老年人咀嚼能力及營養狀態與認知功能之橫斷性研究

Abstract

目的：認知障礙是高齡者中最常見的老年症候群之一，它可能與許多因素有關，而營養狀態不良與咀嚼能力差可能與高齡者認知障礙有關，但目前尚不清楚之間的關聯。故本研究旨在調查高齡者的營養狀態和咀嚼能力與認知功能之關聯性。 參與者和研究方法：本研究為橫斷性研究設計，於 2020 年 9 月至 2022 年 1 月期間於臺大醫院老年醫學部蒐集資料。招募標準為 65 歲或以上高齡 者至臺大醫院老年醫學部門診就醫或者曾參與過老人健檢者。本研究運 用迷你營養評估-簡表來衡量營養不良的風險，單題項之問題詢問受試者 的主觀咀嚼能力，簡易智能檢查評估認知功能。統計方法包括獨立樣本 t 檢定、卡方檢驗以及二元邏輯斯回歸。 結果: 本研究共計 256 名高齡者納入分析（平均年齡：80.6±7.1 歲；53.9% 女性）。在調整潛在干擾因子後，無營養不良風險或咀嚼能力良好的高齡 者與認知障礙風險沒有顯著的關聯性。在合併營養狀態與咀嚼能力後，亦 與認知障礙風險沒有顯著的關聯性。 結論：在此樣本中發現，營養狀態、咀嚼能力的好壞皆與認知功能風險無 任何顯之關聯性。未來研究可增加更多咀嚼能力之客觀測量方式，以更加 了解營養狀態及咀嚼能力與認知功能的關聯性。 關鍵詞:營養不良、咀嚼不良、認知障礙、高齡者、臺灣OBJECTIVES: Cognitive impairment is the most common geriatric syndromein the older adults, it may be related to many factors. Both the risk of nutritionalstatus and poor masticatory ability may be correlative with cognitive functionin the older adults, but the specific relationship between them is still unclear.In addition, few studies have focused on the relationship between poornutritional status and poor masticatory ability with cognitive function status.Therefore, this study aimed to investigate the association of nutritional statusand masticatory ability with cognitive function in the older adults.PARTICIPANTS AND METHODS: This study was designed as a crosssectional study. Data were collected at the Department of Geriatrics andGerontology (DGG), National Taiwan University Hospital (NTUH) fromSeptember 2020 to January 2022. Recruitment criteria were people aged ≥ 65years or above who went to the out-patient departments or physical check-upbefore. This study used the Mini Nutritional Assessment-Short Form (MNASF) to measure the risk of malnutrition, and used a single item question to askthe participants' perceived masticatory ability, and the Mini-Mental State Exam (MMSE) was used to assess cognitive function. Statistical methods included independent samples t-test , chi-square test, and binary logistic regression. RESULTS: A total of 256 older adults were included in this study (mean age: 80.6±7.1 years; 53.9% female). Regardless of adjustment for potential confounding factors, no risk of nutritional status or good masticatory ability was not associated with the risk of cognitive impairment. After the combinationof nutritional status and masticatory ability, there was still no significantassociation with the risk of cognitive impairment.CONCLUSION: This study was found that nutritional status and masticatoryability was not associated with the risk of cognitive function. Future studycould utilize objective masticatory ability measures to confirm the associationof nutritional status and masticatory ability with cognitive function. This studyshowed that nutritional status and masticatory ability were not associated withcognitive function in the sample of Taiwanese older adults. Using objectivemeasures to investigate the association of nutritional status and masticatoryability with cognitive function in the future are still needed.KEYWORDS: Malnutrition, Poor masticatory ability, Cognitiveimpairment, Older adults, Taiwan