık Bilimleri Dergisi. 2019;4(4):506-18.
• Kiriş Y. Kayseride yaşayan altmış beş yaş ve üzeri bireylerde beslenme ile günlük yaşam aktiviteleri arasındaki ilişkinin değerlendirilmesi. Kayseri: Erciyes Üniversitesi 2015.
• Nishioka S, Wakabayashi H, Nishioka E, Yoshida T, Mori N, Watanabe R. Nutritional improvement correlates with recovery of activities of daily living among malnourished elderly stroke patients in the convalescent stage: a cross-sectional study. Journal of the Academy of Nutrition and Dietetics. 2016;116(5):837-43.
• Yoshimura Y, Uchida K, Jeong S, Yamaga M. Effects of nutritional supplements on muscle mass and activities of daily living in elderly rehabilitation patients with decreased muscle mass: a randomized controlled trial. The Journal of nutrition, health and aging. 2016;20(2):185-91.
• Artaza-Artabe I, Sáez-López P, Sánchez-Hernández N, Fernández-Gutierrez N, Malafarina V. The relationship between nutrition and frailty: Effects of protein intake, nutritional supplementation, vitamin D and exercise on muscle metabolism in the elderly. A systematic review. Maturitas. 2016;93:89-99.
• da Rosa Camargo L, Doneda D, Oliveira VR. Whey protein ingestion in elderly diet and the association with physical, performance and clinical outcomes. Experimental Gerontology. 2020;137:110936.
• Karagoz S, Kocaer HO, Unveren A. Düzenli egzersiz yapan 60 yaş ve üzeri bireylerin sağlıklı beslenmeye ilişkin tutumları ve bilişsel esneklik durumlarının yaşam doyumu üzerine etkisi. Journal of ROL Sport Sciences. 2023;4(1):208-28.
• Ge L, Yap CW, Heng BH. Association of nutritional status with physical function and disability in community-dwelling older adults: a longitudinal data analysis. Journal of nutrition in gerontology and geriatrics. 2020;39(2):131-42.
• Fiorilli G, Buonsenso A, Centorbi M, Calcagno G, Iuliano E, Angiolillo A, et al. Long term physical activity improves quality of life perception, healthy nutrition, and daily life management in elderly: A randomized controlled trial. Nutrients. 2022;14(12):2527.
• Bohannon RW. Muscle strength: clinical and prognostic value of hand-grip dynamometry. Curr Opin Clin Nutr Metab Care. 2015;18(5):465-70.
• Rantanen T. Muscle strength, disability and mortality. Scand J Med Sci Sports. 2003;13(1):3-8.
• Ahn SH, Park EB, Seo S, Cho Y, Seo DH, Kim SH, et al. Familial Correlation and Heritability of Hand Grip Strength in Korean Adults (Korea National Health and Nutrition Examination Survey 2014 to 2019). Endocrinology and Metabolism. 2023;38(6):709-19.
• Hong S. Association of relative handgrip strength and metabolic syndrome in Korean older adults: Korea National Health and Nutrition Examination Survey VII-1. Journal of obesity & metabolic syndrome. 2019;28(1):53.
• Zhang XS, Liu YH, Zhang Y, Qing X, Yu XM, Yang XY, et al. Handgrip strength as a predictor of nutritional status in Chinese elderly inpatients at hospital admission. Biomedical and Environmental Sciences. 2017;30(11):802-10.
• Malafarina V, Serra Rexach JA, Masanes F, Cervera-Diaz MC, Lample Lacasa L, Ollero Ortigas A, et al. Results of High-Protein, High-Calorie Oral Nutritional Supplementation in Malnourished Older People in Nursing Homes: An Observational, Multicenter, Prospective, Pragmatic Study (PROT-e-GER). J Am Med Dir Assoc. 2021;22(9):1919-26 e5.
• Chilima DM, Ismail SJ. Nutrition and handgrip strength of older adults in rural Malawi. Public Health Nutr. 2001;4(1):11-7.
• Amasene M, Besga A, Medrano M, Urquiza M, Rodriguez-Larrad A, Tobalina I, et al. Nutritional status and physical performance using handgrip and SPPB tests in hospitalized older adults. Clin Nutr. 2021;40(11):5547-55.