关键词: 衰弱, 营养不良, 老年人, 住院病人, 影响因素分析, 临床研究

Abstract: Background　Frailty and malnutrition are common problems in the elderly people.Malnutrition has attracted more and more attention as a modifiable risk factor for frailty in recent years.Early identification of malnutrition and timely delivery of targeted interventions may delay or even reverse frailty.Objective　To explore the prevalence and associated factors of frailty，and the degree of association of frailty with malnutrition in elderly inpatients，to provide a reference for frailty intervention research.Methods　From September 2018 to May 2019，362 inpatients≥60 old years from Department of Gerontology and Geriatrics，Beijing Friendship Hospital，Capital Medical University were enrolled.The Comprehensive Geriatric Assessment （CGA），FRAIL scale，and Mini-Nutritional Assessment-Short Form （MNA-SF） were used by professionals to assess the prevalence of geriatric syndrome，frailty，and malnutrition，respectively.The number of patients with frailty was counted.Multivariate Logistic regression was used to identity the influencing factors of frailty.Spearman rank correlation analysis was used to analyze the degree of association of frailty and malnutrition.Results　Of the 362 cases，91（25.1%） were identified with frailty，172（47.5%） with prefrailty，99（27.4%） with robust health；27（7.5%） were identified with malnutrition，125（34.5%） with risk of malnutrition，210（58.0%） with normal nutrition.Multivariate Logistic regression analysis showed that diabetes〔OR=2.844，95%CI（1.309，6.178）〕，malnutrition〔OR=6.055，95%CI（1.580，23.200）〕，IADL score〔OR=0.603，95%CI（0.523，0.695）〕，hemoglobin〔OR=0.981，95%CI（0.964，0.998）〕and hs-CRP level〔OR=1.017，95%CI（1.004，1.030）〕 were influencing factors of frailty（P<0.05）.The FRAIL score decreased with the increase of BMI（rs=-0.244），MNA-SF score（rs=-0.585），hemoglobin（rs=-0.360），albumin（rs=-0.420），TC（rs=-0.164），TG（rs=-0.117），HDL-C（rs=-0.124） and LDL-C（rs=-0.151），but increased with the decrease of age（rs=0.537），blood urea nitrogen（rs=0.172） and creatinine（rs=0.168）（P<0.05）.Conclusion　In our study，the prefrail cases accounted for about half of all the cases，which deserves attention.Diabetes，malnutrition，activities of daily living，hemoglobin，and hs-CRP may be associated with frailty.In particular，nutritional status may be has a more significant association with frailty.In view of this，clinicians should pay attention to functional status assessment and comorbidity management in elderly hospitalized patients.

Key words: Frailty, Malnutrition, Aged, Inpatients, Root cause analysis, Clinical research