营养状况在养老机构老年人口腔衰弱与衰弱的中介效应

The Mediating Effect of Nutritional Status on Oral Frailty and Frailty among the Elderly in Elderly Care Institutions

摘要: 目的：探究营养状况在养老机构老年人口腔衰弱与衰弱间的中介作用。方法：采用横断面设计，纳入南宁市两所养老机构324名老年人。使用口腔衰弱筛查工具(SOFT)、微型营养评估简表(MNA-SF)和临床衰弱量表(CFS)量表分别评估口腔衰弱、营养状况及衰弱，使用层级回归分析及Bootstrap法检验模型。结果：养老机构老年人营养状况得分为10.00 (9.00, 12.00)分、口腔衰弱得分为4.00 (3.00, 5.00)分、临床衰弱得分为5.00 (3.00, 6.00)分。Spearman相关分析口腔衰弱与衰弱呈正相关(r = 0.272, P < 0.01)，与营养呈负相关(r = −0.181, P < 0.01)；营养与衰弱呈负相关(r = −0.449, P < 0.01)。营养在口腔衰弱与衰弱间起部分中介作用，中介效应占比为30.51%。结论：养老机构老年人口腔衰弱、营养风险与衰弱三者关联密切。建议将口腔功能筛查与营养评估纳入养老机构常规健康管理，通过早期识别高风险个体并开展针对性支持，为改善老年人口腔健康、营养状况及衰弱管理提供参考。

Abstract: Objective: This paper aims to explore the mediating role of nutritional status in the relationship between oral frailty and clinical frailty among older adults in long-term care facilities. Methods: A cross-sectional study was conducted with 324 older adults from two nursing homes in Nanning. Oral frailty, nutritional status, and frailty were assessed using the Screening for Oral Frailty Tool (SOFT), Mini-Nutritional Assessment short-form (MNA-SF), and the Clinical Frailty Scale (CFS), respectively. A hierarchical regression analysis, combined with bootstrapping, was conducted to test the model. Results: Among the institutionalized older adults, the median (interquartile range) scores were 10.00 (9.00, 12.00) for nutritional status, 4.00 (3.00, 5.00) for oral frailty, and 5.00 (3.00, 6.00) for clinical frailty. Spearman correlation analysis showed a positive correlation between oral frailty and clinical frailty (r = 0.272, P < 0.01), a negative correlation between oral frailty and nutritional status (r = −0.181, P < 0.01), and a negative correlation between nutritional status and clinical frailty (r = −0.449, P < 0.01). Nutritional status played a partial mediating role between oral frailty and clinical frailty, accounting for 30.51% of the total effect. Conclusion: Oral frailty, nutritional risk, and frailty are closely interrelated among older adults in long-term care facilities. It is recommended that oral function screening and nutritional assessment be incorporated into routine health management in these settings, so that high-risk individuals can be identified early and provided with targeted support. These measures may help improve oral health, nutritional status, and frailty management in institutionalized older adults.