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Abstract：
OBJECTIVE: This study aims to investigate the association between malnutrition using the global consensus criteria and food texture levels in residents of Integrated Facilities for Medical and Long-Term Care (IFMLCs), which are new long-term care insurance facilities in Japan.
METHODS: This single-center study had a retrospective cross-sectional design. The study was conducted from November 1 to 30, 2021, and the study participants were residents admitted to an IFMLC during the study period. Malnutrition was diagnosed according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Food texture levels consumed by patients at admission were categorized based on the International Dysphagia Diet Standardization Initiative (IDDSI) framework. Multivariate logistic regression models were used to determine the association between the food texture levels consumed and malnutrition.
RESULTS: A total of 98 older residents were analyzed in this study. The median age of the participants was 88 years, and 68 (69%) female participants were included. The IDDSI framework levels were 24% in levels 7 and 6 and 26% in levels 5 and 4. A significant difference in the prevalence of low BMI, reduced muscle mass, and reduced food intake or assimilation was noted between IDDSI framework levels 4 and 7. Multivariate logistic regression analysis was performed for malnutrition, adjusting simultaneously for potential confounders. IDDSI level 4 (odds ratio, 5.074; 95% confidence interval, 1.059-28.092; p=0.042) consumption was independently associated with malnutrition.
CONCLUSIONS: The consumption of lower food texture levels categorized using the IDDSI framework was associated with a higher malnutrition prevalence in IFMLC residents.
METHODS: This single-center study had a retrospective cross-sectional design. The study was conducted from November 1 to 30, 2021, and the study participants were residents admitted to an IFMLC during the study period. Malnutrition was diagnosed according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Food texture levels consumed by patients at admission were categorized based on the International Dysphagia Diet Standardization Initiative (IDDSI) framework. Multivariate logistic regression models were used to determine the association between the food texture levels consumed and malnutrition.
RESULTS: A total of 98 older residents were analyzed in this study. The median age of the participants was 88 years, and 68 (69%) female participants were included. The IDDSI framework levels were 24% in levels 7 and 6 and 26% in levels 5 and 4. A significant difference in the prevalence of low BMI, reduced muscle mass, and reduced food intake or assimilation was noted between IDDSI framework levels 4 and 7. Multivariate logistic regression analysis was performed for malnutrition, adjusting simultaneously for potential confounders. IDDSI level 4 (odds ratio, 5.074; 95% confidence interval, 1.059-28.092; p=0.042) consumption was independently associated with malnutrition.
CONCLUSIONS: The consumption of lower food texture levels categorized using the IDDSI framework was associated with a higher malnutrition prevalence in IFMLC residents.
摘要：
目的：本研究旨在使用全球共识标准调查营养不良与医疗和长期护理综合设施（IFLC）居民的食物质地水平之间的关系。这是日本新的长期护理保险设施。
方法：这项单中心研究采用回顾性横断面设计。该研究于2021年11月1日至30日进行，研究参与者是研究期间进入IFMLC的居民。根据全球营养不良领导力倡议（GLIM）标准诊断营养不良。根据国际吞咽困难饮食标准化倡议（IDDSI）框架对患者入院时消耗的食物质地水平进行分类。使用多变量逻辑回归模型来确定所消耗的食物质地水平与营养不良之间的关联。
结果：本研究共分析了98名老年居民。参与者的平均年龄为88岁，68（69％）女性参与者被纳入。IDDSI框架水平在7级和6级为24%,在5级和4级为26%。低BMI的患病率存在显着差异，肌肉质量减少，在IDDSI框架水平4和7之间注意到食物摄入或同化减少。多因素logistic回归分析营养不良，同时调整潜在的混杂因素。IDDSI4级(赔率比，5.074；95%置信区间，1.059-28.092；p=0.042）消费与营养不良独立相关。
结论：使用IDDSI框架分类的较低食物质地水平的消费与IFMLC居民较高的营养不良患病率相关。
方法：这项单中心研究采用回顾性横断面设计。该研究于2021年11月1日至30日进行，研究参与者是研究期间进入IFMLC的居民。根据全球营养不良领导力倡议（GLIM）标准诊断营养不良。根据国际吞咽困难饮食标准化倡议（IDDSI）框架对患者入院时消耗的食物质地水平进行分类。使用多变量逻辑回归模型来确定所消耗的食物质地水平与营养不良之间的关联。
结果：本研究共分析了98名老年居民。参与者的平均年龄为88岁，68（69％）女性参与者被纳入。IDDSI框架水平在7级和6级为24%,在5级和4级为26%。低BMI的患病率存在显着差异，肌肉质量减少，在IDDSI框架水平4和7之间注意到食物摄入或同化减少。多因素logistic回归分析营养不良，同时调整潜在的混杂因素。IDDSI4级(赔率比，5.074；95%置信区间，1.059-28.092；p=0.042）消费与营养不良独立相关。
结论：使用IDDSI框架分类的较低食物质地水平的消费与IFMLC居民较高的营养不良患病率相关。
