在宅高齢者にも, 継続した栄養管理を

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Decreased independence, autonomy and activities of daily living are linked to requirements for nursing care and admission to care facilities, regardless of age. The present longitudinal study used the Mini Nutritional Assessment (MNA) to investigate the nutritional status of elderly people and provide data for maintaining or preventing a decrease in quality of life. Subjects comprised a total of 257 day- or short-term residents of W Nursing Home surveyed in March 2009 (n=89), May 2010 (n=84) and May 2011 (n=84). The MNA is composed of 18 items : 6 screening items, A-F, and 12 evaluation items, G-R, and involves evaluation based on the graded results of interviews and physical measurements. Subjects were divided into groups I-VII based on total scores. Groups I-III were classified as having favorable nutritional status, groups IV-VI as being at risk of undernutrition and group VII as having poor nutritional status. Interviews and measurements were conducted for all assessment items and question items were analyzed after being grouped into dietary, physical and lifestyle aspects. The 84 subjects included in the third survey were classified as group I, n=39 (46. 4%); group II, n=6 (7. 1%); group III, n=5 (6. 0%); group IV, n=17 (20. 2%); group V, n=13 (15. 5%); Group VI, n=3 (3. 6%); and Group VII, n=1 (1. 2%). Of the 20 subjects followed for the entire study period, MNA scores increased, were maintained and decreased for 12 (60. 0%), 3 (15. 0%) and 5 (25. 0%) subjects, respectively. Reasons for score increases included relief from psychological stress or acute illness and increased body mass index (BMI), while causes for score decreases included BMI, the administration of 3 or more types of medication per day, number of meals, protein intake, and liquid intake (non-alcoholic drinks such as water, milk and juice). While there was an annual turnover in subjects, 61. 9% of subjects participated in all three surveys and there was an increase in repeat day- and short-term residents over the study period. This may have been due to increased use by those requiring care or increased numbers on admission waiting-lists. Factors including psychological stress and acute disease should not be overlooked for the continued health management of elderly people. Dietary habits represent the primary cause of changes in BMI but care is also required regarding psychological factors that decrease appetite. The MNA requires only a short completion time and can be administered by anyone involved with elderly people, and nutritional care and management implemented at the stage of risk of undernutrition may be useful for care prevention. Lifestyle support should be further promoted in order to facilitate elderly people′s ability to continue living at home while using nursing homes on a daily or short-term basis.